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Cognitive Behavioural Therapy for Paruresis or “Shy Bladder Syndrome”: A Case Study

Published online by Cambridge University Press:  21 July 2016

David Hambrook*
Affiliation:
Talking Therapies Southwark, South London and Maudsley NHS Foundation Trust, UK
Tracey Taylor
Affiliation:
Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, UK
Victoria Bream
Affiliation:
Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, UK
*
Correspondence to David Hambrook, South London & Maudsley NHS Foundation Trust, Talking Therapies Southwark, Middle House, Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK. E-mail: david.hambrook@slam.nhs.uk

Abstract

Background: Paruresis, or “shy bladder syndrome”, is a relatively common anxiety disorder, yet little is known about the causes of, and effective treatments for this disabling condition. Aim: This report describes a case study in which a man (Peter) presenting with paruresis was treated using formulation-driven CBT, which aimed to address the idiosyncratic processes that were maintaining his anxiety and avoidance of urinating in public. Method: Peter attended 12 sessions of CBT including one follow-up session a month after treatment had ended. Treatment involved collaboratively developing an idiosyncratic case conceptualization (identifying longitudinal and cross-sectional factors involved in the development and maintenance of his difficulties), followed by a number of standard cognitive and behavioural interventions commonly used in evidence-based CBT protocols for other anxiety disorders. Peter completed sessional outcome measures of paruresis symptomatology, anxiety, depression, social anxiety and functional impairment. Results: Peter subjectively found the intervention helpful and his scores on all of the outcome measures reduced over the course of his therapy, and were maintained at one month follow-up. Conclusions: This report adds to the scarce literature regarding effective treatments for individuals suffering with paruresis. Limitations of the design are acknowledged and ideas for further research in this area are discussed.

Type
Brief Clinical Reports
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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