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Feasibility of one-session treatment for specific needle phobia in an adult IAPT service – a case series

Published online by Cambridge University Press:  16 November 2020

Ursula Maria Hiermeier  and
Layla Mofrad Open the ORCID record for Layla Mofrad [Opens in a new window]
Ursula Maria Hiermeier
Affiliation:
Talking Helps Newcastle, New Croft House, Market Street, Newcastle upon Tyne NE1 6ND, UK
Layla Mofrad*
Affiliation:
Talking Helps Newcastle, New Croft House, Market Street, Newcastle upon Tyne NE1 6ND, UK
*
*Corresponding author. Email: l.mofrad@nhs.net
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Abstract

One-session treatment for specific phobias (OST; Öst, 2012) has been found to be efficient and effective in reducing the severity of phobia in an adult population. This study aimed to investigate the feasibility of OST in an Improving Access to Psychological Therapy (IAPT) primary care service in the North East of England. Participants were four women and one man between the ages of 21 and 46 years; all presented with needle phobia. Treatment consisted of three clinical contacts: a 1-hour pre-treatment interview to identify the catastrophic belief centred on the phobic situation; a 2.5–3-hour treatment session using exposure in vivo (i.e. images, videos and handling of a syringe – no actual injections) and participant modelling in accordance with OST protocol; and a 30-minute follow-up telephone appointment. Outcome was measured with standard IAPT and additional psychometrics, as well as qualitative client feedback. The outcome suggests the application of OST to be effective for needle phobia, as well as feasible and cost- and resource-efficient in its application to an IAPT primary care service. Further research needs to investigate its effects in comparison with multiple single sessions of cognitive behavioural therapy in an adult population, as well as appropriate outcome measures to suit an IAPT application.

Key learning aims

  1. (1) To gain a basic understanding of one-session treatment for specific phobias (OST).

  2. (2) To enhance understanding of the implications of OST in an IAPT primary care service.

  3. (3) To acquire useful information about practicalities and challenges of OST in an IAPT primary care setting.

Keywords

IAPTone-session treatment for specific phobias
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e51
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Davis, T. H. III, Ollendick, T. H., Öst, L.-G. (eds) (2012). Intensive One-Session Treatment of Specific Phobias. New York, USA: Springer. https://doi.org/10.1007/978-1-4614-3253-1 CrossRefGoogle Scholar

