Collaborative Treatment of Choking Phobia in an Older Adult

Abstract

This article describes the case of a 69-year-old man with a long history of swallowing difficulties and a past diagnosis of obsessive-compulsive disorder. He was seen for treatment by a speech-language pathologist and a clinical psychologist. Prior to treatment, he ate only one type of sweet dessert and some pureed foods, at restricted times of the day, and without others present. Treatment focused on increasing variety in his diet, increasing bolus size, reducing ritualistic and safety behaviors, and eating in social situations. Treatment methods included surface electromyographic biofeedback and systematic desensitization. After 19 months of treatment (49 sessions), the patient was able to eat a variety of soft/ground foods. He gained weight and was able to eat in social situations. At post-treatment, 8-month and 48-month follow-up, he reported being satisfied with his progress and did not wish to pursue further goals involving eating solid foods or increasing bolus size of liquids.