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Public transport EssayThe technique the customer and I used to attempt to help her manage her agoraphobia was to expose her gradually to her fear of un only whentoned spaces. We did this by going for walks increasing the distance each time as the guests anxiety levels decreased. We would not put out distancing until the client could reach a certain agreed point without feeling anxious. During the exposure the client and I would argue how she was feeling and if she became very anxious we would stop and adopt relaxation techniques in the form of breathing. A fuller discussion of these techniques will be discussed later on.The aim was to relax the clients while confronting her with her fear and accordingly build up gradually so she could take a taxi to her fathers flat and take different public transport.When the client reached the stage where she became comfortable with the walking distances we arranged a public transport ride. During the eld prior to the journey we adopt ed visualisation where the client would imagine what would happen in the bus. We would also discuss how she would deal with the situation if she were to suffer an epileptic fit while in a bus or out walking.This technique is a form of behaviour therapy called graded exposure (Atkinson 1993) it is all very come up facilitating the person to understand why she is phobic tho this does not mean the person will be cured of her phobia (Manville 1991).The aim of behaviour therapy is to change the clients behaviour. It micturates on the principle that the behaviour has been learnt, however this did not cause her to change her behaviour.The basic approach of graded exposure is to relax the phobia and therefore introduce her gradually to the object or situation she fears. The nurse canister either do this with the client through visualisation or actual exposure (Atkinson 1993).This client was exposed using visualisation but the technique used the most was direct exposure to the situatio n.The ideas to take the clients smallest fear and confront this first functional up to their largest fear. This is called the graded hierarchy. The clients smallest fear was to go out of her front door and her largest was to be able to motivity on public transport at will. Working towards the clients largest goal gradually is most effective.Clients may discharge their fears much readily if they actually expose themselves to anxiety provoking situations in a sequence of have steps.(Sherman 1972 cited in Atkinson 1993 page 678).Another technique we use to help clients manage her agoraphobia was relaxation techniques.The clients experienced various unpleasant anxiety symptoms usually just before and during the exposure. The client would feel agitated at the sentiment of experiencing anxiety while outside. She would suffer from m either physical symptoms. She would have increased pulse set out, pounding heart, sickness and a dry mouth. She would also sweat and complain of butte rflies in her stomach or churning.As get around of my assignment of the clients anxiety I needed to be able to have observe these feelings and symptoms in the client. so together we could deal with them and ease her uncomfortable state. I asked questions to myself such as Is she sweating? Is her body row suggestive of anxiety? This would mean shaking or agitated moments.During times when the client was anxious she strand it difficult to concentrate and calculate rationally or logically. She found it difficult to name her feelings. These are public reactions. (Wilson and Kneisl 1996).Emotionally the client described herself as tense, nervy, anxious and like Im going to die. The clients would also have minus thoughts about herself. She would say she was silly and useless. So anxiety affected her physical state and cognitions.This anxiety was cause the client to become increasingly isolated in her flat and also affected her self-esteem because she tangle the anxiety controlled her. She recognised the need to control her anxiety, and she wanted to control it and therefore needed to be amend about anxiety and then hopefully she feels more competent to deal with her feelings.The client and I engage in teaching about anxiety. It was explained that anxiety symptoms occur when our brains interpret a given situation as anxiety provoking. (Baker 1995). The subject of our body involved in the replys in these responses is the autonomic nervous system, which is divided into dickens components the Sympathetic and the Parasympathetic systems. The Sympathetic system causes the individual responses to speed up and the Parasympathetic causes the responses to slow down.So when a person encounters an anxiety-provoking situation, for example, a person approaches someone with a knife, does that person run away or stay and fight? This is termed to fight or flight Syndrome and is dependent on the individuals or biological response to the stressor.These responses to stress are quite normal and we need them to protect us from danger. Anxiety becomes a line when a person perceives a situation as a stressor even when it is not.The person will incur it difficult to relax and calm down. The interpretation of their anxiety and unpleasant feelings will in turn reinforce more anxiety. Severe anxiety and panic will interfere with the persons role of functioning and daily vivification as it did with this client. She could not do any of her own shopping or engage in any of her hobbies due to lack of concentration and also could not engage in employment. A consistently supersensitive body will eventually become mentally and physically exhausted which prevents activity and decreases esteem (Weekes 1995).It was grand for the client to be taught the facts because then the client can begin to recognise when she feels anxious and also can realise that it is a normal reaction to stress (Wilson and Kneisl 1996).The client and myself would sit in comfortable chairs and think of a place we associated with being relaxed and peaceful environment, for example, in the farm or beach, then we would imagine ourselves in the peaceful surroundings again.This technique is based on the rationale that muscle tension is the bodys response to anxiety. powerful tension increases the feeling of anxiety and reinforces it. Deep muscle relaxation decreases the tension and blocks the anxiety. It aims to decrease the pulse rate and respiratory rate, blood pressure and perspiration, which are both heightened in anxiety. (Wilson and Kneisl 1996). As the client experienced those feelings the technique seemed relevant to attempt to alleviate the uncomfortable feelings.So graded exposure and relaxation techniques are highly effective when combined together to alleviate fears and phobias. The principles of the treatment are to substitute a response that is dissonant with anxiety, that is, relaxation. It is difficult to be anxious and relaxed all the same time. (Atkins on 1993). beforehand we begin the exposure and relaxation, the client could not even make it as far as the front step outside her front door. By the time the exposure therapy was undergoing she began to gradually improve until more comfortable with going outside. She was far from cured but she was gradually becoming more confident when been exposed.Current research on behaviour therapy supports it as a treatment for agoraphobia. For example Behavioural treatment based on exposure and can provide perdurable relief to the majority of patients. (Giovanne et al 1995 p 87).The education I engaged in with a client regarding relaxation techniques and the biology of anxiety could be said but to be health prolonging. We were trying to work together to empower the clients to make her own decisions about her treatment based on the knowledge of her illness. erst she understood her illness she could begin to make health choices. This education may affect her perception of her illness. perceive health stresses play a role in the frequency of health promotion behaviour (Pencle 1987). Before we began the therapies the client had a very negative opinion of herself and her abilities, this affected her self-esteem and therefore her experiences of well being. then this affected her perceptions of her illness. Through education, knowledge and practice the client began to fill more positive and began making more decisions about her health and treatment. These examples of decision-making could then be reinforced to her to emphasise the value of good health. (Pender 1987).