The Behavioural Approach to Treating Phobias

Question 1

What are the two treatments to phobias:

Answer 1

• Systematic Desensitisation
• Flooding

Question 2

Why Systematic Desensitisation works? + Aim

Answer 2

• It is impossible to feel two opposite emotions fear and relaxation at the same time.
• SD uses classical conditioning to replace irrational fears and anxieties associated to phobic objects with relaxation
• Learned relaxation technique (e.g breathing excersises) is used by clients + replaces anxiety as the client is gradually exposed in stages of rising intensity to phobic stimulus.

Question 3

What are the 3 processes involved in Systematic Desensitisation:

Answer 3

• Anxiety hierarchy
• Relaxation
• Exposure

Question 4

Anxiety hierarchy:

Answer 4

The therapist and patient tg construct an anxiety hierarchy- a list of situations related to the phobic stimulus that provoke anxiety, arranged in order from least to most frightening (low to high intensity) + give example

Question 5

Relaxation:

Answer 5

The therapist uses relaxation training to teach the patient to relax as deeply as possible. Might involve breathing excersizes or mental imagery techniques

Question 6

Exposure:

Answer 6

Finally, the patient gradually moves up the anxiety hierarchy in a relaxed state using relaxation techniques. This takes place across several sessions, starting at the bottom of the anxiety hierarchy. When the patient can stay relaxed in the presence of the lower levels of the stimulus, they move up the hierarchy. Treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy.

Question 7

How does flooding work?

Answer 7

• It is the direct and immediate exposure to phobic stimulus without a gradual build up in anxiety hierarchy
• exposure to very frightening situation for extended periods of time
• patients are prevented from avoiding the phobic stimulus as they are forced to stay in presence of phobic stimulus until fear has receded - flooding sessions are typically longer than SD sessions, often lasting 2-3 hours - e.g making someone with a phobia of lifts stay in a lift for several hours without being able to leave until they no longer feel afraid

Question 7

Why does flooding work?

Answer 7

Flooding stops phobic response very quickly. May be because patient does not have option to avoid phobic stimulus - soon learns it is harmless. In terms of CC, this process is called EXTINCTION. - Conditioned stimulus (e.g dog) is encountered without unconditioned stimulus (e.g being bitten). The result is that the conditioned stimulus no longer produces the conditioned response - COUNTER CONDITIONING. In addition - it may b that patinet achieves relaxation in presence of phobic stimulus bc they have become exhausted by their own fear response.

Question 8

A strength of SD is that research has found it can b extremely effective in the treatment of specific phobias.

Answer 8

Gilroy et al (2003) followed up 43 who had been treated for spider phobia in three 45 minute systematic desensitisation 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. Shows that SD is an effective and longlasting treatment of phobias - increasing in utility.

Question 9

How many ppl had been treated for spider phobia?

Answer 9

43

Question 10

How long were the systematic desensitisation sessions?

Answer 10

45 min

Question 11

Who followed up the people with spider phobia?

Answer 11

Gilroy et al (2003)

Question 12

A limitation of both flooding and SD is that they may not be addressing the real cause of the phobia.

Answer 12

The treatments have been criticised by the psychodynamic model, which claims that behavioural therapies focus only on symptoms and ignores the causes of abnormal behaviour. Psychoanalysts claim that the symptoms are merely the tip of the iceberg and that the real cause of phobias may be traumatic childhood experiences which are repressed into the unconscious mind - behaviourist therapy does not deal w these issues, rather tries to alleviate the anxiety caused by it. In long term - lead to phobia resurfacing in a different form (symptom substitution). Therefore, using behavioural therapies such as these to treat phobias may be ineffective in long run.

Question 13

What do Psychoanalysts claim?

Answer 13

symptoms are merely the tip of the iceberg and that the real cause of phobias may be traumatic childhood experiences which are repressed into the unconscious mind

Question 14

What does the psychodynamic model claim?

Answer 14

behavioural therapies focus only on symptoms and ignores the causes of abnormal behaviour

Question 15

Further limitation is that flooding is extremely traumatic for the patient.

Answer 15

Flooding requires patients to consent to give up their right to withdrawal - can lead to patients experiencing extreme emotion and sometimes physical symptoms such as fainting or breathing problems. Problem as stressful nature of flooding - ppl may be put off from trying it, esp ppl w existing respiratory/ heart issues. + Ppl attempting flooding may have to stop session to seek medical attention for sudden physiological problems triggered by stress and if treatment is stopped or abandoned, may make phobia even worse.
Therefore, SD could be considered more appropriate, effective and ethical treatment - gives patient full control and allows them to withdraw at any time - reducing credibility of flooding.

Question 16

Strength of flooding - more appropriate and time efficient than other treatment.

Answer 16

Ougrin - behavioural therapies significantly quicker than cognitive therapies.
Some cognitive therapies, e.g. CBT require patients to keep diaries and do hw to overcome the disorder. Flooding requires less conscious effort on patient’s part compared to psychotherapies, where patients must play a more active part.

Patients more likely to continue with treatment + lower attrition rate + overcome their phobia. This demonstrates treatment more effective than cognitive treatments.