Behavioural Approach to Treating Phobias

Systematic desensitisation

A behavioural therapy that gradually reduces phobic anxiety through counterconditioning.

Counterconditioning

Learning a new response to the phobic stimulus, replacing fear with relaxation.

Reciprocal inhibition

Idea that fear and relaxation cannot occur at the same time.

Relaxation techniques

Breathing exercises, meditation or progressive muscle relaxation used during therapy.

Anxiety hierarchy

A list of situations involving the phobic stimulus arranged from least to most frightening.

Exposure (SD)

Patient gradually exposed to phobic stimulus while remaining relaxed.

In vivo exposure

Real-life exposure to the phobic stimulus.

In vitro exposure

Imagined exposure to the phobic stimulus.

Success of SD

Most effective for specific phobias such as spiders or agoraphobia.

Strength of SD: effective

Research shows up to 90 percent success for simple phobias.

Strength: suitable for all ages

Gentle approach makes it ideal for children and people with learning difficulties.

Strength: low drop-out rate

Less traumatic than flooding, leading to better patient engagement.

Flooding

A behavioural therapy that exposes patient to phobic stimulus immediately and intensely.

Flooding mechanism

Prevents avoidance and exposes patient until fear response extinguishes.

Extinction in flooding

Learner realises phobic stimulus is harmless; fear gradually decreases.

Ethical safeguards

Patients must give informed consent and be screened for health risks.

Strength of flooding: fast

Often effective in a single long session.

Strength: cost-effective

Requires fewer sessions than other therapies.

Limitation of flooding: traumatic

High anxiety levels may lead to drop-out.

Limitation: not suitable for all

Not appropriate for complex phobias (e.g. social phobia) involving cognitive distortions.

Limitation: symptom substitution

Phobia may be replaced by another anxiety disorder.

Comparison: SD vs flooding

SD is gradual and gentle; flooding is immediate and intense.

SD focus

Replaces fear with relaxation.

Flooding focus

Stops avoidance and breaks fear cycle quickly.