behavioural approach to treating phobias

Question 1

what can phobias be removed by?

Answer 1

counterconditioning

Question 2

what is counterconditioning?

Answer 2

● learning a new response to the feared stimulus

● principle behind systematic desensitisation

Question 3

explain the process involved in systematic desensitisation

Answer 3

● anxiety hierarchy put together by client and therapist
list of situation related to phobic stimulus that provoke anxiety - in order from least or most frightening

● therapist teaches client relaxation techniques such as breathing exercises or mental imagery techniques

● client exposed to phobic stimulus while in relaxed state - takes place across several sessions, starting at bottom of anxiety hierarchy - gradual exposure
when client can stay relaxed in lower levels of hierarchy, then they can move up

● treatment is successful when client can stay relaxed in situations high on anxiety hierarchy

● based on idea of reciprocal inhibition - impossible to be afraid and relaxed at same time - one emotion prevents the other

Question 4

what is flooding?

Answer 4

● immediate exposure

● without option of avoidance

● patient learns quickly phobic stimulus is harmless through exhaustion of fear response

● this is known as extinction

● important to gain informed consent - unpleasant procedure

Question 5

evaluation

Answer 5

● systematic desensitisation:

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p: effective in treatment of specific phobias
e: gilroy followed up 42 patients who had been treated for spider phobias in three 45 min sessions
measures included assessing response to spiders - control group given only relaxation and no exposure
both 3 and 33 months later - sd group were less fearful than relaxation group
c: strength as shows sd can improve persons qol as they no longer have to avoid certain situations

p: less trauma involved than flooding
e: used with diverse range of patients (some sufferers are young, experiences learning difficulties so is much more ethical)
some patients may find it hard to understand what is happening in flooding - could be issues of informed consent related to this
c: strength as it results in low refusal rates (number of patients refusing to start treatment) for sd compared to flooding, meaning more people with phobias can be treated

● flooding:

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p: effective as other treatments for specific phobias, and quicker than systematic desensitisation
e: outrun found flooding is highly effective much quicker than sd and cbt
patients can be cured after 2-3 hour sessions, whereas SD takes on average 6-8 sessions to complete the therapy
c: strength as patient is free of phobia symptoms quicker, making flooding more cost effective than alternatives

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p: attrition rate is high
e: many people refuse to start treatment once they are faced with day of completing treatment or drop out part way through
as flooding traumatic process - no option of avoidance
c: limitation as time and money wasted preparing patients only to have them refuse to start or finish treatment before they have overcome their fear
sd is more beneficial in this respect as more humane and gradual so has low attrition rate