**L7 - Behavioural Treatments for Phobias Flashcards
what are the TWO BEHAVIOURAL TREATMENTS for PHOBIAS?
1) SYSTEMATIC DESENSITISATION
2) FLOODING
what is SYSTEMATIC DESENSITISATION? - PT 1
SD is a BEHAVIOURAL THERAPY DEVELOPED BY WOLPE to REDUCE PHOBIAS by USING CLASSICAL CONDITIONING.
A person experiences FEAR AND ANXIETY as a BEHAVIOURAL RESPONSE TO A PHOBIC OBJECT.
SD REPLACES THAT FEAR AND ANXIETY with RELAXED RESPONSES INSTEAD
what is SYSTEMATIC DESENSITISATION? - PT 2
The CENTRAL IDEA OF SD is that it is IMPOSSIBLE TO EXPERIENCE TWO OPPOSITE EMOTIONS AT THE SAME TIME, this is called RECIPROCAL INHIBITION.
Therefore if a patient can LEARN TO REMAIN RELAXED in the PRESENCE OF THEIR PHOBIA, they CAN BE CURED.
This is called COUNTER CONDITIONING
what are the 3 STAGES of SYSTEMATIC DESENSITISATION? (ARG)
1) (A) Anxiety Hierarchy
2) (R) Relaxation Training
3) (G) Gradual exposure
what is ‘A’ in ARG?
ANXIETY HIERARCHY - A HIERARCHY OF FEAR is established by the THERAPIST AND THE PATIENT.
Situations invoking the PHOBIC OBJECT are RANKED from LEAST FEARFUL TO MOST FEARFUL
If a person has a PHOBIA OF SNAKES, the therapist might first get them to just look at a photo of a snake, then at a snake in a tank, until eventually they are asked to hold a snake
What is the ‘R’ in ARG?
RELAXATION TRAINING - patients are TAUGHT DEEP MUSCLE RELAXATION TECHNIQUES, such as PROGRESSIVE MUSCULAR RELAXATION (PMR) and the RELAXATION RESPONSE.
The idea behind PMR is to TENSE UP A GROUP OF MUSCLES so that they are as TIGHTLY CONTRACTED AS POSSIBLE, HOLD THEM in a STATE OF EXTREME TENSION FOR A FEW SECONDS and then RELAX THE MUSCLES TO THEIR PREVIOUS STATE.
Finally, CONSCIOUSLY RELAX THE MUSCLES EVEN FURTHER so that you are as RELAXED AS POSSIBLE.
Patients are asked to SIT QUIETLY, and COMFORTABLY and CLOSE THEIR EYES. They then start relaxing the muscles from toe to head whilst BREATHING DEEPLY, MEDITATING and IMAGINING RELAXING SITUATIONS
what is the ‘G’ in ARG?
GRADUAL EXPOSURE - gradual exposure is when the patient is INTRODUCED TO THEIR PHOBIC OBJECT and they WORK THEIR WAY UP THE ANXIETY HIERARCHY starting with the LEAST FRIGHTENING STAGE
They USE THEIR RELAXATION TECHNIQUES whilst they are EXPOSED TO THE PHOBIC OBJECT
WHEN THEY FEEL COMFORTABLE with one PARTICULAR STAGE of the hierarchy they move on to the NEXT STAGE - eventually through REPEATED EXPOSURE to PHOBIC OBJECTS with RELAXATION and NO FEAR, the PHOBIA IS ELIMINATED
+ JONES (EVALUATION OF SYSTEMATIC DESENSITISATION)
+ JONES supports the USE OF SD to ERADICATE ‘LITTLE PETER’S’ PHOBIA.
A WHITE RABBIT was PRESENTED TO LITTLE PETER at GRADUALLY CLOSER DISTANCES and each time his ANXIETY LEVELS LESSENED.
