psychopathology: behavioural approach to treating phobias Flashcards
What are the two types of exposure therapy?
- Systematic desensitisation
- Flooding
What is systematic desensitisation?
A behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning
Who introduced systematic desensitisation?
Joseph Wolfe (1958)
What is counter conditioning?
The learning of a different response to the stimulus e.g. relaxation instead of anxiety
What is reciprocol inhibition?
When you can’t feel two emotions at once so anxiety and relaxation cant be felt at the same time
What are the three stages of systematic desensitisation?
- The anxiety hierarchy
- Relaxation
- Exposure
Outline the steps of systematic desensitisation?
1) The anxiety hierarchy
- This is put together by the patient and therapist. This is a list of situations related to the phobic stimulus
2) Relaxation
- The patient is taught relaxation through breathing techniques, meditation or mental imagery techniques
3) Exposure
- The patient follows the anxiety hierarchy over multiple sessions until the patient can stay relaxed in high anxiety situations (as the hierarchy increases)
What is flooding?
This involves immediate exposure to a very frightening situation regarding the phobic stimulus. They last for two or three hours but require less sessions until the fear response disappears
What is the aim of flooding?
To extinguish or remove the learned association between the stimulus and response
Why does flooding have ethical issues?
Due to the unpleasant experience so patients must provide fully informed consent and should be prepared before the flooding session
Explain the process of flooding:
- A learned response is distinguished when the conditioned stimulus is encountered without the unconditioned stimulus
- the result is that the conditioned stimulus no longer produces the conditioned response (fear)
What is extinction and how does it relate to flooding?
When the client quickly learns that the phobic stimulus is harmless
- termed this by classical conditioning
Evaluation of systematic desensitisation: evidence of effectiveness -> strength
- research shows that systematic desensitisation is effective in its treatment for specific phobias
- e.g. Gilroy et.al (2003) followed up 42 patients who had been treated by systematic desensitisation for a spider phobia
- at both three and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure
- In a recent review, Theresa Wechsler et.al (2019) concluded that SD is effective for specific phobias, social phobia and agraphobia
- This means that SD is likely to be helpful for people with phobias
Evaluation of systematic desensitisation: People with learning disabilities -> strength
- A further strength of SD is that it can be used to help people with learning disabilities
- people with learning disabilities often struggle with cognitive therapies that require complex rational thought
- this means that SD is often the most appropriate treatment for people with learning disabilities who have phobias
Counterpoint: exposure therapies less effective for treating complex phobias -> limitation
- Although ET are effective for treating some phobias e.g. object phobias, they can be less effective for treating complex phobias
- e.g. social phobias
- this may be because these phobias have cognitive aspects
- e.g. a sufferer of social phobia does not just experience an anxiety response but they may think negative/irrational thoughts about the phobic situation
- this type of phobia may benefit from cognitive therapies e.g. CBT because they may be more effective at tackling the irrational thoughts
Evaluation of flooding: fast and cost effective -> strength
- The quick result is a strength because it means that patients are free of their symptoms in fewer sessions/one session which makes the treatment cheaper
- has clinical effectiveness and is not expensive so is cost-effective
- This means that people can be treated at the same cost with flooding than with SD or other therapies
Evaluation of flooding: traumatic -> limitation
- highly unpleasant experience
- confronting one’s phobic stimulus in an extreme form provokes tremendous anxiety
- Sarah Schumacher et. al (2015) found that pps and therapists rated flooding as significantly more stressful than SD
- raises the ethical issue for psychologists of knowingly causing stress to their clients
- not a serious issue provided they obtain informed consent
- traumatic nature of flooding means the attrition rates are higher than for SD
- symptom substitution may occur: when the phobia is replaced with another
- suggests that overall, therapists may avoid using this treatment
