Treatment of Phobias - Systematic Desensitisation Flashcards
What is systematic desensitisation?
a type of behavioral therapy based on the principle of classical conditioning
What is the aim of systematic desensitisation?
aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning
What is the first step of systematic desensitisation?
the patient is taught a deep muscle relaxation technique and breathing exercises. E.g. control over breathing, muscle detensioning or meditation. This step is very important because of reciprocal inhibition, where once response is inhibited because it is incompatible with another. In the case of phobias, fears involves tension and tension is incompatible with relaxation.
What is the second step of systematic desensitisation?
the patient creates a fear hierarchy starting at stimuli that create the least anxiety (fear) and building up in stages to the most fear provoking images. The list is crucial as it provides a structure for the therapy.
What is the third step of systematic desensitisation?
the patient works their way up the fear hierarchy, starting at the least unpleasant stimuli and practising their relaxation technique as they go. When they feel comfortable with this (they are no longer afraid) they move on to the next stage in the hierarchy. If the client becomes upset they can return to an earlier stage and regain their relaxed state.
How many sessions of systematic desensitisation is required?
4-6 sessions, up to 12 for a severe phobia
How can exposure be done?
- In vitro – the client imagines exposure to the phobic stimulus.
- In vivo – the client is actually exposed to the phobic stimulus.
What has research by Menzies and Clarke 1993 found?
that in vivo techniques are more successful than in vitro
What is a practical issue of the in vitro systematic desensitisation?
relies on the client’s ability to be able to imagine the fearful situation. Some people cannot create a vivid image and thus systematic desensitization is not always effective (there are individual differences).
What is a practical issue with systematic desensitisation?
is a slow process, taking on average 6-8 sessions. Although, research suggests that the longer the technique takes the more effective it is.
What is a theoretical issue with systematic desensitisation?
SD is not effective in treating serious mental disorders like depression and schizophrenia.
Although
highly effective where the problem is a learned anxiety of specific objects/situations
What have studies shown about the relaxation or hierarchy part of the therapy?
That neither are necessary.
The important factor is just exposure to the feared object or situation
Is systematoc desensitisation an effective therapy for social phobias or agoraphobia?
No.
Could it be that there are other causes for phobias than classical conditioning? For example, if a fear of public speaking originates with poor social skills then phobic reduction is more likely to occur in a treatment which includes learning effective social skills than systematic desensitization alone.
What did Rothbaum find?
Participants who were afraid of flying had lower anxiety levels than the control group and this improvement was maintained when they were followed up 6 months later
What are some ethical issues involved with systematic desensitisation?
SD creates high levels of anxiety when patients are initially exposed, which raises ethical issues and so questions appropriateness. It should be noted that the virtual reality therapy does help resolve these issues.
