Meeting the psychologists
In short: Russell meets the psychologists for the first time and sees them using therapy to treat phobias. He helps with needle phobia treatment and he ends up taking too much credit for simply doing the blood test at the end of the treatment.
As a doctor training in psychiatry I was attached to the psychology department for a period of training. It is fair to say there is always a little healthy rivalry between psychiatry and psychology. Psychologists see psychiatrists as obsessed with medication and psychiatrists think psychologists just talk, and talk... and talk. I approached my time with them with unfair skepticism, but I actually really enjoyed it. I also had the opportunity to see the difference skilled therapists can make.
One of the clinics I attended was for people with needle phobia in Sheffield, UK. The therapist, John Davies, used systematic desensitisation and---to my surprise---people improved. It should be said my dramatic input into the process was to take blood from the patients as one of the final steps, so I can't take much credit for their improvement. The really impressive part was the simplicity of the approach, but like many things it is harder to do it simply.
My career moved on and I went off to do other things, but these sessions stayed with me. When anyone was critical of psychological therapies I would use them as an example of their efficacy. Recently I have been back in touch with the psychologist who patiently tried to teach me. We reminisced about the good old days and caught up on what each of us were doing.
He told me about the work he is doing on dental phobia, which I thought was really impressive so here it is. I don't like going to the dentist and I particularly dislike the paying bit at the end. For some people it is a true phobia and when they do need work doing this has to be done under heavy sedation or general anaesthesia. This brings with it a small but significant risk and a large and very significant cost.
John had done a study nearly ten years ago on people who routinely required sedation or anaesthesia to have dental work done. He used cognitive behavioural therapy (CBT) for one group and normal treatment for the other. In the CBT group only 4% needed sedation compared to 70% in the treatment as normal group. Here's the really impressive thing: he has followed the CBT group for ten years via their electronic records. All the patients they could find appear to have maintained their improvement and have not had sedation since.
We got chatting about the phobia app we are doing and John asked why I hadn't told him about my spider phobia as he would have happily treated me. The honest answer is I felt stupid and was a bit embarrassed to tell people. My hope for the app is that,whilst not replacing a trained therapist, it allows people to help themselves with their phobia and makes them see it isn't 'stupid' and that they can improve.