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Don’t fear the needle

U therapists have partnered with a nationwide network helping people overcome needle phobia.

Jeanne (a hypothetical person whose story is based on real cases) had been fearful of needles for as long as she could remember. Injections, blood draws—anything to do with needles created intense anxiety, enough to qualify as a phobia. She’s not alone; 10% to 25% of people have a fear of needles, often called needle phobia.

Jeanne’s needle phobia caused her to avoid healthcare appointments. She begrudgingly agreed to blood work in light of a family history of Type 2 diabetes, only to end up on the floor after fainting, a common response for people with a needle phobia.

Needle phobia can make decisions like getting the COVID-19 vaccine much more complicated and fraught with anxiety. But University of Utah therapists are now partnering with a nationwide organization to help people overcome needle phobia for free, via telehealth, typically in only two sessions.

“Although motivations certainly vary from person to person, individuals often seek treatment for needle phobia when it seriously and negatively impacts areas of life that are important to them,” says Feea Leifker, research assistant professor of psychology and co-director of the U’s Behavioral Health Innovation and Dissemination Center (BHIDC). “In the case of needle phobia and COVID-19, individuals may be looking to get vaccinated to be able to safely see loved ones and/or protect others and themselves from severe disease or death if they contract COVID-19.”

The Free Needle Phobia Project

Leifker, Katie Baucom, assistant professor of psychology, and other psychologists and therapists at the BHIDC have partnered with The Free Needle Phobia Project, a growing network of therapists nationwide providing free exposure-based therapy (more on that below) for people with needle phobia who want to get vaccinated.

Jocelyn Sze, a licensed psychologist in the San Francisco Bay Area started The Free Needle Phobia Project to help people overcome needle hesitancy as a barrier to vaccination. The project launched on October 1, 2021 and has already enrolled 81 therapists and 54 participants. Participants are matched with volunteer therapists in their home state or a state with a reciprocal telepsychology agreement, and meet with the therapists twice, for an hour each time.

“Now that we are two months in, we are starting to get the encouraging news from around the country of participants getting successfully vaccinated through the initiative,” Sze says.

The program also provides other resources for people with needle phobia and training materials for therapists.

“I’ve been deeply moved by the response from volunteer therapists,” Sze says, “many of whom have contributed to these materials.”

Needle phobias

Sze says needle phobia is a condition of avoidance, citing a recent study showing 27% of U.S. hospital employees avoided annual flu shots because of needle phobia. The phobia can arise from a traumatic health care experience, but is also partially due to the body’s natural response to needles.

“Needles can activate an extremely acute fight-or-flight response, in which the brain’s limbic system mistakenly registers the needle as a life-threatening stimulus and tries to protect the person from danger by running away,” Sze says.

A needle phobia can lead to general avoidance of health care, Sze says, and disproportionately impacts people of color. “If we can work together to make healthcare delivery less frightening and more comfortable, starting at the pediatric level by implementing strategies to reduce needle-related pain and fear,” Sze says, “we will solve the problem of needle phobia.” 

How exposure therapy works

Participants engage in what’s called exposure therapy, which helps people approach “feared situations or objects in a gradual and systematic way,” Baucom says. “For example, in the case of needle phobia, they may start off looking at a picture of a needle, move to watching a video of an injection, and eventually a final goal may be to get an injection themself.”

Interested people will receive two therapy sessions, she says, between which they’ll engage in exposure practices.

“You’ll be a bit nervous, but as you gain experience, things become easier and anxiety goes down,” Baucom says. “That’s part of how exposure works. The treatment is designed to address a mild case of needle phobia in two sessions, though it is possible that individuals may want or need additional exposure therapy before they’re ready to get vaccinated.”

Our hypothetical patient Jeanne sought exposure therapy when she was hoping to become pregnant but was apprehensive about the many medical interactions, including encounters with needles, that could happen throughout pregnancy, labor and delivery.

Jeanne and her therapist created a list of situations that involved needles that could be used as exposures. Jeanne’s exposures included looking at pictures of needles, watching videos of individuals getting injections and blood draws, lightly pricking herself with a needle and ultimately getting a blood draw. 

There are also other ways to ease needle phobia. Therapists often teach a technique called “applied muscle tension” that raises blood pressure to prevent fainting. Doctors can use vibration or an anesthetic like lidocaine to block the feeling of pain. Parents of kids with needle phobia can employ breathing techniques – or something as simple as a video on a phone for distraction.

The Free Needle Phobia Project is currently enrolling only adult participants, but with pediatric COVID-19 vaccines now approved, parents have a range of resources available to help ease kids’ fear of a jab.

“Empower children with as much choice and control as possible,” Sze says, “such as whether they want to look away when the needle goes in, who they want to be there with them and helping them focus on the benefits of getting vaccinated (or the lollipop that awaits them after the jab). As much as possible avoid the use of restraints. It really helps if the parent or caregiver maintains a calm and steady presence through the process.”

How did exposure therapy help Jeanne? After her exposure practices both during and outside of her therapy sessions, Jeanne learned that she could tolerate the fear she experienced around needles. Two years later, she gave birth to a healthy baby boy. Although her situation is hypothetical, therapists say that exposure therapy is very effective.

How to get started

If you or someone you know would like to participate, go to to sign up as a participant or to access resources. They’ll match you with a local provider. Regardless of which therapist you’re matched with, you’ll engage in two free telehealth sessions. If desired or needed, the BHIDC can help with additional sessions on a sliding fee scale, either in person or via telehealth.

Learn more about BHIDC here or at their website here.