Usefulness of a trauma‐focused treatment approach for travel phobia

Abstract

Despite its prevalence and potential impact on functioning, there are surprisingly little data regarding the treatment responsiveness of travel phobia. The purpose of this non-randomized study was to evaluate the usefulness of a trauma-focused treatment approach for travel phobia, or milder travel anxiety arising as a result of a Road Traffic Accident (RTA). Trauma-focused Cognitive Behavioural Therapy (TF-CBT), and Eye Movement Desensitization and Reprocessing were used to treat a sample of 184 patients who were referred to a psychological rehabilitation provider.Patients in both treatment groups were encouraged to encounter their feared objects and situations between sessions. Specific (i.e. travel) phobia was diagnosed in 57% of cases. Patients in both treatment conditions showed equally large, and clinically significant, decreases in symptoms as indexed by three validated measures (Impact of Event Scale, Hospital Anxiety and Depression Scale, and General Health Questionnaire), therapist ratings of treatment outcome, and a return to driving or travelling by car or motorbike. These improvements were obtained within an average course of 7.3 sessions of one hour each. Patients with travel phobia responded with a greater reduction of anxiety and PTSD symptoms than those with milder travel anxiety. Passengers reported higher levels of trauma symptoms than drivers, but no difference in effectiveness of treatment was found between these groups. The results suggest that trauma-focused psychological interventions can be a treatment alternative for patients with travel anxiety. Given the seriousness of the clinical problems related to RTAs more rigorous outcome research is warranted and needed.3 Key Practitioner Message:• As the literature on the treatment of travel phobia is largely limited to small-n studies, this is the largest naturalistic outcome study of the treatment of patients with fear and avoidance of travel, subsequent to a traumatic event, to date.• Travel phobia following RTAs should be regarded as a treatable psychological condition requiring a limited number of sessions. In a significant minority of cases the condition is unlikely to remit spontaneously, potentially disrupting occupational, social and personal adjustment• Besides a purely exposure, in vivo based approach, a mainly trauma-focused approach such as imagery exposure or EMDR can be an effective intervention for both travel phobia and milder forms of travel anxiety, and for both drivers and passengers.

Survivors’ experiences of consequences and recovery five years after a major bus crash

“…Travel phobia was diagnosed in 57% of cases. Patients showed clinically significant decreases in symptoms, and the improvements were obtained within an average course of seven sessions of one hour each . The symptomologies of PTSD and travel phobia after RTCs have been found to overlap, implying that psychological interventions would benefit both conditions .…”

The impact of eye movements and tones on disturbing memories involving PTSD and other mental disorders

“…To this end, EMDR is increasingly applied as a treatment for other (anxiety) disorders (De Jongh & Ten Broeke, 2009), such as driving phobias (De Jongh, Holmshaw, Carswell, & van Wijk, 2011), and other conditions and symptoms that developed following an adverse event (see for instance De Jongh & Ten Broeke, 2010;Maxfield & Melnyk, 2000). If the working memory model is a valid explanation for what occurs during EMDR, it would mean that taxing working memory is effective in resolving negative memories that play a role in, or underlie, a broad variety of psychological symptoms and conditions.…”

Efficacy of a trauma‐focused treatment approach for dental phobia: a randomized clinical trial

“…Eye Movement Desensitization and Reprocessing (EMDR) represents an internationally well‐established and empirically validated treatment of PTSD . Some recent studies hinted on the beneficial effect of EMDR in patients with specific phobias . Indeed, one study, using a multiple baseline design, showed a significant reduction of self‐ and observer‐rated anxiety, dysfunctional beliefs concerning dental treatment, following two to three sessions of EMDR .…”