Understanding Needle Phobia & Effective Treatment

How Exposure and Response Prevention (ERP) Can Help Overcome Needle Fear

 

What You'll Learn:

• How needle phobia develops and its common causes

• The real-life consequences of avoiding medical care due to needle fear

• How Exposure and Response Prevention (ERP) is used to treat needle phobia

• How ERP can involve healthcare providers to improve long-term outcomes

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Fear of needles (“trypanophobia”) affects 33-63% of children and 14-38% of adults.

Fears typically emerge between 5-10 years old and can be the result of genetics (i.e., having a parent who also has a phobia) or learned (i.e., viewing others’ negative responses to needles or having a negative personal experience). People who suffer with needle phobia have often had negative experiences at the doctor that may have included restraint, forcible needle administration, or being asked to not return to a care provider following a big emotional or behavioral reaction. A small percentage of people with needle phobia also have vasovagal syncope, a medical condition where their needle fear triggers a sudden drop in blood pressure and subsequent fainting. This experience of loss of control can also fuel the phobia.

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Needle phobia can prevent individuals from receiving essential healthcare.

Not being able to tolerate routine needle procedures can result in sufferers not receiving healthcare such as vaccinations, bloodwork that is necessary to begin or continue taking certain prescriptions, and other potentially life-saving interventions. Some individuals face not being able to attend schools or universities where proof of vaccination is required, not being able to travel internationally without certain vaccinations, or not being able to pursue pregnancy or in vitro fertilization. Many people with needle phobia ultimately avoid going to any healthcare setting.

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Exposure and Response Prevention (ERP) is an evidence-based treatment for needle phobia.

ERP helps patients gradually face the aspects of a needle procedure that they fear (e.g., the appearance of a needle, its proximity to their skin, preparatory activities like applying alcohol to the injection site). This component is called exposure. During exposures, patients practice resisting the use of avoidance strategies (e.g., tensing their muscles, looking away, various forms of escape). This is known as response prevention. For example, we may first design an exposure where a patient spends time looking at cartoon images of needles. We may then choose to graduate to more lifelike images, then videos, and eventually “in vivo” exposures which are closer to “real life.”

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ERP is a collaborative and structured intervention.

All exposures are planned in advance and there are no surprises. I have found it helpful to work directly with a client’s healthcare team to eventually practice exposures in the office. Most healthcare offices are happy to help with exposures given that they have often seen first-hand the reactions of needle phobia sufferers and know the long-term implications of not being able to receive proper healthcare. Through participating in exposures, a patient’s medical providers learn the do’s and don’ts to help their patients receive the care they need.