treatment of phobias

Question 1

Systematic desensitisation

Answer 1

A behavioural therapy designed to reduce an unwanted response, such as anxiety
Classical conditioning - counterconditioning

Question 2

SD - 3 processes

Answer 2

The anxiety hierarchy - list of situations related to the phobic stimulus that provoke anxiety - from least to most
Relaxation - reciprocal inhibition - breathing exercises - drugs - meditation
Exposure - exposed to phobic stimulus

Question 3

SD - Anxiety hierarchy

Answer 3

High and low anxiety situations identified involving the phobic stimulus

Question 4

SD - Relaxation

Answer 4

Client taught relaxation techniques or introduced to anti-anxiety drugs

Question 5

SD - Gradual exposure

Answer 5

Client works up the anxiety hierarchy, maintaining relaxation at each level

Question 6

How does SD work?

Answer 6

Counterconditioning - the phobia stimulus is paired with a relaxing stimulus until it triggers relaxation not anxiety

Question 7

SD - Evidence of effectiveness

Answer 7

• Strength
• Gilroy et al - 42 people who had SD for spider phobias in 3 45-minute sessions
• SD group less fearful than control group treated by relaxation without exposure
• SD likely to be helpful for people with phobias

Question 8

SD - People with learning disabilities

Answer 8

• Strength
• People with learning disabilities often struggle with cognitive therapies that require complex rational thought
• Feel confused and distressed by flooding
• SD often most appropriate treatment for people with learning disabilities who have phobias

Question 9

SD in virtual reality

Answer 9

• Advantages to conducting in VR
• Avoid dangerous situations such as heights and is cost-effective
• However
• Less effective and lacks realism

Question 10

Flooding

Answer 10

Exposed to extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus

Question 11

FD - Fast process

Answer 11

Small number of long sessions, sometimes just one session of three hours

Question 12

FD - Preparing the client

Answer 12

Flooding is a traumatic experience so the client needs to be well prepared for the exposure

Question 13

How does FD work

Answer 13

Stops phobic response very quickly - extinction - the conditioned stimulus is presented without the unconditioned stimulus until it no longer triggers a response

Question 14

FD - Ethical safeguards

Answer 14

Not unethical per se - unpleasant experience - important that clients give fully informed consent

Question 15

FD - Cost-effective

Answer 15

• Strength
• Highly cost-effective
• NHS - need to think about cost
• Clinical effectiveness - how effective a therapy is at tackling symptoms
• Flooding can work in one session - 10 sessions for SD
• More people can be treated at the same cost with flooding than with SD or other therapies

Question 16

FD - Traumatic

Answer 16

• Limitation
• Highly unpleasant experience
• Schumacher at al - participants and therapists rated flooding as significantly more stressful than SD
• Raises ethical issues for psychologists of knowingly causing stress to their clients - not a serious issue when provide informed consent
• Attrition (dropout) rates higher than for SD
• May avoid using this treatment

Question 17

FD - Symptom substitution

Answer 17

• Limitation of behavioural therapies
• Mask symptoms and don’t tackle underlying causes
• Persons - reported cause of women’s phobia of death treated using flooding
• Fear of death declined, fear of being criticised got worse
• However
• Only evidence of symptom substitutions comes from case studies so may only generalise to the phobias of the case studies