Treatment for Injection Anxiety (Workbook and Manual available)

Fear of needles and injections is common. At least 3.5% of Americans have an injection phobia severe enough to prevent them from receiving injections, while as many as 22% have milder forms of injection phobia and anxiety that make it difficult for them to receive injections. Increasingly medications are being developed that can only be injected. In multiple sclerosis ( MS ) for example, the disease modifying medications must be injected – some subcutaneously (i.e., under the skin) and some intramuscularly ( i.e., directly into the muscle ) – from once every other day to every week. Medications that must be injected on a regular basis are used to treat a variety of other diseases as well, including diabetes, HIV, chronic infection, fertility problems, migranes, and many others. Usually it is recommended that people prescribed these medications learn to self-inject. However, people with injection anxiety or phobia often cannot self-inject and must rely on others to perform the injection.

Our research has found that up to 50% of people who are prescribed medications requiring intramuscular injection are unable to self-inject because of their injection anxiety. This means that other people must be trained to perform the injection (e.g., a family member), or the person must go to a clinic to obtain the injections. We found that people who were not able to self- inject due to injection anxiety were much more likely to discontinue taking the medication. We have therefore developed a brief model of counseling to teach people to overcome their injection anxiety and learn to self inject. An initial pilot of our self-injection counseling program showed that it was highly successful in teaching people to self-inject. We are currently completing a trial of the intervention that will more definitively test whether or not this program is effective at teaching self-injection.

Workbook and Manual

The manual and workbook are copyrighted. We make them available to patients and counselors free of charge. To read them you will need Adobe Acrobat Reader. If you need a copy of Acrobat Reader, go to the Adobe website and follow the instructions to download Acrobat Reader free of charge.

To obtain the workbook or manual, visit the links below:

Patient Injection Workbook (1,222 KB) - for patients wanting to manage

Self-injection Anxiety Counselor Injection Manual (254 KB) - for counselors working with patients managing self-injection anxiety.

References

Mohr, D.C., Cox, D., Epstein, L., Boudewyn, A. (2002). Teaching patients to self-inject: pilot study of a treatment for injection anxiety and phobia in multiple sclerosis patients prescribed injectable medications. Journal of Behavior Therapy and Experimental Psychiatry, 33, 39-47.

Mohr, D. C., Cox, D., Merluzzi, N. (2005). Self-injection anxiety training: successful treatment for patients unable to self-inject injectable medications. Multiple Sclerosis, 11, 182-185.