Psychological intervention with a child experiencing reflex anoxic seizures: A case report

Abstract

Objectives: We describe the case of a ten-year old girl who experienced anoxic seizures in response to medical instruments and settings. The girl was referred to Clinical Psychology and received around fifteen weekly sessions of therapy. We summarise the key strategies and principles of the intervention and outline the positive impact of the work on both the girl and her family. Methods: Intervention utilised an integrated approach including psychoeducation about anxiety, graded exposure to feared stimuli (eg blood pressure monitors), family work, and the use of narrative therapy techniques. It particularly focused on enhancing the girl's ability to cope with triggers and the reduction of unhelpful avoidance behaviours. Results: By the end of the initial treatment phase, the girl was able to have her blood pressure taken by a nurse, tolerate medical settings and watch procedures on the television. Despite increased contact with triggers, she had not experienced any seizures since starting therapy. Both the girl and her parents reported large reductions in anxiety about seizures and increases in their belief in her ability to cope. Standardised measures reflected a fall in the girl's anxiety and depression levels, and in her mother's parenting stress levels. Conclusions: In this case, psychological intervention offered effective support in the management of anoxic seizures. Techniques can be used to reduce the frequency of seizures, to enhance self-efficacy and to lower family anxiety levels. Medical professionals should consider referring children experiencing reflex anoxic seizures and their parents for psychological assessment, intervention and support.