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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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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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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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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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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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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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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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.BACK 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.
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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
Email address: swag@tne.net.au
Phone: 08 8294 6543 Mobile: 0412 226 117
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