behavioural approach to treating phobias Flashcards
What are the two techniques for treatment of phobias?
- flooding
- systematic desensitisation
What is systematic desensitisation?
a behavioural therapy designed to gradually reduce phobic anxiety though classical conditioning principle.
What are the three aspects of systematic desensitisation?
- Anxiety hierarchy
- relaxation
- exposure
What is the anxiety hierarchy?
Put together by patient and therapist.
* A list of situations related to the phobic stimulus that provoke anxiety are arranged in order from most to least frightening
What is the relaxation aspect?
T herapist teaches the patient to relax as deeply as possible.
* Breathing exercises or patient might learn mental imagery techniques
* → Patients taught to imagine themselves in relaxing situation
Meditation
What is the exposure part?
Patients exposed to stimulus while in a relaxed state.
- Takes place across several sessions starting at the bottom of the anxiety hierarchy
- When patient able to stay relax in presence they move up the hierarchy
Treatment is successful when a patient is able to stay relaxed in situations at the top of the hierarchy.
What is flooding?
Involved exposing patients to phobic stimulus - but without gradual build up
* Involves immediate exposure to a very frightening situation
How does flooding work ?
- Stops response very quickly - as without the option of avoidance behaviour patient quickly learns the phobic stimulus is harmless
- In terms of classical conditioning this is called extinction
- A learned response is presented when the CS ( e.g a dog) is encountered with UCS (being bitten)
the result is that the CS no longer produces the CR of fear
In what cases are the patient may achieve relaxation ?
as they are exhausted by their own far response.
Strengths
- It is effective
Research shows SD is effective
Gilroy - followed 42 patients - been treated with spiders in 3 45 minute sessions of SD
Spider phobia was measured including questionnaire + assessing response to spider
At both 3 mths/33 months after treatment the fearful group less fearful than relaxation group
Effective in showing effectiveness and long lasting effects of SD - Acceptable to patients - SD
Patients prefer it - those given the choice
Largely due to the fact it does not involve trauma
Learning relaxation procedures are pleasant
Lower refusal / attrition rates
More accessible as no language / reflection required
- Suitable for a diverse range of patience - SD
Therefore, for these patients systematic desensitisation is probably the most appropriate treatment - Flooding effectiveness
Quick compared to CBT
Choy - reported both SD and flooding were effective but flooding was more effective of the two - Cost effective - flooding
Studies comparing cognitive theories have found flooding is highly effective and quicker than alternatives
Patients are free of their symptoms sooner + makes treatment cheaper
limitations
- Not appropriate for all phobias - SD
Ohman - suggest that SD may not be effective
Phobias may have an underlying evolutionary survival component
So treating phobias in terms of they have been acquired as a result of personal experience may not work - flooding would be better
Although, flooding is good for simple phobias it is not for complex social phobias - may be due to the fact they have cognitive aspects - may benefit from CBT more to tackle irrational beliefs
- Flooding - unethical
Unethical as could cause trauma → patient could drop out causing for avoidance - further causing for negative reinforcement
Wasting NHS time and money as phobia is still maintained
- Not suitable for all people - flooding
However, Flooding and cognitive therapies are not suitable for some sufferers who have anxiety disorders or learning difficulties.
Can make it hard to engage or understand what is happening / be able to engage in cognitive therapies
- However, this is not necessarily reliable findings as - other evidence has suggested they are equally effective
So no difinitive
