Treatment for Phobia's

Question 1

What is Systematic Desensitisation?

Answer 1

A therapy based upon behaviourist principles,
- Phobias are regarded as maladaptive behaviours and SD aims to replace these with adaptive behaviours using classical conditioning.
-The phobic learns to associate their phobic stimulus with a new response, relaxation – counter-conditioning
-This reduces the anxiety that the phobic stimulus originally produced – they are now desensitised.

Exposure can be done in two ways:

In vitro – the client imagines exposure to the phobic stimulus.
In vivo – the client is actually exposed to the phobic stimulus.

Question 2

What is the procedure of Systematic Desensitisation?

Answer 2

-The patient is firstly taught relaxation techniques to take attention away from the phobic stimulus and reduce the body’s anxious state.
-Focusing on breathing and progressive muscle relaxation.
-Both the therapist and patient create an anxiety/desensitisation hierarchy. This is a series of scenes that starts with a very low fear response and then gradually increases this fear response/scenario in a stepped way progressing to the most feared scenario.
- Whilst in a relaxed state, the patient starts to work through their least feared scenario.
- When the patient learns to cope with this situation, they move up to a higher level of fear This continues until they are able to
cope with the scenarios at the high end of the hierarchy.
- Relaxation techniques and reinforcement are paired with every stage of the process.

-Once the patient reaches the scenarios at the top end of the hierarchy, their treatment is now complete - they become counter-conditioned and associate the previous phobic stimulus with
relaxation.

Question 3

A03 - Systematic Desensitisation - Cost

Answer 3

SD is relatively cheap and convenient in terms of time and effort, the patient may not enjoy the experience, but they know what is required of them.
-As SD is relatively easy, requiring only little effort, it may be more
appropriate for children and people with learning difficulties than other therapies,
= E.g., CBT, requires the patient to heavily engage with the way in which their automatic thought processes need amending.
-The ease of SD means that people can buy self-help books to ease their phobia - impacting positively on the cost to the
economy and strengthening SD as an effective tool against phobias

Question 4

A03 - Systematic Desensitisation - Pace

Answer 4

SD is directed at the pace of the client and therefore can be a gentle approach to treating a phobia.
-SD allows the patient to control the steps he/she must make until fear is overcome.
-Whilst the ethics of this steady approach gives the patient control, understanding and time to assimilate the process, the pace and control may lead to patient to not achieve their ultimate goal as the fear is too great.
-This questions SD as a treatment for all phobias, particularly ancient ones (heights) which may be challenging to treat.

Question 5

What is Flooding?

Answer 5

Flooding was invented by psychologist Thomas Stampfl in 1967.
- A therapy based upon the behaviourist principles of classical conditioning.
-Phobias are regarded as maladaptive behaviours and flooding aims to replace these with adaptive behaviours using classical conditioning. - The phobic learns to associate their phobic stimulus with a new
response, relaxation. This reduces the anxiety that the phobic stimulus originally produced.

• In a single session, the patient is presented with their phobic stimulus in their most feared situation.
  -The session continues until the patient becomes fully relaxed, likely to last between 2 and 3 hours.
  -As time progresses the adrenaline response caused by the phobic stimulus will naturally gradually decease and this, together with the relaxation, allows a new stimulus-response association to be learnt by the patient.
• More recently, flooding has adopted a virtual reality aspect – a computer program can produce an environment that stimulated the phobic situation.

Question 6

A03 - Flooding - Too Impactful

Answer 6

• Flooding is likely to be highly traumatic for patients and cause high levels of anxiety.
  -Although patients provide informed consent, many do not complete their treatment because the experience is too stressful.
• Hence, flooding is a waste of time and money if patients do not finish their therapy.

-Furthermore, with high drop-out rates, one must question the competency of the procedures used when gaining ‘informed’ consent
from a patient.
- Likewise, the ethics can be questioned in terms of use with children and adults with special needs, who cannot give their informed consent
-This therefore limits the application of flooding as a treatment
for phobias for all individuals.

Question 7

A03 - Flooding - Effectiveness

Answer 7

• Flooding is a fast technique that can produce results in 2-4 hours
• Whilst this can be highly beneficial for some phobics, there are many practical and transferable issues with the procedure.
  -Firstly, acquiring, caring for and ethically returning some phobic stimuli would be highly challenging e.g., fear of snakes.
• Likewise, there are issues of transferability outside the clinical setting once the flooding session is over.
  -This therefore questions the use of flooding as a practical and long-term treatment for phobias.