[Behaviour therapy of phobic symptoms].

The paper reviews current criteria for behaviour therapy of phobic symptoms, emphasizing the need of a clinical approach, the clinical diagnosis and a thorough comprehensive study of the patient's situation, prior to any therapeutic action. General therapeutic principles are examined, in four groups: a) Direct symptom treatment. Phobic patients are generally impervious to implosive techniques and other direct approaches to the symptom. b) Treatment of personality characteristics. When the symptom is completely organized and structured in an adult, this approach is of little use; but when the symptom is only starting, specially in children, it is possible to lessen neuro-vegetative reactivity or neuroticity by means of drugs, or to re-direc behaviour by means of assertive techniques. c) Modification of environment. At early stages of symptom development, it is possible to extinguish it by means of the removal of stimuli from the environment having a reinforcing effect. d) Action on psychopathological mechanisms. This is the most effective principle to be applied, through different techniques, among which the following: a) Reciprocal inhibition; b) Desensitization; c) Association of phobic stimulus with reduction of anxiety; d) Extinction. Several specific techniques are discussed, emphasizing the importance of comprehensive clinical approach, and stressing its role in the selection of the particular techniques to be used in a given case.