Areas of Specialization - Children and Adolescents
Systematic Desensitization for Specific Fears (Phobias)
Case example
Samantha is a typical 14
year old who does well in
school and is popular with
her peers. She is captain
of the junior varsity baseball
team and class treasurer.
However Samantha is terrified
of dogs. Samantha never liked
dogs and would always avoid
playdates at friend's homes
who have a dog. Samantha has
even avoided going to parks
and beaches where she fears
a dog may be off its leash.
Last season she even refused
to pitch in her team's final
playoff game because a dog
was playing nearby in the
field. Samantha has never
had a bad experience with
a dog but she knows her mother
was bitten as a child and
has never liked dogs. Her
two brothers have begged their
parents for a dog but Samantha
always appealed to her mother's
fears. However now that Samantha
is older her fear of dogs
is becoming a larger problem
as she realizes her ideal
college is in a small town
with a campus that permits
dogs to freely roam and live
in fraternity and sorority
houses.
Nathan is nine years old and
refuses to go to the doctor
out of fear he will need a
blood test or injection. He
not only avoids his pediatrician,
but this year he began to
refuse his dental check ups
after his friend told him
about his first cavity filling.
Nathan's mother has become
increasingly frustrated as
he would not take his flu
shot and became so ill this
winter that he missed two
weeks of school. Most recently,
Nathan has stated that he
can not stand the sight of
blood. Last week he reported
that he felt he was going
to pass out during recess
when his classmate slipped
off the jungle gym, cut his
lip and was bleeding. Nathan
now refuses to watch certain
television shows or read mystery
books out of fear that he
will feel sick at the mere
mention of blood. |
Samantha and Nathan are two children
who have specific fears that impair
their functioning only when confronted
with the phobic object or situation.
Common examples of specific phobias
in children and adolescents include
fears of the dark, animals, insects,
storms, loud noises, vomit, clowns,
injections, doctors/dentists,
flying, water and heights. Although
children and adolescents with
a specific phobia will typically
avoid the feared situation, they
will frequently express their
anxiety in the form of tantrums,
crying, clinging, or freezing
when confronted with the phobic
stimuli. Fears are a part of childhood,
thus it is extremely important
to differentiate a specific phobia
from normal, developmental fears.
The defining characteristics of
a specific phobia are the fear
response is out of proportion
to the demands of the situation;
the child's reaction is without
volition; the anxiety creates
avoidance of situations and objects;
and the fear persists, is maladaptive
and interferes with family functioning.
Cognitive
Behavioral Treatment in Children
and Adolescents - Specific Phobias>>
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