The diagnostic setting – implications for
the practice: Can “workplace phobia” be
used as a proper diagnosis?
Workplace phobia can be associated with a very complex
stimulus and therefore appears not only as a specific, but
even as a “complex” specific phobia. Workplace phobia has
far-reaching consequences for work participation and thus
can mean existential endangerment for the affected person.
As specific phobias are usually not going along with comparable
severe work participation problems (Greenberg et al.,
1999), they are not expected to provoke existential fears in
the same degree. Therefore also existential threat appears as
a specific consequence of workplace phobia.
Another point which makes workplace phobia appear different
from the conventional specific phobia is the treatment
aspect. Expositions can only be made in a therapeutically
supervised working trials or in sensu. Treatment often does
not focus on anxiety (symptom) management only, but on
the improvement of social skills and competencies.
51
Due to empirical findings and their practical implications
which have been discussed, it seems to be necessary to describe
the phenomenon of workplace phobia with an extra
diagnosis instead of subsuming it under a conventional anxiety
disorder like “agoraphobia”. It makes a difference
whether a person avoids leaving the own flat because of the
fear to come into situations where help is not possible (agoraphobia),
or whether a person avoids going out because of a
possible confrontation with colleagues or superiors from the
feared workplace (workplace phobia). In both cases the
avoidance reactions look like the same, and implicate the
diagnosis of agoraphobia, but the psychological mechanisms
lying behind are different.
To give the diagnosis of workplace phobia by naming it
“workplace phobia”, additionally to a comorbid or behind
lying primary conventional mental disorder therefore has
good practical reasons.
In primary medical, psychotherapeutic and socio-medical
practice, workplace phobia should be named as a proper
diagnosis. Primary care physicians should be aware of workplace
phobia in patients who are on long-term sick leave.
This seems especially relevant as the majority of patients
with mental disorders initially seek help in primary care
(Kroenke et al., 2000).
It can be suggested to diagnose “workplace phobia” explicitly
with the ICD-10 number F 40.8 (other phobic disorders).
The diagnostic setting – implications forthe practice: Can “workplace phobia” beused as a proper diagnosis?Workplace phobia can be associated with a very complexstimulus and therefore appears not only as a specific, buteven as a “complex” specific phobia. Workplace phobia hasfar-reaching consequences for work participation and thuscan mean existential endangerment for the affected person.As specific phobias are usually not going along with comparablesevere work participation problems (Greenberg et al.,1999), they are not expected to provoke existential fears inthe same degree. Therefore also existential threat appears asa specific consequence of workplace phobia.Another point which makes workplace phobia appear differentfrom the conventional specific phobia is the treatmentaspect. Expositions can only be made in a therapeuticallysupervised working trials or in sensu. Treatment often doesnot focus on anxiety (symptom) management only, but onthe improvement of social skills and competencies.51Due to empirical findings and their practical implicationswhich have been discussed, it seems to be necessary to describethe phenomenon of workplace phobia with an extradiagnosis instead of subsuming it under a conventional anxietydisorder like “agoraphobia”. It makes a differencewhether a person avoids leaving the own flat because of thefear to come into situations where help is not possible (agoraphobia),or whether a person avoids going out because of a
possible confrontation with colleagues or superiors from the
feared workplace (workplace phobia). In both cases the
avoidance reactions look like the same, and implicate the
diagnosis of agoraphobia, but the psychological mechanisms
lying behind are different.
To give the diagnosis of workplace phobia by naming it
“workplace phobia”, additionally to a comorbid or behind
lying primary conventional mental disorder therefore has
good practical reasons.
In primary medical, psychotherapeutic and socio-medical
practice, workplace phobia should be named as a proper
diagnosis. Primary care physicians should be aware of workplace
phobia in patients who are on long-term sick leave.
This seems especially relevant as the majority of patients
with mental disorders initially seek help in primary care
(Kroenke et al., 2000).
It can be suggested to diagnose “workplace phobia” explicitly
with the ICD-10 number F 40.8 (other phobic disorders).
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