Case Presentation About specific Phobia..

1. 1/2/2015
Koya University
Faculty of science & health
Dept. of Clinical Psychology
3rd 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 characterizedby 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 listedbelow:
• Fear of animals—this caninclude 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—thiscan include fear of seeing the blood of other
people as well as fear of experiencing this stimuli oneself.
• Fear of situations—this caninclude fear of traveling by different means as well as
claustrophobia (fear of being in enclosedplaces).
• Other Fears—this can include fear of dying by illness, fearof incontinence and fear
of other bodily sensations.
During the interview with client, the therapist (students’ Third stage in Clinical
Psychology) askssomequestions to the client Include: whatare 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 fromit?, Etc…

3. The clients answer for questions during the interview:
In early of her age, she didn’t remember when happened , shejustthought that
maybe somebad 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 fromanimals in generally(all of the animals) especially the cat , during the process
the Therapistasks in more detail aboutit .
She has a problemwith 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 sheknew that in there
has a cat, it mean shechose avoidancefromthese situation, in that time she was feel so
feared, stressfuland 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’tcontrol herself ….etc.
These symptoms was moreand more when she faced in a closed place and nobody in
there!, during the facing of animals she shoutand try to get a help fromothers , if
nobody in there shetry to run away fromthese place so fast and sheavoid 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
roomand she was alone, when she went to there she was so so much feared and feeling
so tension ,shoutfor help and so fright, so shesaid that I feel down because nobody in
there (Alone),and she was trembling ,shaking and also hibernation in her legs , can’trun
away fromthis situation, even can’t think about a way to resolveit( it mean how try to
avoid it )! Suddenly run away fromthis place and go to the last roomand keyed the door!
, After a long time shetry to be a little Relaxed, and also she mentioned that shewas
goes in a place justbecause 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 maybecan’t control myself( too much worry, fear, anxiety, trembling, ....) in that
Situation difficultly For controlling if alone, even with others she doesn’tlike to goes
near it(the places that a cat in there), I don’t know when this fear was growth fromand
also the main cause it maybethis 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 anywherebecausetoo much fear, and also my emotion was changed while

4. facing it face by face and even sometime in the movies also , Don’tlike to watch and she
try to avoid to don’tsee it.
For answering this questions that why you feared all of the animals? She answered as a:
maybe I justhavean idea about that animals like a human!, I can’t expect that other
things like human! , it was uncomfortablefor 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: Shedidn’t have any disease & also didn’t take a surgery.
Psychiatric or counseling history: Shedidn’tsee any Psychiatric or counseling for it and
before.
Family mental healthhistory:in their family didn’t have any Disease or disorders.
Alcohol and drug history:She didn’t have any History withAlcohol andalso for drugs
was true.

5. Stressful life event:the last stressful eventoccurs last 3 month.
Family and social relationships: She lives withher husband and also has a good
relationshipwith him.
Current psychological concerns or problems:
She fears a lot of from animals especially withacat but for cat her fear was so much,
while she saw it, she faceda stress andother symptoms of Phobia, and try to avoidthis
place,she thought that animals have similarity withthe Human, because that she can’t
accept that other similar and alike to the Human from it and also make her trembling,
problemin heart rate and breathing, face changes after she saw it, and other
symptoms of Phobia.
For diagnosing this casetherapist 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 Therapistdetermined that The Client has Specific phobia
with the animals.
And this is a scalethat Therapists useit. For more information see the Appendix 1 *.
The clients Goal Is that shelikes to reduce these fear fromanimals, and can control
herself to avoid situation if shedetect 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
possiblethat clients have.
Treatment Plan:
CBT is the best treatment for Phobia.
Exposuretherapy.
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 respondto each
itemby marking (or x)
one box per row.
Never Occasionally Half of the
time
Most of the
time
All of
the time
Item
score
1 feltmomentsof sudden
happen,fear,orfrightin
these situations
  3
2 feltanxious,worried,or
nervousaboutthese
situations
 3
3 had thoughts of being injured,
overcome with fear, or other
bad things happening in these
situations
 4
4 felt a racingheart,sweaty,
trouble breathing, faint,or
shaky in these situations
 4
5 felt tense muscles,felt on
edge or restless,or had
trouble relaxingin these
situations
 3
6 avoided,ordidnot
approach or enter,these
situations
 4
7 movedawayfromthese
situationsorleftthemearly
 4
8 spenta lotof time
preparingfor,or
procrastinatingabout(i.e.,
puttingoff),these
situations
 3
9 distractedmyself toavoid
thinkingaboutthese
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
CraskeM, 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 cliniciansfor usewith their patients .