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Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
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Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia: Randomized

Robert Schibbye1,2, Erik Hedman-Lagerlöf3, Viktor Kaldo4,5

  • 1Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.

Journal of Medical Internet Research
|February 21, 2024
PubMed
Summary

Internet-based cognitive behavioral therapy (ICBT) effectively reduced dental phobia (DP) and injection phobia (IP) in children and adolescents. This therapy enabled children to receive dental treatment, improving their oral health outcomes.

Keywords:
CBTadolescentschildrencognitive behavioral therapydental anxietydental fearinternetspecific phobia

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Area of Science:

  • Pediatric Dentistry
  • Clinical Psychology
  • Behavioral Therapy

Background:

  • Dental phobia (DP) and injection phobia (IP) are significant barriers to pediatric dental care.
  • Cognitive behavioral therapy (CBT) is effective for anxiety but limited in dental settings.
  • Internet-based CBT (ICBT) offers a scalable solution, but randomized trials are needed.

Purpose of the Study:

  • To evaluate the efficacy of therapist-guided, parent-supported ICBT in reducing DP and IP in children and adolescents.
  • To determine if ICBT enables children with phobias to undergo dental treatment.

Main Methods:

  • A randomized controlled trial with 33 children diagnosed with DP, IP, or both.
  • Participants were randomized to 12-week ICBT (n=17) or a waitlist control group (n=16).
  • ICBT involved an at-home program, therapist contact, and parent coaching; outcomes measured via diagnostic interviews and validated questionnaires.

Main Results:

  • 41% of the ICBT group no longer met diagnostic criteria for DP/IP post-treatment, compared to 0% in the control group (P=.004).
  • ICBT significantly improved the Picture-Guided Behavioral Avoidance Test (PG-BAT) scores (Cohen's d=1.6 child-rated, 1.0 parent-rated).
  • Significant reductions in dental fear, injection fear, and negative cognitions, alongside improved self-efficacy, were observed in the ICBT group.

Conclusions:

  • Therapist-guided ICBT is an effective treatment for pediatric dental and injection phobias.
  • ICBT increases accessibility to anxiety treatment, potentially reducing the need for sedation and restraint.
  • This approach can lead to improved dental health outcomes for children and adolescents with phobias.