The behavioural approach to treating phobias Flashcards
What are the two behavioural approaches to treating phobias?
Systematic desensitisation and flooding
What is systematic desensitisation?
A behavioural therapy designed to gradually reduce phobic anxiety to a stimulus through classical conditioning
How can systematic desensitisation cure phobias?
If the sufferer can learn to relax in the presence of the phobic stimulus they will be cured
What causes systematic desensitisation?
Counterconditioning
What is counterconditioning?
Learning a new response to a phobic stimulus (replacing anxiety with relaxation)
What does counterconditioning lead to?
Reciprocal inhibition
What is reciprocal inhibition?
Feeling afraid and relaxed at the same time, so one emotion prevents the other
What are the three processes involved in systematic desensitisation?
1) The anxiety hierarchy
2) Relaxation
3) Exposure
What is the anxiety hierarchy?
A list of situations related to the phobic stimulus that provoke anxiety, arranged in order from least to most frightening
What is relaxation?
When the therapist teaches the patient to relax as deeply as possible
What are the four ways relaxation can be achieved?
1) Breathing exercises
2) Mental imagery techniques
3) Meditation
4) Drugs, e.g. Valium
What is exposure?
When the patient is exposed to the phobic stimulus while in a relaxed state
How is exposure carried out?
Across several sessions, starting at the bottom of the hierarchy
When the patient can stay relaxed in the presence of the lower levels of the phobic stimulus they can move up the hierarchy
When is systematic desensitisation successful?
When the patient can stay relaxed in situations high on the anxiety hierarchy
Give an example of research showing that systematic desensitisation is effective?
Gilroy et al (2003) followed up 42 patients who were treated for spider phobia in three 45-minute sessions of systematic desensitisation
They were assessed by the Spider Questionnaire and by their responses to a spider
Results were compared to a control group which was treated by relaxation without exposure
What were the findings of Gilroy’s study?
At both 3 and 33 months after the treatment, the systematic desensitisation group were less fearful than the control group
Why is this research a strength of systematic desensitisation?
It shows that it is helpful in reducing anxiety in specific phobias and the effects are long-lasting
Why is systematic desensitisation better than flooding and cognitive therapies?
It is suitable for a diverse range of patients, including those with learning difficulties
Why are flooding and cognitive therapies less effective in patients with learning difficulties?
Learning difficulties can make it hard to understand what is happening during flooding or to engage with cognitive therapies that require reflection
What is the biggest strength of systematic desensitisation?
It is acceptable to patients and patients prefer it over other treatment options
Why do patients prefer systematic desensitisation?
It doesn’t cause the same degree of trauma and flooding and it includes some pleasant elements, e.g. learning relaxation procedures
How is this preference reflected?
There are low refusal and attrition rates
What is flooding?
A behavioural therapy in which phobic patients are exposed to their phobic stimulus without gradual build-up in an anxiety hierarchy, to reduce anxiety triggered by that stimulus
Why is flooding a much quicker treatment?
It involves an immediate exposure to a very frightening situation and the sessions usually last longer
How does flooding work?
It stops phobic responses very quickly because patients don’t have the option of avoidance behaviour, so they quickly learn that the phobic stimulus is harmless and their anxiety is reduced
What is this process called?
Extinction
How is a learned response extinguished?
When the conditioned stimulus is encountered without the unconditioned stimulus, so the conditioned stimulus no longer produces the conditioned response (fear)
What are the ethical safeguards of flooding?
Flooding isn’t unethical but it is an unpleasant experience so patients must give informed consent to this traumatic procedure and must be fully prepared before the session
What is a strength of flooding?
It is cost-effective?
Why is flooding cost-effective?
Studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives, meaning that patients are free of their symptoms quicker and the treatment becomes cheaper
What are the two limitations of flooding?
1) It is less effective for some types of phobia
2) The treatment is traumatic for patients
Why is flooding less effective for some types of phobia?
More complex phobias (e.g. social phobias) because they have cognitive aspects, e.g. irrational thoughts so they will benefit more from cognitive therapies
Why is the traumatic treatment a problem?
Patients give consent but are often unwilling to see it through to the end so time and money are sometimes wasted preparing patients only for them to start or complete treatment
