FearFighter Review

The following articles are a sample of the available published literature:

1. MacGregor, A. D., Hayward, L., Peck, D. F., & Wilkes, P. (2009). Empirically grounded clinical interventions: Clients’ and referrers’ perceptions of computer-guided CBT (FearFighter). Behavioural and Cognitive Psychotherapy, 37(1), 1-9. doi:10.1017/S135246580800492X
   • “Although most patients benefited only slightly or not at all from the programme, the majority of all the patients (including those who derived little benefit) would recommend FearFighter to a friend; and most would try FearFighter again if they were to seek further therapy. This, plus the responses to the open-ended questions, suggests that patients who did not benefit had no misgivings about the programme per se, or about the CCBT approach in general; rather, the content of FearFighter did not match their particular problems.”
2. McCrone, P., Marks, I. M., Mataix-Cols, D., Kenwright, M., & McDonough, M. (2009). Computer-aided self-exposure therapy for phobia/panic disorder: A pilot economic evaluation. Cognitive Behaviour Therapy, 38(2), 91-99. doi:10.1080/16506070802561074
   • This study evaluated whether FearFighter is more cost-effective than face-to-face phobia treatments.
   • “Here we found that FF is less expensive than clinician-led exposure, even when supplementary clinician input to the FF group is included” (p. 96).
3. Gega, L., Norman, I. J., & Marks, I. M. (2007). Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: randomized controlled trial with pre-registration nursing students. InternationalJournal of Nursing Studies, 44(3), 397-405.
   • “Computer-aided self-instruction saved almost all preparation time and delivery effort for the expert teacher. When added to past results in medical students, the present results in nurses justify the use of computer-aided self-instruction for learning about exposure therapy and phobia/panic and of research into its value for other areas of health education” (p. 397).
4. Hayward, L., MacGregor, A. D., Peck, D. F., & Wilkes, P. (2007). The feasibility and effectiveness of computer-guided CBT (Fearfighter) in a rural area. Behavioural and Cognitive Psychotherapy, 35(4), 409-419. doi:10.1017/S1352465807003670
   • “Seventy percent rated the quality of service as good or excellent; and 97% were satisfied with the help and advice received.”
   • “Participants demonstrated substantial improvements in their fears on eight outcome measures, at post-treatment (N= 32) and at follow-up (N = 19)… Effect sizes for the 19 who provided follow-up data for HADS Anxiety (0.82) and BAI (1.46) were high, and seem to compare well with the typical level of effect sizes reported for face-to-face therapies…”
5. Schneider, A. J., Mataix-Cols, D., Marks, I. M., & Bachofen, M. (2005). Internet-Guided Self-Help with or without Exposure Therapy for Phobic and Panic Disorders. Psychotherapy and Psychosomatics, 74(3), 154-164. doi:10.1159/000084000
   • “At the end of 10 treatment weeks, phobia/panic sufferers improved without attending a clinic by doing CBT self-help guided mainly at home using either of two internet together with brief screening and therapist support by phone. At 1-month follow-up, if the self-help instructions had concerned exposure, gains were significantly greater on 5 of 10 measures and effect sizes for exposure’s superiority were moderate to large on 5 measures” (p. 162).
6. Marks, I. M., Kenwright, M., McDonough, M., Whittaker, M., & Mataix-Cols, D. (2004). Saving clinicians’ time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia/panic disorder. PsychologicalMedicine, 34(1), 9-17.
   • “The clinical outcome was consistent with the study’s first hypothesis that a computer aid could save clinician time without sacrificing efficacy. The time gain was 73% taking all drop-outs and completers into account” (p. 15).
   • “Drop-outs occurred significantly more often in the two self-exposure groups (43% if mainly computer-guided, 24% if entirely clinician-guided) than with self-relaxation (6%)…” (p. 9).
   • “The present study’s results are also consistent with its second hypothesis, that phobia/panic patients would improve more when self-exposure rather than self-relaxation is guided mainly by a computer over the same length of time” (p. 16).