Helping triumph over phobia

When a colleague asked if I would be interested in running a support group for people with phobias, I was enthusiastic to find out more. Aware of long NHS waiting times, I was keen to get involved in a group that helps provide almost instant access to support. From my first meeting at TOP (Triumph Over Phobia) Kentish Town, I was hooked. This UK charity helps individuals with phobias, OCD and other anxiety disorders find ways to overcome their fears. The groups follow a self-help model of cognitive behaviour therapy (CBT) and exposure therapy. Working as an assistant psychologist in the NHS I have experience using CBT with patients and was interested to transfer these skills to a self-help group.

Often the group leaders are past group members. I strongly value the different skills and viewpoints that my colleague and I bring to the sessions, myself from a therapeutic background and my colleague bringing experience as an ex-sufferer having once attended the group herself. Our role is to provide a warm and encouraging space where we help members set and monitor goals and work through weekly tasks to face their fears.

The range of difficulties brought to the groups is varied with emetophobia (fear of vomit) agoraphobia, claustrophobia, OCD, hoarding and social anxiety to name just a few. Through structured sessions, homework tasks and a supportive environment, members work through their anxieties step by step. The exposure is graded and guided by the individuals' goals and what they feel comfortable working towards.  

Each week we discuss how they got on with their homework. Rating their anxiety before, during and after each task helps us monitor progress. We then help them decide their next step, often reviewing their short- and long-term goals to assist with decision making. We are also creative in developing ideas for exposure within sessions. We have written plays for a member with social anxiety to perform to the group and found recordings of vomit sounds to help with emetophobia. If members are struggling with what to do next we come up with different ideas and they chose what they feel ready for. We recently revisited the vomit audio and it was so rewarding to see the member laughing along, when previously this task would have been almost intolerable.

A particular challenge I have faced was moving away from the more directive role of a therapist to the motivational approach required of a group leader. Welcoming new members can also be challenging, as you are engaging individuals in something completely new and asking a lot by requesting that they put themselves in situations that are very anxiety provoking.

After a recent new member observed the first session and gave a detailed history of their difficulties, we explained the group would focus on the present. The next session they soon went off topic and I had to be firm, bringing them back to the focus of our discussion. Balancing empathy with structure can be difficult, and it can feel uncomfortable being assertive, but this structure and focus enables members to target a specific problem and achieve their goals.

Members soon become independent with their goals and homework setting, and it is rewarding to see how quickly people make progress. Endings can be difficult, and part of my role is helping members recognise when it might be time for them to start working towards leaving the group.

This new role as Group Leader for TOP-UK has expanded my clinical knowledge and experience. Not only has it given me insight into the part clinical psychology can play outside of the NHS, it has also given me experience with a new clinical population. Watching more experienced group members share their insight and advice to help the newer members of the group has been valuable; the whole group collaborates and works together. TOP-UK value their volunteers and I have benefited from training days where evidence-based theories are discussed alongside real-life experiences to help our learning. Discussions about our own fears and anxieties highlighted for me how we all have fears and anxieties, but it is how they affect us that can be very different.

I am so pleased to be given this opportunity to help people help themselves. It has been a pleasure to work alongside these individuals and watch them achieve their goals. It has also been a valuable learning experience for me; I have already learned so much more about these difficulties through my time at the group and look forward to continuing my work with TOP-UK.

At TOP-UK we are keen to spread the word that help is here. If you or someone you know is suffering from a phobia, OCD or other anxiety disorder or if you are interested in finding out more about the charity please get in touch:
01225 422705, [email protected]
www.topuk.org