Mindanao State University

College of Health Sciences

Marawi City

RESOURCE UNIT

PHOBIA
Prepared By: CAMID, Abdul Azis G.

General Objective: Within 15 minutes, the assigned student nurse will be able to discuss about the phobia to the learners.

SPECIFIC TOPICS/CONTENT METHODS/LEARNING TIME REFERENCES EVALUATION

OBJECTIVES ACTIVITIES FRAME
At the end of this Assalamualaykum and good afternoon, student Brief lecture discussion in 15 mins. Hope, I. (2018). Phobia Disorders At the end of the health
learning nurses! I am Abdul Azis Camid, you can call me an interactive way and Nursing Management. Retrieved on teaching, the presenter
experience, the Ace. For today’s class, I will be presenting and using a language that is 28th March 2023, at will assess the learners
discussing to you one of the most intriguing parts understandable to the
learner will be able https://rnspeak.com/phobia- through reflective
in Psychiatric Nursing which is PHOBIA or audience.
to: PHOBIC DISORDERS. disorders-nursing-management/ questions. The learners
Factsheets will also be will be asked questions
• Learn about the Let us first define what is phobia. distributed to facilitate the RNpedia. (2023). Phobias. related to the topic
definition of effectiveness of health Retrieved on 28th March 2023, at discussed and must be
phobia Definition https://www.rnpedia.com/nursing- able to answer.
A phobia is an illogical, intense, and persistent fear teaching. notes/psychiatric-nursing-
of a specific object or a social situation that causes
• Learn the notes/phobias/
extreme distress and interferes with normal
different types functioning.
of phobias Videbeck, S. (2020). Psychiatric-
Phobias usually do not result from past negative Mental Health Nursing Eight Edition.
• Learn about experiences. Wolter Kluwer: Philadelphia.
cause and risk
factors of In fact, the person may never have had contact Wayne, G. (2023). Fear Nursing
with the object of the phobia.
phobia Care Plans. Retrieved on 28th March
People with phobias have a reaction that is out of 2023, at
• Learn about the proportion to the situation or circumstance. https://nurseslabs.com/fear/
signs and
Some individuals may even recognize that their fear
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College of Health Sciences
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symptoms of is unusual and irrational but still feel powerless to

phobia stop it (Kimmel & Roy-Byrne, 2017).

People with phobias develop anticipatory anxiety

• Learn the
even when thinking about possibly encountering
different the dreaded phobic object or situation.
medical
treatment for They engage in avoidance behavior that often
phobia severely limits their lives. Such avoidance behavior
usually does not relieve the anticipatory anxiety for
• Learn about the long.
different
There are three categories of phobias:
nursing • Agoraphobia, which is fear of being in places
interventions or situations from which escape may be difficult
or help may not be readily available; fear with
being alone or in public places
• Specific phobia, also called simple phobia,
which is an irrational or persistent fear of a
particular object or a situation
• Social anxiety or phobia, which is anxiety
provoked by certain social or performance
situations

Many people express “phobias” about snakes,

spiders, rats, or similar objects. These fears are
specific, easy to avoid, and cause no anxiety or
worry. The diagnosis of a phobic disorder is made
only when the phobic behavior significantly
interferes with the person’s life by creating marked
distress or difficulty in interpersonal or occupational
functioning.

Specific phobias are subdivided into the

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College of Health Sciences
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following categories:
• Natural environmental phobias: fear of
storms, water, heights, or other natural
phenomena
• Blood–injection phobias: fear of seeing
one’s own or others’ blood, traumatic injury, or
an invasive medical procedure such as an
injection
• Situational phobias: fear of being in a
specific situation such as on a bridge or in a
tunnel, elevator, small room, hospital, or
airplane
• Animal phobia: fear of animals or insects
(usually a specific type; often, this fear
develops in childhood and can continue through
adulthood in both men and women; cats and
dogs are the most common phobic objects)
• Other types of specific phobias: for
example, fear of getting lost while driving if not
able to make all right (and no left) turns to get
to one’s destination.

