Behavioural Approach To Treating Phobias Flashcards
What is SD
Systematic Disensitisation is type of behavioural therapy developed by wolpe. It aims to reduce the fear of phobias by using classical conditioning. Fear is a behavioural response to the phobic object and SD uses classical conditioning to replace these irrational fears with and anxieties with calm and relaxed ones. The central idea is that you cannot feel two opposite emotions at the same time, for example fear and relaxation; this is known as reciprocal inhibition. Therefore if the person can learn to remain relaxed in the presence of Their phobia then they can be cured. This is known as counter conditioning
What is the process of SD?
1) Hierarchy of Fear: this is constructed between the therapist and patient and the patient has to rank situations involving the phobic object from least fearful to most fearful. For example a person with a phobia of snakes may first see a picture of one then eventually hold one.
2) Relaxation techniques: Patients are taught deep muscle relaxation techniques, such as progressive muscular relaxation and the relaxation response. The idea behind PMR is to tense a group of muscles as tightly as possible for a few seconds then relax the muscles to their original state and then further relaxing them consciously so that the patient is as relaxed as possible. When asked to do the relaxation response, patients are to have their eyes closed and sit quietly. They should then begin to relax their muscles from the feet, working their way up. Whilst relaxing their muscles, they are encouraged ti meditate and think of relaxing situations.
3) Gradual Exposure: the patient is introduced to the stages of their fear hierarchy one at a time, starting from the least fearful one. At each stage they must use relaxation techniques until they feel like they are comfortable at that stage and can move onto the next stage of the fear hierarchy. Eventually through repeated exposure of the phobic object with feelings of relaxation and no fear, the phobia is eliminated. However this will take many therapy sessions.
Evaluation of SD?
+ Jones supports the use of SD to irradiate little peters phobia of a white rabbit. The white rabbit was introduced to him at a long distance away. It was then gradually presented closer and closer and each time it got closer, little peters anxiety lessened. Eventually he developed affection for the white rabbit which was generalised to all fluffy white objects, supporting that SD works compared to other therapies
+ Klosko et al supports SD after assessing various treatments for panic disorders and found that 87% were panic free after SD compared to 50% on medication and 36% on a placebo and 33% with no treatment. Therefore SD is more effective compared to other treatments.
+ SD is less traumatic than other behavioural therapies such as flooding where patients have to confront their phobia directly. SD has less ethical implications like psychological harm and can be less upsetting for patients to endure
- SD may be difficult and impractical to apply to some real life situations and phobias. The step by step situations may be hard to control and arrange, for example if a person is afraid of sharks then SD may be hard to apply and can question the effectiveness of the therapy
What is flooding?
Flooding involves directly exposing the patient to the phobic object. Beforehand the patient would be taught relaxation techniques such as deep muscle relaxation, deep breathing and meditation. However there is no gradual build up with a fear hierarchy and instead flooding involves immediate exposure to a frightening and extreme situation. E.g. a person scared of snakes may be put in a room full of snakes. This can be done in real life, or by imagining the situation. Flooding stops phobic responses quickly because there is no opportunity for avoidance behaviour as they cannot run away from their phobic object. Because of this, patients may realise that their phobic object is harmless, and extinction occurs. The patient may also achieve relaxation in the presence of their phobic object because they are so exhausted by their own fear response. The fear response is so much that they become exhausted and the phobic response diminishes. Despite the psychological harm flooding can exhibit, it is completely ethical as patients give their fully informed consent. Patients can be given the choice between SD or Flooding. Flooding takes around 2-3 hours which is much quicker than SD, which requires many sessions
Flooding Eval?
+ An advantage of flooding is that it is cost effective when compared to other behavioural therapies such as SD which take months or even years to rid the person of their phobia. It’s very quick for eradicating phobias which is useful as patients are removed from their phobia as soon as possible, this also makes it cost effective and cheaper.
- Disadvantage is that it is highly traumatic and patients may be unwilling to continue to the end. Time, money and resources will be wasted in effort to set it up flooding for the patient, and the phobia remains uncured. Waste of time and money and alternatives such as SD may be better.
+ Wolpe supports flooding. In order to remove a patients phobia of cars, the patient was forced into a car and driven around for 4 hours until her phobia was eradicated, demonstrating how flooding is effective for treating phobias.
