Evi dence Based Interventions & Use of Specific Phobia Flashcards
KKDP 4
Evidence Based Interventions
E vidence-based interventions are treatments that have been found to be effective on the basis of scientific evi dence.
Biological Interventions
Biological interventions target the bodily mechanisms believed to be contributing to a phobia or its symptoms.
Use of Anti-Anxiety Benzodiazepine Agents
Benzodiazepines are a group of drugs that work on the central nervous system, acting selectively on GABA receptors in the brain to increase GABA’s inhibitory effects and make postsynaptic neurons resistant to excitation.
Drugs can either be:
Agonists - stimulating neurotransmitters function
Antagonists - Inhibit neurotransmitters function
● Benzodiazepines are GABA agonists, stimulating GABA receptors and
mimicking its inhibitory effects.
● Benzodiazepines have both anti-anxiety and sleep-inducing properties.
○ O en referred to as sedatives, mild tranquilisers or depressants as they slow down CNS acti vity.
● Generally benzodiazepines relieve symptoms of anxiety by reducing physiological arousal and promoting relaxation.
○ Long-term use is not recommended.
● Amplifies the effects of GABA if present; has little effect if GABA is absent.
● Benzodiazepines are processed and eliminated at different rates
○ Short Acting: benzodiazepine remains in the bloodstream and is cleared from the body in a short period of time.
○ Long-acting: may accumulate in the bloodstream or take a longer period of time to leave the body
Breathing Retraining
Breathing retraining: an anxiety management technique that involves teaching correct breathing habits to people with specific phobia.
● Poor breathing patterns are common for people with specific phobias.
● Over-breathing can result in lower CO2 levels.
○ Causing dizziness, lightheadedness, pins and needles and blurred sion.
● Slowing the respiration rate is also an effective method of inhibiting the
fight-flight-freeze reaction and returning to a normal state following
activation.
● Breathing retraining involves teaching the indi dual how to quickly restore the
level of carbon dioxide if they start over-breathing.
○ Indi duals are taught strategies to increase carbon dioxide levels by
taking in less oxygen.
● Can be used by itself or in combination with other treatments.
Psychological Interventions
Psychological Interventions focus on changing the cognition and emotional reactions to phobic stimuli.
Cognitive Behavioural Therapy
CBT: is a type of psychotherapy that intends to change the thoughts and beha ours that perpetuate mental disorders and to improve coping skills.
● Utilised cognitive and behavi oural therapies to treat phobias and other mental disorders.
● Mental health professionals work with indi viduals to identify unhelpful thoughts, emotions and behavi ours and challenge them facts & statistics that replace them with positive, adaptive ones.
● The cognitive therapy aspect of CBT is based on the theory that distressing emotions and maladaptive behavi ours are the result of faulty patterns of thinking.
● The behavi oural therapy aspect of CBT is based on the theory that beha viour is learned and therefore can be changed.
Systematic Desensitisation
Systematic desensitisation is a kind of beha our therapy that aims to replace an anxiety response with a relaxation response when an indi dual with a specific phobia encounters the phobic stimulus.
● The technique applies classical conditioning principles in a process that involves unlearning the connection between anxiety and a specific object by reassociating feelings of relaxation (and safety) with the stimuli.
● Systematic desensitisation involves a three-step process that requires the indi dual to learn to relax while gradually facing increasing anxiety-producing phobic stimuli.
○ Over time the indi dual associates being relaxed with the phobic stimulus instead of anxiety.
Systematic Desensitisation - steps
Step 1: Teaching the indi vidual a relaxation technique
Step 2: Indi dual creates a fear hierarchy - a list of feared objects or situations ranked from least to most anxiety-producing. Ideally this should consist of 10-15 specific situations (o en ranked on 100 point scale).
Step 3: Involves systematic exposure to each step of the fear hierarchy one at a time. Ensuring that the indi vidual achieves relaxation before mo ving to the next situation.
Social Interventions
Social interventions: used to complement one or more biological and psychological interventions.
Psychoeducation for Families & Supporters
Psychoeducation: the pro sion and explanation of information to indi duals about their phobia to assist their understanding of its characteristics and treatment.
● In some cases psychoeducation may be broadened to include family members and others supporters to educate them about the importance of challenging innapropriate thoughts and not encouraging avoidance behaviours
.
● Based on the assumption that understanding symptoms, treatment options,
servi ces available and recovery patterns enable indi duals to cope more effectively.
Challenging Unrealistic & Anxious Thoughts
● People with a specific phobia typically have anxious thoughts about their phobic stimulus.
○ These anxious thoughts that trigger and fuel phobias are usually negative and unrealistic.
○ Leads to overestimation of severity of exposure and underestimation of ability to cope.
● Family and supporters play an important role in helping a person to cope with or overcome a phobia by encouraging them to recognise and challenge unrealistic thoughts.
Not Encouraging Avoidance Behaviours:
● While avoidance beha ours can make an indi dual feel better in the short term, it prevents them from learning that their phobia may not be as frightening as they think or how to cope with their fears, perpetuating their phobia.
○ It is important that family and supporters understand what avoidance beha ours are
■ Doesn’t mean family and supporters should deliberately force a person with a phobia to be exposed to phobic stimulus.
○ Family and supporters may learn about the importance of gently and calmly encouraging and supporting the indi dual to not engage in avoidance beha ours.
