Lesson 7: Behavioural Approach Of Treating Phobias

Question 1

What is systematic desensitisation?

Answer 1

• A behavioural therapy developed by Wolpe (1958) to diminish phobias by using classical conditioning.
• SD uses classical conditioning to replace irrational fears and anxieties associated with the phobic response with calm and relaxed responses
• it is impossible to experience two opposite emotions at the same time, this is called reciprocal inhibition. If a patient can learn to remain relaxed they can be cured from their phobia. This is called counter conditioning

Question 2

What is the process involved in systematic desensitisation?

Answer 2

• 1) Hierarchy of Fear: constructed by therapist and patient, situations with the phobic object are ranked
• 2) relaxation techniques: patients are taught deep muscle relaxation techniques, deep breathing, progressive muscular relaxation and the relaxation response.
• you need to tense a group of muscles as tightly as possible and hold them for a few seconds before relaxing them to their previous state.
• consciously relax the muscles starting at the feet and working up the body, and breathe deeply meditate and imagine relaxing situations whilst doing so
• 3) gradual exposure: patient is introduced to phobic object gradually (through fear hierarchy) and use the relaxation technique whilst exposed at each stage. When they feel comfortable at one stage you progress up the fear hierarchy.
• through repeated exposure to phobic objects with relaxation and no fear, the phobia is eliminated. This process takes many therapy sessions

Question 3

Evaluation of systematic desensitisation (-)

Answer 3

• it is not always practical, situations are difficult to arrange and control, and situations may not apply to real life phobias (phobia of happiness) and this can question the effectiveness of the therapy.
• although behavioural treatments address symptoms of phobia, critics believe that the underlying causes of the phobia will remain and symptoms will return or symptom substitution will occur

Question 4

Evaluation of systematic desensitisation (+)

Answer 4

• (Jones 1924) used systematic desensitisation to eradicate little Peters phobia. A white rabbit was presented at gradually closer distances and each time his anxiety lessened. Eventually affection developed and extended to all white fluffy objects
• (Klosko et al 1990) Assessed various therapies for treatment of panic disorders, and found 87% of patients with panic free after receiving SD. 50% panic free after receiving medication, 36% for placebo and 33% for no treatment at all
• SD is the less traumatic therapy for phobias like flooding, and has less ethical implications and is less upsetting

Question 5

What is Flooding?

Answer 5

• Flooding is directly exposing the phobic patient to their phobic object in an immediate situation. There is no gradual buildup instead it is an immediate exposure to a frightening and extreme situation. This can be done in vivo or it could be virtual
• flooding stops phobic responses very quickly. The patient does not have the option for avoidance and is not allowed to run away. They learn that the object is harmless and extinction occurs.
• some patients achieve relaxation but also exhausted by their own fear response that the phobic response diminishes.
• flooding is ethical although it causes initial psychological harm. The patient gives their fully informed consent

Question 6

Evaluation of Flooding (-)

Answer 6

• less effective for curing social phobias as social phobias have more cognitive aspects that flooding cannot address very well
• it is a highly traumatic experience, and patients may be unwilling to continue with the therapy until the end. Time and money may be wasted and the patient might decide that they do not want to take part or complete the treatment and the phobia remains uncured

Question 7

Evaluation of Flooding (+)

Answer 7

• cost effective, when compared to cognitive behavioural therapy which may take months or years to work. It is a quick therapy and patients are free of symptoms ASAP
• Effective and rapid treatment that delivers immediate improvements. The patient is encouraged to continue self-directed exposure outside of the therapy session. Flooding can be applied to every day life outside.