Eventually he DEVELOPED AFFECTION FOR THE WHITE RABBIT
+ KLOSKO ET AL (EVALUATION OF SYSTEMATIC DESENSITISATION)
+ KLOSKO ET AL SUPPORTS THE USE OF SD.
He ASSESSED THERAPIES for the TREATMENT OF PANIC DISORDERS and found that 87% OF PATIENTS were PANIC FREE AFTER RECEIVING SD, COMPARED TO 50% ON MEDICATION, 36% ON A PLACEBO and 33% RECEIVING NO TREATMENT AT ALL
- TIP OF THE ICEBERG (EVALUATION OF SYSTEMATIC DESENSITISATION)
- BEHAVIOURAL TREATMENTS address the SYMPTOMS OF PHOBIAS. However some critics believe the SYMPTOMS ARE MERELY THE TIP OF THE ICEBERG and claim that UNDERLYING CAUSES of the PHOBIA WILL REMAIN.
In the future, the SYMPTOMS WILL RETURN or SYMPTOM SUBSTITUTION WILL OCCUR, when OTHER ABNORMAL BEHAVIOURS REPLACE THE ONES THAT HAVE BEEN REMOVED
what is FLOODING? - PT 1
FLOODING involves DIRECTLY EXPOSING THE PATIENT TO THEIR PHOBIC OBJECT.
Beforehand the patient would be TAUGHT RELAXATION TECHNIQUES such as DEEP MUSCLE RELAXATION, DEEP BREATHING and MEDITATION .
However, there is NOT A GRADUAL BUILD UP USING THE ANXIETY HIERARCHY: instead FLOODING involves IMMEDIATE EXPOSURE to a VERY FRIGHTENING and EXTREME SITUATION,
This can be done FOR REAL, or it could BE VIRTUAL, by IMAGINING THE SITUATION
what is FLOODING? - PT 2
FLOODING STOPS PHOBIC RESPONSES VERY QUICKLY.
This is because the patient DOES NOT HAVE THE OPTION FOR ANY AVOIDANCE BEHAVIOUR, and they QUICKLY LEARN that the PHOBIC OBJECT IS HARMLESS, and therefore EXTINCTION OCCURS.
In some cases the patient might achieve RELAXATION in the presence of their phobic object because they are SO EXHAUSTED BY THEIR OWN FEAR RESPONSE.
FLOODING CONCLUSION
FLOODING IS ETHICAL, even though it can CAUSE A GREAT DEAL OF INITIAL PSYCHOLOGICAL HARM; the patient would have to give their FULLY INFORMED CONSENT so that they were FULLY PREPARED FOR THE FLOODING SESSION
Patients are given the CHOICE of either having SD or FLOODING.
FLOODING THERAPY SESSIONS usually last 2-3 HOURS, which is MUCH LONGER THAN SD SESSIONS
+ WOLPE (EVALUATION OF FLOODING)
+ WOLPE SUPPORTS THE USE OF FLOODING to REMOVE A PATIENT’S PHOBIA of BEING IN CARS.
A GIRL WAS FORCED INTO A CAR and DRIVEN AROUND for FOUR HOURS UNTIL HER HYSTERIA WAS ERADICATED.
This demonstrates how EFFECTIVE FLOODING IS AS A TREATMENT FOR PHOBIAS
- HIGHLY TRAUMATIC (EVALUATION OF FLOODING)
- a disadvantage of flooding is that it is a HIGHLY TRAUMATIC EXPERIENCE and MANY PATIENTS might be UNWILLING TO CONTINUE WITH THE THERAPY UNTIL THE END.
TIME and MONEY MAY BE WASTED PREPARING PARTICIPANTS for the FLOODING EXPERIENCE, and then the patient might decide that they DO NOT WANT TO TAKE PART OR COMPLETE THE TREATMENT, and their PHOBIA REMAINS UNCURED
Because FLOODING IS TRAUMATIC it is UNSUITABLE FOR CHILDREN
