Case Study 1: Marla
A mid-twenties advertising executive named Marla is starting a new job upon graduating college. Marla has worked hard to get where she is, and her fear of social settings is jeopardizing that effort. Marla was able to navigate university with her fears by avoiding social events. This tactic is proving unsuccessful in her new position with the advertising firm, and the obligations of her position are soon going to require her presence at social events. She is terrified at the thought. Marla is intelligent and moderately successful at her job, and recognizes that the employment and the social avoidance cannot long co-exist in her life. She has decided to seek help.
Specifically, what Marla is experiencing is social anxiety.
…show more content…
The relaxation techniques would be taught, the fear hierarchy and SUDS would be developed in the same way. This is where the similarity ends. With in-vivo instead of describing the fear scenario, the client is actually physically introduced to the fear producer. Then the same desensitization occurs where the client is brought closer and closer to the object(s) of fear while using the relaxation. The advantage to in-vivo is that it takes less time before the fears are confronted, perhaps allowing for a quicker treatment.
A behavior modification procedure for Marla would entail the use of in-vivo desensitization. I would teach her the relaxation skills. There are three components to the behavioral relaxation training and these are focus on muscle tension, correct breathing, and attention focusing (Miltenberger, 2015). I would then devise the hierarchy with her that involved increasing degrees of social interactions. We would gradually work our way into Marla being able to be in crowded room.
Beyond the systematic and in vivo desensitization treatments, there are other procedures that may be used to treat fears. These include flooding, where an individual is exposed to the fear producing stimulus at full intensity for a lengthy time, and modeling-which involves watching another individual perform an act when faced with the object of fear; this method is generally more effective with children (Miltenberger,
One of the most common anxiety disorder is social phobia, which can sometimes be interchangeable with Social Anxiety Disorder (SAD). Marc de Rosnay, and others, states that Social Anxiety Disorder is characterized by a clearly noticeable fear and avoidance of most social situations where the individual may be put under scrutiny by others, and by fear in such situations, the individual will behave in an embarrassing manner (de Rosnay). One of the most notable feature of social phobia is that it has an early onset, as early as 7-9 months in most cases. The characteristics of having social phobia, or social anxiety disorder, is that the individuals are shy when meeting new people, quiet in a large group, blush easily, and often avoids making eye contact. There are a lot of concerns/problems with having social anxiety disorder. As a group, individuals with anxiety disorders had the largest burden of role disability compared to other common mental health conditions, exceeding the burden for mood disorders and in some cases, substance abuse (Grigorenko).
For a person diagnosed with agoraphobia, there are a number of restrictions and consequences associated with the disorder. A serious consequence is the incidence of severe and paralysing panic attacks. In the early stages of agoraphobia people suffer recurring panic attacks when in certain public places or situations. These attacks cause the person to feel generally uncomfortable in public settings. Eventually, fear of the recurrence of the panic attacks results in an obvious reluctance or refusal to enter all situations associated with the attacks. Other consequences of agoraphobia may include fear of being alone, fear of being in places where escape might be difficult, feelings of helplessness, dependence on others and depression. These consequences place many serious restrictions on a person with this disorder. Agoraphobia causes people to restrict their activities to smaller and smaller areas in order to avoid crowds, and open and public places or situations. This may finally lead to the inability of a person to leave their home without suffering a panic attack.
Client A is a 22 year old college student experiencing intense fear and worry of social situations (e.g. parties, dating, sporting events, group activities) or situations where she will be the center of attention (e.g. birthday party, public speaking, answering in class). Client A describes racing thoughts, intense upset stomach, rapid heartbeat, trembling, and sweating when she considers being part of the above stressful situations and ultimately often avoids these situations. She stated she became a homebody during high school when she began feeling uneasy around others and worrying about what they would say about her or something bad will happen. Client A desires to be more involved with friends, activities, and clubs; she believes her intense fear and anxiety are affecting her academic and occupational goals. Her good friend recently teased her about rarely leaving the dorm room which encouraged Stacy to seek help.
