Cognitive-behavioral treatment of an 11-year-old male presenting with emetophobia: A case study

The goal of the current case study was to illustrate an evidence-based assessment and the cognitive-behavioral treatment of an 11-year-old male with emetophobia. A multimodal assessment of the child's anxiety symptoms was conducted, including a semistructured diagnostic interview (Anxiety Disorders Interview Schedule: Child and Parent Versions), parent report (Behavior Assessment System for Children-Second Edition.), and child self-report (Revised Children's Manifest Anxiety Scale and Child Depression Inventory). Emetophobia symptoms were assessed via parent and child report of the Emetophobia Questionnaire. Treatment included graduated exposure, cognitive restructuring, and parent training. Improvement was seen within 22 sessions and maintained at a 6 months follow-up. In addition to a reduction in symptoms of emetophobia, discontinuation of medication, and no longer meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for specific phobia, treatment gains also included a reduction in internalizing and somatization symptoms as well as an increase in the patient's adaptive skills. This case study illustrates the use of CBT along with parent training as an efficacious treatment for children with emetophobia. It also demonstrates how to incorporate simple, everyday technology (i.e., Internet) to simulate exposures that are otherwise difficult to duplicate in the therapy session.