“This is how treatment for phobia of dogs might be, with the dog lying down at the far end of the room, by the front door, and with the patient at the other end with the therapist, ” says Anna Mautner, who teaches cognitive behavioural therapy and practices psychology at the Psychology Clinic at the Department of Psychology.
Her colleague Per Carlbring has just brought in his “care dog” Ludde, a golden retriever, who lay down calmly by the far door of the therapy room. Ludde is wearing a colourful jacket with the text “Dog at work” around his stomach.
“When you work with someone who has a phobia of dogs, what usually works well is to gradually get closer to the dog, based on what the patient thinks is scariest,” says Per Carlbring, who is a professor at the Department of Psychology and a specialist in clinical psychology.
“First, the patient is in the same room as the dog, for a short time and at a distance; we usually set a timer to ring after about three minutes. The next step might be a little longer, say five minutes, until the patient feels brave enough to sit next to the dog and maybe pet it, like this”, Per Carlbring demonstrates and then gives Ludde a dog treat as a reward.
Special room for treating phobias
The room is a specially built “exposure room”, which is used for patients with different phobias where the treatment method is based on an individual being confronted at their own pace with the object of their phobia.
“There are two doors, one that leads to the corridor inside and one that leads directly outdoors, so that we can bring a dog, a box with spiders or a snake directly from outside into the room”, says Anna Mautner.
For students studying on the psychology programme at the university, therapy sessions with patients are included towards the end of the course.
“They choose a specialization, either psychodynamic therapy or cognitive behavioural therapy and get to see patients”, says Anna Mautner who goes on to explain that the treatment for phobias is something that is included in the beginning of the programme for the students who study cognitive behavioural therapy.
Each semester, about 100 students complete treatment with patients which is offered free of charge to the public.
“To be able to start the practical part of their course and conduct therapy sessions is a long-awaited step and the students handle it very well”, says Aina Lindgren who is the head of the clinic at the Department of Psychology.
She shows us round the new premises in Albano, which the department moved into at the beginning of the autumn, and tells us that they have been treating patients since the 1980s.
Certified supervisors are responsible for the treatment
“We function as a normal clinic where the students’ need for education and the patients’ need for therapy are both met, but we do not have a normal healthcare assignment; the students have certified supervisors who are responsible for the treatment and who provide support throughout.”
The clinic has its own entrance for visitors and there is a newly decorated waiting room with plants, a long corridor with ten therapy rooms and another corridor with supervisor rooms. The therapy rooms include this special room for the treatment of phobias and a room where it is possible to have remote video therapy. In addition, there is a computer room where students can work with their medical records, and various spaces for supervisors.
“Before lunch like now it can be quiet here, but in the afternoons it is usually fully booked”, says Aina Lindgren.
She adjusts some of the curtains so that they hang straight in the therapy rooms; most of the furnishings are in place now.
“Patient privacy was important when planning the new premises, so that they can have their sessions in peace without anyone looking in,” she says.
The move to Albano important
The move to Albano has meant a lot for the clinic, according to Aina Lindgren.
“We are now an integral part of the department, previously the department was spread over four buildings and the clinic didn’t have so much space. Now we are close to both researchers and students, which is good.”
One idea with the new premises has been to link the research more closely to the clinic’s research projects.
“At last, it is as it should be, with a close link between the clinic and the research”, says Jan Bergström who is a senior lecturer in clinical psychology and director of the research centre at Stockholm University Psychology Clinic.
He says that the previous therapy work was integrated into a new center formation in 2015 following a decision by the President, and that the new organization thereby received a clearer and broader assignment.
“We wanted to create an attractive environment for clinical research and now with the new premises there is an even greater opportunity for that. There is a very good infrastructure for patient flows and for data collection that facilitates research, says Jan Bergström.
For educational purposes, all therapy sessions are recorded on video in a closed system – after approval from the patient. Only students and supervisors who are involved in the treatment have access to the recordings that take place in an authorization-controlled secure system.
Increased competition from digital care providers
Anna Mautner, who is responsible for the recruitment of patients to the CBT specialization, has noticed increased competition from digital care providers recently and for the next semester it has been difficult to find patients.
“In addition we also know that there is a huge need for psychological treatment for anxiety and depression. We are also aware that many health care facilities cannot provide enough psychotherapy to meet the need and that certain specific problems such as phobias are not addressed at all in public healthcare. Our Psychology Clinic fills an important gap in health care,” she says.
“We want to reach patients who are suffering greatly but who can’t afford to pay for therapy, most of all we want to reach the public. For many people who have phobias, it is a big obstacle in their everyday life and here we can make a contribution”.
Those who want to have therapy can send in an application via the clinic’s website, and accept the relevant conditions. The clinic then reviews the applications to see if the patient’s needs can be met.
“Sometimes we have to refer someone to the emergency hospital instead, or to another clinic. We also do not have psychiatric treatment, for example when it comes to medicine.”
They also conduct interviews with all patients prior to treatment.
“Each patient requires a lot of time and effort so we want to make sure that they stay for the entire course of treatment. It costs a lot if we lose someone and it is a risk for the students who need their assessments”, says Anna Mautner.
Right now, the clinic is looking for about 30 people who want to receive therapy for phobias during the spring semester 2022. Those who apply for therapy must be at least 16 years old. Application forms can be found on the clinic’s website.
Read more about the clinic (Swedish).
Photos: Annika Hallman