In general, Social Anxiety Disorder, or Social Phobia, is defined as an anxiety disorder characterized by an overwhelming amount of anxiety and excessive self-consciousness in everyday social situations (“Social Phobia,” 2014). These individuals have trouble with basic communication and interaction, often to the point where they can physically feel the effects of their anxiety. Profuse sweating, stomach ache, and nausea are not uncommon occurrences when a person with Social Anxiety Disorder is placed in an uncomfortable situation. There are several hypothesized causes of Social Anxiety Disorder; however, one of the most
A psychotherapist using cognitive-behavioral therapy (CBT) approach would conceptualize Mary’s symptoms of social phobia as being a result of distorted or irrational thoughts. In CBT, all psychological disturbances can be traced back to the client having one or more dysfunctional thoughts. For example, one of Mike’s cognitions, or thoughts that we are having at any given time, is that he will have a heart attack if he joins in with a large group of people. As a result of having this cognition, he isolates himself by not not going to eat at the dining hall, distancing himself from his classmates, and quitting activities that he is truly very passionate about. Because he thinks this way and displays these behaviors, Mike feels anxious anytime he is put into a situation where he must deal with a large group of people. This provides evidence that one’s cognitions, behavior, and affect impact each other. If you ...
One of the most famous example of fear conditioning is the Little Albert experiment conducted by Watson and Rayner in 1920. In this experiment, an infant, Albert, was presented with a white rat, and as expected, Albert initially displayed no signs of fear and began touching and playing with the rat. Soon, the experimenters began pairing the presentation of the rat with a loud noise (US) produced by banging a hammer on a steel bar. The noise caused Albert to startle and cry (UR). After several pairing, Albert learned to fear the rat (CS) and would crawl away or cry (CR) when the rat was subsequently presented (Watson and Rayner, 1920)
Virtual reality can be used to help people face their fears. The University of Oxford used virtual reality to help patients overcome a fear of heights (Mathieson, 2017, p. 19). A virtual environment was created where the patients were standing at the edge of a balcony looking down and a virtual guide was giving them instructions (Mathieson, 2017, p. 19). Using virtual reality in this way allows people to face their fears in a safe environment. By placing them in a virtual environment, it allows them to encounter a virtual copy of what they fear most which will hopefully give them encouragement to face the real thing at some point in the near
The whole of cognitive behavioral therapy is quite vast, with a number of different approaches and techniques that ultimately intend to accomplish the same goals. As a therapeutic device, it has proven quite successful in helping diminish phobias, overcome anxiety disorders, and relieve the symptoms of
In order to treat the fear you must treat it with relaxation while in the presence of the feared situation. The first step in Wolpe’s study was to focus on relaxing your body. He recommended a process that involves tensing and relaxing various groups of muscles until a deep state of relaxation is achieved (Wolpe,264). The second stage was to develop a list of anxiety-producing situations that are associated with the phobia. The list would descend with from the least uncomfortable situation to the most anxiety producing event you can imagine. The number of events can vary from 5 to 20 or more. The final step is to desensitize, which is the actual “unlearning” of the phobia. Wolpe told his patients that no actual contact with the fear is necessary, and that the same effectiveness can be accomplished through descriptions and visualizations(Wolpe,265). Wolpe’s participants are told to put themselves in a state of relaxation which they are taught. Then, the therapist begins reading the first situation on the hierarchy they have made up. If the patient stays relaxed through the first situation the therapist continues to the next until the state of relaxation is broken. If they feel a slight moment of anxiety they are to raise their index finger until the state of relaxation is restored. The average number
Bryant, Moulds, Guthrie, Dang, Mastrodomenico, et al. (2008) study illustrated that Prolonged exposure (PE) proved to be an effective treatment modality that can be used in addition to other TF-CBT strategies or be used alone. Exposure therapy is a mental health treatment that helps to reduce anxiety through confronting feared thoughts, situations, and activities often associated with traumatic experiences. Foa, Hembree, and Rothbaum (2007) described PE as a treatment that contains, in vivo exposure, imaginal exposure, and processing of imaginal exposure. However, it is also necessary for the mental health practitioner to assist the individual with understanding the rational for PE treatment approach through providing a psychoeducation and training in controlled breathing component. This training and psychoeducation provides the individual information on the nature of trauma and trauma reactions (Foa, Hembree, and Rothbaum,
