Behavioural Approach to Treating Phobias

Question 1

Systematic Desensitisation (SD)

Answer 1

Behavioural therapy designed to reduce an unwanted response such as anxiety to a stimulus through classical conditioning.

Question 2

Counterconditioning

Answer 2

A new response to stimulus is learned: relaxation instead of anxiety.

Question 3

Reciprocal Inhibition

Answer 3

Can’t be afraid and relaxed simultaneously so one emotion prevents the other.

Question 4

3 process involved in SD

Answer 4

Anxiety hierarchy, Relaxation, Exposure

Question 5

Anxiety Hierarchy

Answer 5

Put together by patient and therapist. List of sitchs related to stimulus that provoke anxiety arranged in order from least to most scary.

Question 6

Relaxation

Answer 6

Relax as deeply as possible: breathing exercises, learning mental imagery techniques, meditation.

Question 7

Exposure

Answer 7

Exposed to phobic stimulus when relaxed. When patient can stay relaxed in presence of lower levels of phobic stimulus, then they move up the hierarchy. If they can relax in presence of stimulus even at the high end of hierarchy then cured.

Question 8

Flooding

Answer 8

Behavioural therapy in which patient is exposed to extreme form of phobic stimulus in order to reduce anxiety triggered by stimulus. Takes place in a few long sessions. No gradual build up but immediate exposure.

Question 9

How does flooding work?

Answer 9

Stops phobic responses fast. This is because no avoidance behaviour, the patient quickly learns that stimulus is harmless. Learned response is extinguished when CS (dog) is encountered without UCS (being bitten). Result is CS no longer produces CR (fear). Some may achieve relaxation as tired by their own fear response.

Question 10

Ethical Safeguards

Answer 10

Unpleasant experience so patient has to give full informed consent and be prepared.

Question 11

Strength (Gilroy)

Answer 11

Effective. Followed up 42 patients who has been treated for spider phobia in 3 45 min sessions of SD. Assessed for spider phobia by assessing response to spider. Control group was treated by relaxation but no exposure. At both 3 months and 33 months after treatment, less fearful than control group. Shows it is helpful in reducing anxiety and long lasting effects.

Question 12

Strength

Answer 12

SD is suitable for diverse range of patients. Alternatives (flooding & cognitive therapies) aren’t suited to some patients. Some may have learning difficulties so can’t understand flooding or to engage with cognitive therapies that require ability to reflect on what you are thinking. Therefore SD is appropriate for patients.

Question 13

Strength

Answer 13

Patients prefer SD due to no causing the same degree of trauma as flooding. Also includes relaxation which is nice.

Question 14

Strength

Answer 14

Flooding is effective for specific phobias and it is a quicker alternative. Patients are free of their symptoms asap which makes treatment cheaper.

Question 15

Weakness

Answer 15

Less effective for some phobias: social phobia. This is due to having cognitive aspects. A sufferer of social phobia doesn’t simply experience an anxiety response but thinks unpleasant thoughts about the social sitch. Doesn’t tackle irrational thinking.

Question 16

Weakness

Answer 16

Flooding is traumatic. Patients are often unwilling to see it through to the end. Limitation as waste of time and money.

Question 17

Weakness of Both

Answer 17

One phobia might appear after one disappears: symptom substitution. This may be because they were focusing on removing the symptoms rather than identifying main cause.