Phobias

The Fear Survey Schedule-Revised, described in Table 12.10, is useful for identifying specific fears. When it is clear that the child’s anxiety is confined to a specific group of stimuli or situations, such as the dark, particular animals, dental treatment or a specific medical procedure, the child and the parents may be given an explanation of the cognitive, affective-somatic and behavioural components of anxiety. If no clear precipitating event caused the phobia, it is sufficient to say that being frightened of potentially dangerous situations is a good survival skill but that for some children it becomes overdeveloped and generalizes to situations which are not dangerous for reasons we do not understand. These fears become self-perpetuating when children enter feared situations briefly and then withdraw before their anxiety has reached a peak and begun to subside. The next time, the same situation will be even more frightening for them. Treatment following from this understanding of phobic anxiety involves exposure to feared situations until anxiety subsides (King, Muris & Ollendick, 2004; Ollendick et al., 2004).