Flooding treatment of phobia to having her feet touched by physiotherapists, in a young woman with Down's syndrome and a traumatic brain injury

Abstract

This case study describes the treatment of a 32-year-old woman with Down's syndrome and a recent head injury, for phobia to treatment of her feet by physiotherapists. The phobia had the potential to severely limit rehabilitation progress in terms of the client regaining the ability to stand, assist with transfers (including to and from a car), and walk. A single session, in vivo, flooding intervention was used. The treatment resulted in a substantial change in tolerance of physiotherapists' touching of feet to the extent rehabilitation was able to proceed within the bounds of expectation had a phobia not been evident. Benefits were maintained at multiple follow-ups. The results of the case study extend the evidence for the utility of such behavioural interventions to people with complex disability and unusual phobias in neurological rehabilitation systems.

Acknowledgments

Thanks are expressed to the clinical staff of the Godwin Unit and to Ms Julie Lloyd, Consultant Clinical Psychologist, Surrey Hampshire Borders NHS Trust (for learning disability consultation). Helen Wain contributed graphic design.

Code of Practice: As there exists the potential to exacerbate a condition if correct procedures are not followed, only those with appropriate training should carry out interventions such as that described in this article. Treatments should be conducted under guidelines for good practice such as Guidelines for Good Practice of Behavioural and Cognitive Psychotherapy (British Association for Behavioural and Cognitive Psychotherapy, 2004).