Behavioural approach to treating phobias : Flooding (4)

Flooding

• A less widely-used and more controversial behavioural treatment for phobias is flooding

• Flooding involves a sudden, extreme exposure to the phobic stimulus without any prior build-up or gradual, stage-by-stage approach

• Unlike SD, flooding does not rely on relaxation training or a fear hierarchy — it is an 'all or nothing' approach:

  • The individual is exposed directly to their most feared stimulus, either in real life (in vivo) or through imagination (imaginal exposure)

  • The patient must remain in sustained contact with the fear trigger without engaging in any avoidant or safety behaviours

  • It may take place in one session lasting a few hours

  • The sudden exposure to the phobic conditioned stimulus is designed to extinguish the fear, e.g.

    • taking an acrophobe to a high building and having them stand on the edge of it

    • getting a koumpounophobe to plunge their hands into a box full of buttons

    • immediately putting a spider on an arachnophobe

What is the extinction process?

• Anxiety initially peaks but, because no actual danger occurs, the fear response cannot be maintained indefinitely and eventually subsides

• This process is known as extinction — it occurs because the patient cannot avoid or escape the phobic stimulus

• Over repeated sessions, the new association is reinforced — what once filled the patient with fear is now regarded as 'just a spider' or 'just a high building'

Strength 1 Evaluation of flooding

• Flooding is cheap compared to all other forms of phobia therapy

  • Although individual flooding sessions are usually longer than SD sessions, fewer sessions are needed overall, which equals a lower cost to the patient

  • Thus the cost-effective nature of the therapy means that it has beneficial economic implications

Strength 2 Evaluation of flooding

• Flooding works well with 'simple,' straightforward phobias, e.g., arachnophobia and acrophobia which means that those needing the therapy can be easily identified

Limitation 1 Evaluation of flooding

• Flooding can be traumatic for the patient (even though they will have given informed consent prior to the therapy) so it may be ethically compromised

  • Schumacher et al. (2015) found both patients and therapists rated flooding as significantly more stressful than SD

    • This means that the therapy may lack ethical validity

Limitation 2 Evaluation of flooding

• Flooding is less effective with more complex phobias, such as social phobias 

  • Social phobias involve a variety of different interpersonal interactions dependent on the occasion

  • To be able to navigate the different demands of social events takes some skill and training, which flooding cannot provide