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Childhood Fears and Phobias: Assessment and Treatment Export

Child and Adolescent Mental Health, Vol. 10, No. 2. (May 2005), pp. 50-56.

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"Phobic adolescents, in our experience, are able to participate and benefit from the systematic desensiti-sation package developed by Wolpe (1958). However, variants of systematic desensitisation are usually required for children reflecting their level of physical maturation and cognitive-verbal skills. Common vari-ants include graduated real–life desensitisation pro-grams as developed by Pomerantz et al. (1977) for the treatment of a 4-year-old child with severe water phobia. Following training in the treatment procedure, the mother was responsible for the implementation of the program at home. After 11 ·30-minute sessions, the extreme anxiety and avoidance previously exhibited at bath time were no longer observed. Referred to as emotive imagery, another creative variant is the use of narrative stories in which the child, with the help of hero figures such as Superman or Inspector Gadget, over-comes his/her fear of darkness or burglars following a graduated hierarchy (Lazarus & Abramovitz, 1962; King, Cranstoun, & Josephs, 1989; King, Molloy et al., 1998). At least eight group studies have been reported (e.g. Cornwall, Spence, & Schotte, 1996; Kuroda, 1969; Miller et al., 1972; Ultee, Griffioen, & Schellekens, 1982). Consistent with our earlier observation, one study (Ultee et al., 1982) found that in vivo desensiti-sation was more effective than imaginal desensitisation with 5–11-year-olds. At older ages, imaginal and in vivo desensitisation appeared to be equally effective."

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