Cognitive-Behavioral Treatment of Tomophobia (Fear of Medical Procedures) Using an Innovative, Virtual-Reality-Augmented Approach: A Case Study in a Patient With Breast Cancer

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Cognitive and Behavioral Practice Pub Date : 2026-08-01 Epub Date: 2025-12-11 DOI:10.1016/j.cbpra.2025.12.002

Tamara M. Williamson, Pamela Hebbard, Renée El-Gabalawy

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引用次数: 0

Abstract

Most patients experience elevated anxiety prior to surgery; however, a subset of these individuals will present with clinically significant preoperative anxiety and meet criteria for tomophobia. Tomophobia is a subtype of Specific Phobia characterized by an intense fear of medical procedures, which can lead to avoidance of necessary, even lifesaving, interventions. Despite its clinical significance, research on tomophobia remains limited, and best-practice interventions are not well established. This case study illustrates a promising Cognitive Behavioral Therapy (CBT) approach that incorporates interdisciplinary care and innovative exposure methods using virtual reality (VR). The patient was a treatment-naïve middle-aged woman who was refusing necessary surgical care for breast cancer due to a fear of surgery (i.e., Specific Phobia, Blood-Injection-Injury Type). Assessment and treatment were delivered over 12 preoperative sessions with one postoperative follow-up session. Engagement in treatment resulted in functional improvements, including willingness to undergo surgery, and clinically significant reductions in the validated Severity Measure for Specific Phobia (intake score = 25; final preoperative session score = 7; postoperative session score = 5). This case study highlights how interdisciplinary care and VR can be integrated to systematically expose patients to typically inaccessible yet triggering environments, such as the operating room, providing useful guidance for clinicians treating tomophobia and significant preoperative anxiety.

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使用创新的虚拟现实增强方法治疗Tomophobia（对医疗程序的恐惧）：一个乳腺癌患者的案例研究

大多数患者在手术前焦虑升高；然而，这些个体中的一小部分会表现出临床上显著的术前焦虑，并符合恐惧症的标准。恐惧症是一种特殊恐惧症的亚型，其特征是对医疗程序的强烈恐惧，这可能导致避免必要的，甚至是挽救生命的干预。尽管它具有临床意义，但对tomophobia的研究仍然有限，并且最佳实践干预措施尚未得到很好的确立。本案例研究说明了一种有前途的认知行为疗法（CBT）方法，该方法结合了跨学科护理和使用虚拟现实（VR）的创新暴露方法。该患者为treatment-naïve中年妇女，因害怕手术（即特异性恐惧症，血液注射损伤型）而拒绝接受必要的乳腺癌手术治疗。术前12次评估和治疗，术后1次随访。参与治疗导致功能改善，包括接受手术的意愿，以及经验证的特定恐惧症严重程度量表的临床显著降低（摄入评分= 25；最终术前评分= 7；术后评分= 5）。本案例研究强调了如何将跨学科护理和虚拟现实技术相结合，系统地将患者暴露在通常无法进入但会触发的环境中，如手术室，为临床医生治疗tomophobia和显著的术前焦虑提供有用的指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cognitive and Behavioral Practice PSYCHOLOGY, CLINICAL-

CiteScore

4.80

自引率

3.40%

发文量

118

审稿时长

84 days

期刊介绍： Cognitive and Behavioral Practice is a quarterly international journal that serves an enduring resource for empirically informed methods of clinical practice. Its mission is to bridge the gap between published research and the actual clinical practice of cognitive behavior therapy. Cognitive and Behavioral Practice publishes clinically rich accounts of innovative assessment and diagnostic and therapeutic procedures that are clearly grounded in empirical research. A focus on application and implementation of procedures is maintained.