4.1.11 treatments for phobias

Question 1

What are the treatments for phobias?

Answer 1

• Systematic desensitisation
• Flooding

Question 2

What is systematic desensitisation?

Answer 2

A behavioural therapy designed to gradually reduce phobic anxiety through the principles of classical conditioning

A new response to the phobic stimulus is learned (relaxation instead of anxiety). The learning of a different response is called counterconditioning

Its impossible to be afraid and relaxed at the same time, so one emotion prevents the oher. This is called reciprocal inhibition

Question 3

describe how systematic desensitisation works

Answer 3

• The anxiety hierarchy is constructed by client and therapist – least to most anxiety provoking (e.g. person with arachnophobia might identify seeing a picture of a small spider at the bottom and holding a tarantula at the top)
• Relaxation - the client is taught to relax as deeply as possible – breathing exercises, mental imagery techniques, or via drug (like Valium).
• Exposure – finally, the client is exposed to the phobic stimulus while in a relaxed state in several sessions, starting at the bottom of the hierarchy. when the client can stay relaxed in the presence of the lower levels of the phobic stimulus, they move up the hierarchy.
• treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy

Question 4

describe flooding

Answer 4

• The immediate exposure to a phobia using the process of extinction (classical conditioning) – the conditioned stimulus is encountered without the unconditioned response so the conditioned stimulus no longer produces the conditioned response.
• sometimes only one long session is needed to cure a phobia
• client may achieve relaxation in the presence of the phobic stimulus because they become exhausted by their own fear response

Question 5

strengths of SD

Answer 5

• Evidence to support effectiveness: Capafons (1998) found SD is a highly successful treatment for fear of flying, success rate of 90%. Gilroy (2003) Compared a control group given relaxation techniques and a group given SD. Those given S.D. were cured of their phobia for much longer.
• SD is less intense and unpleasant than compared to Flooding as it involves the gradual exposure to the phobic objects/situation and patient is in complete control of progress through stages

Question 6

weaknesses of SD

Answer 6

• Reductionist: It reduces phobias down to a learned association between S-R bonds, therefore it ignores the role of genes and role models. This doesn’t make the therapy less successful, but it questions the validity of the theory (CC) it is based on.
• Limited usefulness: Not effective for all: individual must learn to relax and be engaged in the whole process, it’s not a passive treatment. Not everyone is able to do this, so anti-anxiety drugs may be better for some.

Question 7

strengths of flooding

Answer 7

• Evidence to support effectiveness: Ougrin 2011 compared flooding to to cognitive therapies and found flooding is highly effective and quicker than alternatives.
• Convenient: Sessions are longer than SD session lasting 2-3 hours but less are needed in total, sometimes 1 is enough to cure a phobia because of such immediate exposure to a frightening situation results in quick extinction.

Question 8

weaknesses of flooding

Answer 8

• Flooding involves directly facing a fear, so is more stressful and unpleasant than SD, therefore consent is vital and patients must be given a choice between flooding and SD.
• Despite extinction of the association between the phobic object/situation and the fear response, there can be spontaneous recovery. This can happen with SD too, but less likely as SD takes place over a long period of time with a stronger disconnection between the stimulus and response. This suggests flooding treatment may have short term effectiveness