Psychopathology - Behavioural Treatments of Phobias

Question 1

what are the behavioural treatments of phobias

Answer 1

• Systematic desensitisation
• Flooding

Question 2

define systematic desensitisation

Answer 2

main behaviourist therapy to treat phobias and it is designed to slowly reduce the anxiety caused by the phobia using classical conditioning.
If the patient can learn a new response to the phobic stimulus, as well as learn to relax in the presence of the phobia, then they will be cured.

Question 3

What are the 3 processes involved in systematic desensitisation

Answer 3

• Anxiety hierarchy
• relaxation
• exposure

Question 4

define anxiety hierarchy

Answer 4

High and low anxiety situations identified involving the phobic stimulus.

Question 5

How is the anxiety hierarchy used in systematic desensitisation

Answer 5

The client and therapist work together to construct an anxiety hierarchy, which they will work though at a pace comfortable with the client.

Question 6

Define the relaxation process

Answer 6

Patient taught relaxation techniques or introduced to anti-anxiety drugs.

Question 7

Explain how relaxation process is used in systematic desensitisation

Answer 7

It is impossible to be afraid and relaxed at the same time so techniques are taught or drugs are given to the client which prevents them from feeling afriad as one emotion takes priority - this is called reciprocal inhibition

Question 8

define reciprocal inhibition

Answer 8

Cannot be afraid and relaxed at the same time – one emotion prevents the other

Question 9

Explain how exposure is used in systematic desensitisation

Answer 9

Whilst in a relaxed state the patient is exposed to the phobic stimulus starting at the bottom of the hierarchy
This is likely to take several sessions between the patient and the therapist
Once the patient is comfortable and relaxed in the lower levels of the hierarchy, then they move up the scale

The aim of the treatment is to allow the patient to be successful and move up to the top of the hierarchy, whilst remaining relaxed

Question 10

what are the strengths of systematic desensitisation

Answer 10

• effective
• suitable for a wide range of patients
• Low levels of refusal/ dropping out
• clients enjoy the pleasant experience of learning relaxation techniques.

Question 11

Explain effectiveness as a strength of systematic desensitisation

Answer 11

• A strength is that systematic desensitisation is effective. This is shown by Gilroy et al 2003, who followed up on 42 clients who had been treated for arachnophobia in 3, 45minute sessions of systematic desensitisation.

Question 12

Explain how systematic desensitisation being effective for a wide range of clients is a strength

Answer 12

A strength is that it is suitable for a wide range of clients. This is a strength because alternatives such as flooding and cognitive therapies are not well suited to some patients. Eg. some sufferers of anxiety disorders like phobias also have learning difficulties. These can make it very hard for some patients to understand what is happening during flooding or to engage with cognitive therapies that require reflection. This means that systematic desensitisation is the most suitable to the widest range of patients.

Question 13

what are the limitations of systematic desensitisation

Answer 13

• doesnt treat the cause only the behaviour the phobia causes
• slower than flooding

Question 14

Explain how not treating the cause but just the resulting behaviour is a weakness of systematic desensitisation

Answer 14

A limitation is that systematic desensitisation doesnt treat the cause of the phobia just the behaviour it causes. This is a limitaion because it may leave the patient vulnerable to other phobias developing as the real reason behind the fear has yet to be uncovered (Psychodynamic theory). This means that is becomes only temporarily effective.

Question 15

Explain how being slower than flooding is a weakness of systematic desensitisation

Answer 15

It is a limitation because it costs more money as the process takes longer (multiple sessions) additionally the result will take longer to reach so if there is a time-crunch this isnt the best option.

Question 16

Define flooding

Answer 16

the patient is flooded with their phobia

Question 17

describe the process of flooding

Answer 17

• Flooding stops the phobic responses quickly
  1. The client cannot avoid the phobia in the flooding situation so, their irrational behaviour of avoidance is stopped.
  2. The client realises the phobic stimulus is harmless
  3. the phobic response stops, and the learned response is extinguished: In classical conditioning, this process is called extinction
  4. Counterconditioning happens and the patient learns to relax around the phobic stimulus instead of the anxiety they faced before

Question 18

Define extinction in the process of flooding

Answer 18

the gradual weakening of a conditioned response resulting in a behavior stopping, or going extinct

Question 19

How long does flooding therapy take

Answer 19

1-2 sessions lasting ~2-3hrs

Question 20

How long does systematic desensitisation take

Answer 20

as long as it take to go through the anxiety hierarchy

Question 21

What are the strengths of flooding as a treatment for phobias

Answer 21

• cost effective
• highly effective
• quicker than alternatives

Question 22

Explain how being cost-effective is a strength of flooding

Answer 22

A strength of flooding is that it is cost effective, this is a strength because it is quick and efficient. Studies comparing flooding to cognitive therapies (such as Ougrin 2011) have found that flooding is highly effective and quicker than alternatives. This means that clients are free of their symptoms faster and therefore treatment is cheaper.

Highly effective and quicker than alternatives

Question 23

What are the limitations of flooding

Answer 23

• less effective for some types of phobias
• traumatic for clients.
• Requires fully informed consent.

Question 24

Explain how being less effective for some types of phobias is a limitation of flooding

Answer 24

A weakness is that it is less effective for some types of phobias. Eg. social phobias. Social phobias don’t just have behavioural and emotional aspects but cognitive aspects too -negative thoughts when not in presence of stimuli.

Question 25

Explain how flooding being traumatising is a limitation

Answer 25

• A weakness is that the treatment is traumatic for clients. This is a weakness because clients are often unwilling to see the process through till the end. This means that time and money are wasted preparing clients only to have them refuse to start of complete the treatment.
• Schumacher et al. 2015 found that both patients and therapists rated flooding as significantly more stressful than systematic desensitisation

Question 26

Explain how requiring fully informed consent is a limitation of flooding

Answer 26

A weakness is that it requires fully informed consent. This is a weakness because if the consent is not received it becomes unethical, this means that patients must have a complete understanding before starting.

Question 27

outline the method of Gilroy et al 2003

Answer 27

• He assessed 42 clients with arachnophobia on several measures including a questionnaire and assessing their response to a spider.
• He also used a control group who were treated by relaxation but not exposure.
• At both 3 months and 33 months after the treatment the systematic desensitisation group were less fearful than the relaxation group. This is a strength because it shows that systematic desensitisation is helpful in reducing anxiety and has long lasting effects.