Behavioural - Treating Phobia Flashcards
Systematic Desensitisation (SD)
Based on Classical Conditioning.
1) The therapy aims to gradually reduce anxiety through counter conditioning:
• Phobia is learned so that phobic stimulus (conditioned stimulus, CS) produces fear (conditioned response, CR).
• CS is paired with relaxation and this becomes the new CR.
Reciprocal inhibition - not possible to be afraid and relaxed at the same time, so one emotion prevents the other.
SD - Anxiety Hierarchy
1) Client and therapist design an anxiety hierarchy - fearful stimuli arranged in order from least to most frightening.
2) A person with arachnophobia might identify seeing a picture of a small spider as low on their anxiety hierarchy and holding a tarantula as the final item.
SD - Relaxation Practiced
1) Person with phobia is first taught relaxation techniques such as deep breathing and/or meditation.
2) Person then works through the anxiety hierarchy. At each level the person is exposed to the phobic stimulus in a relaxed state.
3) This takes place over several sessions starting at the bottom of the hierarchy. Treatment is successful when the person can stay relaxed in high-anxiety situations.
Flooding Treatment
1) Flooding involves exposing a person with a phobia with the phobic object without a gradual build-up.
2) A person with arachnophobia receiving flooding treatment may have a large spider crawl over their hand until they can relax fully.
3) Without the option of avoidance behaviour, the person quickly learns that the phobic object is harmless through the exhaustion of their fear response. This is known as extinction.
Ethical Safeguards - Flooding
1) Flooding is not unethical but it is an unpleasant experience so it is important that people being treated give informed consent.
—> They must be fully prepared and know what to expect.
STRENGTH of SD
EVIDENCE OF EFFECTIVENESS
1) Researchers followed up 42 ppl
who had SD for spider phobia. At follow-up, the SD group were less fearful than a control group.
—> SD is likely to be helpful for ppl with phobias.
STRENGTH of SD
USEFULNESS FOR PPL WITH LEARNING DISABILITIES
1) Main alternatives to SD
are unsuitable for people
with learning disabilities,
e.g. cognitive therapies
require a high level of
rational thought and
flooding is distressing.
2) SD, on the other hand,
does not require
understanding or
engagement on a
cognitive level and is not
a traumatic experience.
—> SD is often the most
appropriate treatment
for some people.
EXTRA Evaluation
EFFECTIVE IN VIRTUAL REALITY
1) The exposure part of SD
can be done in VR which avoids
dangerous situations (e.g.
heights) and is cost-
effective.
2) But may be less effective than real exposure for social phobias because it lacks realism.
—> SD using VR is sometimes but not always appropriate.
STRENGTH of Flooding
COST-EFFECTIVE
1) A therapy is described as cost-effective if it is clinically effective and not expensive. Flooding can work in as little as one session.
2) Even with a longer session (e.g. three hours) this makes flooding more cost-effective than alternatives.
—> This means that more people can be treated at the same cost by flooding than by SD or other therapies.
LIMITATION of Flooding
TRAUMATIC
1) Researchers found that both
pps and therapists rated flooding as more stressful than SD.
2) Thus there are ethical
concerns about knowingly
causing stress (offset by
informed consent), and
the traumatic nature of flooding also leads to higher attrition rates than for SD.
—> This suggests that, overall, therapists may avoid using this treatment.