In social phobia, also known as social anxiety

disorder, the person becomes severely anxious to
the point of panic or incapacitation when
confronting situations involving people. Examples
include making a speech, attending a social
engagement alone, interacting with the opposite
sex or with strangers, and making complaints. The
fear is rooted in low self-esteem and concern about
others’ judgments. The person fears looking
socially inept, appearing anxious, or doing
something embarrassing such as burping or spilling
food. Other social phobias include fear of eating in
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public, using public bathrooms, writing in public, or

becoming the center of attention. A person may
have one or several social phobias; the latter is
known as generalized social phobia.

Cause
Specific phobias usually occur in childhood or
adolescence. In some cases, merely thinking
about or handling a plastic model of the dreaded
object can create fear.

Specific phobias that persist into adulthood are

lifelong 80% of the time. The peak age of onset for
social phobia is middle adolescence; it sometimes
emerges in a person who was shy as a child. The
course of social phobia is often continuous, though
the disorder may become less severe during
adulthood. Severity of impairment fluctuates with
life stress and demands.

Risk Factors
• Learning theory
o The belief that phobias are learned and
become conditioned responses when
the client needs to escape an
uncomfortable situation.
• Cognitive theory
o Phobias are produced by anxiety-
inducing self-instructions of faulty
cognitions.
• Life experiences
o Certain life experiences, such as
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traumatic events, may set the sage for

phobias later in life.

Signs and Symptoms

• Withdrawal
• High levels of anxiety
• Inability to function and meet self-care needs
• Inappropriate behavior used to avoid the feared
situation, object, or activity
• Dysfunctional social interactions and
relationship

Medical Treatment
• Behavioral Therapy
o Behavioral therapy works well.
Behavioral therapists initially focus on
teaching what anxiety is, helping the
client identify anxiety responses,
teaching relaxation techniques, setting
goals, discussing methods to achieve
those goals, and helping the client
visualize phobic situations.
o Therapies that help the client develop
self-esteem and self-control are
common and include positive reframing
and assertiveness training.
o One behavioral therapy often used to
treat phobias is systematic (serial)
desensitization
o Systematic Desensitization
➢ process of gradual exposure to
phobic object or situation aimed
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at decreasing the fear and

increasing the ability to function
in the presence of phobic
stimulus
➢ in which the therapist
progressively exposes the client
to the threatening object in a
safe setting until the client’s
anxiety decreases.
➢ During each exposure, the
complexity and intensity of
exposure gradually increase, but
the client’s anxiety decreases.
The reduced anxiety serves as a
positive reinforcement until the
anxiety is ultimately eliminated.
➢ For example, for the client who
fears flying, the therapist would
encourage the client to hold a
small model airplane while
talking about his or her
experiences; later, the client
would hold a larger model
airplane and talk about flying.
Even later, exposures might
include walking past an airport,
sitting in a parked airplane, and,
finally, taking a short ride in a
plane. Each session’s challenge
is based on the success achieved
in previous sessions (Huppert &
Foa, 2017).
➢ Flooding is a form of rapid
desensitization in which a
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behavioral therapist confronts

the client with the phobic object
(either a picture or the actual
object) until it no longer
produces anxiety.
• Because the client’s
worst fear has been
realized and the client
did not die, there is little
reason to fear the
situation anymore. The
goal is to rid the client of
the phobia in one or two
sessions. This method is
highly anxiety producing
and should be conducted
only by a trained
psychotherapist under
controlled circumstances
and with the client’s
consent.
• Administration of antianxiety
medications
o Benzodiazepine - Alprazolam (Xanax):
social phobia, agoraphobia
o Nonbenzodiazepine anxiolytic -
Buspirone (BuSpar): social phobia
o Tricyclic antidepressant - Imipramine
(Tofranil): agoraphobia
o SSRI (Selective serotonin reuptake
inhibitor) antidepressant - Paroxetine
(Paxil) & Sertraline (Zoloft): social
phobia
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College of Health Sciences
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Nursing Interventions
• Determine the type of the patient’s fear
by thorough, rational questioning and
active listening.
o The external cause of fear can be
known. Patients who find it
unacceptable to expose fear may find it
convenient to know that someone is
willing to listen if they choose to share
their feelings at some time in the future.
• Assess the behavioral and verbal
expression of fear.
o This information provides a foundation
for planning interventions to support
the patient’s coping strategies.
• Evaluate the measures the patient
practices to cope with that fear.
o This information helps determine the
effectiveness of coping strategies used
by the patient.
• Learn to what extent the patient’s fears
may be influencing his or her ability to
function.
o Anti-anxiety medications or referral to
specially designed treatment programs
is necessary for persistent, immobilizing
fears. Patient safety must always be a
priority.
• Open up about your awareness of the
patient’s fear.
o This approach validates the feelings the
patient is holding and demonstrates
recognition of those feelings.
• Discuss the situation with the patient and
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College of Health Sciences
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help differentiate between real and