References

American Psychological Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edm). Washington, DC, USA: American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596.dsm04 Google Scholar
Bandura, A., Jeffery, R. W., & Wright, C. L. (1974). Efficacy of participant modeling as a function of response induction aids. Journal of Abnormal Psychology, 83, 56–64. https://doi.org/10.1037/h0036258 CrossRefGoogle ScholarPubMed
Beck, A. T. (1979). Cognitive Therapy and the Emotional Disorders. New York, USA: Penguin Group. Retrieved from: https://books.google.co.uk/books?hl=en&lr=&id=nSFvAAAAQBAJ&oi=fnd&pg=PT8&dq=cognitive+therapy+and+the+emotional+disorder&ots=FfhH3DVBZw&sig=F_b_pYW2lSzm26PyuYfBwSYanHk#v=onepage&q=cognitive therapy and the emotional disorder&f=falseGoogle Scholar
Becker, E. S., Rinck, M., Türke, V., Kause, P., Goodwin, R., Neumer, S., & Margraf, J. (2007). Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study. European Psychiatry, 22, 69–74. https://doi.org/10.1016/j.eurpsy.2006.09.006 CrossRefGoogle ScholarPubMed
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oa CrossRefGoogle Scholar
Cameron, I. M., Crawford, J. R., Lawton, K., & Reid, I. C. (2008). Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. British Journal of General Practice, 58, 32–36. https://doi.org/10.3399/bjgp08X263794 CrossRefGoogle ScholarPubMed
Clark, D. M. (2011). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. International Review of Psychiatry, 23, 318–327. https://doi.org/10.3109/09540261.2011.606803 CrossRefGoogle ScholarPubMed
Coelho, C. M., Gonçalves-Bradley, D., & Zsido, A. N. (2020). Who worries about specific phobias? – a population-based study of risk factors. Journal of Psychiatric Research, 126, 67–72. https://doi.org/10.1016/j.jpsychires.2020.05.001 CrossRefGoogle ScholarPubMed
Craske, M., Wittchen, U., Bogels, S., Stein, M., Andrews, G., & Lebeu, R. (2013). Severity Measure for Specific Phobia–Adult. Retrieved from: ps://www.psychiatry.org/FileLibrary/Psychiatrists/Practice/DSM/APA_DSM5_Severity-Measure-For-Specific-Phobia-Adult.pdf Google Scholar
Davey, G. C. L. (2007). Psychopathology and treatment of specific phobias. Psychiatry, 6, 247–253. https://doi.org/10.1016/j.mppsy.2007.03.007 CrossRefGoogle Scholar
Dear, B. F., Titov, N., Sunderland, M., McMillan, D., Anderson, T., Lorian, C., & Robinson, E. (2011). Psychometric comparison of the Generalized Anxiety Disorder Scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder. Cognitive Behaviour Therapy, 40, 216–227.CrossRefGoogle ScholarPubMed
Emmelkamp, P. M. G., & Wittchen, H.-U. (2009). Specific phobias. In Gavin, A., Charney, D. S., Sirovatka, P. J., & Regier, D. A. (eds), Stress-Induced and Fear Circuitry Disorders: Advancing the Research Agenda for DSM-V (pp. 77–101). Washington, DC, USA: American Psychiatric Publishing, Inc.Google Scholar
Flower, S. (2018). Blood-injection-injury phobias at Step 2. CBT Today, 46, 14–15. Retrieved from: https://issuu.com/babcpcomms/docs/cbt_today_may_2018_final_lo-res Google Scholar
Hood, H. K., & Antony, M. M. (2012). Evidence-based assessment and treatment of specific phobias in adults . In Davis, T. H. , III, Ollendick, T., & Öst, L.-G. (eds), Intensive One-Session Treatment of Specific Phobias (pp. 19–37). New York, USA: Springer.CrossRefGoogle Scholar
Kleinknecht, R. A., Thorndike, R. M., & Walls, M. M. (1996). Factorial dimensions and correlates of blood, injury, injection and related medical fears: cross validation of the medical fear survey. Behaviour Research and Therapy, 34, 323–331. https://doi.org/10.1016/0005-7967(95)00072-0 CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x CrossRefGoogle ScholarPubMed
Labus, J. S., France, C. R., & Taylor, B. K. (2000). Vasovagal reactions in volunteer blood donors: analyzing the predictive power of the Medical Fears Survey. International Journal of Behavioral Medicine, 7, 62–72. https://doi.org/10.1207/S15327558IJBM0701_5 CrossRefGoogle Scholar
Lindner, P., Frykheden, O., Forsström, D., Andersson, E., Ljótsson, B., Hedman, E., … & Carlbring, P. (2016). The Brunnsviken Brief Quality of life scale (BBQ): development and psychometric evaluation. Cognitive Behaviour Therapy, 45, 182–195. https://doi.org/10.1080/16506073.2016.1143526 CrossRefGoogle ScholarPubMed
Mataix-Cols, D., Cowley, A. J., Hankins, M., Schneider, A., Bachofen, M., Kenwright, M., … & Marks, I. M. (2005). Reliability and validity of the Work and Social Adjustment Scale in phobic disorders. Comprehensive Psychiatry, 46, 223–228. https://doi.org/10.1016/j.comppsych.2004.08.007 CrossRefGoogle ScholarPubMed
