L7: The Behavioural Approach To Treating Phobias- Systematic Desensitisation and Flooding Flashcards
What is Systematic Desensitisation? (AO1)
A behavioural therapy developed by Wolpe that aims to reduce/diminish phobias by using classical conditioning.
Why does SD use classical conditioning?
A person with a phobia experiences fear and anxiety as a behavioural response to an object or situation. Classical conditioning aims to replace irrational fears and anxieties associated with phobic objects with calm and relaxed responses instead.
What is the main idea of SD?
It is impossible to experience 2 opposite emotions at the same time (fear and relaxation)- reciprocal inhibition. If a person can learn tor remain calm in the face of their phobia, they can be cured- counter conditioning.
Process of SD- 1) The hierarchy of fear
This is constructed by the therapist and the patient who creates a list of situations involving the phobia object and are ranked from least to worst. E.g. someone with a phobia of snakes may start by looking at a photo of snakes then end up with holding a snake.
Process of SD- Step 2) Relaxation Techniques
Patients are taught deep muscle relaxation techniques like deep breathing and Progressive Muscular Relaxation (PMR) and the relaxation response. The idea is to tense a few muscles then let go so the patient is as relaxed as possible. Patients are asked to sit quietly and comfortably and close their eyes. They relax with the feet first then build upwards slowly, deep breathing, meditating and imagining relaxing situations simultaneously.
Process of SD- Step 3) Gradual Exposure
The patient is exposed to the phobic object gradually and work their way up the fear hierarchy starting with the first stage. When they feel comfortable with one stage, they move on to the next. They are told to use the relaxation techniques taught at every stage while exposed to the phobic object and intensity. Eventually, through repeated exposure to the phobic object, fear is replaced by relaxation and the phobia is extinguished. This is a long process.
Evaluation- SD (Jones- little Peter) (+)
Jones’ research supports the idea of SD to eradicate little peters phobia. A white rabbit was presented to little Peter at gradually closer distances and each time his anxiety levels decreased. Eventually he developed affection towards the white rabbit and extended to all white fluffy objects.
Evaluation- SD- Klosko et al. (Various therapies) (+)
He assessed various therapies for the treatment of panic disorders and found 87% of patients were panic free after SD compared to 50% receiving medication, 36% receiving a placebo and 33% no treatment at all. SD is effective compared to others
Evaluation- SD- trauma (+)
SD has less trauma than other therapies for treating phobias, like flooding, where the patient confronts their phobia directly. SD has less ethical implications and is less upsetting for the patient to endure.
Evaluation- SD- (practical) -(-)
It is not practical for individuals to be desensitised by confronting real life phobic situations. E.g. a shark phobia is hard to follow step by step. Difficult to apply to real life situations. Questions effectiveness of the therapy
Evaluation- SD (symptom) (-)
Behavioural treatments address symptoms of phobias but critics believe symptoms are the tip of the iceberg and that the underlying causes of phobias still remain. In the future the symptoms will return or ‘symptom substitution’ will occur, when other abnormal behaviours replaced the ones that have been removed.
Flooding (Implosion) - AO1
This involves directly exposing a phobic patient to their feared object in an immediate situation. The patient is taught relaxation techniques like deep breathing and PMR before but there is no gradual build up. It involves an immediate exposure to a very frightening and extreme situation for a long time. This can be done ‘in vivo’ - either in real life or by imagining it.
Why does flooding stop phobic responses quickly?
The patient does not have the option to avoid the phobic object. They may learn quickly that the object is harmless- causing extinction. In some cases patients receive relaxation because they are so exhausted by their phobic response. They become so tired the phobic response diminishes. Flooding is ethical despite the initial severe psychological harm, a consent form with their fully informed consent is given prior and patients have the choice between SD and flooding. Flooding lasts usually 2-3 sessions
Evaluation- flooding (cost effective) (+)
It is cost effective compared to other behavioural therapies which take months or years to work out. Flooding is a quick therapy which means patients are rid of their phobic symptoms ASAP making the treatment cheaper and more cost effective.
Evaluation- flooding (social phobia) (-)
It might be less effective for treating phobias such as social phobias because these have more cognitive aspects that flooding struggles to address. E.g. addressing negative thoughts about public speaking. These can be cured better using cognitive therapies.
