Dual-Session Tokophobia Intervention, a Novel Ultrashort Cognitive Behavioral Therapy Protocol for Women Suffering From Tokophobia in the Third Term of Pregnancy

Abstract

Tokophobia is a debilitating, relatively prevalent, and undertreated anxiety disorder, which can lead to prenatal, natal, and postpartum adverse effects. This article provides an outline of the Dual-Session Tokophobia Intervention (DSTI), an ultrashort exposure-based cognitive behavioral therapy (CBT) protocol that can be delivered by non-mental-health professionals to women in the third term of pregnancy. The detailed description of the intervention is illustrated by a case study that is part of an ongoing clinical trial, targeting the specific needs of women suffering from Tokophobia near term. DSTI is carried out in two sessions (for a total of 4 hours) with a 1-week interval in between. The intervention protocol presented in this article, to the best of our knowledge, is the first to offer treatment specifically for women near term. It aims to decrease anxiety and provide women and their newborns with better obstetric and psychiatric outcomes. The patient presented was screened by the Fear of Birth Scale and a Structured Clinical Interview for DSM Disorders. She indicated her Subjective Units of Distress on a list of specific fears related to childbirth, before and after the intervention. Following treatment, the patient showed a 70% decrease in SUDS, a cessation of avoidance and information seeking behaviors, a short labor duration and a subjective experience of being able to calm herself during a difficult birth and concentrate on the delivery process. Six weeks postpartum there were no signs of depression or PTSD.