The behavioural approach to treating phobias

What are the two therapies used to treat phobias?

Systematic desensitisation

Flooding

What is the main reason that phobias may persist?

Phobics avoid the phobic stimulus.

Therefore there is no opportunity to learn that their feared stimulus is not so fearful after all.

Behavioural treatments stop this avoidance.

How do these treatments eliminate the phobia?

Through counterconditioning (form of conditioning).

This is where a fear response is replaced with a relaxation response.

Who developed the technique of systematic desensitisation?

Joseph Wolpe

What is systematic desensitisation?

A method of treatment where the client is gradually exposed to the fearful situation under relaxed conditions until the anxiety reaction is diminished.

What are the 3 features of systematic desensitisation?

Counterconditioning

Relaxation

Desensitisation hierarchy

Explain Counterconditioning in systematic desensitisation

This is the basis of the therapy.

The patient is taught a new association counter to the original association.

The patient is taught, through classical conditioning, to associate the phobic stimulus with a new response - relaxation instead of fear.

This reduces anxiety - desensitisation

Why do behaviourists (including Wolpe) believe that replacing the fear association with a relaxing association will diminish the phobia?

Reciprocal inhibition - theory that assumes that fear and relaxation as opposite emotions cannot co-exist.

Explain Relaxation in systematic desensitisation

The therapist teaches the patient relaxation techniques (eg focusing on breathing and taking slow, deep breaths).

This is done to calm stress and anxiety.

It is the first thing the therapist does with the patient.

These techniques are also useful for life - long term.

Explain the desensitisation hierarchy in systematic desensitisation

The person is gradually introduced to the phobic stimulus one step at a time so it is not as overwhelming.

The therapist and patient work together to construct the desensitisation hierarchy.

At each stage the patient practises relaxation so the situation becomes more familiar. This diminishes anxiety.

What is Flooding?

This method involves the patient being immediately immersed with the phobic stimulus in one long session.

This makes the person experience their phobia at its worst.

The session continues until the patient’s anxiety has disappeared.

What are the two ways the procedure can be conducted in?

In vivo (actual exposure) or in vitro, with virtual reality.

Virtual reality is not as effective.

Give an example of flooding.

A person who is afraid of spiders has a large hairy spider on their hand. They remain in position until they have become calm.

What is the rationale behind flooding?

A person’s fear response (and adrenaline underlying this) has a maximum capacity and time limit.

As adrenaline levels naturally decrease, a new stimulus-response link can be learned.

So the feared stimulus is now associated with a non-anxious response.

Systematic desensitisation eval (positive and negative)

Research support - SD has been found as very successful for a range of phobias. McGrath (1990) found that 75% of patients respond to SD. So the technique is effective.

Evolutionary argument - Öhman (1975) argued that SD may not be effective in treating phobias that have an underlying evolutionary survival component (eg fear of heights). This is because the fears are built in to our minds.

Flooding eval

Effective - Choy (2007) stated that flooding is more effective than SD at treating phobias.

Individual differences - flooding is a highly traumatic procedure. This can be too much for people, causing them to quit during the treatment. This reduces effectiveness of the treatment.

Positive eval of behavioural therapies in general

Behavioural therapies are faster, cheaper and require less effort from the patient than other psychotherapies (such as CBT)

Lack of ‘thinking’ in these treatments is useful for people who lack insight into their phobias (such as children, people with learning disabilities)

Can be self-administered - convenient for patient. This was found to be as effective as therapist-guided therapy.

Negative eval of behavioural therapies in general

May also be the expectation of being able to cope with the feared stimulus is important - placebo (Klein, 1983). So cognitive factors may be more important than the behavioural approach acknowledges.

Behavioural therapies only remove the symptoms, the cause still remains. Symptoms may resurface.