P - The behavioural approach to treating phobias

Question 1

What are the 2 behavioural approaches to treating phobias?

Answer 1

Systematic desensitization and flooding.

Question 2

What process do both SD and flooding involve?

Answer 2

Counterconditioning.

Question 3

What is counterconditioning in terms of phobias?

Answer 3

Whereby a fear response to an object or situation is replaced with a relaxation response.

Question 4

What is counterconditioning a form of?

Answer 4

Classical conditioning.

Question 5

What is counterconditioning achieved by/through?

Answer 5

Through a slow process of gradual exposure or one single intense exposure.

Question 6

When is phobia treatment (counterconditioning) complete?

Answer 6

When the patient can relax in the presence of their most feared stimulus.

Question 7

What is flooding used to treat?

Answer 7

Phobias (and other anxiety disorders).

Question 8

What is flooding?

Answer 8

A form of behavioural therapy used to treat phobias and other anxiety disorders. A client is exposed to (or imagines) an extreme form of the threatening situation under relaxed conditions until the anxiety reaction is distinguished.

Question 9

How many sessions does it takes to expose the phobia in flooding?

Answer 9

One long session.

Question 10

When does a session of flooding stop?

Answer 10

When the patient’s anxiety has disappeared.

Question 11

In what ways can the flooding procedure be conducted?

Answer 11

In vivo techniques (actual exposure) or in virtual reality.

Question 12

Why does flooding work to treat phobias?

Answer 12

Rationale - a person’s fear response (and the release of adrenaline underlying this) has a time limit. As adrenaline levels naturally decrease, a new stimulus-response link can be learned - the feared stimulus is now associated with a non-anxious response.

Question 13

What is systematic desensitisation (SD)?

Answer 13

A form of behavioural therapy used to treat phobias and other anxiety disorders. A client is gradually exposed to (or imagines) the threatening situation under relaxed conditions until the anxiety reaction is extinguished.

Question 14

When does systematic desensitisation stop?

Answer 14

When the anxiety reaction to the phobia is extinguished.

Question 15

What is a reason why phobias may persist?

Answer 15

Phobics avoid the phobic stimulus and therefore there is no opportunity to learn that their feared stimulus is not so fearful after all.

Question 16

Who developed systematic desensitisation?

Answer 16

Joseph Wolpe (1958).

Question 17

What is reciprocal inhibition?

Answer 17

The idea that you cannot feel afraid and relaxed at the same time, meaning that one emotion prevents the other.

Question 18

What is the stress plateau?

Answer 18

Stress increases then plateaus before decreasing as it has a physiological limit.

Question 19

Does stress have a limit?

Answer 19

Yes - refer to the stress plateau because of the physiological limit.

Question 20

What is the first thing a therapist does in SD and flooding?

Answer 20

Teaches the patient relaxation techniques and about the stress plateau.

Question 21

How can relaxation be achieved in SD?

Answer 21

By the patient focussing on their breathing and taking slow, deep breaths and being mindful of ‘here and now’ as well as focusing on a particular object or visualising a peaceful scene. Progressive muscle relaxation is also used.

Question 22

What key feature does SD use?

Answer 22

A desensitisation hierarchy.

Question 23

What are the stages of systematic desensitisation?

Answer 23

1 - agree a hierarchy.
2 - teach relaxation techniques.
3- gradual exposure to feared stimulus using hierarchy.

Question 24

How many sessions of SD do patients normally have?

Answer 24

Normally 12.

Question 25

What are the first couple of SD sessions like?

Answer 25

They are educational teaching patients about the stress plateau etc.

Question 26

What are the stages of flooding?

Answer 26

1 - relaxation of the patient.

2 - patient exposed to fear and accomplishes it completely in one long session.

Question 27

What are the different exposure techniques used in SD?

Answer 27

Often a number of different exposure techniques are involved - in vivo, in vitro and also modelling, where the patient watches someone else who is coping well with the feared stimulus (Comer, 2002).