# Therapy for phobias: how fear of flying, heights or needles is treated > You have turned down a trip because of fear of flying or avoided blood tests for years because of needles. How phobias are treated, how long it takes and how to choose a good professional. *https://mypsicotest.com/en/blog/therapy-for-phobias/ · Published: 2026-10-10 · 8 min read · MyPsicoTest team* You have been offered a work trip and made an excuse, yet again, because you cannot picture yourself getting on a plane. Or you have not had a blood test for years because just thinking about the needle makes you dizzy. You know the fear is out of proportion; you have told yourself so many times. It makes no difference. Phobias are among the anxiety problems that respond best to treatment, and yet few people seek it. If you are considering **therapy for phobias**, this guide explains what exactly a phobia is, how it is treated, how long treatment usually takes, what to do if your fear is of blood or needles and how to choose a professional. ## What is a phobia and when does it need treatment? The NHS explains on its [page about phobias](https://www.nhs.uk/mental-health/conditions/phobias/) that they are an anxiety condition usually caused by a particular object or situation, and that some affect life far more than others. It describes two broad groups: - **Specific phobias**, triggered only by something particular: animals such as dogs, insects or snakes; situations such as flying, heights or small spaces; or bodily fluids such as blood or vomit. - **Complex phobias**, which limit daily life much more, such as agoraphobia or social anxiety. The WHO World Mental Health Surveys, covering [more than 124,000 people in 22 countries](https://pmc.ncbi.nlm.nih.gov/articles/PMC5674525/), estimated that 7.4% of people have a specific phobia at some point in their lives. The median age of onset was 8, almost one in five people with a current phobia had severe impairment in daily life and only 23% had received any treatment. There is another finding worth knowing: in most of those who also had another mental health problem, the phobia had come first, which makes it an early warning sign. It is worth seeking help if fear makes you give up important things, such as trips, jobs, medical tests or plans with the people you care about, or if you spend a lot of time organising your life so as not to run into what you fear. ## How a psychologist treats a phobia: exposure The WHO points out that the psychological interventions with the most evidence for anxiety disorders are based on cognitive behavioural therapy, including **exposure therapy**, in which people learn to face their fears. For specific phobias, exposure is the treatment of reference. A meta-analysis by Wolitzky-Taylor and colleagues, covering 33 trials, found that exposure-based treatments had large effects compared with no treatment and outperformed placebo and other psychotherapies. Those involving real contact with the feared object did better at the end of treatment, although the advantage faded over time. Exposure does not mean being thrown in at the deep end. You build a ladder of situations, from the one that frightens you least to the one that frightens you most, and climb it step by step, with the therapist guiding each stage. With fear of flying, for example, you might start by watching videos of take-offs and end on a real flight. ### One-session treatment For some phobias there is an intensive version. According to a review by Zlomke and Davis, one-session treatment combines exposure, modelling by the therapist, challenging catastrophic thoughts and reinforcement in a single session of up to three hours, working up the fear ladder through guided experiments. Research generally supports it, although the authors call for more independent studies and more rigorous comparisons. The Wolitzky-Taylor meta-analysis found that multi-session treatments did slightly better than single-session ones. ### Virtual reality When real-life exposure is hard to arrange, virtual reality is an evidence-based alternative. A [meta-analysis by Carl and colleagues](https://pubmed.ncbi.nlm.nih.gov/30287083/) pooled 30 trials with more than 1,000 participants, 14 of them on specific phobias, and found that virtual reality exposure had a large effect compared with a waiting list and did not differ from in-person exposure. ## Blood, injection and injury phobia This phobia works differently. According to a German study of its treatment, in about 75% of cases the initial fright is followed by a sudden drop in blood pressure that can cause nausea, blurred vision and even fainting. That is why treatment usually combines exposure with **applied tension**: tensing the muscles of the legs and buttocks for 15 to 20 seconds, resting and repeating with the arms added, to counteract that drop. In that study, 70% of participants managed to have blood taken at the end of treatment. ![Woman sitting in a clinic while a nurse prepares to take a blood sample, one of the situations worked on in needle phobia](https://mypsicotest.com/assets/img/blog-fobia-sangre-agujas-1200.webp) The technique also helps outside therapy. In a trial with 282 young blood donors, those who practised applied tension while waiting needed half as much treatment for dizziness and fainting symptoms as those who did not, 8% compared with 16%. ## What about medication? Besides talking therapies, the NHS lists some medicines among the treatments for phobias, such as antidepressants, beta blockers or sedatives, always prescribed by a doctor. The WHO warns that benzodiazepines are generally not recommended for anxiety disorders because of their high potential for