Affective symptoms are often present and under-treated in schizophrenia. This case study reports the effect of treatment of a specific phobia and associated avoidance on the psychotic symptoms of a patient with medication resistant schizophrenia. The treatment of the specific phobia and agoraphobia followed a traditional systematic desensitization procedure. The successful treatment of the phobias led to improvements in psychotic symptoms. Previously, the client had only a limited response to a number of antipsychotic medications including clozapine but responded well to a traditional systematic desensitization program that produced positive consequences for the psychotic symptomatology. The clinical and theoretical aspects of this case are discussed.