About phobias
A phobia is an intense, persistent fear of a specific object or situation (flying, animals, heights, blood…) that leads to avoidance. Gradual exposure therapy is highly effective and often requires a limited number of sessions.
Therapist is the everyday word for a professional who offers talking therapy: depending on the country it can be a psychologist, a psychotherapist, a licensed counsellor, a marriage and family therapist or a clinical social worker. Profiles show each therapist’s actual title, training and registration.
Getting mental health care in Madagascar
Public health system · Ministère de la Santé publique
Public psychiatric services exist at the university hospitals (CHU) of the six former provinces, including the psychiatry department of CHU Joseph Raseta Befelatanana in Antananarivo; mental health prevention and diagnosis centres exist only in Antsirabe, Ambositra and Manakara. The country has very few psychiatrists (a few dozen) and only one psychologist employed by the state. Many patients first see traditional healers, which delays care. More information
How to check that a professional is licensed
- Ordre national des psychologues de Madagascar (ONPM). Psychologists have a national professional order, the ONPM. Ask the psychologist whether they are a member.
- Ordre national des médecins de Madagascar. Doctors, including psychiatrists, belong to the Ordre national des médecins, which oversees medical ethics. Ask for the doctor's order registration.
Urgent help in Madagascar
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 117 · Police secours (depuis un mobile)
Information reviewed in November 2026 · Sources: ncbi.nlm.nih.gov, newsmada.com, lexpress.mg, newsmada.com
Signs to look out for
Fear is normal in dangerous situations. A phobia is an intense, persistent fear of something specific, such as flying, heights, animals, needles, blood or enclosed spaces, that is out of proportion to the real risk. It becomes a problem when you go out of your way to avoid it, feel panic when facing it, or when avoidance limits your work, travel, health care or relationships.
What helps: treatments and professionals
Specific phobias respond very well to cognitive-behavioural therapy (CBT) with gradual exposure, in which you face the feared situation step by step with support. Exposure can be done in real life, through imagination or, in some cases, with virtual reality. Some phobias can improve with relatively short, intensive treatment. Psychologists and clinical psychologists usually lead this work.
When to seek urgent help
Phobias are rarely emergencies, but a fear of needles, doctors or hospitals should not stop you from getting necessary care; tell health staff so they can help. Contact your local emergency services if fear prevents you from seeking urgent treatment, or if intense panic comes with chest pain or symptoms you have not had before. Seek urgent help for any thoughts of self-harm.
What you can do in the meantime
Avoidance keeps fear alive, so small, planned steps towards what you fear can help, for example looking at pictures before approaching the real thing. Practise slow breathing to manage physical symptoms. Learn reliable facts about the real risk. Ask a supportive person to accompany you, and acknowledge each step forward. If fear is very intense, it is better to do this with a professional.
What does a therapist do?
A therapist helps you talk through what is worrying you and find practical ways to feel and cope better. In sessions they listen, ask questions, help you notice patterns in your thoughts, emotions and relationships, and agree goals with you. Depending on their training they may use cognitive-behavioural, humanistic, systemic, psychodynamic or other evidence-based approaches, with individuals, couples, families or groups.
When to see a therapist
It makes sense to look for a therapist when stress, anxiety, low mood, grief, relationship problems, a difficult change or the effects of past experiences start to weigh on your daily life, or when you simply want space to understand yourself better. If symptoms are severe, you may need medication or there are signs of a medical cause, involve your doctor or a psychiatrist as well.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in Madagascar cover psychological care?
Public psychiatric services exist at the university hospitals (CHU) of the six former provinces, including the psychiatry department of CHU Joseph Raseta Befelatanana in Antananarivo; mental health prevention and diagnosis centres exist only in Antsirabe, Ambositra and Manakara. The country has very few psychiatrists (a few dozen) and only one psychologist employed by the state. Many patients first see traditional healers, which delays care.
How do I check that a therapist is licensed in Madagascar?
Ordre national des psychologues de Madagascar (ONPM): Psychologists have a national professional order, the ONPM. Ask the psychologist whether they are a member.