Behavioural approach: Treating phobias Flashcards
Systematic desensitisation (SD)
Treating phobias: Systematic desensitisation
Behavioural therapy designed to gradually reduce phobic anxiety through CC
If person can learn to relax in presence of phobic stimulus they will be cured
Essentially a new response to phobic stimulus is learned
This is counterconditioning
There are 3 process involved in SD:
1. Anxiety hierachy
2. Relaxation
3. Exposure
Anixety hierarchy
Treating phobias: Systematic desensitisation
Put together by client w/ phobia & therapist
List of situations related to phobic stimulus that provoke anxiety arranged in order from least to most frightening
Relaxation
Treating phobias: Systematic desensitisation
Therapist teaches client to relax as deeply as possible
Impossible to be afriad & relaxed at same time, so one emotion prevents the other
This is reciprocal inhibition
Relaxation may involves breathing exercises or clieny may learn mental imagery techniques
Clients can be taught to imagine themselves in relaxing situations or they might learn meditation
Relaxation can also be achieved using drugs such as Valium
Exposure
Treating phobias: Systematic desensitisation
Client is expose to phobic stimulus while in relaxed state
Takes place across several sessions, starting w/ bottom of anxiety hierarchy
When client can stay relaxed in presence of lower levels of phobic stimulis they move up hierarchy
Treatment is successful when client can stay relaxed in situations high on anxiety hierarchy
Evaluation: Evidence of effectiveness
Treating phobias: Systematic desensitisation
Strength: evidence for effectiveness
Gilroy et al followed up 42 people who had SD for spider phobia in three 45m sessions
At both 3 & 33 months, SD group were less fearful than CG treated by relaxation w/o exposure
Wechsler et al concluded that SD is effective for specific phobia, social phobia & agoraphobia
Therefore, SD is likely helpful for peope w. phobias
Evaluation: People w/ learning disabilities
Treating phobias: Systematic desensitisation
Strength: can help people w/ learning disabilities
Some people requiring treatment for phobias also have learning disability
However, main alternatives to SD are not suitable
People w/ learning disabilities often struggle w/ cog therapies that require complex rational thought
May also feel confused & distressed by traumatic experience of flooding
Therefore, SD is often most appropriate treatment for people w/ learning disabilities who also have phobias
Flooding
Treating phobias: Flooding
Involves exposing people w/ phobia to phobic stimulus but w/o gradual build-up in an anxiety hierarchy
Flooding involves immediate exposure to frightening situation
Flooding sessions are typically longer than SD sessions
Sometimes only one long session is needed to cure a phobia
How does flooding work?
Treating phobias: Flooding
Flooding stops phobic responses very quickly
May be because w/o option of avoidance, client quickly learns that phobic stimulus is harmless
In CC terms this process is called extinction
Learned response is extinguished when CS is encountered w/ UCS
Result is that CS no longer produces CR
In some cases client may achieve relaxation in presence of phobic stimulus simply because they become exhausted by their own fear response
Ethical safeguards
Treating phobias: Flooding
Flooding is not unethical per se but is an unpleasant experience so its important that clients give fully informed consent to this traumatic procedure & that they are fully prepared before flooding session
Client would normally be given choice of SD or flooding
Evaluation: Cost-effective
Treating phobias: Flooding
Strength: highly cost effective
Clinical effectiveness means how effective a therapy is at tackling symptoms
However, when we provide therapies in health systems like the NHS we also need to think about how much they cost
A therapy is cost-effective if it is clinically effective & not expensive
Flooding can work in as little as one session as opposed to say 10 sessions for SD to achieve same result
Even allowing for a longer session (perhaps 3 hours) makes flooding more cost-effective
Therefore, more people can be treated at same cost w/ flooding than w/ SD or other therapies
Evaluation: Traumatic
Treating phobias: Flooding
Liimit: highly unpleasant experience
Confronting one’s phobic stimulus in an extreme form provokes tremendous anxiety
Schumacher et al found ppts & therapies rated flooding as sigly more stressful than SD
This raises ethical issue for psychologists of knowingly causing stress to their clients, althought this is not a serious issue provided they obtain informed consent
More seriously, the traumatic nature of flooding means attrition rates are higher than for SD
Therefore, therapists may avoid using thei treatment
