Abstract
This case report concerns a woman with intellectual disability, schizoaffective disorder, and avoidance and refusal of having her blood drawn. She required but refused blood draws to properly monitor the therapeutic dose of a necessary psychotropic medication. During intervention at a community-based habilitation setting and under simulated conditions, direct-care and supervisory staff (a) gradually exposed her to steps constituting a blood draw, (b) reinforced completed steps (praise and tokens), and (c) offered a monetary incentive to participate in an actual blood draw. Evaluated in a changing criterion design, the woman demonstrated increased compliance and eventually completed blood draws immediately following intervention, months later, and at 12- to 24-month follow-ups. We discuss implications from the case and the advantages of in vivo intervention for overcoming medical fears among people who have intellectual disability.
ACKNOWLEDGMENTS
This study was conducted at May Institute. We acknowledge the contribution of Dr. David Sall.