When litigating a road accident claim, travel anxiety and associated stress is one of the typical sub headings of damages. Depending on whether physical injuries exist, the severity and level of disruption socially and occupationally of any travel anxiety are crucial to accurate and viable quantum assessment. Paul Elson and Karen Addy both have considerable experience in differentiating clinical and sub-clinical types of ‘travel nerves’.Travel nervousness following a road accident is almost a universal psychological consequence among those people unfortunate enough to suffer such an event. The level of nervousness displayed by individuals varies considerably. For some people it is very mild and soon disappears as they return to driving. This can essentially be considered a normal response that does not require treatment. For others however the level of nervousness suffered is more problematic. This group of people fall within three categories, namely those for whom the problem is considered ‘mild’, ‘moderate’ or ‘severe’.Mild travel nervousness describes those people who, while displaying a clear degree of travel anxiety, are nevertheless able to travel in a vehicle without too much difficulty and as such there is no avoidance behaviour. Those people with a moderate degree of travel nervousness display increased nervousness and have consequently reduced their level of travel, typically limiting their travel to essential journeys only. Finally, those people whose problem is considered severe display both marked anxiety regarding the prospect of travelling in a vehicle and in addition have markedly reduced such travel or even avoid travel altogether. The level of travel anxiety suffered by those people for whom it is considered mild is unlikely to meet the criteria for a psychological disorder, ie it is not clinically significant. The level of travel anxiety suffered by those people for whom it is considered moderate may or may not meet the criteria depending on the level of anxiety suffered and the degree of avoidance involved. For those who are suffering from severe travel anxiety it is likely that they will be suffering from a diagnosable psychological disorder, most commonly a specific phobia.There are various approaches to tackling these problems. First, a person may benefit from learning strategies to relax, such as deep breathing or progressive muscle relaxation. This may be available on the NHS (usually via the person’s GP), privately, or could be accessed through simply buying a relaxation tape that will talk the person through the skills needed. This approach would be of particular benefit for those people considered to be suffering from mild travel anxiety and could be sufficient to help the individual overcome their nervousness. Behavioural approaches, such as encouraging an increase in travel practice, are essential to recovery as avoidance of travel maintains the nervousness and reduces confidence in travelling. Thus encouraging a person to increase the time or distance involved in their travelling would help them regain their confidence. Refresher driving lessons can also play a part in increasing confidence and reducing avoidance; this approach is likely to be beneficial to all three levels of travel nervousness.For people with more severe travel anxiety and those that meet the criteria for a specific phobia, more formal psychological treatment is often required. The most common and evidence-based therapy used in such cases is cognitive behaviour therapy. This is a well-established psychological treatment that seeks to teach people to overcome their nervousness by tackling both the individual’s thought processes (the cognitive component) and by working on the degree to which they actually travel or else avoid doing so (the behavioural component). It is practically-oriented, involving the teaching of skills and homework-type assignments. Its effectiveness is grounded in scientific research. This approach would be indicated in those individuals whose problem is moderate or severe and usually consists of a course of 8-10 sessions. Ideally, the person receiving the treatment should possess a degree of psychological mindedness, ie they possess the ability to reflect on their thoughts, feelings and behaviour.Another form of psychological therapy used to treat travel nervousness is that of Eye Movement Desensitization Reprocessing (EMDR). This approach involves encouraging the client to bring into awareness distressing material (thoughts, feelings, etc) from the past and present and which is then followed by sets of bilateral stimulation, most usually side-to-side eye movements. Once the eye movements cease the individual is asked to let material come to awareness without attempting to ‘make anything happen’. After EMDR processing, clients generally report that the emotional distress in relation to the memory has been eliminated, or greatly decreased. EMDR is primarily used to treat post traumatic stress disorder (PTSD), for which there is some scientific evidence demonstrating its benefits, and although it may also be used to treat travel phobia, the research evidence supporting this is more anecdotal.The above approaches are not mutually exclusive and it is likely that in practice a combination of treatment approaches is needed. For example, a person undergoing cognitive behaviour therapy is also likely to benefit from being taught relaxation techniques and to increase their travel practice, components which usually form part of this therapeutic approach. They may also be receiving EMDR treatment.While the approach to tackling an individual’s particular problem is partially determined by the nature and severity of the problem, as outlined above, it is also dependent on the preference of the individual concerned, as some people would rather try tackling the problem themselves, having received some simple informal advice, while others would prefer something more formal, such as psychological therapy. Either way, the person needs to be motivated to tackle their problem and ideally possess some belief in the effectiveness of the approach that they are using.The following case highlights a typical anxiety