lesson 7 behavioural therapies for phobias

Question 1

systematic desensitisation ao1

Answer 1

-behavioural therapy developed by Wolpe (1958) to reduce/diminish phobias by using classical conditioning
-SD uses classical conditioning to replace the irrational fears and anxieties associated with phobic objects with calm relaxed responses instead
-central idea is that is impossible top experience two opposite emotions at the same time, reciprocal inhibition
-if patient learns to remain relaxed (new emotional response) in presence of phobia they can be cured = counter conditioning

Question 2

SD process

Answer 2

Hierarchy of fear- constructed by patient and therapist, situations involving phobia are ranked from least to most fearful
Relaxation techniques- patients are taught deep muscle relaxation techniques such as deep breathing, progressive muscular relaxation and relaxation response, PMR - tense up a group of muscles so that they are tightly contracted as possible, hold them in a state of extreme tension for a few seconds and then relax to previous state then consciously relax muscles even further so patient is relaxed as possible, patients asked to sit quietly and comfortably and close their eyes, start by relaxing muscles at feet and work up their body, while asked to breathe deeply, meditate and imagine relaxing situations
Gradual exposure- patient is introduced to phobia gradually and work their way up the fear hierarchy starting with least frightening, must use relaxation techniques while exposed at each stage, when comfortable with one particular stage of hierarchy/no longer afraid they move onto next stage, eventually through repeated exposure to phobic objects with relaxation and no fear the phobia is eliminated, process will take many therapy sessions

Question 3

SD ao3

Answer 3

-Jones (1924) supports use of SD to eradicate Little Peters phobia, a white rabbit was presented at gradually closer distances and each time his anxiety levels lessened, eventually he developed affection for white rabbit which extended to all white fluffy objects, shows SD can eliminate phobias
-Klosko et al (1990) supports use of SD, 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
-less traumatic therapy for phobias compared to others such as flooding, therefore less ethical implications/less psychological harm, less upsetting for patient to endure
-not always practical for patients to be desensitised by confronting real life phobic situations, real life step by step situations are difficult to arrange/apply to real life situations, questions effectiveness of therapy
-addresses symptoms of phobias however some critics claims underlying causes of phobia will remain and in the future symptoms will return or symptom substitution will occur and other abnormal behaviours will replace the ones that have been removed

Question 4

flooding ao1

Answer 4

-directly exposing the patient to phobia in immediate situation
-beforehand taught relaxation techniques such as deep muscle relaxation, deep breathing, meditation
-no gradual buildup, involves immediate exposure to a very frightening extreme situation, can be done in vivo/for real or virtually by imagining the situation
-flooding stops phobic responses very quickly because patient does not have the option for any avoidance behaviour, not allowed to run away or not face phobia
-might quickly learn that phobia is harmless therefore extinction occurs, or might achieve relaxation in presence of phobia because they are exhausted by own fear response, phobic response diminishes
-ethical even though it can cause a great deal of initial psychological harm, patient would have to give fully informed consent so they were fully prepared for flooding session
-usually 2-3 hours each session, much longer than SD

Question 5

flooding ao3

Answer 5

-cost effective especially when compared to CBT which take months or years to work and rid the person of phobias, flooding seems to be quick therapy for phobias which is useful for patients as it means they are free of symptoms as soon as possible, cost effective and cheaper
-less effective for curing some types of phobias such as social phobia, might be because social phobias have more cognitive aspects that flooding cannot address very well, better cured by using cognitive therapies
-highly traumatic experience for patients and many might be unwilling to continue until the end, time and money might be wasted preparing patients for flooding experience and they decide not to complete the treatment and remain uncured, other alternatives may be better
-Ost (1997) stated flooding is an effective and rapid treatment that delivers immediate improvements for phobic patients, especially the case when a patient is encouraged to continue self directed exposure to phobia outside of therapy sessions, results from flooding can be applied to everyday life outside of the therapy situation