The Efficacy of The Thrive Programme with Emetophobic Clients: Results of a Survey

by Rob Kelly and Charlotte Allen

We have recently completed a comprehensive examination of Emetophobia and how its symptomology is affected after following a course of the Thrive Programme with one of our Approved and Licensed Thrive Consultants. A summary of the research is provided below. You can also download the full report, by scrolling down the page.

Summary of the research

Background: There has not been much research into the treatment of emetophobia. Veale and Lambrou (2006, p. 139) have stated that “clinicians generally regard it as challenging to treat because of high drop out or a poor response to treatment.” To date, the largest published study exploring the treatment of a fear of vomiting involved only seven participants (Philips, 1985), highlighting that larger scale studies are needed. Additionally, there is likely to be a reporting bias of successful treatment outcomes within the research literature. Veale and Lambrou (2006) found that twenty-nine percent of their sample of vomit phobics had received some form of therapy for their fear, which overall they rated as largely ineffective.

Aims of this study

Rob Kelly has developed a cognitive training programme, the Thrive Programme, which has been designed to help sufferers with a wide range of psychological disorders. Follow-up of and feedback from clients suggested that the Thrive Programme was highly effective at reducing emetophobia symptoms. The efficacy had not, however, been systematically explored. This study, thus, aimed to investigate the effectiveness of the Thrive Programme with emetophobic clients.

Participants: Participants were 61 paying clients with emetophobia, who had undertaken the Thrive Programme. A comparison group of 50 paying clients with other psychological disorders and problems (including general anxiety, social anxiety, sexual problems, depression and weight loss)

Methods: All participants undertook the Thrive Programme. Respondents completed a post-treatment questionnaire online, which explored their symptom severity before and after completing the Thrive Programme. All participants were, also, asked to fill in their scores for measures of locus of control, self-esteem and social anxiety, before and after completing the programme.

Results: The emetophobic participants reported that their phobia had started at a mean age of 11 years (range 5 to 22 years). On average these clients had been suffering from their fear for 23 years. Almost all (61, 98.39%) emetophobic respondents rated their phobia as having a severe impact upon their lives (on a four point scale which included: little to no; modest; significant; severe), with the remaining participant rating the phobia as significant. This was in contrast to the comparison group, of whom the majority (35, 70.00%) rated their symptoms as having a significant impact. Twelve (24.00%) of the comparison group rated their symptoms as severe, two (4.00%) rated them as having a modest impact and one (2.00%) as having little or no impact on their lives. The emetophobic participants also completed a measure of emetophobia severity (ESS), where higher scores represented greater severity and impairment (possible range 0 to 30). Participants scored an average of 25.11 (range 18 to 30).
Emetophobic participants’ initial locus of control, social anxiety and self-esteem scores were compared to those of the comparison group, prior to undertaking the Thrive Programme, using independent samples t-tests. The emetophobic and comparison groups contained unequal sample sizes, with substantially more participants in the emetophobic group, and the assumption of homogeneity of variance was also violated for all measures. T-tests are not robust in the face of violation of homogeneity of variance and unequal sample sizes. As a consequence, the sample sizes were balanced, by selecting a random sample from the emetophobic participants, equal in size to that of the comparison group.

There was a significant difference in the initial social anxiety scores of the emetophobic participants compared to comparison group, with the emetophobes displaying higher levels of social anxiety. There was also a significant difference in the initial self-esteem scores of the emetophobic participants compared to comparison group.

The Thrive Programme Treatment Response
The treatment response of the emetophobic participants was explored. All participants fully completed the Thrive Programme. After finishing the programme, the majority (88.71%) of the emetophobic participants rated their symptoms as having little to no impact on their lives. The remaining seven (11.29%) rated them as having a modest impact.

There was a significant decrease in the emetophobic participants’ Emetophobia Severity Scale (ESS) scores post the Thrive Programme compared to their initial scores: participants’ severity substantially decreased after completing the programme.

The initial and final locus of control, self-esteem and social anxiety scores of the emetophobic participants were also compared and there was a significant decrease in the participants’ locus of control scores after the Thrive Programme

Conclusions:

Findings within this study also indicated that the emetophobic participants had high initial levels of social anxiety, indeed higher than the comparison group, some of which had consulted specifically for social anxiety. This might indicate that social anxiety plays a role in emetophobia and/or is increased by having a fear of vomiting. Additionally there was a significant difference found in levels of self-esteem between the emetophobia and the comparison groups, with the emetophobic group demonstrating lower self-esteem than the comparison group.

The results of this survey suggested that the Thrive Programme is a highly effective treatment for emetophobia, as all participants with a fear of vomiting reported improvements in their condition. Significant improvements were also seen in the participants’ emetophobia severity scale (ESS) scores, with emetophobic clients scoring substantially lower on the ESS after completing the Thrive Programme compared to their initial scores. These initial results support the notion that interventions that challenge emetophobics’ unhelpful beliefs and thinking styles can be successful in substantially improving symptoms.

It should be noted that the emetophobia symptom severity scale needs further research in order explore reliability and validity. Improvements in the ESS scores in this study do, however, agree with the participants’ reported improvements in the extent to which their fear impacted upon their lives, providing validity evidence.

One strength of this study is that it involved a much larger sample than other research exploring the success of treating emetophobia. Previously, the largest study specifically exploring the treatment of a fear of vomiting involved only seven participants (Philips, 1985). Veale and Lambrou (2006) noted that clinicians tend to regard emetophobia as challenging to treat due to high drop out or a poor response to treatment, but, in this study, all participants completed the programme and all reported a substantial improvement in their symptoms. The results of this study, therefore, highlight the potential for wide scale successful treatment of emetophobia.