3.5. Phobias Treatment - Behaviourist Approach

Question 1

What does systematic desensitisation state?

Answer 1

Two emotional states cannot exist at the same time

Question 2

What is systematic desensitisation based on?

Answer 2

Classical conditioning

Question 3

What is the process of counterconditioning?

Answer 3

• The patient is taught a new association that runs counter to the original.
• Classical conditioning is used to associate the phobic stimulus with relaxation instead of fear -> therefore anxiety is reduced or desensitised

Question 4

What is reciprocal inhibition?

Answer 4

The response of relaxation inhibits the response of anxiety

Question 5

What is the process of relaxation?

Answer 5

• Patient learns new relaxation techniques, such as controlled breathing, taking slow and deep breaths and visualising a peaceful scene.
• Progressive muscle relaxation is also used to relax one muscle group at a time

Question 6

What is the process of desensitisation?

Answer 6

SD works by gradually introducing the person to the feared situation, one step at a time, therefore not as overwhelming as flooding
At each stage, the patient practices relaxation so their anxiety diminishes

Question 7

How does systematic desensitisation work?

Answer 7

1. Teach relaxation techniques
2. Construct a desensitisation hierarchy -> least to most fear provoking
3. Patient step by step gradually works through hierarchy
4. Only once step has been 100% mastered, then they can move onto the next step
5. Patient will eventually overcome fear- reach the top of the hierarchy and realise they shouldn’t fear it
6. Can be in vivo ( actually exposed) of in vitro (images)

Question 8

Strength: effectiveness of SD

Answer 8

+ Researchers have found that SD is successful for a range of phobic disorders
+ McGrath (1990) reported that about 75% of patients with phobic disorders respond to SD
+ Choy (2007) found that in vivo is more beneficial compared to in vret
+ Modelling can also help, watching someone who copes well with the feared stimulus

Question 9

Strength: general effectiveness of behavioural therapies

Answer 9

+ Therapies are generally fast and require less effort than psychotherapies that require the patient to think, CBT requires a lot of willpower from the patient, in understanding their behaviour and applying new insights.
+ Therefore, they’re useful for those that lack insight, such as children or adults with learning difficulties
+ SD can also be self-administrated and has been found to be just as effective as therapist led SD, this will be a lot cheaper

Question 10

Weakness: SD is not appropriate for all phobias

Answer 10

Ohman (1975) suggested that due to preparedness, SD may not be as effective at treating phobias with an evolutionary survival component such as fear of the dark compared to those that have been developed due to a personal experience.

Question 11

What is flooding?

Answer 11

One long session (3 hrs) where the patient experiences the phobia at its worst, while at the same time, practising relaxation techniques

e.g. a patient that fears spiders being placed in a room full of spiders

Question 12

What can flooding be in?

Answer 12

Vivo ( real life) or vret (virtual reality)

Question 13

What happens with the fear response?

Answer 13

It has a time limit and, as it’s exhausted, a new association between the feared stimulus and relaxation is learned

Question 14

What method makes the learning quick?

Answer 14

Exhaustion -> no option of avoidance, fear response is exhausted

Question 15

Does flooding have ethical issues?

Answer 15

It’s not unethical but it is unpleasant

Question 16

What is important for those being treated to give?

Answer 16

Informed consent

Question 17

How does flooding work?

Answer 17

1. Patient is taught relaxation techniques
2. Patient flooded, patient overcomes fear
3. Completed in one long session

Question 18

Flooding strength: quick and cost effective

Answer 18

+ Flooding is a quick treatment -> 1 session compared to many for SD
+ Implication of this in the real world
+ However, Craske (2008) concluded that SD and flooding were equally effective
+ Flooding is cost effective because it’s clinically effective and not expensive (can work in as little as one session)-> even with a longer session, it is more cost effective than alternatives

Question 19

Flooding weakness: traumatic

Answer 19

• Flooding isn’t for everyone, it’s very intense and puts the patient under immense anxiety -> they are informed prior to the treatment
• Therefore, patients may quit during the treatment which reduces the overall effectiveness of flooding
• Schumacher et al (2015) found that ppts and therapists rated flooding as more stressful than SD -> there are ethical concerns about stress caused

Question 20

Flooding weakness: symptom substitutions

Answer 20

• Behavioural therapies remove symptoms but don’t treat the overall cause
• This may lead to symptom substitutions
• e.g. a smoker quits smoking but then comfort eats because underlying smoking issue wasn’t dealt with