Treating Phobias

Question 1

What are the 2 behavioural approaches to treating phobias?

Answer 1

1) Systematic desensitisation
2) Flooding

Question 2

1) Systematic desensitisation

Answer 2

This treatment assumes that phobias are caused by the automatic response of fear becoming associated to particular objects/situations via classical conditioning.

Systematic desensitisation is a form of counter-conditioning, where the therapist tries to replace the fear response by the alternative response of relaxation.

This is because the body cannot experience fear and relaxation at the same time - this is called reciprocal inhibition.

1) The client is taught how to relax and they learn how to control their breathing and muscles. This takes several sessions. It works on the principle of reciprocal inhibition. It is where 1 response is inhibited or stopped because it is incompatible with another i.e. you can’t be anxious and relaxed at the same time.
2) They then form an anxiety hierarchy.
3) Gradually, they move up in the hierarchy until the highest is reached in a state of relaxation.

Question 3

2) Flooding

Answer 3

This is more extreme than systematic desensitisation. Rather than exposing a person to their phobic stimulus gradually, a person is exposed to the most frightening situation immediately.

For example, a person with a phobia of dogs would be placed in a room with a dog and asked to stroke the dog straight away.

With flooding, a person is unable to avoid (negatively reinforce) their phobia and through continuous exposure, anxiety levels decrease.

Flooding can take one of two forms:
a) in vivo (actual exposure)
b) in vitro (imaginary exposure)

A patient is taught relaxation techniques and these techniques are then applied to the most feared situation either through direct exposure, or imagined exposure.

Question 4

Strength of systematic desensitisation

Answer 4

There is research support showing that it is effective. McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation, when using in vivo techniques. This shows that systematic desensitisation is effective in treating phobias.

Question 5

Strength of systematic desensitisation

Answer 5

Further support comes from Gilroy et al. (2002) who examined 42 patients with arachnophobia. Each patient was treated using three 45-minute systematic desensitisation sessions. When examined 3 months and 33 months later, the systematic desensitisation group were less fearful than a control group (who were only taught relaxation techniques). This provides further support for systematic desensitisation, as a long-term treatment for phobias.

Question 6

Weakness of systematic desensitisation

Answer 6

It is not effective for all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning) for example, a fear of heights, are 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. These phobias highlight a limitation of systematic desensitisation which is ineffective in treating evolutionary phobias.

Question 7

Strength of flooding

Answer 7

One strength of flooding is it provides a 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 quickly. This is a strength because patients are treated quicker and it is more cost effective for health service providers.

Question 8

Weakness of flooding

Answer 8

One limitation of flooding is that it is a highly unpleasant experience. Confronting one’s phobic stimulus in an extreme form provokes tremendous anxiety. Sarah Schumacher et al. (2015) found that participants and therapists rated flooding as significantly more stressful than systematic desensitisation. This raises the ethical issues for psychologists of knowingly causing stress to their clients, although this is not a serious issue provided they obtain informed consent. More seriously, the traumatic nature of flooding means that attrition (dropout) rates are higher than for systematic desensitisation. This suggests that, overall, therapists may avoid using this treatment.

Question 9

Weakness of flooding

Answer 9

Although flooding is highly effective for simple (specific) phobias, the treatment is less effective for other types of phobias, including social phobia and agoraphobia. Some psychologists suggest that social phobias are caused by irrational thinking and are not caused by an unpleasant experiences (or learning through classical conditioning). Therefore, more complex phobias cannot be treated by behaviourist treatments and may be more responsive to other forms of treatment, for example cognitive behavioural therapy (CBT), which treats the irrational thinking.