A HOME
TREATMENT PROGRAMME FOR AGORAPHOBIA SUFFERERS
(by Professor A Mathews-Oxford University) Published by S.W.A.G.(AUST.)
INC.
ISBN 0 9591710 0 2
DE-SENSITIZATION AND GRADED EXPOSURE
CONTINUED-PART I
ANSWERS
9.
a) Go out for a walk This is
not quite clear enough. How long should the walk last? How far should you
go before you feel that you have succeeded?
b) Practice going out everyday Of course you should practise going
out everyday but this is not really a treatment target. It is a habit you
want to learn.
c) Walk alone to the school- Correct. This is a useful description
of a treatment target. It is precise, so that you know when you have successfully
completed the item. c) Try to keep calm when shopping in the supermarket.
Telling yourself, to "try and keep calm" isn't a useful description
of a treatment target, because it is too vague for you to know exactly
what to do.
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TO QUESTIONS
10.
a) Start practice in mixing
with small groups of people.-Correct. Practice with smaller groups
will help change your feelings towards large ones and build up confidence
for more difficult practice.
b) Tell yourself there is no reason to be afraid Telling yourself
there is no reason to be afraid can help, but it isn't enough to stop you
feeling frightened. If it were, the treatment of agoraphobia would be much
easier.
c) Find ways to make yourself feel differently about crowds. The
best way to make yourself feel differently about crowds is to change the
way you behave which will lead to changes in feelings later on.
d) None of these No, one of these would be a good way to deal with
your fear of large crowds.
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TO QUESTIONS
11. a)
If several days go by without practice it may get harder. It is
true that by not practising for several days you learn to avoid the feared
situations, and this may increase fear again. However, daily practice is
also important for other reasons.
b) It builds confidence for harder items later. Success with easier
items does build confidence to attempt more difficult ones later, and daily
practice is the best way to achieve this but increased confidence is not
the only advantage of daily practice.
c) With each practise the fear will tend to get less. Regular practice
in going out will gradually reduce the fear you feel, but daily practice
is helpful in other ways as well.
d) All of these-Correct. All of these are reasons why you should
practise daily.
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TO QUESTIONS
12 a)
TRY IT AGAIN TOMORROW- Correct. Now that you have achieved the item once,
you should repeat it a few times to check it and increase your confidence.
b) TRY A MORE DIFFICULT ONE A single success does not mean that the item
is finished, you should repeat it a few times to make sure.
c) TRY AN EASIER ONE No, there would be no point in leaving off when you
are winning.
d) CONGRATULATE YOURSELF AND HAVE A WELL-EARNED REST. No, by "resting"
you are avoiding going out and this is just what you must not do.
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TO QUESTIONS
13
a) GOING WITH SOMEONE BY BUS TO THE SCHOOL This is one way of bridging
the gap, but other items might be used as well.
b) GOING ALONE FOR JUST ONE STOP AT FIRST Travelling for just one stop
would be a useful in-between item, but it is not the only possibility.
c) GOING ALONE, BUT BEING MET AT THE OTHER END. This item could be used,
but it might be too difficult at first, and other, slightly easier items,
might be needed as well.
d) ALL OF THESE -Correct. All of these would be ways of bridging the gap
between the items, as they are more difficult than (1) but less difficult
than (2).
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TO QUESTIONS
14
a) THEY ARE SLIGHTLY EASIER THAN THE LAST TARGET ITEM SUCCESSFULLY PRACTISED.
No, they should be slightly more difficult than the last target item successfully
practised.
b) THEY BUILD CONFIDENCE It is true that practising in-between targets
builds confidence, but that is not an end in itself. There is a more specific
reason for using them.
c) THEY BRIDGE ANY LARGE GAPS IN DIFFICULTY BETWEEN TARGETS -Correct. By
bridging any large gaps in difficulty, smooth progress can be continued
and confidence increased until it is time to try the next target.
d) ALL OF THESE No, not all of the answers are correct.
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TO QUESTIONS
15
a) GO ON TO THE NEXT MOST DIFFICULT ITEM As a rule you should not go on
to a more difficult item until the current one has been successfully completed.
This will only lead to more difficulties.
b) REPEAT THE SAME ITEM SEVERAL TIMES When an item has been achieved for
the first time, it is useful to repeat it, but if tranquillisers have been
used, simple repeating the item with the same dose is not the most useful
thing to do.
c) STOP PRACTICE FOR A WHILE No. There is no reason to think this will
help and it may be more difficult to start again after a pause.
d) GRADUALLY REDUCE THE DOSE WHILE PRACTISING THE SAME ITEM -Correct. By
repeating the item with a gradual reduction in dose, you should eventually
be able to do it without any tranquillisers at all.
