An Interdisciplinary Intervention for Fear of Falling: Lessons Learned from Two Case Studies

ABSTRACT

This article describes two case studies using an interdisciplinary intervention for homebound older adults who experience fear of falling, resulting in debility and isolation. The patients discussed received separate home visits from a physical therapist (two and four visits) and psychologist (six and eight visits) and intervention components included an initial assessment of physical ability, prescription of home exercise program, exposure therapy, and cognitive restructuring. Both patients reported satisfaction with the fear of falling intervention and showed improved ability to walk, both in distance and in requiring less assistance. These findings suggest significant positive treatment effects can be achieved through interdisciplinary exposure-based interventions aimed at reducing unrealistic fear of falling and associated avoidance behaviors. Similar interventions should be considered for more systematic evaluation of effects and mechanisms of change as well as inclusion in interdisciplinary treatment planning.

KEYWORDS:

• Anxiety
• exposure
• fear of falling
• older adults
• physical therapy

Acknowledgments

These case studies were completed while one author (JR) was receiving postdoctoral training in clinical psychology supported by the Department of Veterans Affairs.