Intervention Plan, Research Paper Example

The Targeted Fear

The client is a 45-year-old female who reports an increase in anxiety levels from her long history of issues related to a self-diagnosis of claustrophobia. Claustrum, in Latin, meaning “closed up” and Phóbos, in Greek, meaning, “fear of.” Her problem is that whenever she feels like she is in a place from which it would be difficult of awkward to exit, she experiences an increased heart rate, feelings of panic, and the urgent need to get out –and quickly. In her workaday life, this hinders her ability to negotiate elevators and back seats of sports utility vehicles. Soon she plans to undergo an MRI, and she is anxious about the procedure.

The Treatment Strategies

 The client will begin exposure therapy, with gradual exposure, through experimentation with her child’s 3-D virtual reality games. Using the glasses that accompany them, she will shut out the world beyond the realm of the games. She will practice feeling a part of the virtual worlds with the constant reminder that, even though her eyes are “closed in,” she still maintains freedom of movement.

This is called Virtual Reality Therapy (VRT). It involves placing a subject in a simulated environment with computer technology. It does not matter whether the person is viewing a realistic or fantasy environment, the person transports to another place –a place of suspended belief.

The client will begin to sit in the back seat of her parked SUV. She will leave the doors open if necessary. This suggestion intends to get her used to what it feels like to sit there while the car is not in motion and there are no other people in the vehicle.

The client will practice riding in elevators while watching a video on her BlackBerry. The intent of this exercise is to get her focus on the video and off the ride. This distraction should not pose an interference with her learning that she can tolerate her anxiety.  At first, she should attempt to perform this task at times when she does not think that the elevator will be full, or at other non-peak times.

The Choice Justification

As for her upcoming procedure, researchers have had success with virtual reality therapy with confirmed claustrophobic patients. Scientists have reported a reduction in patient anxiety with MRIs when they have viewed three-dimensional images during the scans (Garcia-Palacios, Hoffman, Hunter, Richards, Seibel, & Sharer, 2007). Of interest is that patients who received only music feeds during similar procedures did not report a decrease in anxiety. Since this has been the case during actual procedures, the client will ask medical personnel, in advance of her visit, if any form of VRT would be allowed during her pending procedure. If it is, she will use it. If it is not, then she will practice VRT until the last possible moments prior to her procedure.

Other virtual therapies have helped as well. Malbos, Mestre, Note, & Gellato (2008) worked with patients who reported decreases in their anxiety levels immediately after receiving multiple-context, graded, closed in, virtual environment treatments. Six months after their fears subsided, the patients commented that their good feelings lingered as a result of their treatments.

Not only do claustrophobic patients find help through virtual therapies, so do those who suffer from other problems. Phobias of heights, spiders, and flying lessen when patients work through virtual means to overcome them (Rothbaum, 2009). This is good news for thousands of people whose lives modify because of these and similar fears.

The Treatment Outcome

The treatment strategies suggested here need to commence from two to four weeks prior to the scheduled MRI. Since the successful MRI requires a patient to remain for a short time within a closed chamber, the client will need to build confidence in her quest for success. Through virtual therapy, she will rehearse what it might feel like to escape to another place while she is “closed in.” Additionally, the tasks of sitting in the car and riding in elevators while viewing palm videos might bring successful experiences that would assist greatly on the day of the procedure.

The specific measure that will show the degree to which this treatment is effective will take the form of a brief Likert, psychometric Scale survey, completed by the client a week following the MRI. The survey statements will call for the client to make bipolar responses to inquiries using the items, strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree. A sample question could be something like this: “As a result of my VR interactions, my general feelings about closed in places have improved.”   

References

Garcia-Palacios, A., Hoffman, H., Hunter, G., Richards, T., Seibel, E., & Sharer, S.       (2007). Use of virtual reality distraction to reduce claustrophobia symptoms            during a mock magnetic imaging resonance imaging brain scan. CyberPsychology & Behavior, 10(3), 485-488.

Malbos, E., Mestre, D., Note, I, & Gellato, C. (2008). Virtual reality and claustrophobia: Multiple components therapy involving game editor virtual environments exposure. CyberPsychology & Behavior, 11(6), 695-697.

Rothbaum, B. (2009). Using virtual reality to help our patients in the real world. Depression & Anxiety, 26(3), 209-211.