We present a case of an eight-year-old boy with a specific phobia of vomiting who developed subsequent food restrictionand weight loss. Our case report includes a review of treatment modalities for specific phobias including cognitivebehavioural and exposure therapy in young children and the importance of parental involvement in the treatment process.After an initial assessment and diagnosis of this boy with emetophobia, treatment took place over ten subsequent visits,one hour each in duration. His treatment included a cognitive approach utilizing exposure therapy to re-introduce foodsto his diet, working through a fear hierarchy, addressing cognitive distortions/misconceptions and psychoeducationalsupports. Intermittent reinforcement was applied to help extinguish what we believe was an associatively learned fear ofvomiting. Outcomes of the treatment were measured by changes in behaviour and overall increase in food intake reportedby the patient’s parents. On completion of treatment, the family was no longer concerned with the amount and variety offood he was eating, the patient reported less nausea, and he was more likely to eat in public. A post-treatment three-weektelephone follow-up showed continued gains. Congruent with reported literature, this case confirms and highlights theefficacy of exposure therapy and age-appropriate cognitive treatment adaptations in treatment of emetophobia. In addition,parental education and participation is recommended in treatment of child cases.
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