imagined threats to well-being.
o This approach helps the patient deal
with fear.
• Tell the patient that fear is a normal and
appropriate response to circumstances in
which pain, danger, or loss of control is
anticipated or felt.
o This reassurance places fear within the
field of normal human experiences.
• Be with the patient to promote safety,
especially during frightening procedures
or treatment.
o The physical connection with a trusted
person helps the patient feel secure and
safe during a period of fear.
• Maintain a relaxed and accepting
demeanor while communicating with the
patient.
o The patient’s feeling of stability
increases in a peaceful and non-
threatening environment.
• Familiarize the patient with the
surroundings as necessary.
o Familiarity with the setting promotes
comfort and a decrease in fear.
• Provide accurate information if irrational
fears based on incorrect information are
present.
o Replacing inaccurate beliefs with
accurate information reduces anxiety.
• If the patient’s fear is a reasonable
response, empathize with him or her.
Avoid false reassurances and be truthful.
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o Reassure patients that asking for help is

both a sign of strength and a step
toward the resolution of the problem.
• Use simple language and easy-to-
understand statements regarding
diagnostic procedures.
o The patient may find it hard to
understand any given explanations
during excessive fear. Simple, clear, and
brief instructions are necessary.
• Maintain a quiet environment whether at
home or in a hospital setting. Drop any
unnecessary stuff around the patient.
o The patient’s fear is not reduced and
resolved if the environment is unsafe.
• Provide safety measures within the home
when indicated (e.g., alarm system,
safety devices in showers or bathtubs).
o The patient’s fear will not be reduced or
resolved if the home environment is
unsafe.
• Support the patient in recognizing
strategies used in the past to deal with
fearful situations.
o This method allows the patient to think
that fear is a natural part of life and can
be dealt with successfully.
• As the fear subsides, encourage the
patient to be involved in specific events
preceding the onset of the fear.
o Recognition and explanation of factors
leading to fear are vital in developing
alternative responses.
• Allow the patient to have rest periods.
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College of Health Sciences
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o Relaxation improves the ability to cope.

The nurse needs to pace activities,
especially for older adults to conserve
the patient’s energy.
• Suggest the patient bring comforting
objects when away from home.
o This method can enhance feelings of
security in a new environment.
• Access community resources to meet the
fearful needs of the patient and family
(e.g., spiritual counselor, social worker).
o Appropriate resources render organized
and regulated patient care that
indicates supportive healthcare service.
• Initiate alternative treatments. Provide
verbal and nonverbal (touch and hug with
permission) reassurances of safety if
safety is within control.
o Meditation, prayer, music, Therapeutic
Touch, and healing touch techniques
help lighten fear.
• Refer to cognitive behavioral group
therapy.
o A reward that comes from participating
in a group is the opportunity to meet
others with the same problem. Even if
not everyone will have the same
triggers or severity of symptoms, it is
helpful to know that the patient realizes
that he or she is not alone.

So, that concludes my discussion about phobia and

before I end my presentation, I will present a short
activity in a form of video presentation to evaluate
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College of Health Sciences
Marawi City

RESOURCE UNIT

your knowledge about what we have discussed

about earlier.

Are you all familiar with “Duet and Blind React”

videos in TikTok? Our activity will be similar to it
and I hope you will correctly answer all of the
questions on the video.

(play the video)

Finally, we are done with our topic about phobia. I

hope you have learned something about it and if
you know or identified some phobias you have, I
hope you will be able to overcome it. I am ending
my presentation with a quote from Bear Grylls, a
famous British adventurer,

“Being brave isn’t the absence of fear. Being brave

is having that fear but finding a way through it.”

Thank you and padayon, future nurses!