dependence and limited long-term effectiveness. For specific phobias, the tool with the strongest evidence remains exposure. ## How long phobia treatment takes It depends on the type of phobia and how much it limits your life. Some specific phobias are tackled in a single intensive session of up to three hours; in general, more sessions are linked to slightly better results. Complex phobias usually need more work: for social anxiety, for example, the NICE guideline describes up to 14 sessions of 90 minutes. What matters is that the professional explains the plan from the start and that you review progress together. ## Can a phobia be treated online? The evidence is promising. A meta-analysis by a team at Universitat Jaume I in Castellón, Spain, pooled nine studies of internet- and mobile-based interventions for specific phobias, almost all based on exposure, and found a substantial reduction in symptoms, although there are still few studies. In a trial on spider phobia, a five-week internet programme with therapist support almost matched a three-hour face-to-face session at follow-up, although at the end of treatment the face-to-face session had produced more clear improvements. In practice, online sessions are useful for preparing and reviewing the exposure exercises you do between sessions. ## What you can do in the meantime The NHS suggests some ideas for managing a phobia: - Try breathing exercises to help you relax. - Talk to someone you trust about your phobia. - Join a self-help group, online or in person, with people who have similar phobias. - Be careful when looking up information online, as you may come across images you are not ready for. - Check whether places such as zoos and airlines run sessions for people with phobias. - Avoid caffeinated or energy drinks after 3pm, as they can affect your sleep and make anxiety worse. If you suspect your anxiety goes beyond one particular phobia, the [Anxiety Test](https://mypsicotest.com/en/anxiety-test/) can help you put a name to it, and if your fear is of speaking in public or being judged, [Fear of public speaking: why you freeze and when it is social anxiety](https://mypsicotest.com/en/blog/fear-of-public-speaking/) may help. ## How to choose a psychologist to treat a phobia These checks help you choose well: - **Licensing and registration.** That comes first, whatever the approach. - **They use exposure.** Ask how they approach it: it should be gradual, agreed with you and follow a clear ladder of steps. - **If your fear is of blood or needles**, they should know applied tension. - **A plan with a timescale.** They should tell you roughly how many sessions they expect and how you will measure progress. - **They look at the bigger picture.** Phobias often come with other anxiety problems, as we explain in [Therapy for anxiety: when to see a psychologist and what works for each type of anxiety](https://mypsicotest.com/en/blog/therapy-for-anxiety/). ## A psychologist to treat phobias At MyPsicoTest we recommend [Xènia Capel Salcedo](https://psicologaigualada.es/en/therapist-psychologist-igualada/), a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. The treatment of anxiety disorders is one of the services at her practice in Igualada and in her [online therapy](https://psicologaigualada.es/en/online-therapy-online-therapist/), and on her blog she has published guides on specific phobias, fear of spiders, fear of flying, claustrophobia and fear of heights. She works from an integrative, evidence-based approach: on her website she explains that she uses tools from cognitive behavioural therapy, EMDR, systemic therapy and person-centred therapy. Sessions last about 60 minutes and are available in English, Spanish or Catalan, how long the process takes depends on each case, and the first contact is a free, no-commitment information session by phone. She herself points out that in a serious crisis or psychiatric emergency, immediate in-person care is what is needed. ## Frequently asked questions ### What kind of psychologist treats phobias? A licensed psychologist with experience in anxiety disorders and cognitive behavioural therapy, which includes exposure, the treatment with the strongest evidence for specific phobias. ### How many sessions does it take to overcome a phobia? It depends on the phobia. Some specific phobias are treated in a single intensive session of up to three hours, although several sessions tend to give slightly better results. Complex phobias, such as social anxiety, take longer. ### Can a phobia be cured in one session? For some specific phobias, a single intensive exposure session of up to three hours can bring a significant improvement. Studies support it, although they call for more independent research. ### Does virtual reality work for phobias? Yes. A meta-analysis of 30 trials found that virtual reality exposure had a large effect compared with a waiting list and did not differ from in-person exposure. ### What should I do if I feel faint when I see blood? It is common in blood and needle phobia, because of a sudden drop in blood pressure. A psychologist can teach you applied tension, which involves tensing the muscles of your legs, buttocks and arms to counteract it. ### Can phobias be treated online? There are promising studies of internet programmes based on exposure, although there are still few of them. Online sessions are useful for planning and reviewing the exposure exercises done between sessions. ### Do I need medication for a phobia? It is not usually the first step. The treatment with the strongest evidence for specific phobias is exposure, and benzodiazepines are generally not recommended for anxiety disorders.