A comparison of in vivo and vicarious exposure in the treatment of childhood water phobia

Abstract

The effectiveness of in vivo exposure and vicarious exposure in reducing children's phobic anxiety and avoidance of water was investigated. Forty-eight water phobic children between the ages of 3 and 8 yr were randomly assigned to one of four groups: (1) in vivo exposure plus vicarious exposure (IVVE); (2) vicarious exposure (VE); (3) in vivo exposure (IVE); and (4) assessment only control. All subjects in the treatment groups received three individually administered treatment sessions. At the conclusion of treatment it was found that the IVE condition had produced statistically and clinically significant gains that had generalized to another situation involving water, and were largely maintained over a period of 3 months. In contrast, the VE condition did not lead to statistically greater treatment benefits than those observed in the control subjects. Furthermore, there was no significant difference between the IVVE condition and the IVE condition in their level of improvement from pre- to post-treatment. Hence, by post-treatment, vicarious exposure had not only failed to produce benefits when used on its own, but had also failed to enhance the benefits achieved through in vivo exposure. However, a tendency for the vicarious component to enhance the maintenance of treatment benefits was found at follow-up. The implications of these findings are discussed.