08. Phobia Treatment Flashcards
What are the 4 necessary steps for systematic desensitisation (SD).
- Functional analysis
- Develop an anxiety hierarchy
- Relaxation training
- Gradual exposure
Describe the first step, functional analysis.
A conversation between therapist and client to identify the nature of anxiety and the possible triggers.
Describe the second step, developing an anxiety hierarchy.
Working jointly, the client and therapist create a hierarchy of fear from least to most.
Describe the third step, relaxation training.
Client is taught relaxation techniques that suit them best.
Describe the final step, gradual exposure.
Working through the anxiety hierarchy, each step of the hierarchy is slowly introduced. They started with the least feared item and remain with that until they are able to feel relaxed in its presence. This confrontation may be real or imagined. The process continues until they reach the top of the hierarchy and feel relaxed in the presence of all the items or at the top of the hierarchy’ of anxiety.
What is systematic desensitisation?
-This therapy aims to extinguish an undesirable behaviour of fear by replacing it with a more desirable one relaxation.
-This uses the principles of classical conditioning to form new associations (relaxation) with the conditioned stimulus.
How does systematic desensitisation work?
-At the beginning there are relaxation techniques.
-At the end the aim is to be able to respond to the feared object or situation (stimulus) with relaxation and not fear.
-This is known as reciprocal inhibition.
-It is ‘reciprocal’ because the two are related; as relaxation increases, anxiety lessens.
-It is ‘inhibition’, as the new relaxation techniques inhibit the anxiety.
To check for relaxation, what can be used?
Biofeedback.
-For example pulse rate or breathing rate.
-Biofeedback is useful to the individual to learn to take control of their own physiological responses. They can learn to control their pulse rate and breathing rate.
Describe the flooding treatment for phobia.
-Physically placing the client in the situation with their feared object/situation.
-The fear must be quickly presented, continuously and in a situation where escape is not possible.
-The ‘fear’ is a biological reaction (high glucose levels) making the body on high alert (pulse and breathing rate).
What is the learning theory idea for the flooding treatment for phobia?
-The learning theory (CC) idea is that with repeated, constant exposure the client will see it as less fear producing.
-Their body can only be at ‘alarm’ stage for so long before it gets tired and the feeling lessons to eventually feel calm. The person will then learn by association (CC) that a calmer response is linked to the object they were phobic about.
-Also based on the principles of CC is the fear response is automatic (not controlled consciously) and is therefore a biological reflex response.
Define implosion (a type of flooding therapy).
-A form of flooding that asks the person to imagine the phobic stimulus.
-Good in treating PTSD (as you may be unable to recreate the exact situation they were in such as war).
What are the strengths of systematic desensitisation treatment?
-Gilroy et al (2003) showed SD is effective when treating specific phobias. They compared clients receiving SD for spider phobia with a control group. At both 3 months and 33 months after treatment, the treatment group were less fearful than the control group.
-Has been shown to have real life application, Capafons et al (1998) 90% success rate treating a fear of flying using SD.
-It is ethical because it is a gradual process that works at the clients pace using their hierarchy.
-It is supported by research which shows you can learn a response by association (Watson and Rayner or Pavlov).
What are the weaknesses of systematic desensitisation treatment?
-Research which refutes flooding may be used to refute SD.
-It may not last as a treatment and spontaneous recovery of the phobia may occur.
-Lacks real life application for some social phobias and individuals for instance it is not useful for such mental health issues like psychosis (need to be able to relax).
What are the strengths of flooding therapy?
-Application Ougrin et al found that flooding is more effective and faster than cognitive therapies.
-Wolpe (1973) was able to use flooding to help a girl afraid of cars.
-Supported by research using CC (Watson and Rayner or Pavlov).
What are the weaknesses of flooding therapy?
-Research which supports SD may also refute flooding.
-Ethics flooding can be stressful and even traumatic, but is is quick, as the alarm reaction cannot be maintained for long, this may be better as it’s over sooner than SD.
-Research support is mixed as Barrett (1969) used therapy on college students who had a phobia of snakes which resulted in many suffering from insomnia.
-Real life application may be limited as there is evidence of spontaneous recovery of the phobia.
-Compared with SD the extinction may be less complete, as the association of ‘calm’ in flooding is not as strong as ‘relaxation’ brought about by SD. This suggests that flooding may be short lived in it effectiveness compared with SD which is a weakness.