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TO QUESTIONS
SUMMARY a) TRY
EACH ITEM ONCE, IF SUCCESSFUL MOVE ON No, each item should be practised
more than once before moving on. b) DECIDE ON TARGET BEHAVIOURS AND PRACTISE
ONE EVERY DAY It is essential to practise every day, but it is sometimes
necessary to use items 'in-between' targets.
c) START PRACTISING WITH EASIER ITEMS AND PROGRESS TO MORE DIFFICULT ONES.-Correct.
It is important to move from less to more difficult items as this helps
to build up confidence for the more difficult ones.
d) USE TRANQUILLISERS DURING PRACTICE SESSIONS Tranquillisers should be
used only for difficult practice sessions, not all sessions.
BACK
TO QUESTIONS
16 a)
THE CONDITIONED FEAR REACTION TO CERTAIN PLACES The conditioned fear reaction
to certain places is likely to trigger panic feelings, but other things
contribute as well. b) WORRY ABOUT THE STRANGE FEELINGS DURING PRACTICE
Worry about strange feelings often makes panic feelings worse - but other
things are also involved. c) THINKING THAT THE FEAR IS GOING TO GET OUT
OF CONTROL Thinking that the fear will get out of control certainly does
make panic feelings worse, although other things are also involved. d)
ALL OF THESE -Correct. Each of the things described can play a part in
bringing about a panic attack.
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TO QUESTIONS
17
a) DOING SOMETHING NEW WITHOUT ANY TROUBLE FOR THE FIRST TIME This is obviously
encouraging but does not necessarily mean that it will be as easy every
time, and you may not be confident of it when not at your best.
b) TRYING SOMETHING NEW BUT COMING BACK BECAUSE OF TENSION This is no indication
of progress, since this was probably what happened when the agoraphobia
was getting worse.
c) DOING SOMETHING NEW DESPITE EXPERIENCING SOME PANIC AT FIRST-Correct.
When you can manage this you know you are making progress both in what
you can do and in coping with fear.
d) DOING SOMETHING NEW BUT FINISHING IN A TOTAL PANIC This could be a step
forward or a step back, depending on whether you can do it again soon,
with less panic. In general you should avoid leaving off when still in
a panic.
BACK
TO QUESTIONS
18 a)
TRY TO SNAP OUT OF IT Yes, of course, you should but the question was getting
at something more specific.
b) GET HOME AS SOON AS POSSIBLE Going home immediately might make avoidance
more likely next time, because you have 'learned' that only after going
home does the fear go down.
c) GO TO ANOTHER STORE Going to another store might help, provided that
it is nearby. There is a danger, however, that you will learn to be afraid
of, and avoid, the first store.
d) STAY UNTIL YOU FEEL BETTER-Correct. If it is possible to stay until
the fear goes down, this might make it easier for you to cope next time.
BACK
TO QUESTIONS
19
a) FORCE YOURSELF TO GET ON THE NEXT BUS This sometimes works but has some
dangers - if the same thing happens again it might get more and more difficult
to go on practising.
b) TRY AGAIN SOON AFTER TAKING A TRANQUILLISER-Correct. You should, of
course, try not to get off the bus in the first place, but once this has
happened, it would be best to try again, when calmer.
c) TRY AN EASIER 'IN-BETWEEN' ITEM This is one possibility, but there is
something else which you could try first.
d) ALL OF THESE No, some of the answers are not advisable.
BACK
TO QUESTIONS
SUMMARY
a) CONTINUE PRACTICE WITHOUT STOPPING This
might work, but there is a risk that the panic will increase until it is
impossible to do anything except go home.
b) LET IT HAPPEN AND WAIT FOR IT TO PASS- Correct. This is always the best
course although it will need persistent practice to learn how to do it.
c) GO HOME AND RELAX No, this should be avoided if at all possible. If
you go home you will probably need to repeat the practice soon with a tranquilliser.
d) TAKE A TRANQUILLISER AS SOON AS POSSIBLE This is unlikely to work fast
enough to help right away, although it could be used before the next practice.
BACK
TO QUESTIONS
20
a) IT PROVIDES REGULAR PRACTICE IN GOING OUT' This is one of the main reasons,
although there are others. b) IT IS A SOURCE OF SATISFACTION AWAY FROM
HOME This is an important aspect of a job or outside interest, but there
are other more direct effects that are just as important. c) MEETING NEW
SITUATIONS AND PEOPLE HELPS BREAK THE HABIT OF AVOIDANCE This is one of
the important advantages of a job or outside interest, although there are
other important aspects. d) ALL OF THESE -Correct. Several different reasons
add together to make getting a job and developing outside interests an
important aim.
BACK
TO QUESTIONS
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STATE WIDE AGORAPHOBIA GROUP (AUSTRALIA) INCORPORATED
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