Regina Christina Wielenska

Choking phobia: full remission following behavior therapy

OBJECTIVE A phobic behavior pattern is learned by classical and operant conditioning mechanisms. The present article reviews the main determinants of choking phobia etiology and describes the behavior therapy of an adult patient. METHOD Psychoeducation, functional analysis, and graded exposure to aversive stimuli were used to treat the patient, after extensive psychiatric and psychological assessment. Ingesta and anxiety levels were measured along treatment and at follow-up. RESULTS A multiple assessment baseline design was used to demonstrate the complete remission of symptoms after seven sessions, each of them exposing the patient to a different group of foods. CONCLUSION Psychoeducation and exposure were critical components of a successful choking phobia treatment.

Terapia comportamental do transtorno obsessivo-compulsivo

Behavior therapy, an experimentally-based approach, has been able to successfully treat obsessive-compulsive disorder by means of graded exposure to feared stimuli and response prevention procedures. This article will present the main treatment features, emphasizing behavioral assessment, motivational interviewing techniques, session planning guidelines, and issues on rehabilitation.

Fobia de deglutição: discussão analítico-comportamental de seus determinantes e da amplitude da mudança

The behavior-analytic therapy of choking phobia in a 35 yrs-old woman, a case previously published focusing strictly on its psychiatric aspects, is now presented concerning specific life history determinants of both choking phobia and other responses of the same functional class, all of them involving experiential avoidance. Psychoeducation included detailed functional analysis of choking phobia and relationship problems, correlating both set of phenomena under a single perspective. By means of therapist-assisted graded exposure sessions to different sets of foods, according to a multiple baseline design, the fear subsided and ingesta returned to normal levels. In parallel, significant changes occurred in relationship patterns. Relational frame theory provides a possible explanation to the fact that the client promoted extensive and progressive changes in her eating pattern and relationship with significant others.