Blood-injection-injury phobia (BII) is a specific type of phobia that includes anxiety and avoidance behaviors against blood, injection, injuries or medical practices. Children and adolescents are seen with a frequency of 0.8% to 1.5% and the median age of onset is 5.5. It has been shown to have some unique factors (fainting, disgust, physiological symptoms, and pain) compared to other phobia subspecies. The increase in heart rate and blood pressure follows a sudden decrease, and this condition is called vasovagal syncope. Cognitive Behavioral Therapy (CBT) is one of the most effective treatment methods in BII. CBT can be applied for one session or 8-12 sessions. CBT includes psychoeducation, automatical thoughts detection and restructuring, prevention of exposure and avoidance. Blood pressure increasing techniques, especially applied muscle tension technique, to prevent syncope during exposure, increase the effectiveness of therapy. In this case report, the treatment process of adolescent patient admitted with blood-injection-injury phobia successfully completed using CBT techniques will be discussed. After ten sessions of cognitive behavioral therapy, the patient's blood concerns and avoidance behaviors were completely gone. He managed to give blood, which he stated the highest degree of discomfort in the hierarchy of fear, without experiencing syncope. It has been demonstrated with the fact that CBT, which involves exposure, especially in combination with blood pressure raising techniques, is effective in the treatment of BII in children and adolescents, as in adults.
Key words: Blood-injection-injury phobia, cognitive behavioral therapy, applied muscle tension, exposure, adolescent
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