Social phobias easily lead individuals to shunning situations where they feel they might be the focus of other people in the society, as they often feel unaccomplished and therefore assume that they will be the subject of the said populations (American Psychiatric Association, 2015). The fear of negative judgment imposed by other people in the society points at a situation where one ensures that they stay devoid of situations that involve socializing with other people in the society. This makes it almost impossible for individuals with these phobias to take up roles that require public participation (Randi and Irena, 2015). It ascribes to what one can view as the phobia of other people 's reaction to an individual. Fear of rejection by others is a good example of a social phobia. Social phobias can take the form of gelotophobia, which is the fear of other people laughing at an individual, or even glossophobia, which is the fear public speaking. Social phobias can easily limit an individual y ensuring that one avoids all situations that can lead to scrutiny or contact with the public. This is debilitating and can easily lead to harmful consequences that include the inability of an individual to perform their roles in the society or even the inability to take up work for fear of judgment by others (Bourne,
Main Point 1: There are three main categories of phobias. The first category is Specific Phobias which are known as simple phobias. Specific phobias or simple phobias are usually fears about specific situations, living creatures, places, activities, or things. Examples of simple phobias is dentophobia (dentists), aerophobia (flying), claustrophobia (small spaces), and acrophobia (heights). The other two categories are Social Phobia and Agoraphobia. These two are known as complex phobias. The article “What is a Phobia?”, describes them as complex phobias because “they are linked to deep-rooted fear or anxiety about certain situations, incidents or circumstances, which make them more disabling than simple phobias.” Social phobia is also referred to as social anxiety disorder. Social phobia may be defined in which a person has an excessive and unreasonable fear of social situations. (Webmd.com) A person with social phobia finds being in social situations very difficult to handle with because of the lack of social skills or experiences that person may have. Going out to social events such as parties or functions may cause anxiety to a person with social phobia. There is that fear a person has of being embarrassed in public. People with this phobia may be afraid of a specific situation such as public speaking. Medicinenet.com defines “agoraphobia” as “a fear of being outside or otherwise being in a situation from which one either cannot escape or from which escaping would be difficult or humiliating.” The results of agoraphobia are anxiety and panic attacks. People with agoraphobia sometimes confine themselves inside their own home when symptoms are
...first started out with cats being exposed to mild shocks accompanied by specific sounds and visual stimuli. The cats connected the shocks with the sounds or visual stimuli that produced fear in them. When the cats were exposed to the same sounds or visual stimuli plus receiving food instead of shocks, they eventually unlearned their fears. Eventually this behavior therapy would be applied to humans.
Cognitive-Behavior Therapy (CBT) is also often paired with systematic desensitization. CBT is focused on regaining control of reactions to stress and stimuli, ultimately reducing the feeling of helplessness (Palazzolo, 2014). One specific case of Psychotherapeutic Treatment for Aquaphobia takes a closer look at the break down of how systematic desensitization would be applied. Initially, the patient would be given information on their phobia, making it seem as unthreatening as possible and by showing them that they are not alone, as this disorder is common and that there is a cognitive approach to treat their condition. You first explain to the patient step by step the therapy that is going to take place. You ask them to carefully watch themselves throughout each situation and take notice at what parts they find challenging or lead them to avoidance. It is also suggested that the patients rates her anxiety during those situations on a scale from 1-10. The duration of this therapy would be approximately 13 sessions, meeting once a week for 30-45 minutes. The first three sessions are centered around their life and story of their disability, the diagnosis and the analysis of the disorder while working out a review of each sessions and what their ultimate goal
· Systematic Desensitization- by approaching the situation associated with a great deal of anxiety in steps, the patient can gradually decrease the anxiety related to it. This process usually contained three steps- relaxation techniques (which includes breathing exercises, mental imagery and biofeedback), Creating a Hierarchy (The therapist creates a series of situations in which the feared event occurs more and more intensely) and finally desensitization (where the patient can finally handle the m...