L7 The Behavioural Approach To Treating Phobias (SD & Flooding) Flashcards
What is SD ?
- developed by Wolpe
- Systematic desensitisation is a behavioural therapy
- used to reduce/ diminish phobias by classical conditioning
How does SD work ?
- A person with a phobia experiences fear and anxiety as a behavioural response to an object or situation.
- SD uses classical conditioning to replace the irrational fears and anxieties associated with phobic objects with calm and relaxed responses instead.
- The central idea of SD is that it is impossible to experience two opposite emotions at the same time e.g. fear and relaxation; this is called reciprocal inhibition.
- Therefore if the patient can learn to remain relaxed (a new emotional response) in the presence of their phobia, they can be cured. This is called counter conditioning.
What is the process behind SD ?
1) The hierarchy of fear - constructed by therapist and patient. Situation involving fearful object are ranked from most fearful to least fearful eg. Seeing a pic of a cartoon snake and holding a snake
2) Relaxation techniques - patients are taught deep muscle relaxation techniques eg. Deep breathing and PMR. Tense a group of muscles very tight hold for a few seconds, consciously relax and imagine relaxing situations
3) Gradual exposure - introduce patient to phobic object gradually working through hierarchy of fear. Use relaxation techniques when exposed to feared object through rising intensity. After repeated exposure phobia should be eliminated. Will require multiple sessions.
Evaluation of SD ( Little peter’s phobia)
1) Jones (1924) 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 lessoned. Eventually he developed affection for the white rabbit, which extended to all white fluffy objects. This shows how SD can work to eliminate phobias
Evaluation of SD (Klosko et al)
2) Klosko et al. (1990) supports the use of SD. He assessed various therapies for the treatment of panic disorders and found that 87% of patients were panic free after receiving SD, compared to 50% receiving medication, 36% receiving a placebo and 33% receiving no treatment at all. Therefore SD is an effective therapy compared to others
Evaluation of SD ( less traumatic therapy)
3) SD had the advantages of being a less traumatic therapy for phobias than other behavioural therapies, like flooding, where the patient has to confront their phobias directly. Therefore SD has less ethical implications (less psychological harm) than other types of behavioural therapies, and it is less upsetting for the patient to endure (
Evaluation of SD ( not always practical)
4) A disadvantage of SD is that it is not always practical for individuals to be desensitized by confronting real life phobic situations. Real life step-by-step situations are difficult to arrange and control, e.g. someone is scared of sharks! Therefore SD might be very difficult to apply to real life situations/phobias and this can question the effectiveness of the therapy
Evaluation of SD ( addresses symptoms of phobias)
5) Behavioural treatments do have the advantage that they 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, and in the future the symptoms will return or symptom substitution will occur, when other abnormal behaviours replaced the ones that have been removed.
What is flooding ?
- direct exposure to feared object in an immediate situation
- beforehand, patients taught relaxation techniques such as deep muscle relaxation
- no fear of hierarchy
- can be done in Vivo ( virtual, imagine situation) or real life
What does flooding achieve ?
- stops phobic responses very quickly
- no option for avoidance
- extinction of phobia occurs
- may achieve relaxation due to exhaustion from fear response
Therefore phobia diminishes
The flooding sessions?
- ethical , even though they can cause a great deal of psychological harm
- informed consent must be gained
- choice of SD or flooding is given
- flooding sessions are usually 2 to 3 hours much longer than SD sessions.
Evaluation of flooding( cost effective )
1) Flooding has the advantage of being cost effective, especially when being compared to cognitive behavioural therapies which take months or years to work and rid the person of their phobia. Flooding seems to be a quick therapy for phobias which is useful as it means that patients are free of their symptoms as soon as possible, and this makes the treatment cost effective and cheaper
Evaluation of flooding ( less effective for certain phobias)
2) A disadvantage of flooding is that it is less effective for curing some types of phobias such as social phobia. This might be because social phobias have more cognitive aspects that flooding cannot address very well, e.g. addressing negative thoughts about speaking in public. Social phobias can be cured more successfully by using cognitive therapies
Evaluation of flooding ( highly traumatic experience)
3) 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 might be wasted preparing patients 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. This is a waste of time and money, and maybe other alternatives might be better such as SD
Evaluation of flooding ( Rapid/effective treatment)
4) Ost (1997) stated that flooding is an effective and rapid treatment that delivers immediate improvements for phobic patients. This is especially the case when a patient is encouraged to continue self directed exposure to feared objects and situations outside of the therapy situation. The results from flooding can be applied to everyday life outside of the therapy situation
