The behavioural approach to treating phobias Flashcards
What are the two behavioural treatments for phobias?
Systematic desensitisation (SD)
Flooding
What is SD?
Designed to gradually reduce phobic anxiety through classical conditioning.
If a person can learn to relax in the presence of the phobic stimulus then they will be cured. Essentially, the phobic stimulus is repeatedly paired with relaxation rather than anxiety. This learning of a different response is called counterconditioning.
What is anxiety hierarchy?
The anxiety hierarchy is put together by the client and their therapist.
This is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
For example, a person with arachnophobia might identify a picture of a small spider as low on their anxiety hierarchy and holding a tarantula at the top of the hierarchy.
What is relaxation?
The therapist teaches the client to relax as deeply as possible. It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other. This is called reciprocal inhibition
What would relaxation involve?
Involve breathing exercises, or the patient might be taught to imagine themselves in relaxing situations or they might learn meditation.
Alternatively, they may be given drugs such as Valium to help calm themselves down.
What is exposure?
The client is exposed to the phobic stimulus whilst in a relaxed state.
This takes place across several sessions, starting at the bottom of the anxiety hierarchy.
When the client can stay relaxed in the presence of the lower levels of the phobic stimulus they move up the hierarchy. Treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy.
AO3: SD is not appropriate for all phobias
SD may not be effective against all phobias.
Ohman et al. (1975) suggest that SD may not be as effective in treating phobias that have an underlying evolutionary survival component (eg. fear of heights), than in treating phobias which have been acquired as result of personal experience.
This suggests that SD can only be used effectively in tackling some phobias.
AO3: Effectiveness for SD
Research has found that SD is successful for a range of phobias.
For example, McGrath et al. (1990) reported that about 75% of patients with phobias respond to SD. The key to success appears to lie with actual contact with the feared stimulus, so in vivo techniques are more successful than ones just using pictures or imagining the feared stimulus. Often a number of different exposure techniques are involved - in vivo, vitro and also modelling, where the patient watches someone else who is coping well with the feared stimulus.
This demonstrates the effectiveness of SD, but also the value of using a range of different exposure techniques.
What is flooding?
A person with a phobia is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus.
This takes place across a small number of long therapy sessions, often lasting two to three hours.
What is an example of flooding?
So, a person with arachnophobia receiving flooding treatment might have a large spider crawl over them for an extended period of time.
How does flooding work?
Flooding stops phobic responses very quickly. This may be because, without the option of avoidance behaviour, the client quickly learns that the phobic stimulus is harmless.
In terms of classical conditioning, flooding achieves behavioural extinction. A learned response is extinguished when a conditioned stimulus (eg. a dog) is encountered without the unconditioned stimulus (eg. being bitten). The result is that the conditioned stimulus no longer produces the conditioned response (fear).
AO3: Flooding is effective.
Flooding can be an effective treatment for those who stick with it and it is relatively quick compared to CBT.
For example, Choy et al. reported that both SD and flooding was the more effective of the two at treating phobias. On the other hand, another review (Craske et al, 2008) concluded that SD and flooding were equally effective in the treatment of phobias.
This shows that flooding is an effective therapy, albeit just one of the several options.
AO3: Individual differences for flooding.
Flooding is not for every patient.
It can be a highly traumatic procedure. Patients are obviously made aware of this beforehand but, even then, they may be quit during the treatment, which reduces the ultimate effectiveness of the therapy for some people.
Individual differences in responding to flooding therefore limit the effectiveness of the therapy.
