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Britons Go Online To Conquer Phobias

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By MARIA CHENG, The Associated Press

Published: October 5, 2007

LONDON - For nearly her entire life, Mary had a crippling fear of cramped spaces that meant she couldn't travel on airplanes, subways or cars.

Seeing a psychologist didn't help. So she tried something else. The 61-year-old bookkeeper, who only gave her first name to protect her privacy, sat down in front of a computer and spilled out her problems to a psychiatric computer game called 'Fearfighter.'

Last year, 'Fearfighter' was one of two programs endorsed by Britain's health advisory watchdog for people with panic attacks, mild depression or phobias.

People uncomfortable with getting advice from a computer still can choose to see therapists, but the option of logging on for help is now available and will be paid for by the government-run National Health Service.

In Britain, patients registered with the health service routinely wait up to six months to see a psychiatrist; nearly 90 percent of people with mild depression never see a therapist.

The computer programs now mean getting psychiatric counseling is as easy as getting a password from a general practitioner to access the program online.

'Six months for some patients might be too long,' said Paul Grime, an occupational medicine expert at London's Royal Free Hospital.

Since the endorsement was made in February, many British psychiatric patients have skipped the weekly sessions at their doctor's office. Instead, they now log on at home, or go to libraries to use computers designated to run the programs, where there is a health professional ready to help if necessary.

The computers are not authorized to prescribe medicine. A qualified human is required for that.

The computerized treatment is possible because people with phobias, from fear of spiders to fear of heights, tend to get the same basic therapy.

'The idea is that the repetitive parts of the therapy are done by a computer, which can then make decisions based on these answers,' said Isaac Marks, a professor emeritus at King's College Institute of Psychiatry in London and co-developer of 'Fearfighter.'

Treating short-term problems like phobias or mild depression often simply means teaching patients new ways to think or react, something a computer can be programmed to do, Marks said.

In 'Fearfighter,' patients are taught to recognize the signs that trigger their panic attacks in the hopes of preventing one. But if that doesn't work, they're also instructed on how to cope with their fears.

In the anti-depression program, patients watch staged vignettes in the lives of depressed people, using professional actors. For example, in a scene where a character has an argument with a spouse, patients are shown how the person thinks through different ways of responding. It is then up to the patients to decide how the character will react, in a process that psychiatrists say helps them develop new thinking patterns.

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