Treatments for phobias

What are the two treatments most used for phobias?

Systematic desensitisation and flooding

What theory is systematic desensitisation based on?

Classical conditioning

Who developed systematic desensitisation? When?

Wolpe, 1958

BRIEF explanation of how it works? (think - essay opener) (systematic desensitisation)

It uses counter-conditioning to replace maladaptive responses to a stimulus with healthier responses

What is the concept of ‘reciprocal inhibition’? (systematic desensitisation)

Developed by Wolpe, it is the idea that we cannot feel fear and relaxation at the same time, as the two emotions are not compatible

What determines the number of sessions needed? (systematic desensitisation)

The strength of the phobia

The process of systematic desensitisation can either be in ‘vivo’ or in ‘vitro’. What do these terms mean?

• ‘vivo’ - exposure to a real object

• ‘vitro’ - imagined situations

What occurs in stage 1 of systematic desensitisation?

The patient is taught deep muscle relaxation techniques and breathing exercises, such as meditation

What occurs in stage 2 of systematic desensitisation?

The patient creates a fear hierarchy, starting at stimuli which create the least anxiety and building up in stages to the most fear-provoking stimuli. This provides a structure for the therapy.

What occurs in stage 3 of systematic desensitisation?

The patient works their way up the fear hierarchy, starting at the least unpleasant stimuli and practicing their relaxation technique as they go. When they feel comfortable with a stimulus (they are no longer afraid and have replaced their anxiety response with a relaxed response to the stimulus), they move into the next stage in their hierarchy. If the client he finds upset, they can return to an earlier stage and regain their relaxed state.

What indicates that systematic desensitisation has been successful?

When the client has repeatedly imagined (or has been confronted by) the situation until it fails to evoke any anxiety at all.

Strength of systematic desensitisation?

There is supporting evidence to the effectiveness of systematic desensitisation as a treatment for specific phobias. Gilroy (2003) gave 42 patients three 46-minute sessions of systematic desensitisation. Patients were assessed on the severity of their arachnophobia via a Spider Questionnaire and observed response to a spider. Gilroy allocated patients to one of two conditions: control group who were treated with relaxation without exposure and the experimental group who were treated with systematic desensitisation. The researchers found at both 3 month and 33 month follow up’s that the SD group were less fearful of spiders than the relaxation group. Therefore, this evidence adds validity to the use of systematic desensitisation as an effective treatment for phobias.

Weakness of systematic desensitisation?

It is not able to fully treat all phobias. For example, it js less effective in treating someone with generalised anxiety disorder who has worries about imprecise situations as it is much harder to create a structured hierarchy of fear for imprecise situations. Therefore, this treatment is not the most appropriate way to treat a minority of patients and only works if the situation / object producing the fear can be clearly identified.

What theory is flooding based off of?

Classical conditioning

What are the two components of flooding?

• Unavoidable exposure

• Extinction

Explain ‘unavoidable exposure’ (flooding)

This involves introducing an individual to the thing they fear most in an immediate and unavoidable way.

Explain ‘extinction’ (flooding)

The process of an individual learning to associate the thing they feel with something neutral

How does flooding work?

When the body’s ‘alarm phase’ comes to an end, an individual feels drained but unafraid. This is because the fear response is limited. If the feared object is still present after the fear has subsided, an individual will learn to associate the stimulus with a lack of emotion rather than fear - causing extinction.

Strength of flooding?

There is evidence supporting the effective’s of using flooding to treat phobias. For example, Kaplan and Tolin (2011) reported that 65% of patients with a specific phobia given a single session of flooding showed no symptoms of the specific phobia 4 years later. This suggests that rapid exposure to a fearful situation or stimulus via flooding can prove effective as a treatment.

Weakness of flooding?

It is not very effective in treating social phobias. For example, most social phobias actually have a cognitive aspect - the patient is not simply afraid or anxious of the social situation, but they also have accompanying unpleasant thoughts or feelings. Therefore, this treatment could not be the only treatment used for these social phobias as it only tackles behavioural responses, not the cognitive aspects.