4. The Behavioural Approach To Treating Phobias Flashcards
What is systematic desensitisation?
A behavioural therapy designed to reduce an unwanted response, such as anxiety, to a stimulus. SD involves drawing up a hierarchy of anxiety-provoking situations related to the phobic stimulus, teaching the patient to relax, and then exposing them to phobic situations. The patient works their way through the hierarchy whilst maintaining relaxation.
What is flooding?
A behavioural therapy in which a phobic patient is exposed to an extreme form of the phobic stimulus in order to reduce anxiety triggered by that stimulus. This takes places across a small number of long therapy sessions.
Who developed systematic desensitisation?
Wolpe
What is systematic desensitisation based on?
It is based on classical conditioning and the idea that two conflicting emotions (fear and relaxation) cannot occur at the same time (reciprocal inhibition).
What are the three key aspects of systematic desensitisation?
- Relaxation - breathing techniques or meditation is learned (sometimes drugs are used).
- The anxiety hierarchy - a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
- Exposure - to the phobic object.
The patient is gradually exposed the the threatening situation/object under relaxed conditions until the anxiety reaction is extinguished. Patients can overcome their anxiety by learning to relax in the presence of stimuli that have previously made them anxious.
Systematic desensitisation can also work without the presenting the feared stimuli but have the client imagine it. What is this called?
In vitro exposure
What study supports systematic desensitisation as a treatment of phobias?
Lang and Lazovik
Describe Lang and Lazovik’s study
It was a controlled experiment to assess the effectiveness of desensitisation as a treatment for people with a phobia of snakes.
People with a phobia of snakes were divided into 2 groups. Group 1 received desensitisation therapy for their phobia, group 2 was a control group and received no therapy.
The findings showed that group 1 showed less fear of snakes after receiving the therapy than the control group. The same people were followed up after 6 months and those in group 1 still showed a reduced fear of snakes to the control group.
So we can conclude that desensitisation therapy has both an immediate and a long-term effect in reducing fear associated with specific phobias, such as fear of snakes.
EVALUATION OF SYSTEMATIC DESENSITISATION
Outline three strengths of systematic desensitisation
- a strength of systematic desensitisation is that it is effective
- a strength is that systematic desensitisation is suitable for a diverse range of patients
- a strength is that systematic desensitisation tends to be acceptable to patients
EVALUATION
Explain the strength of SD in that it is effective
Gilroy et al followed up 42 patients who had systematic desensitisation for spider phobia in three 45-minute sessions. At both three and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure.
This is a strength as it shows it’s helpful in reducing anxiety in phobias and the effects of the treatment are long- lasting.
EVALUATION
Explain the strength of systematic desensitisation in that it is suitable for a diverse range of patients
The alternatives to systematic desensitisation such as flooding and cognitive therapies, are not well suited to some patients. For example, having learning difficulties can make it very hard for some patients to understand what is happening during flooding or to engage with cognitive therapies which require reflection.
A strength is that for these patients, systematic desensitisation is probably the most appropriate treatment.
EVALUATION
Explain the strength of systematic desensitisation in that it tends to be acceptable to patients
A strength of systematic desensitisation is that patients prefer it. Those given the choice of SD or flooding tend to prefer SD, this is because it doesn’t not cause the same degree of trauma as flooding. It may also be because SD includes some elements that are actually pleasant, such as time talking to a therapist. This is reflected in low refusal rates (number of patients refusing to start treatment) and low attribution rates (number of patient dropping out of treatment) for SD.
This is a strength of systematic desensitisation.
EVALUATION
Give one limitation of systematic desensitisation
One limitation of systematic desensitisation is that the benefits of the therapy may not generalise beyond the clinical setting. Even though phobic patients may make considerable progress within therapy, this progress may not extend beyond the treatment setting. When the phobic is presented with the phobic object of situation without warning - and without the support of the therapist - in a real-life setting, they make quickly regress back to their original state.
This means that systematic desensitisation may not have long-term benefits which may be a weakness for the therapy.
What is flooding?
Flooding involves immediate exposure to the phobic stimulus by bombarding (flooding) the phobic patient with the phobic object without the gradual build-up.
Without the option of avoidance behaviour, the patient quickly learns that the phobic object is harmless through the exhaustion of their fear response. This is known as extinction. This is based on the assumption that the body only has limited energy and panic cannot continue indefinitely.
What are the three steps involved in flooding?
- A patient is exposed to the object/situation that causes anxiety (e.g. A room full of snakes)
- The patient is initially overwhelmed and very fearful, but this subsides after a while
- The patient recognises that anxiety levels have dropped and that although such situations have been avoided in the past, there is in fact no reason for this.
