From the Guidelines
Techniques to help patients with claustrophobia include cognitive-behavioral therapy (CBT), medications such as benzodiazepines, and practical strategies like distraction techniques and virtual reality therapy. According to the most recent study 1, imaging patients with claustrophobia can be challenging, but tailoring examinations for shorter scan times and using motion-reducing sequences can be helpful.
Some key techniques for managing claustrophobia include:
- Cognitive-behavioral therapy (CBT) involving gradual exposure to confined spaces and teaching coping skills like deep breathing, progressive muscle relaxation, and positive visualization
- Medications such as benzodiazepines like lorazepam (0.5-2mg) or alprazolam (0.25-0.5mg) taken 30-60 minutes before anticipated triggers
- Practical strategies like distraction techniques, mindfulness meditation, and reality testing to challenge irrational thoughts
- Creating a sense of control by using an exit strategy, bringing a support person, or using virtual reality therapy for practice
These approaches work by addressing both the physiological stress response and the cognitive distortions that maintain claustrophobia, allowing patients to gradually build tolerance to confined spaces while reducing their anxiety response, as supported by studies 1. Additionally, techniques like breathing techniques, progressive muscle relaxation, grounding strategies, visualization, distraction, thought reframing, mindfulness, and integrating activities of enjoyment can also be helpful in managing anxiety and claustrophobia, as mentioned in study 1.
From the Research
Techniques to Help Patients with Claustrophobia
- Open MRI scanners can help reduce claustrophobic reactions, enabling more examinations of claustrophobic patients without incurring the safety issues associated with conscious sedation 2
- Psychological interventions and self-empowerment of patients might become the next level of coping strategies for claustrophobia 3
- Various interventions such as:
- Quieter machines
- Information in combination with psychological support or an anxiety reduction protocol
- Mock MRI
- Team training
- Prone scanning
- Audiovisual systems
- Cognitive behavioural therapies
- Fragrance administration
- Guided imagery
- Patient positioning devices
- Paediatric preparation booklets can have a positive effect on reducing anxiety, claustrophobia, sedation, and non-completions, and improving satisfaction for patients undergoing medical imaging 4
- Patient education, through supportive discussion, prior to their MRI scan is considered an effective technique for facilitating scan completion and managing claustrophobia 5
- Communication and interaction with the patient are recognised as important in managing claustrophobia, although time can be a barrier to always being able to provide patient-centred care 6
Interventions for Reducing Claustrophobia
- Radiographers may use several strategies to effectively manage patients with claustrophobia during MRI, including claustrophobia reduction and relaxation techniques 5
- Educating claustrophobic patients prior to their MRI scan is necessary to enhance their experience and optimise scan completion rates 5
- Ongoing support is needed for both patients and radiographers to improve experience within MRI 6