Case Presentation (specific Phobia)

Case Presentation About specific Phobia..

1. 1/2/2015



Koya University
Faculty of science & health
Dept. of Clinical Psychology
3
rd
Stage
Abnormal Psychology


Clinical Case with
Specific Phobia

Mariwan Ismael Aref

2. 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…

3. 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
go alone for anywhere because too much fear, and also my emotion was changed while

4. 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!.


In take information:
Age: 29
Gender: Female
Marital status: Marriage
Address: Koya
Nationality: Kurdish
Religion: Muslim
Employer: teacher
Economic: Normal
Education: teachers


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.

5. 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.
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.

6. Severity Measure for Specific Phobia—Adult
Age: 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.