Behaviorual Approach To Treating Phobais Flashcards
What is counter-conditioning?
a new response to the phobic stimulus is learned by pairing with relaxation instead of anxiety.
What is systematic desensitisation?
Patients learn to respond to a feared stimuli with relaxation instead of anxiety. The main idea is that fear and relaxation cannot co-exist, we call this reciprocal inhibition.
The anxiety hierarchy:
SD involves the client and therapist designing a hierarchy of stressful/
frightening events or objects. Each step gets progressively more stressful or
frightening. [give examples in an exam situation].
Systematic Desensitisation- Relaxation:
The client is then taught deep muscle relaxation.
- It is impossible to experience fear and be relaxed at the same time (reciprocal
inhibition).
- Involves breathing expertise, meditation, or mental imagery.
- Can also involve drugs, such as Valium, or hypnosis.
Gradual exposure:
Finally, the therapist helps the client to work their way up the hierarchy while
maintaining this deep relaxation.
What is flooding?
Flooding also involves exposing phobic patients to their fear but without a gradual build-up in an anxiety hierarchy. Instead flooding involves immediate exposure to a very frightening situation to prevent avoidance. [immediate exposure not gradual]
Why is flooding effective?
Flooding stops phobic responses very quickly. This is because, it prevents avoidance behaviour, so the patient quickly learns that the phobic stimulus is harmless. In classical conditioning terms this process is called extinction.
• A learned response is extinguished when the conditioned stimulus (e.g. a dog) is encountered without the learnt response of fear (CR) as the association with the UCS has been broken.
• The result is that the conditioned stimulus no longer produces the conditioned response (fear).
• In some cases, the patient may achieve relaxation simply because they become exhausted by their fear response due to the immediate exposure.
A strength of systematic desensitisation compared to flooding is that it is often preferred as a treatment for phobias by patients.
E: This is because it does not cause the same levels of distress that can occur when presented with the fear‐inducing stimulus immediately and as a result there are low attrition rates.
E: It is therefore considered a more appropriate treatment for individuals who may suffer from severe anxiety disorders since learning the relaxation techniques can be a positive and pleasant experience.
L: Therefore, SD may be seen as a more ethical treatment for these patients.
P: A strength of SD is that it can be used in conjunction with virtual reality, rather than in person in a real-world setting.
E: Exposure through VR can be used to avoid dangerous situations (eg heights) and is cost-effective because the psychologist and client need not leave the consulting room. E: However, there is also some evidence to suggest that VR exposure may be less effective than real exposure for social phobias, because it lacks realism (Wescler et al., 2019)
L: This means that the advantages of VR-based SD may be suitable for some, but not all phobias
P: A limitation is that systematic desensitisation is not effective in treating all phobias.
E: Patients with phobias which have not developed through a personal experience (classical conditioning), such as a fear of snakes, are not effectively treated using systematic desensitisation as it cannot be that their phobia has been learnt and therefore cannot be unlearnt.
E: Some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning.
L: This highlights a limitation of systematic desensitisation, which is ineffective in treating evolutionary phobias which have an innate basis.
A strength of flooding as a treatment of phobias is that it is at least as effective as other treatments for specific phobias but more cost effective.
E: Ougrin (2011) compared flooding to cognitive therapies and found that flooding is highly effective and quicker than alternatives. This quick effect is a strength because it means that patients are free of their symptoms as soon as possible and that makes the treatment more-cost effective.
E: This evidence has implications for the economy as it could reduce the financial burden on the NHS by offering a quicker and cheaper treatment for those suffering from phobias.
L: Therefore, flooding can be seen as a useful treatment and perhaps should be the first type of treatment for NHS patients to overcome their phobias.
P: A limitation of flooding is that it is not appropriate for all patients due to how traumatic it can be.
E: Schumacher (2015) found that patients and therapists rated flooding as significantly more stressful than SD. The problem is not that flooding is unethical because patients give informed consent, but that patients are often unwilling to see it through to the end as it can be extremely distressing.
E: The intensity of the experience can lead to high attrition rates (people that drop out) and it can actually make the phobia even worse it the treatment is not completed.
L: This shows that individual differences can be a limitation of how effective flooding is as treatment for phobias.
P: A limitation of flooding is that it is not appropriate for phobias that involve high level of cognition, such as social phobias.
E: For example, a sufferer of a social phobias does not simply experience an anxiety response but thinks unpleasant thoughts about the social situation.
E: It therefore may be more beneficial for the more complex phobias to be treated with cognitive therapies because such therapies tackle the irrational thinking.
L: Therefore, whilst flooding may be appropriate in some situations it may not be suitable for all phobias and therefore this reduces its usefulness as a treatment.
