Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Daniel W McNeil

Committee Co-Chair

Robert Stuchell

Committee Member

Constance Toffle


Exposure therapy, including its self-directed forms, is effective for treatment of specific phobias. Nevertheless, there are issues with patient adherence in the use of exposure therapy, including its self-directed formats. Technological advancements, as with smartphones, may improve adherence to self-directed exposure therapy, perhaps due to exposure stimuli being more readily accessible. Thus, there is a need to examine how presenting phobic material on a smartphone might promote increased adherence in conducting self-directed exposure. Additionally, exposure can incorporate phobic material from different perspectives (i.e., first-person or third-person), which is one factor that may impact treatment effectiveness. Participants (N = 36) were randomly assigned to a treatment or control condition, and completed a pre-assessment and then a post-assessment two weeks later. The assessment consisted of a multimodal approach (e.g., self-report, physiological response, and overt behavior). Participants in the treatment condition were instructed to watch a standard exposure video of a dental examination and prophylaxis three times daily for two weeks. One week of videos was shown in a first-person perspective and the same video was shown in a third-person perspective for one week. Results indicated that the smartphone-based stimuli were utilized by the participants, and that the treatment was acceptable to them. There was a significant interaction of time by condition for self-reported anxiety during a behavioral avoidance task. Participants in the treatment condition had significantly lower self-reported anxiety at the post-assessment compared to the pre-assessment, and no change in anxiety was found for the control group from pre- to post-assessment. A significant decrease in heart rate and trait anxiety was found from pre- to post-assessment for all participants. Results demonstrated the potential utility of smartphone-based self-directed exposure therapy for specific phobia.