Behavioural apporach to treating phobias

What is systematic desensitisation?

Behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning.

How does systematic desensitisation hypothetically cure phobias?

If the person can be relaxed in the presence of the stimulus, they will be cured

What is counterconditioning?

Learning a new response to phobic stimulus - pairing relaxation with stimulus instead of anxiety

What are the three processes involved in SD?

1. Anxiety hierarchy

2. Relaxation

3. Exposure

How does the anxiety hierarchy work?

Therapist and client compile a list of phobia-related situations that increasingly provoke anxiety

How does relaxation work?

Reciprocal inhibition - therapist makes client calm as you can’t be relaxed and afraid at the same time.

How does exposure work?

Client is exposed to phobic stimulus in a relaxed state, done multiple times and they work their way through anxiety hierarchy

What is flooding?

Exposing people to their phobic stimulus without the gradual build-up (anxiety hierarchy)

How does flooding work?

Stops phobic responses quickly as the person can’t use avoidance behaviour and quickly learns phobic stimulus is harmless or may become relaxed out of exhaustion from fear.

How does flooding work in terms of conditioning?

A learned response is destroyed when CS is encountered without the US - no longer producing CR.

What ethical safeguards does their need to be in flooding?

It is not unethical but an unpleasant experience - important the clients give informed consent

What supporting evidence is there for systematic desensitisation?

• Gilroy et al. (2003) followed up 42 people who had SD for arachnophobia.

• At 3 and 33 months, the SD group were less fearful than a control group who were not exposed.

• Wechsler et al. (2019) concluded SD is effective for specific phobia.

How is systematic desensitisation helpful for people with learning difficulties?

Cognitive therapies require complex rational thought. Flooding can be distressing and confusing. SD is most appropriate for people with learning difficulties.

Are there advantages of having SD in VR?

• Can be used to avoid dangerous situations, cost-effective because therapist and client don’t need to leave the room.

• Wechsler et al. (2019) suggest it is less effective than real exposure as it lacks realism.

How is flooding cost-effective?

It is clinically effective and not expensive = cost-effective. It can achieve what 10 sessions of SD does.

Why may therapists not want to use flooding?

• It is a highly unpleasant experience.

• Schumacher et al. (2015) found participants and therapists rate flooding as significantly more stressful than SD.

• Perhaps ethical issue of causing intentional stress to clients.

• Also means attrition rates are higher than for SD.

Why may flooding cause symptom substitution?

• May only mask symptoms rather than tackling underlying cause of phobia.

• Persons (1986) found a woman with a phobia of death was treated with flooding, which worsened her fear of being criticised.

• However, only evidence to support this is case studies, may only generalise to phobias within the study.