Example Skills Class Abstract
Assessing and treating a Specific Phobia of Vomiting
David Veale, Instiute of Psychiatry, Kings College London
Background
A Specific Phobia of Vomiting (SPOV) commonly develops in childhood with a mean duration of about 25 years and occurs almost exclusively in women (Veale and Lambrou, 2006; Lipsitz and Fyer, 2001). Clinicians generally regard SPOV as more difficult to treat and different in psychopathology compared to other specific phobias. People with SPOV tend to be more handicapped than people with other specific phobias (for example avoidance of a desired pregnancy or being significantly underweight from restriction of food). There is very little research in SPOV and no controlled trials in SPOV. It is however possible to use many of the advances in other disorders such as OCD and health anxiety for understanding the factors that maintain the preoccupation, distress and handicap in SPOV. Our team provides a national service for treating SPOV and we are developing a research programme for assessing and treating SPOV. A SPOV is not a common specific phobia that presents for therapy but when it does most therapists seek help as patients may be difficult to engage. By the end of the class participants will be able to apply what they have learnt in the class to their everyday practice in treating SPOV and generalise some of the principles to other anxiety disorders.
Learning Objectives
By the end of the class, participants will be able to:
1. Diagnose a Specific Phobia of Vomiting (and differentiate it from an eating disorder; OCD; health anxiety; panic or social phobia).
2. Make a developmental formulation which can be used in engagement
3. Describe a cognitive behavioural formulation and model for treating SPOV
4. Use new assessment measures for monitoring SPOV
5. Use a variety of strategies from imagery rescripting, exposure in imagination and in vivo, and behavioural experiments for dropping of safety and avoidance behaviours.
Skills Class Leader
David Veale is a Consultant Psychiatrist in CBT at the South London and Maudsley Trust and The Priory Hospital North London. He is an Honorary Senior Lecturer at the Institute of Psychiatry, Kings College London. He is a Consultant at the Bethlem Royal Hospital which provides a national out-patient and residential service for people with SPOV and at the Priory Hospital North London which provides a specialist in-patient service for SPOV. He has published about 70 peer-reviewed articles (mainly in OCD and BDD) and three self help books.
Background readings
Boschen, M. J. (2007). “Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda.” Journal of Anxiety Disorders 21(3): 407-19.
Lipsitz, J. D., A. J. Fyer, et al. (2001). “Emetophobia: preliminary results of an internet survey.” Depression & Anxiety 14(2): 149-52.
Veale, D. and C. Lambrou (2006). “The psychopathology of vomit phobia.” Behavioural and Cognitive Psychotherapy 34(2): 139-150.
Veale, D. (in submission). Treating a specific phobia of vomiting. The Cognitive Behaviour Therapist.
