LEARNING - TREATMENT OF PHOBIAS

Question 1

systematic desensitisation (SD)

Answer 1

AO1:
->this theory is based on the principles of CC, the idea that a stimulus and involuntary response are associated, developed by Wolpe in the 1950s
–>it takes place over a number of sessions depending on the strength of the phobia and the clients ability to relax, usually 4-6 sessions, up to 12 for severe phobias
->4 stages of SD:
->1) functional analysis: careful questioning to discover the nature of the anxiety and possible triggers (find out anxiety situations)
->2) anxiety hierarchy: client and therapist derive a hierarchy of anxiety provoking situations from least to most fearful
->3) relaxation training (desensitisation): people are taught to relax their muscles, breathing techniques, imagine happy scenarios, meditate, anything that helps to relax
->4) gradual exposure: the above stages are combined and therapy begins, working through each stage using the relaxation techniques learnt, replacing fear with calm and gradually working up the hierarchy (this is either done in-vivo (real life) or in-vitro (imagination, eg. VR))

AO3: EVALUATION
D->(strength) SD is more effective at treating phobias than other treatments eg. flooding and drug treatment
–>SD is much more ethical and less traumatic than flooding, and provides a permanent solution, unlike drug treatments, which stop working if you stop taking the drugs

E->(strength) SD is highly ethical due to the anxiety hierarchy
–>if a client is working their way up the hierarchy through gradual exposure but gets too overwhelmed, they can move back a step and go at the pace they’re comfortable with

S->(strength) Rowe and Craske 1998 provide supporting research for SD
–>they found SD so useful that they suggest that the multiple exposures (as seen in SD) should also be used in different settings using varied stimuli to improve the durability and generalisability of treatment to real world encounters

S->(strength) SD has little/no side effects
–>as it is not a drug treatment there are no biological side effects, and relaxation techniques are taught which reduces the chances of panic attacks as a side effect

E->(weakness) SD takes place over up to 12 sessions depending on the strength of the phobia
–>this means that a professional should be paid for their time over multiple weeks, which may not be a financially viable option for everyone

R->(weakness) Craske and Barlow 1993
–>found tat between 60-80% of agoraphobics showed SOME improvements after SD, but it was only slight and often clients relapse completely after 6 months
–>therefore, it only masks the symptoms

T->(weakness) SD is time consuming
–>takes place over up to 12 sessions and clients must be patient to see the full effect of treatment, making it longer than other treatments like flooding
–>this may put some people off SD if they want immediate results

Question 2

flooding

Answer 2

AO1:
->rationale behind treatment:
–>the patient’s anxiety is maintained at such a high level that eventually some process of exhaustion or stimulus satiation must take place
–>if a client is prevented from making their normal escape/avoidance response then extinction of the phobia will occur

->clients are immediately exposed to the highest anxiety provoking situation
–>flooding provides the client with no escape options which causes the fight or flight response; no escape means we are forced to calm down and realise that we are not in any danger

->our ANS triggers our biological fight or flight response, which causes the SNS to speed up our breathing rate and heart rate, but this intense heightened state cannot be sustained so our PNS brings our SNS response back down, causing us to finally relax

->the blind panic (CR) contrasts the new feeling of relaxation (learned response), but you can’t feel two contrasting emotions at the same time, this is called reciprocal inhibition
–>the CS (phobic situation) no longer produces the CR (fear)
–>this exposure therapy tends to be done in vitro (with VR) to immediately place the client in the most anxiety provoking situation

AO3: EVALUATION
D->(weakness) SD is a better way of treating phobias than flooding
–>flooding can be a very traumatic experience, whereas SD goes at the client’s own pace and teaches relaxation techniques
–>therefore, SD is better

E->(weakness) flooding is NOT ethical
–>exposing the client’s to such high anxiety levels has been known to cause severe panic attacks, eg. Barrett (1969) used flooding to try to cure a college student’s fear of snakes, every time she shut her eyes she was told to imagine snakes, which later caused her to have debilitating insomnia
–>therefore, this puts a lot of people off flooding as a treatment for phobias

S->(strength) Wolitzky-Taylor (2008) carried out a meta analysis of 33 studies and found that exposure-based treatments were very effective at treating phobias compared to no treatment

S->(weakness) flooding may cause severe panic attacks as a side effect of the immediate exposure to, and no escape from, the highest anxiety situation

E->(strength) flooding is a cheaper alternative to other phobia treatments
–>the quick nature of flooding means that patients are free of their symptoms ASAP, which makes the treatment much cheaper than alternatives such as SD, which can take up to 12 sessions, costing much more

R->(weakness) reason or MASK?
–>flooding doesn’t take the time to find the cause of the phobia, instead just masking the symptoms

T->(strength) flooding is a time efficient treatment for phobias
–>the exposure happens in one long session unlike SD which takes place over the course of weeks
–>this makes it a more appealing option