reaction to a car accident and the recommended treatment for such symptoms:Mr. M was a 28 year old who was in an accident in May 2008. He was a front seat passenger, in a car driven by a friend. The car they were traveling in was hit from the rear by a lorry and pushed into another lorry whilst on a motorway. Mr. M was trapped in the car and was cut free by the fire service. He received whiplash injuries and burns to his legs as a result of the car’s water tank spilling on him. Early psychological symptoms (developed within 2 months of the accident) were stress symptoms of intrusive thoughts, nightmares, some avoidance phenomena and persistent arousal symptoms. These symptoms as described did not meet the full criteria for Post Traumatic Stress Disorder (PTSD) (DSM.IV 309.81).However, he experienced mood disturbance with variable low mood reactive to pain, feelings of worthlessness and low self-esteem, sleep disturbance, reduced appetite and weight loss, lethargy and reduced motivation, consistent tearfulness, loss of interest in usual activities and consistent irritability, exacerbated by physical discomfort. He also stated that he was generally more anxious, describing worries about potential hazards and being more jumpy and hyper-vigilant to perceived danger. Following the accident Mr. M avoided driving and at the time of the interview (15 months since the accident) he had not driven. In addition he avoided traveling as a passenger whenever possible. There was social withdrawal due to travel anxiety and low mood. He reported stopping usual activities such as going to the gym and going out with friends. Mr. M had not worked since the accident. He reported that he was physically unfit for approximately six months, however had not returned to work due to a fear of travelling in a car preventing him from accessing work.The symptoms described by Mr.M meet the criteria for a Specific Phobia (DSM.IV 300.29) related to travel and a Depressive Disorder (DSM.IV 311). Mr M completed a course of cognitive behavioural therapy (12 sessions) which included a graded approach to increasing his travel practice and incorporated general relaxation techniques. After six months Mr M had significantly increased his driving and passenger travel, had started to work part time and no longer met the criteria for either a specific phobia or depressive disorder. It is unlikely that without appropriate psychological treatment such improvement in Mr M’s condition would have occurred as evidence suggests that maximum natural improvement in symptoms will occur 6-12 months following the index accident.Travel anxiety, a common response to experiencing a distressing road traffic accident, is a well documented and understandable phenomenon. It can and does improve with self help, advice, and where appropriate, professional help.
Do you love to travel? Do you own an iPad? Do you want to tour the globe with the best travel tips from regular people who have lived or visited your destination recently?Then you’re in luck!A global travel services company called WorldNomads.com has launched an innovative mobile application designed exclusively for the iPad, known as ‘Ask A Nomad.’ The great part about this app is that it allows users to connect to a global network of knowledgeable people who can provide first-hand information about travel questions, local trips advice and where to seek assistance in that part of the world.You can also connect with like-minded tourists from different parts of the globe as Travel Knowledge Network, which is a group of tour operators powering this app, shares their online communities’ database with the iPad app users, enabling them to ask related questions anytime, anywhere.It also has a provision for utilizing geo location programs for searching travel related content close to the user’s current location so its account holders simply need to connect to the net and sign in to their account to ask questions, store answers and access these offline later at anytime. This is a huge advantage for tourists who face limited or no Internet access during travel, especially to remote or exotic destinations.So, one can get pertinent advice from local experts, travel journalists, travel writers, frequent travellers and government approved tour operators all of who are reliable advisors for the region since they will have travelled extensively through the area.As Christina Tunnah of WorldNomads.com explains this unique app for iPads from her company, “When you pose a query, your question gets routed to the travellers in the network most likely able to answer it based on their travel profile and answer history.”After completing a simple sign up process, account holders can download the app and browse a list of Q and A from global travellers and ask their own questions from the large community of travellers; they can share their answers to become active members of the community.If the statistics from Frommer’s Unlimited May 2011 Travel User and Experience Survey is anything to go by, it would emphasize the need for reliable and current travel content because the research reveals a considerable spurt in consumption of travel content by users of mobile devices, including iPad users. This 3rdAnnual Survey reports 52% respondents to the study used mobile devices to access travel content while travelling; out of this number, 72% were in the 18 to 34 age-bracket. That left only 38% of survey respondents using their mobile devices for planning.However, it’s not just the convenience factor that makes the Ask A Nomad app so practical and welcome in this age of fast-travel. It’s the fact that the answers received through this application are also updated and current to different situations and a wide variety of destinations that makes it so much more fun and easy to use as compared to travel guides or travel website newsletters.A truly handy and efficient travel companion, the Ask A Nomad app is a great tool for special interest tour groups like travel writers, singles, seniors, women and many others apart from companies looking to offer a useful service for their customers ensuring a safe and stress-free holiday for them – anywhere in the world!