specific phobia
Pharmacotherapy
Currently
regarding pharmacotherapy phobic disorders is less studied than psychotherapy. However,
several studies show that the medication event is an effective drug, alone or
in combination of psychotherapy (Stein, 2005).
Among
the various drugs used in the treatment of specific phobias in adults are:
-
Selective inhibitors of serotonin reuptake inhibitors (SSRIs) are supported by
various research studies (Agene and Hamilton, 1998, Benjamin et al., 2000), demonstrating
their usefulness together with a psychotherapy, as well as in cases where it
can not offer. Antidepressants are better tolerated and safer. They are also
effective in patients with concomitant diseases that respond well to these
drugs.
-
Benzodiazepines (BZD) are the most widely used psychotropic medications for the
treatment of anxiety disorders. They are effective in times where you have to
make an immediate psychotherapeutic intervention. In addition, these drugs not
be used for a long time that some patients can result in abuse and risk tolerance.
-
Migraine: is a tricycles antidepressant drug that is capable of raising the
concentrations of the neurotransmitters nor epinephrine and serotonin in the
brain, improving symptoms of depression and other nerve disorders.
In
children and adolescents with specific phobia school phobia situational or migraine
has been used. But, the amount of side effects that brings the antidepressant
drug, limited case studies of these disorders phobic in childhood, and the
positive results of cognitive behavioral psychotherapy advise choosing the
latter (Horse, Simon, 2005).
psychotherapeutic
intervention
Psychotherapy
is the primary tool of the treatment of specific phobias. It can be treated
from two notable theoretical strategies: cognitive and behavioral.
In
therapeutic practice is often a mix of both, is what is known as cognitive-behavioral
treatments.
Cognitive
strategies are primarily focused on recognizing distorted thoughts in
individuals with some anxiety, and that irrationally perceive any danger or
harm. They also tend to perceive a threatening manner and anxious ambiguous or
neutral stimuli. In the case of specific phobia, phobic stimulus is perceived
by the patient as long as dangerous (Di Nardo et al., 1988, Stein, 2005).
The
primary task of cognitive therapies will aim to correct any latent mental or
cognitive distortions in the patient, for which the psychotherapist used
conscious reasoning.
Shoran
et al., 1993, Stein, 2005, indicate that in specific phobia, the decrease in
negative cognitions correlates with the decrease of the fear that the patient
can perceive. Similarly, the return of fear correlated with the return of
cognitions or negative and disturbing thoughts.
Furthermore,
behavioral strategies are based primarily on correcting or unsuitable learning
unlearn, and disrupting the individual's behavior. As noted Craske and Rowe (1997),
Stein, (2005) exposure therapy is most suitable for specific phobia overcome as
it has long term effects. It is based on gradual exposure by the student to the
phobic stimulus until fear disappears response. In addition, it will help to
not overestimate the degree of threat.
Mendez
(1999) and Knight and Simon (2005) indicate four general strategies that
facilitate the child and adolescent achieve interact with phobic stimuli:
-
Reduce the intensity of fear produced by
the phobic situation. The tactics used in this strategy to reduce fear are: a) Graduate
presentation of phobic stimuli, b) Employing representations of phobic stimuli,
and c) Provide a safe and relaxed.
- Facilitate external help the student to
approach the phobic stimulus. It focuses on the motor component of phobic
reactions. To cause or trigger the behavior desired approach, provides physical
and social stimuli. The tactics used are: a) The research stimuli, and b) modeling
stimuli.
-
Provide internal changes in the student to deal with the situation that
generates fear. For your objective will focus on the control of mental activity
(cognitive responses) and autonomic arousal (psycho physiological responses). The
training tactics used are: a) The self-instruction, and b) The progressive
relaxation, breathing and creative imagination.
-
Encourage the student to repeat his conduct outreach. Once originated
interaction with phobic stimulation may manipulate the contingencies that shall
primarily eliminate avoidance behavior and develop behavioral approach to the
phobic stimulus. To do this, use the following tactics: a) The extinction, b) Positive
reinforcement.
Other
methods in the behavioral treatment are:
-
Techniques neoconductista mediation approach (systematic desensitization, flooding,
applied voltage).
-
The operative techniques (reinforced practice, successive approximation).
-
The modeling procedures (live modeling, symbolic modeling).
The
combination of cognitive and behavioral strategies to treat specific phobia has
proven therapeutic effectiveness (Booth and Ranchman, 1992, de Jonah et al., 1995,
Garcia-Sanchez, 2002 and Stein, 2005).
Although
intervention with therapeutic techniques usually give excellent results, in
some particular cases there may be resistance, which will cause it to be
extended in time. But do not be discouraged by these circumstances, with
tenacity and patience will achieve therapeutic goals proposed.
Sometimes
with the school phobic disorder, the child or adolescent may suffer memory
lapses, lack of attention and concentration, generalized anxiety or depression.
These disturbances can promote school failure, and is experienced negative
feelings: frustration, sadness and hopelessness. Hence they should be taken
into account, so as not to further aggravate the problem already suffering.
It is
also essential that the family (mother, father, etc..) Is open to collaborate
with the psychologist, the psychologist, faculty, teachers (mentoring, support,
special education, etc..), The class group, and director school where the
student is studying. It is important to build a network of links and trust
between them. Doing so will create a new school and social situation that will
flow and positive reinforcement of the therapeutic, educational and socio-affective.
Finally
note that timely action on this phobic disorder is vital. Doing so will help
the student overcome sooner this disruptive behavior, allowing it to continue
to grow in school spaces: educational and integrative.
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