1/2/2015

Koya University

Faculty of science & health

Dept. of Clinical Psychology

3rd Stage

Abnormal Psychology

Clinical Case with Specific Phobia

Mariwan Ismael Aref

Summary about the case:

The client with specific phobia.

What is a specific phobia?

A specific phobia is characterized by an irrational fear of a particular object or situation. Specific phobias have two main components. The first is a strong and consistent fear of an object or situation that the individual realizes poses no actual threat. Secondly, this fear results in the intentional avoidance of the object or situation, causing difficulties in the individual’s life as decisions are made in order to avoid the feared stimulus.

The DSM-IV-TR describes five subtypes of specific phobias as listed below:

• Fear of animals—this can include pets, wild animals and insects. • Fear of natural environment—this can include natural disasters as well as fear of being in unstable places within the environment. • Fear of blood/injections/injury—this can include fear of seeing the blood of other people as well as fear of experiencing this stimuli oneself. • Fear of situations—this can include fear of traveling by different means as well as claustrophobia (fear of being in enclosed places). • Other Fears—this can include fear of dying by illness, fear of incontinence and fear of other bodily sensations.

During the interview with client, the therapist (students’ Third stage in Clinical Psychology) asks some questions to the client Include: what are these things make you feel stressor or anxiety? ,How do you feel and How do you think about it ? Why you fear these things? What are the factors that make you feel stressor?, , Is things or events happens to you that make you feel fear from it?, Etc…

1

The clients answer for questions during the interview:

In early of her age, she didn’t remember when happened , she just thought that maybe some bad things or has experience happens in her lifes but it was unknown in her cognation , when and how it happens, as She said that about her problem : she was so fear from animals in generally(all of the animals) especially the cat , during the process the Therapist asks in more detail about it .

She has a problem with the animals, when faced in a reality life (it mean by face to face) and even in the movies! , if with others maybe it’s better to facing it and control

herself! But in an open place! not close, can’t go to the place if she knew that in there has a cat, it mean she chose avoidance from these situation, in that time she was feel so feared, stressful and a lot of the symptoms happens to her ,such as: Problems in heart rate and with breathing also, trembling ,shaking ,hibernation in her legs, feeling under anxiety, unable to relax ,and sometime can’t control herself ….etc.

These symptoms was more and more when she faced in a closed place and nobody in there!, during the facing of animals she shout and try to get a help from others , if nobody in there she try to run away from these place so fast and she avoid this place, it mean she try to leave the situation without thinking about other things, as she mentioned in her stories that happens about 3 months ago, when a little cat in a kitchen room and she was alone, when she went to there she was so so much feared and feeling so tension ,shout for help and so fright, so she said that I feel down because nobody in there (Alone),and she was trembling ,shaking and also hibernation in her legs , can’t run away from this situation, even can’t think about a way to resolve it( it mean how try to avoid it )! Suddenly run away from this place and go to the last room and keyed the door! , After a long time she try to be a little Relaxed, and also she mentioned that she was goes in a place just because of the animals (it mean they got a new house), and also she had a lot bad experiencing with a cat to facing but this is an closes one! .

I also avoid these places that has a cat!, but if I go to place without knowing in there have maybe can’t control myself( too much worry, fear, anxiety, trembling, ....) in that Situation difficultly For controlling if alone, even with others she doesn’t like to goes near it(the places that a cat in there), I don’t know when this fear was growth from and also the main cause it maybe this fear was develop while I am a child but I don’t remember any events, any experiencing happen to me while Childs life, sometime i can’t

2

go alone for anywhere because too much fear, and also my emotion was changed while facing it face by face and even sometime in the movies also , Don’t like to watch and she try to avoid to don’t see it.

For answering this questions that why you feared all of the animals? She answered as a: maybe I just have an idea about that animals like a human! , I can’t expect that other things like human! , it was uncomfortable for me if seeing other things Like a Human!.

Identifying Information:

In take information:

Age: 29

Gender: Female

Marital status: Marriage

Address: Koya

Nationality: Kurdish

Religion: Muslim

Employer: teacher

Economic: Normal

Education: teachers

Medical and health history. Childhood diseases: She didn’t have any disease & also didn’t take a surgery.

Psychiatric or counseling history: She didn’t see any Psychiatric or counseling for it and before.

Family mental health history: in their family didn’t have any Disease or disorders.

Alcohol and drug history: She didn’t have any History with Alcohol and also for drugs was true.

3

Stressful life event: the last stressful event occurs last 3 month.Family and social relationships: She lives with her husband and also has a good relationship with him.

Current psychological concerns or problems: She fears a lot of from animals especially with a cat but for cat her fear was so much, while she saw it, she faced a stress and other symptoms of Phobia, and try to avoid this place,she thought that animals have similarity with the Human, because that she can’t accept that other similar and alike to the Human from it and also make her trembling, problem in heart rate and breathing, face changes after she saw it, and other symptoms of Phobia.

Diagnostic : For diagnosing this case therapist use a scale that consist 10 Item for each item have 5 option (Never =0 , Occasionally=1 , Half of the time =2, Most of the time =3, All of the time =4 ) .

In the results of the process Therapist determined that The Client has Specific phobia with the animals.And this is a scale that Therapists use it. For more information see the Appendix 1 *.

The clients Goal Is that she likes to reduce these fear from animals, and can control herself to avoid situation if she detect that animals was in the places, but still now she didn’t try to by practically .

The Therapists goal is to help the client to achieve their goals comparatively as much as possible that clients have.

Treatment Plan:

CBT is the best treatment for Phobia.

Exposure therapy.

Relaxation.

Phasing out.

Appendix 1 .4

Severity Measure for Specific Phobia—AdultAge: 29 Sex: Female Date: 11/1/2015

The following questions ask about thoughts, feelings, and behaviors that you may have had in a variety of situations. Please check () the item below that makes you most anxious. Choose only one item and make your ratings based on the situations included in that item.

Please respond to each item by marking (or x) one box per row.

Never Occasionally Half of the time

Most of the time

All of the time

Item score

1 felt moments of sudden happen, fear, or fright in these situations

3

2 felt anxious, worried, or nervous about these situations

3

3 had thoughts of being injured, overcome with fear, or other bad things happening in these situations

4

4 felt a racing heart, sweaty, trouble breathing, faint, or shaky in these situations

4

5 felt tense muscles, felt on edge or restless, or had trouble relaxing in these situations

3

6 avoided, or did not approach or enter, these situations

4

7 moved away from these situations or left them early

4

8 spent a lot of time preparing for, or procrastinating about (i.e., putting off), these situations

3

9 distracted myself to avoid thinking about these situations

2

10

needed help to cope with these situations (e.g., alcohol or medications, superstitious objects, other people)

3

Total/Partial Raw Score:

33

Craske M, Wittchen U, Bogels S, Stein M, Andrews G, Lebeu R. Copyright © 2013 American Psychiatric Association. All rights reserved. This material can be reproduced without permission by researchers and by clinicians for use with their patients.

5