Phobias are an excessive fear; sometimes it is focused on an object like spiders, or situation, like going to the dentist; sometimes, as in social phobia, it involves a fear of social situations, and sometimes people with a phobia will also suffer from panic attacks. Having a phobia can be very embarrassing, and many sufferers will go to great lengths to conceal their phobia from others.
As with all forms of CBT, therapist and client will first create a Formulation. It will explore the history of the problem, but also look at factors in the present that maintain it. Often thoughts of threat and danger are key. People with phobias often have a vivid image of the danger that they fear, and far less fear of many other things that are more dangerous. Fear of flying is a good example; driving is much more dangerous than flying, but fear of flying is much more common.
Actions are often the key factor maintaining a phobia. Many people with phobias engage in Safety Behaviours; these are actions that make them feel safer, without actually being safer. Exploring these thoughts, actions and images helps to understand the phobia. Therapy will often the proceed with Behavioural Experiments, in which the client, either with the therapist of by himself, is able to learn more about how dangerous the thing he fears actually is.
These behavioural experiments will be carefully devised by client and therapist, working in collaboration, to make sure that the client can do them, and that the client will learn important new information from them. Many phobic clients are amazed at how quickly they can make progress thought CBT.