Agoraphobia is typically understood as a type of anxiety disorder (Kivi, 2018), one that can significantly impact the lives of your clients. It generally encompasses “a fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong” (“Overview – Agoraphobia,” 2018). This fear can manifest in a variety of situations, such as in open or enclosed spaces, crowded areas, or even when using public transportation (“Agoraphobia,” 2017).
Professional counsellors have a unique opportunity to help guide clients through difficult times, including those who suffer from agoraphobia. In some cases, the fear can be so extreme and overwhelming that it can prevent individuals from leaving their home (“Agoraphobia,” 2017). As a professional counsellor, you can use your knowledge and skills to support agoraphobic clients in better coping with their fears.
Here, we provide an in-depth look into agoraphobia, offering ways for counsellors to better understand and help those who suffer from it.
Understanding Agoraphobia and the Associated Symptoms and Causes
According to the U.K. National Health Service, “Agoraphobia usually develops as a complication of a panic disorder, an anxiety disorder involving panic attacks and moments of intense fear” (2018). This can occur as individuals associate specific places or situations with panic attacks, and proceed to avoid them (“Overview – Agoraphobia,” 2018).
Panic attacks can range in severity, though they can be identified by some of the following symptoms: chest pain, racing heart, shortness of break, dizziness, numbness, sweating, and nausea, to name a few (Kivi, 2018). Individuals who experience these symptoms might begin to change their behaviour, engaging in “avoidance” (“Overview – Agoraphobia,” 2018). Here, they would seek out company when going out or rely on online transactions as a way to decrease exposure to those stressful situations.
Those interested in pursuing a counsellor therapist career might be interested to know that agoraphobia can be linked to traumatic childhood experiences (death of a parent or sexual abuse), bereavement, other stressful events, or previous history of mental illnesses (“Causes – Agoraphobia,” 2018). The disorder has also been associated in research with a family history of agoraphobia, and sometimes with substance abuse (Kivi, 2018). Additionally, individuals might develop agoraphobia as a result of fears related to “crime, terrorism, illness, or being in an accident” (“Causes – Agoraphobia,” 2018). By understanding these symptoms and causes, counsellors can become better prepared to help clients with agoraphobia navigate and overcome their fears.
Using Counselling Skills to Provide Proper Support to Agoraphobic Clients
Professional counselling skills can significantly impact clients’ wellbeing and quality of life. When dealing with a client known to be agoraphobic, it’s important to be patient and supportive throughout the process of counselling, ensuring that the client is comfortable and ready to make progress. In these cases, counsellors can impart valuable self-help techniques to help agoraphobic clients navigate panic attacks—like staying in place, focusing on visible and non-threatening things, and breathing deeply and slowly (“Overview – Agoraphobia,” 2018).
Counsellors might also be interested in learning about the therapeutic treatments used to help those with agoraphobia, ranging from psychotherapy to exposure therapy. Cognitive Behavioural Therapy (CBT) is considered the “most common form of psychotherapy” used to treat agoraphobia (Kivi, 2018).
Through this technique, mental health professionals can teach clients to break down negative thoughts and feelings and work towards building better, healthier behaviours. The effectiveness of this method can be seen through a naturalistic study, which set out to evaluate the long-term outcomes (psychological health, health-related quality of life, quality of life, and treatment satisfaction) of CBT for panic disorder and agoraphobia. In a sample size of 68 patients with an average follow-up time of 23.8 years since treatment, 98% have experienced a 50% reduction in the PARS-total score (Phobic Avoidance Rating Scale) and 93% were satisfied with the outcomes (Bilet et al., 2020).
While those completing a professional counselling diploma may not be equipped to use all of the available therapeutic interventions for agoraphobia, it’s helpful to know of them in view of any additional therapies a client may be receiving from a wider team of health professionals. This ensures that the client will be receiving the best possible level of support available to them through counselling and other possible interventions.
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Bilet, T., Olsen, T., Andersen, J. R., & Martinsen , E. W. (2020). Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up. BMC Psychiatry, 20. https://doi.org/https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02679-w.
Kivi, R. (2018, August 17). Agoraphobia: Types, Causes, and Symptoms. Agoraphobia: Types, Causes, and Symptoms – Healthline. https://www.healthline.com/health/agoraphobia.
Mayo Foundation for Medical Education and Research. (2017, November 18). Agoraphobia . Agoraphobia – Symptoms and causes – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/agoraphobia/symptoms-causes/syc-20355987.
United Kingdom National Health Service. (2018, December 18). Causes – Agoraphobia. Causes – Agoraphobia – NHS. https://www.nhs.uk/mental-health/conditions/agoraphobia/causes/.
United Kingdom National Health Service. (2018, December 18). Overview – Agoraphobia. Overview – Agoraphobia – NHS. https://www.nhs.uk/mental-health/conditions/agoraphobia/overview/