McMurtry, C. M., Noel, M., Taddio, A., Antony, M. M., Asmundson, G. J. G., Riddell, R. P., … & Bleeker, E. V. (2015). Interventions for individuals with high levels of needle fear: systematic review of randomized controlled trials and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S109–S123. https://doi.org/10.1097/AJP.0000000000000273 CrossRefGoogle ScholarPubMed
Mednick, L. M., & Claar, R. L. (2012). Treatment of severe blood-injection-injury phobia with the applied-tension method: two adolescent case examples. Clinical Case Studies, 11, 24–34. https://doi.org/10.1177/1534650112437405 CrossRefGoogle Scholar
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461–464. https://doi.org/10.1192/bjp.180.5.461 CrossRefGoogle ScholarPubMed
National Collaborating Centre for Mental Health (2018). The Improving Access to Psychological Therapies Manual – Appendices and helpful resources. Retrieved from: https://www.england.nhs.uk/wp-content/uploads/2019/12/iapt-manual-helpful-resources-v2.pdf Google Scholar
National Collaborating Centre for Mental Health (2020). The Improving Access to Psychological Therapies Manual. Retrieved from: https://www.england.nhs.uk/wp-content/uploads/2020/05/iapt-manual-v4.pdf Google Scholar
Oar, E. L., Farrell, L. J., & Ollendick, T. H. (2015). One session treatment for specific phobias: an adaptation for paediatric blood–injection–injury phobia in youth. Clinical Child and Family Psychology Review, 18, 370–394. https://doi.org/10.1007/s10567-015-0189-3 CrossRefGoogle ScholarPubMed
Öst, L. G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27(1), 1–7. https://doi.org/10.1016/0005-7967(89)90113-7 CrossRefGoogle ScholarPubMed
Öst, L.-G. (1992). Blood and injection phobia: background and cognitive, physiological, and behavioral variables. Journal of Abnormal Psychology, 101, 68–74. https://doi.org/10.1037/0021-843X.101.1.68 CrossRefGoogle ScholarPubMed
Öst, L.-G. (2012). One-session treatment: principles and procedures with adults. In Davis, T. H. , III, Ollendick, T., & Öst, L.-G. (eds), Intensive One-Session Treatment of Specific Phobias (pp. 59–95). New York, USA: Springer. https://doi.org/10.1007/978-1-4614-3253-1_4 CrossRefGoogle Scholar
Öst, L.-G., Hellström, K., & Kåver, A. (1992). One versus five sessions of exposure in the treatment of injection phobia. Behavior Therapy, 23, 263–281. https://doi.org/10.1016/S0005-7894(05)80385-5 CrossRefGoogle Scholar
Schmit, E. L., & Balkin, R. S. (2014). Evaluating emerging measures in the DSM-5 for counseling practice. The Professional Counselor, 4, 216–231. https://doi.org/10.15241/els.4.3.216 CrossRefGoogle Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097. https://doi.org/10.1001/archinte.166.10.1092 CrossRefGoogle ScholarPubMed
Taddio, A., Ipp, M., Thivakaran, S., Jamal, A., Parikh, C., Smart, S., … & Katz, J. (2012). Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine, 30, 4807–4812. https://doi.org/10.1016/j.vaccine.2012.05.011 CrossRefGoogle ScholarPubMed
Waller, G. (2009). Evidence-based treatment and therapist drift. Behaviour Research and Therapy, 47, 119–127. https://doi.org/10.1016/j.brat.2008.10.018 CrossRefGoogle ScholarPubMed
Wardenaar, K. J., Lim, C. C. W., Al-Hamzawi, A. O., Alonso, J., Andrade, L. H., Benjet, C., … & de Jonge, P. (2017). The cross-national epidemiology of specific phobia in the World Mental Health Surveys. Psychological Medicine, 47, 1744–1760. https://doi.org/10.1017/S0033291717000174 CrossRefGoogle ScholarPubMed
Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical Psychology Review, 28, 1021–1037. https://doi.org/10.1016/j.cpr.2008.02.007 CrossRefGoogle ScholarPubMed
Wright, B. D., Cooper, C., Scott, A. J., Tindall, L., Ali, S., Bee, P., … & Wilson, J. (2018). Clinical and cost-effectiveness of one-session treatment (OST) versus multisession cognitive-behavioural therapy (CBT) for specific phobias in children: protocol for a non-inferiority randomised controlled trial. BMJ Open, 8, 25031. https://doi.org/10.1136/bmjopen-2018-025031 CrossRefGoogle ScholarPubMed
Zlomke, K., & Davis, T. E. (2008). One-session treatment of specific phobias: a detailed description and review of treatment efficacy. Behavior Therapy, 39, 207–223. https://doi.org/10.1016/j.beth.2007.07.003 CrossRefGoogle ScholarPubMed
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