The behavioural approach to explaining and treating phobias: the two-process model, including classical and operant conditioning; systematic desensitisation, including relaxation and use of hierarchy; flooding

Summarise Mower’s two-process model

In the two-process model Mower (1960) suggests that phobias are first acquired via association (classical conditioning), and then maintained via reinforcement / consequences (operant conditioning).

Explain the 5 steps of classical conditioning

1) The phobic object(s) are at first neutral stimuli, not producing the phobic response.

2) If the phobic object is presented with an unconditioned stimulus (something that naturally frightens us) that produces an unconditioned negative response.

3) The neutral stimulus will then be associated with the unconditioned stimulus and thus the unconditioned response, and so the fear (the phobia) will happen whenever the neutral stimulus appears. 

4) The neutral stimulus becomes the conditioned stimulus, and the unconditioned response becomes the conditioned response.

5) This fear will then be passed onto other stimuli similar to the conditioned stimuli via generalisation (i.e: fear of spiders generalised to all insects).

Explain what happens in operant conditioning

The phobic person avoids situations that may bring the individual with the phobia into contact with the phobic object.

The consequence of this is that anxiety is reduced.

This is a pleasant sensation which acts as a negative reinforcement (removal of negative stimulus).

Explain the 4 types of reinforcement/punishment

Positive reinforcement - increasing likelihood of behaviour by adding something eg. treat

Negative reinforcement - increasing likelihood of behaviour by removing something eg. taking away a seating plan

Positive punishment - decreasing the likelihood of behaviour by adding something eg. detention

Negative punishment - decreasing the likelihood of a behaviour by removing something eg. taking away phone

Describe Skinner’s experiment and findings

Rats were placed in a box where a button was. When pressed, a light came on and food was dispensed.

• A = antecedent

  • a rat accidentally hits a lever releasing food. 

• B = behaviour 

  • the rat continues to press the lever. 

• C stands for consequence

  • food continues to come out and the rat will behave predictable, if it only comes out sporadically, the rat will behave erratically

The rat responds to positive reinforcement.

This appears in systematic desensitisation. In someone w arachnophobia, you might reward them for looking at pictures of spiders, then at a spider far away, and eventually for handling a spider.

What do social learning theorists suggest?

Learning can happen vicariously by observing models. Observing a fear response in others can then result in the same display of fear, especially if the behaviour results in reward for the model (i.e: attention).

What did Watson and Rayner study and what were their findings?

Watson and Rayner (1920) used a child called little Albert to demonstrate how phobias could be induced in a child. They made a loud noise (by hitting a metal bar behind the child’s head) when presenting a white rat to the child, and were able to generalise this fear to other white fluffy objects such as a rabbit.

• This study acts as evidence for the Two-process model via proving how acquisition and generalisation of phobias work

• It was a highly unethical study as it caused its participant (little Albert) emotional harm.

Weakness of behaviourist explanation

Menzies and Clarke (1993) found that only 2% of children could recall a traumatic experience with water though 56% reported fears of water even on the first encounter, suggesting that the behaviourist explanation cannot account for all phobias.

Describe an alternate approach other than behaviourist.

• Seligman (1970) proposed the idea of biological preparedness.

  • Phobias of snakes, birds, and dogs had an evolutionary origin as our very early ancestors could have been hunted/attacked by these creatures. This could explain why these are common phobias, when phobias to objects that are more dangerous in the modern day (i.e: knives, cars) are rare. 

This is the evolutionary biological theory, however this nature explanation goes against the nurture explanation of the behavioural approach, meaning it is an incomplete explanation.

What real life implications has the behaviourist approach had?

Behaviourist theories of phobia formation and maintenance have led to effective counter-conditioning treatments such as flooding and systematic desensitisation.

These are both types of exposure therapy, where the client is exposed to the phobic stimuli with the aim of counter-conditioning them.

If treatments based on the behavioural explanation are effective, then the behavioural explanation may be valid.

What is the general basis of phobia treatments?

Behaviourist therapies are based on the idea that phobias are learnt through association to fear, so therapies attempt to replace the fear association with one of relaxation/calm.

Explain systematic desensitisation

An attempt to use the same classical conditioning techniques that are thought to have caused the phobia to “counter condition” the phobia by replacing the association between the phobic object and fear with an association with relaxation/calm instead.

What is the theory of reciprocal inhibition?

The idea that fear and relaxation are opposite emotions and so cannot coexist at the same time. Therefore if you feel calm around the phobic objects then you can’t simultaneously feel fearful around it, so the fear must have been eradicated.

What are the three stages of systematic desensitisation?

1) To break the phobia down into an anxiety hierarchy, ranking presentations of the stimulus from least feared (a picture of a bee) to most feared (being in a room with lots of bees). These can be in vitro (imagined) or in vivo (real).

2) Relaxation techniques such as breathing exercises or meditation are then taught by the therapist.

3)As they are exposed to each stage of the anxiety hierarchy, clients are encouraged to relax at each stage in a stepped approach (once the client is able to relax at the stage they feel a bit anxious at, then moving on to the next slightly more anxiety-inducing situation ..etc). This gradual exposure leads to the extinction (loss of an association) of the fear association and formation of a new association with relaxation.

How is flooding different to systematic desensitisation?

Flooding counter conditions phobias by immediate full exposure to the maximum level of phobic stimulus (i.e: being put in a room with lots of bees). The scenario would be adjusted to make it safe (i.e: Laura given a beekeeper suit to prevent stings). While SD builds up to it gradually.

What responses are typical in flooding and what is the role of the physician in these?

This immediate exposure will cause temporary panic while bombarded with fear, and they may even attempt to escape to avoid the phobic stimulus. The fact that fear is a time-limited response is the main principle, that the fear will become exhausted and the feelings will dissipate.

The clinician’s job is to prevent avoidance by preventing the client from ending the treatment. Eventually temporary panic will stop and the client will calm down, anxiety will have receded and the fear will be extinguished due to exhaustion.

How effective is SD?

McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation

Limitations of SD

Not effective in treating all phobias. Phobias which have not developed through classical conditioning for example, a fear of heights, are not effectively treated using systematic desensitisation. These phobias highlight a limitation of systematic desensitisation which is ineffective in treating evolutionary phobias.

Systematic desensitisation requires a number of sessions to complete and 1:1 time with the therapist, resulting in a substantially higher cost than for drug treatments.

Strength of flooding

Provides a cost effective treatment for phobias. Research has suggested that flooding is comparable to other treatments, including systematic desensitisation and cognition therapies (Ougrin, 2011), however it is significantly quicker. This is a strength because patients are treated quicker and it is more cost effective for health service providers.

Limitations of flooding

Client does not have any control, the therapist does.

Flooding is not appropriate for older people, people with heart conditions, children, or abuse victims due to ethical concerns, whereas systematic desensitisation is ethically suitable for almost all people.

There are ethical concerns as flooding exposes participants to emotional harm, and it could also end up reinforcing the phobia if treatment is ended too soon.

Highly traumatic for patients and causes a high level of anxiety. Although patients provide informed consent, many do not complete their treatment because the experience is too stressful so is sometimes a waste of time and money as many patients do not finish their therapy.

Systematic desensitisation has a higher completion rate, perhaps because it is a more pleasant experience.

Less effective for other types of phobia, including social phobia and agoraphobia.