Master Clinician Seminar 4 - Fear of Vomit – How to Calm It: Using CBT to Treat Vomit Phobia in Children and Adolescents
Saturday, November 18, 2023
8:30 AM – 10:30 AM PST
Location: Queets (505), Level 5
Earn 2 Credit
Keywords: Phobias, Child, ERP (Exposure and Response Prevention) Level of Familiarity: Moderate Recommended Readings: Breaking Free of Child Anxiety and OCD: A Scientifically Proven Program for Parents, Eli R. Lebowitz, PhD, Gag Reflections: Conquering a Fear of Vomit Through Exposure Therapy, Dara Lovitz and David Yusko, PsD, Emetophobia: A CBT Self-Help Guide for a Fear of Vomiting, Alexandra Keyes & David Veale, Facing Mighty Fears About Throwing Up, Dawn Huebner, Freeing Your Child From Anxiety and/or Freeing Your Child from Obsessive Compulsive Disorder, Tamar Chansky, PhD
Licensed Psychologist Children’s and Adult Center for OCD and Anxiety Penn Valley, Pennsylvania
Emetophobia, or Specific Phobia of Vomiting (SPOV), is one of the most distressing and impairing phobias. Impacting upward of 8% of the population, SPOV has an early age of onset, is chronic in course (van Hout & Bouman, 2012), and interferes significantly in functioning (Veale, 2009). At its most impairing, young people with SPOV are unable to attend school; even in milder cases, SPOV saps joy from youth due to avoidance of previously loved foods, enjoyable activities like parties and extra-curriculars, and family activities like eating out and traveling. Fortunately, CBT can be a highly effective tool for treating SPOV. In this Workshop, case examples will be used to describe how clients with SPOV present, how to differentiate SPOV from other disorders, and how to design an effective, age appropriate course of treatment. Attendees will learn how to develop an individualized SPOV model that focuses on the role of safety behaviors and internal focus of attention as maintaining factors for the disorder. We will also highlight the importance of parental accommodation and discuss the important shift from accommodation to support (Lebowitz, 2021). Participants will learn to develop a hierarchy and carry out effective exposures, which can vary considerably depending on presentation. Consideration will be given to how the COVID pandemic might have impacted rates of SPOV and ethical issues associated with treating this disorder will be addressed. Throughout, focus will be placed on helping youth reclaim joy in their lives by freeing them of this severely impairing anxiety disorder.
Outline: • Workshop will address how to use CBT to treat emetophobia (or specific phobia of vomiting - SPOV) in youth. • Attendees will learn how to develop an individualized SPOV model that focuses on the role of safety behaviors and internal focus of attention as maintaining factors for the disorder. • Consideration will be given to the important role of parental accommodation and how to help parents shift from accommodation to support. • Participants will learn to develop a hierarchy and carry out effective exposures, which can vary considerably depending on presentation. • Ethical issues in the treatment of SPOV will be considered. • Ample case examples will be used to bring the treatment to life.
Learning Objectives:
At the end of the session, the learner will be able to:
Describe how youth with emetophobia present and how to differentiate emetophobia from other disorders.
Lead young clients through the process of developing a model of their emetophobia.
Educate clients about the role of safety behaviors (including parental accommodation) and self-focused attention in the maintenance of emetophobia.
Help a client develop an individualized hierarchy to guide treatment.
Design and carry out exposures with youth across the age range, both in person and via telehealth.
Effectively work with families of youth with emetophobia by addressing parental accommodation and helping parents who themselves are anxious or who have a phobia of vomit.
Resolve ethical dilemmas associated with treating youth with vomit phobia.
Long-term goals: Help clinicians feel comfortable and confident treating emetophobia, a particularly distressing, impairing, and intractable phobia.
Long-term goals: Ensure that clinicians are aware of the most up-to-date research on anxiety in youth, most notably the role of parental accommodation in anxiety maintenance and treatment.