Psychopathology: The behavioural approach to treating phobias

Question 1

What is systematic desensitisation?

Answer 1

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

Question 2

What is flooding?

Answer 2

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

Question 3

Who developed systematic desensitisation?

Answer 3

Wolpe

Question 4

Systematic desensitisation is successful because of the following 2 key factors. What are these?

Answer 4

• The key concept of SD is reciprocal inhibition. This simply means that it is impossible for a person to feel two opposite emotions, e.g., fear and relaxation, at the same time.
• It is a form of counter-conditioning (reverse learning) the individual learns to pair the feared object/ situation with relaxation rather than anxiety.

Question 5

What are the three key aspects of systematic desensitisation?

Answer 5

Counterconditioning: Taught a new association that is to counter the original behaviour learnt. The new response they learn is relaxation instead of fear (being mindful) because fear and relaxation cannot coexist (reciprocal inhibition).

Relaxation: Breathing techniques or meditation is learned (sometimes drugs are used).

Desensitisation hierarchy: A list of situations related to the phobic stimulus that provokes anxiety arranged in order from least to most frightening.

Question 6

Systematic desensitisation can also work without the presenting the feared stimuli but have the client imagine it. What is this called?

Answer 6

In vitro exposure.

Question 7

What is another word for in real life in systematic desensitisation?

Answer 7

In Vivo.

Question 8

What’s the step by step of how systematic desensitisation treats a phobia?

Answer 8

• Client is taught deep relaxation techniques (deep breathing, relaxing muscles etc)
• The client and therapist work to create a hierarchy of increasingly fearful situations.
• The client first learns to associate (Classical conditioning) pleasant relaxation with the least fear-provoking situation at the bottom of the hierarchy (e.g. for someone with a spider phobia this could involve simply looking at a picture of a spider). Once this is achieved, the client is encouraged, to systematically make step-by-step progress up the hierarchy; associating a new relaxed response with the fearful situation at each stage.
• The aim of SD is that eventually, the client will be able to associate the most fearful situation at the top of the hierarchy with a relaxed response (e.g. for a client with a spider phobia this could be finding a tarantula in their bed).

Question 9

What’s the step-by-step of how flooding treats a phobia?

Answer 9

Flooding (also known as implosion) works on the main assumptions of the Behavioural Approach and Systematic Desensitisation (i.e. still operates under the idea of Counter Conditioning), however, instead of operating on the step-by-step approach of the hierarchy to tackle the phobia patients go straight to the top of the hierarchy and imagine or have direct contact with their most feared scenarios. The idea is that the patient cannot make their usual avoidance responses and anxiety peaks at such high levels it cannot be maintained and eventually subsides.

Question 10

A03: Systematic desensitisation

Answer 10

• Research evidence which demonstrates the effectiveness of this treatment for phobias. McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation when using in vivo techniques (see below). Shows that systematic desensitisation is effective in treating phobias.
• Not effective in treating all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning) for example, a fear of heights, is not effectively treated using systematic desensitisation. Some psychologists believe that certain phobias, like heights, have an evolutionary survival benefit and are not the result of personal experience, but the result of evolution

Question 11

A03: Flooding

Answer 11

• Cost-effective treatment for phobias. Research has suggested that flooding is comparable to other treatments, including systematic desensitisation and cognition therapies (Ougrin, 2011), however, it is significantly quicker. This is a strength because patients are treated quicker and it is more cost-effective for health service providers.
• It’s highly traumatic for patients and causes a high level of anxiety. Although patients provide informed consent, many do not complete their treatment because the experience is too stressful and therefore flooding is sometimes a waste of time and money, if patients do not finish their therapy.