# Integrating Artificial Intelligence Into Exposure Therapy: A One Year Follow‐Up Case Report of Emetophobia With Comorbid Panic Disorder

## TL;DR

A 24-year-old woman with emetophobia and panic disorder showed lasting improvement through CBT with AI-assisted attention-shifting techniques.

## Contribution

This case report introduces the novel use of a speech-based AI tool (ChatGPT) to enhance attention-shifting during exposure therapy for emetophobia.

## Key findings

- Symptom reduction was substantial and maintained at one-year follow-up.
- AI-assisted interactions improved attentional flexibility and reduced reliance on safety behaviors.
- The integration of AI with CBT enhanced engagement and tolerance for anxiety-provoking situations.

## Abstract

Emetophobia is a specific phobia characterized by an intense fear of vomiting, often accompanied by panic attacks, hypervigilance to bodily sensations, and avoidance behaviors. This case study describes the Cognitive Behavioral Therapy (CBT)‐based treatment of a 24‐year old woman with Emetophobia and comorbid panic disorder. Her symptoms caused significant impairment, leading her to avoid social settings, public spaces, and situations linked to vomiting (e.g., dining out, public transport, certain media content). Treatment followed a structured CBT protocol for specific phobias, including psychoeducation, cognitive restructuring, exposure therapy, response prevention and attention‐shifting techniques. A novel feature of the intervention was the inclusion of brief, spoken interactions in English with a speech‐based artificial intelligence tool ChatGPT. As English was not the client's first language, these interactions required increased cognitive effort, serving as a structured external distraction that facilitated habituation by helping her remain in anxiety‐provoking situations without relying on safety behaviors. Treatment progress was tracked using validated self‐report measures including the Specific Phobia of Vomiting Inventory, the Emetophobia Questionnaire‐13 and Panic Disorder Severity Scale. Substantial symptom reduction was observed across domains, with improvements maintained at one‐year follow‐up. By the end of therapy, the client no longer depended on safety behaviors and demonstrated greater tolerance for bodily sensations and uncertainty. This case highlights the potential of CBT for treating Emetophobia and suggests that the integration of artificial intelligence, when applied with clear clinical rationale, may improve attentional flexibility and enhance treatment engagement.

This case highlights how integrating artificial intelligence into exposure therapy can enhance outcomes for Emetophobia with comorbid panic disorder. AI assisted attention‐shifting supported sustained engagement, reduced avoidance, and maintained clinical gains at one‐year follow‐up, demonstrating the potential of blending digital tools with CBT to strengthen traditional therapeutic approaches.