Exposure‐based treatments for fear and reactivity to medical procedures: A systematic review of the literature with implications for research and practice

The team read every paper on exposure therapy for medical fears. They found 62 studies with 715 people total.

Most studies used gradual exposure. Kids practiced with toy needles before real shots. Adults watched videos of MRI machines before their scan.

Exposure therapy helps people face medical procedures. The review shows it works, but gives no numbers.

We do not know how much better it is than doing nothing. The authors only describe trends, not effect sizes.

Martinez-Perez et al. (2024) adds punishment to DRA. They found punishment stops the target behavior but does not stop resurgence. This seems to clash with exposure's goal of lasting fear reduction. The difference is timing. Punishment happens during treatment. Exposure happens before the scary event.

Katz et al. (2003) shows rats learn to fear CO2. Stronger CO2 makes stronger fear. This lab work backs up why medical procedures become so scary. The animal data match the human exposure studies.

TWCosta et al. (2017) and Lancioni et al. (2009) teach kids to manage drooling. These studies use self-management, not exposure. They show behavior skills can be taught outside clinics. This supports moving exposure work to home and school settings.

You can start exposure work for medical fears right away. Use small steps. Let the client control the pace. Track fear levels each step. The review says this works, even without exact numbers.