Anxiety Disorders and Stress Q 5
Jordanne is a client with a fear of air travel. She is being treated in a mental institution for phobic disorder. The treatment method involves systematic desensitization. The nurse would consider the treatment successful if:
A. Jordanne plans a trip requiring air travel.
B. Jordanne takes a short trip on an airplane.
C. Jordanne recognizes the unrealistic nature of the fear of riding on airplanes.
D. Jordanne verbalizes a decreased fear of air travel.
Correct Answer: B. Jordanne takes a short trip on an airplane.
Systematic desensitization is a behavioral technique in which the client with a specific phobia is gradually able to work through hierarchical fears until the most fearful situation is encountered. In this case, the most fearful is riding an airplane. Systematic desensitization (gradual systematic exposure of the client to the feared situation under controlled conditions) allows the client to begin to overcome the fear, become desensitized to the fear. Note: Implosion or flooding (continuous, rapid presentation of the phobic stimulus) may show quicker results than systematic desensitization, but relapse is more common, or the client may become terrified and withdraw from therapy.
Option A: Explore client’s perception of threat to physical integrity or threat to self-concept. It is important to understand the client’s perception of the phobic object or situation in order to assist with the desensitization process. Present and discuss the reality of the situation with the client in order to recognize aspects that can be changed and those that cannot. The client must accept the reality of the situation before the work of reducing fear can progress.
Option C: Encourage the client to explore underlying feelings that may be contributing to irrational fears. Help the client to understand how facing these feelings, rather than suppressing them, can result in more adaptive coping abilities. Verbalization of feelings in a non-threatening environment may help the client come to terms with unresolved issues.
Option D: This response may occur earlier in treatment, but not indicative of success. Generally, a phobic individual recognizes that his fear is disproportionate to the things he fears. Explore things that may lower fear level and keep it manageable (e.g. singing while dressing, repeating a mantra, practicing positive self-talk while in a fearful situation). Provides the client with a sense of control over the fear. Distracts the client so that fear is not totally focused on and allowed to escalate.