6 - Bhevaioural Apporach to Treating Phobias

What are the two different methods to treat phobias?

• systematic desensititation

• flooding

What is systematic desenesitation (SD)?

behavioural therapy designed to reduce unwanted response to phobic stmulus (e.g. anxiety)

What is called when you learn a different repsonse?

counter conditioning

What are the 3 steps involved in SD?

• anxiety hierarchy

• relaxation

• exposure

Describe the “anxiety hierarhy“ process during SD

• client + therapist form a list of anxiety provoking situations related to the phobic stimulus

• arranged in order from least to most fightening

  • (e.g. lowest = picture of stimulus, highest = coming into contactwth stimulus)

Describe the “relaxation“ process during SD

• therpaist teach cient how to deeply relax using different techniques such as:

  • breathing techniques

  • mental imagery

  • meditation

  • valium - relaxation drug

What is reciproal inhibiton in terms of relaxation?

it is impossible to be afraid and relaxed at the same time

Describe the “exposure“ process during SD

• client is exposed to phobic stimulus while in relaxed state

• takes place across several sessions, going through anxiety hierarchy

How can we tell that SD treatment is complete?

when the client can stay relaxed in situations high on the anxiety hierarchy

SD Evaluation:Evidence

S - SUPPORTING EVIDENCE

• Gilroy (2003) followed up 42 people who had SD for arachnophobia in three 45 min sessions

  • SD group was less fearful than control group (only relaxation no exposure)

  • supports the effectivenss of SD & it is likely to be helpful for people with phobias

SD Evaluation: Suitability

S - SUITABLE FOR MANY PATIENTS

• helpful for those with learning disabilities who may struggle with cognitive therapies & be distressed w/ flooding

• SD is more suitable for certain people

SD Evaluation: Acceptability

S - MORE ACCEPTABLE TO PATIENTS

• has low refusal & attrition rates

• economical impliations - increases likelihood patient will continue w/ therapist

  • no time & effort is wasted (may be if patient got “cold feet“)

SD Evaluation: Using VR

S - HELPS AVOID DANGEROUS SITUATIONS

• client can be exposed to phobic stimulus without being in danger e.g. heights

• cost efective - client + therapis don’t need to leave the room

L - LACKS REALISM

• client knows phobic stimulus is not real so it may be less effective

What is flooding?

a behavourial therapy where person is exposed to an extreme form of a phobic

What does flooding involve?

immediate exposure to very frightening situation

Why does flooding stop phobic responses very qucikly?

no option for avoidance behaviour so the client quickly learns that the phobic stimulus is harmless

What does it mean when we call flooding an “extinction“ process?

• learned response is extinguished - CS (dog) encountered without the UCS(being bitten)

• conditioned stimulus no longer produces conditioned response

Why is it important to have informed consent fo flooding?

as it is an unpleasant experience as it may be traumatic

Flooding Evaluation: Cost

S - COST EFFECTIVE

• flooding is clinically effective + not expensive

  • can work in as little as one session opposed to SD in 10 sessons and same result

• people can get the same results as SD or other therapies for cheaper using flooding

Flooding Evaluation: Experience

L - TRAUMATIC

• high unpleasant experience + is very stressful

• raises ethical isse for psychologists for knowingly causing stres to clients (not an issue w/ informed consent

• attrition(drop out) is higher than for SD

• therapist less likelt to use this method as it has higher attrition rates wasting resources

Flooding Evaluation: Effectiveness

L - Less Effective for Complex Phobias

• e.g. social phobias include anxiety + cognitive aspect

• cognitive therapy would be more effective

• there are other alternatives that are more effective

Flooding Evaluation: Symptom Substitution

L - SYMPTOM SUBSTITUTION

• behavioural therapies don’t tackle root cause of phobia →symptoms may be substituted

  • e.g. phobia of snakes treated but then fear of worms increases