behavioural approach to treating phobias Flashcards
name the 2 types of approaches to treat phobias
- systematic desensitisation
- flooding
describe systematic desensitisation
- behavioural therapy
- designed to gradually reduce phobic anxiety via classical conditioning
- new response to phobic stimulus learned = counterbalancing
3 steps of systematic desensitisation
- anxiety hierarchy
- relaxation
- exposure
describe step 1 of systematic desensitisation: anxiety hierarchy
- anxiety hierarchy put together by client (with phobia) & therapist
- list of situations related to phobic stimulus that provoke anxiety
- ordered least to most frightening
describe step 2 of systematic desensitisation: relaxation
- therapist teaches client to relax as much as possible
- impossible to be relaxed & afraid at same time = reciprocal inhibition
- eg. breathing exercises, mental imagery techniques
- client can be taught to imagine self in relaxing situations or learn meditation
- can be achieved by drugs (eg. valium)
describe step 3 of systematic desensitisation: exposure
- client exposed to phobic stimulus whilst relaxed
- across several sessions, starting at bottom of anxiety hierarchy
- if client can stay relaxed in presence of lower levels of phobic stimulus, they move up
- treatment is successful if client can stay relaxed in situations high on anxiety hierarchy
describe flooding
- exposing people with phobia to phobic stimulus without gradual build up
- immediate exposure to frightening situation
- flooding sessions often longer than systemic desensitisation sessions
- sometimes only 1 session needed to cure phobia
how does flooding work?
- stops phobic responses quickly
- client doesn’t have option of avoidance behaviour = quickly learns phobic stimulus is harmless (extinction)
- learned response extinguished when conditioned stimulus is encountered without unconditioned stimulus
= conditioned stimulus doesn’t produce conditioned response
ethical safeguards to flooding
- unpleasant experience = important clients provide fully informed consent & are fully prepared prior to session
- client normally given choice between systemic desensitisation & flooding
systemic desensitisation AO3 +) evidence for its effectiveness
E: gilroy et al. (2003)
- followed up 42 people who had SD for spider phobia in three 45-minute sessions
- both 3 & 33 months, the SD group were less fearful than control group treated by relaxation without exposure
- wechsler et al. (2019) concluded SD is effective for specific phobia, social phobia & agoraphobia
T: means SD is likely to be helpful for people with phobias
systemic desensitisation AO3 +) can be used to help people with learning disabilities
E:
- some requiring phobia treatment also have a learning disability
- main alternatives to SD not suitable
- often struggle with cognitive therapies that require complex rational thought
- may also feel confused & distressed by traumatic experience of flooding
T: means SD is often most appropriate treatment for those with learning disabilities who have phobias
flooding AO3 +) cost-effective
E:
- flooding is clinically effective & not expensive
- can work in as little as 1 session, as opposed to many for SD to achieve same result
- can even allow for longer sesion, making flooding more cost-effective
T: means more people can be treated at same cost with flooding than SD/therapies
flooding AO3 -) flooding is a highly unpleasant experience/traumatic
E:
- confronting phobic stimulus in extreme form causes major anxiety
- schumacher et al. (2015) found participants & therapists rated flooding as significantly more stressful than SD
- raises ethical issues for psychologists, although not serious if obtain fully informed consent
- traumatic nature of flooding means attrition (drop out) rates are higher than SD
T: suggests therapists may avoid using treatment
