Behavioural approach to treating phobias

What is systematic dysensitisation

behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning. Essentially a new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety). This learning of a different response is called counterconditioning

What are the 3 processes involved in SD

1. The anxiety hierarchy is put together by a client with phobia and therapist. This is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening. For example, a person with arachnophobia might identify a picture of a small spider as low on their anxiety hierarchy and holding a tarantula at the top of the hierarchy.

2. Relaxation The therapist teaches the client to relax as deeply as possible. It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other. This is called reciprocal inhibition. The relaxation might involve breathing exercises or, alternatively, the client might learn mental imagery techniques. Clients can be taught to imagine themselves in relaxing situations (such as imagining lying on a beach) or they might learn meditation. Alternatively relaxation can be achieved using drugs such as Valium.

3. Exposure Finally the client is exposed to the phobic stimulus while in a relaxed state.
   This takes place across several sessions, starting at the bottom of the anxiety hierarchy.
   When the client can stay relaxed in the presence of the lower levels of the phobic stimulus they move up the hierarchy. Treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy

What is flooding

Immediate exposure to a very frightening situation - sessions last two to three hours

How does flooding work

Flooding stops phobic responses very quickly. This may be because, without the option of avoidance behaviour, the client quickly learns that the phobic stimulus is harmless.

In classical conditioning terms this process is called extinction

What are ethical safeguards of flooding

Flooding is not unethical per se but it is an unpleasant experience so it is important that clients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding session