PP- Behavioural approach to treating phobias Flashcards
What is systematic desensitisation?
- Systematic desensitisation is a behavioural therapy developed by Wolpe to reduce phobias by using classical conditioning.
- 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.
What does reciprocal inhibition mean?
Experiencing two opposite emotions at the same time e.g fear and relaxation.
What does counter conditioning mean?
When a patient learns to remain relaxed in the presence of their phobia.
What are the 3 stages in systematic desensitisation?
- Anxiety hierarchy – the therapist and patient together construct a desensitisation hierarchy, which is a series of events/ stimuli that cause anxiety, with the level of anxiety increasing with every stage
- Relaxation – a patient is taught how to relax their muscles completely as stress and relaxation cannot co-exist or be experienced at the same time (reciprocal inhibition). Eg : breathing techniques used
- Exposure – the patient gradually works through each anxiety-evoking event while engaging in relaxation techniques. Once the patient has
mastered one stage in the hierarchy, they are ready to move on to the next. The patient will eventually master the feared situation
What is the hierarchy of fear?
- A hierachy of fear is constructed by the therapist and the patient.
- Situations involving the phobic object are ranked from least fearful to most fearful.
- If a person has a phobia of snakes, the therapist might at first get the patient to merely look at a photo of the snake, then at a snake in a tank until eventually they are asked to hold the snake.
What are the relaxation techniques?
- Patients are taught deep muscle relaxation techniques such as deep breathing, progressive muscular relaxtion (PMR) and the relaxation response.
What is gradual exposure?
- The patient is introduced to their phobic object gradually and they work their way up the fear hierarchy starting with the least frightening stage.
- They must use their relaxation technique whilst they are exposed to the phobic object at each stage.
- Through repeated exposure to phobic objects with relaxation and no fear, the phobia is eliminated.
What the advantages of systematic desensitisation?
1) SD has 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 than other types of behavioural therapies, and it is less upsetting for the patient to endure.
2) A strength of systematical desensitization is it has been found to be an effective treatment for specific phobias. For example, research by Gilroy et al followed up 42 people who had been treated for their spider phobia in three 45-minute SD sessions. A control group was treated by relaxation without exposure. At both 3 and 33 months after treatment, the SD group were significantly less fearful than control group This is a strength of SD as it shows the treatment works and the effects are also long lasting
3) Klosko et al assessed various therapies for the treatment of panic disorder and found that 87% of the patients were panic free after receiving SD, compared to the other patients receiving medication, placebo or no treatment. Therefore, SD is an effective therapy compared to others.
What are the disadvantages of SD?
1) It is not always practical for individuals to be desensitised by confronting real life phobic situations. Real life step by step situations can be difficult to arrange and control e.g a phobic of sharks.
2) A limitation of both flooding and SD is that they may not be addressing the real cause of the phobia. For example, psychoanalysts who use the psychodynamic model claims that symptoms are merely outward expression of deeper underlying emotional problems
(possibly triggered by traumatic childhood experiences). This is a problem because psychoanalysts believe that treatment of symptoms without any attempt to work out the deeper underlying problems can cause the issue to show itself in another way, through different symptoms. This is known as symptom substitution. Therefore using behavioural therapies such as these to treat phobias may be ineffective in the long run
What is flooding?
- Flooding involves directly exposing the phobic patient to their feared object in an immediate situation.
- Beforehand the patient would be taught relaxation techniques such as deep muscle relaxation, deep breathing and meditation.
- E.g a person scared of snakes might be expected to hold a snake for a long period of time.
What are the advantages of flooding?
1) It is cost effective and seems to be a quick therapy for phobias which is useful as patients are free of their symptoms as soon as possible.
2) Ost stated that flooding is an effective and rapid treatment as the results from flooding can be applied to everyday life outside of the therapy situation.
3) Ougrin compared behavioural therapies to cognitive and found behavioural treatments to be significantly quicker. Some cognitive therapies like CBT requires patients to keep diaries throughout their week and also do homework tasks to try to overcome disorder
This is a strength, as flooding procedures generally require less conscious effort on the patient’s part compared to psychotherapies where the patient has an active role in their treatment. This means patients are more likely to continue with the treatment with lower attrition rate and as a consequence overcome their phobia. Therefore, this demonstrates why such treatment may be more effective than cognitive treatments.
What are the disadvantages of flooding?
1) A limitation of flooding as a treatment for phobias is that it is extremely traumatic for the patient. For example, flooding requires the patients to consent to giving up their right to withdraw and as a result can lead to patients experiencing extreme emotion and sometimes physical symptoms such as fainting or
breathing problems. This is a problem because it not
only puts people off the treatment but may mean that
some patients will not see the therapy through to the end leaving the treatment incomplete. This would waste time and money for people trying to get rid of their phobia. On the other hand, SD could be considered a better treatment as patients are allowed to withdraw at any time but also have control over the therapy. The patient creates the hierarchy with the
therapist and is aware of what is happening at each stage, having more personal control making
the therapy ethical. Therefore, flooding as a
treatment for phobias may not be suitable for all people making it a potentially less credible
treatment
2) A limitation of both flooding and SD is that they may not be addressing the real cause of the phobia. For example, psychoanalysts who use the psychodynamic model claims that symptoms are merely outward expression of deeper underlying emotional problems
(possibly triggered by traumatic childhood experiences). This is a problem because psychoanalysts believe that treatment of symptoms without any attempt to work out the deeper underlying problems can cause the issue to show itself in another way, through different symptoms. This is known as symptom substitution. Therefore using behavioural therapies such as these to treat phobias may be ineffective in the long run
