Chapter 9B

Question 1

evidence based interventions

Answer 1

Evidence-based interventions are treatments proven to be effective based on valid and reproducible
research. There are biological, psychological, and social interventions to treat specific phobias.

Question 2

biological interventions

Answer 2

biological interventions for specific phobia are those treatments which involve acting on the physiological elements of phobias

Question 3

biological interventions include

Answer 3

• benzodiazepines
• breathing training

Question 4

anti-anxiety medication: benzodiazepines

Answer 4

these are a group of drugs that have anti-anxiety and sleep-inducing effects
through acting selectively on GABA receptors in the brain. These drugs enhance GABA’s inhibitory
effects and make neurons resistant to excitation. In other words, benzodiazepines are GABA
agonists which stimulate neurons to enhance and mimic GABA’s inhibitory effects, thereby reducing
symptoms of anxiety, counterbalance the excitatory activity of Glu, and calm the nervous system.
They reduce physiological arousal and promote relaxation. However, benzodiazepines are short
acting and only remain in the bloodstream for a brief period of time. Although they may be effective
in the short term to reduce the physiological stress response associated with specific phobia, they
are not recommended for long-term use, as they are addictive, reduce alertness, and do not address
the underlying cause.

Question 5

breathing retraining

Answer 5

when experiencing a physiological stress response to a phobic stimulus,
individuals often exhibit detrimental breathing methods such as hyperventilation (fast deep breaths),
overbreathing (taking in too much air), and tachypnoea (rapid, shallow breaths). These excessive
breathing methods often occur when experiencing anxiety or a panic attack and upset the body’s
oxygen and carbon dioxide balance, resulting in dizziness, light-headedness, or blurred vision.
Breathing retraining is an anxiety management technique that involves teaching correct breathing
habits to people with a specific phobia. Taking slow, regular, deep breaths in through the nose and
out through the mouth will restore the body’s oxygen and carbon dioxide levels. Breathing retraining
also promotes relaxation by lowering arousal and heart rate, thereby reducing the anxiety and
stress we experience when exposed to a phobic stimulus.

Question 6

how does breathing retraining worK

Answer 6

Step 1:
A person is taught to focus on slow, controlled breaths when facing/thinking of phobic stimulus
Example techniques:
- Square breathing
- In through nose, out through mouth
- Slow counting while breathing
Step 2:
Apply the breathing technique when in the presence of a phobic stimulus

Question 7

psychological interventions

Answer 7

Professional treatment for phobias is avaialble to people where a phobia is causing significant disruption to their lives

Question 8

types of psychological interventions

Answer 8

• cognitive behavioural therapy
• systematic desensitation

Question 9

cognitive behavioural therapy

Answer 9

(CBT): is a type of psychotherapy based on the assumption that the
way people feel and behave is largely a product of the way they think. The cognitive element of CBT
focuses on addressing fear and thoughts related to anxiety, challenging the perceived levels of danger
associated with a phobic stimulus by identifying cognitive distortions. The behavioural element
involves challenging behaviours that reinforce fear and anxiety such as avoidance behaviours, as
well as teaching relaxation strategies that can be used in the presence of a phobic stimulus.

Question 10

systematic desensitisation

Answer 10

is a type of behaviour therapy that aims to replace an anxiety response
with a relaxation response when an individual with a specific phobia encounters a phobic stimulus.
It applies the principles of classical conditioning to unlearn associated fear responses and instead
associate the phobic stimulus with feelings of relaxation.

Question 11

steps in conducting systematic desensitisation

Answer 11

1. The individual will be taught relaxation techniques that decrease physiological symptoms of anxiety, such as through breathing retraining.
2. The phobic stimulus will be broken down into a fear hierarchy, which is a list of feared objects in situations ranked from least to most anxiety arousing. For example, if someone had a phobia of cheese, the bottom of the fear hierarchy may be seeing a picture
   of cheese, whilst the top of the fear hierarchy may be having cheese in one’s mouth and being unable to swallow.
3. Finally systematic, graduated pairing of items in the hierarchy with the learned relaxation techniques will occur, following the principles of classical conditioning. This will start with the least fear-arousing item in the fear hierarchy and continue until the most fear-arousing item produces a relaxation response.

Question 12

steps with reference to: before, during and after conducting

Answer 12

> before conditioning: A phobic stimulus (e.g. cheese) is the INS and will produce a fear response. A relaxation technique (e.g. breathing retraining) is the UCS that will produce a relaxation response, the UCR.
during conditioning: The NS and UCS are repeatedly paired to produce a UCR (e.g. practising breathing techniques in the presence
of the phobic stimulus to relax).
after conditioning: The NS becomes the CS and will
produce the desired relaxation response (CR) instead of an undesirable fear response.

Question 13

social interventions

Answer 13

• psychoeducation
• challenging unrealistic/anxious thought
• not encouraging avoidance behaviour

Question 14

psychoeducation

Answer 14

Psychoeducation: involves the provision and explanation of information to individuals diagnosed
with a disorder to increase their knowledge and understanding of the disorder and its treatment. It
assumes that if a person understands different aspects of the condition, they are more likely to recover or cope.

Question 15

psychoeducation may be

Answer 15

Psychoeducation may be about the nature of the disorder or the individual’s diagnosis, the
impact that it may have on an individual’s family and friends, suggestions for challenging unrealistic
or anxious thoughts, information about medication and interventions, or providing access to support
groups.

Question 16

pyschoeducation for a specific phobia may be

Answer 16

For specific phobia, psychoeducation may involve providing information about the phobic stimulus
and the realistic possibility of harm from the stimulus, information about social support groups and
information about other evidence-based interventions, such as systematic desensitisation, that may
be available.

Question 17

two main approaches to psychoeducation

Answer 17

• challenging unrealistic or anxious thoughts
• not encouraging avoidance behaviours

Question 18

challenging unrealistic or anxious thoughts

Answer 18

family, friends, and supporters should encourage
individuals suffering from a specific phobia to evaluate their thoughts, because these thoughts
are able to trigger phobic responses.

Question 19

how can we challenge anxious thoughts

Answer 19

We can challenge anxious thoughts though asking
questions like:
“Is there any evidence to contradict this thought?”
“Are you making a thinking error?”
“What would you say to a friend with this fear?”
“Could you do anything to resolve this situation if it did occur?”

Question 20

what does challenging anxious thoughts encourage

Answer 20

This will encourage the individual to reflect on their fear, and they may realise that their fear
is irrational or disproportionate to the actual harm posed by a stimulus, which can lead to a
reduction in the intensity of a phobic response.

Question 21

not encouraging avoidance behaviour

Answer 21

these behaviours negatively reinforce phobias, so
it is important for supporters to recognise and not encourage avoidance behaviours which
perpetuate a phobia. However, in doing so, care should be taken to not force an individual
to confront a phobic stimulus, as this can be mentally traumatic. Instead, gradual exposure
to a phobic stimulus while resisting avoidance is typically the best approach, as it provides an
opportunity to learn to cope with the stimulus safely and without overwhelming the individual.