Treating Phobias

Question 1

Systematic Desensitisation

Answer 1

• Developed by Wolpe.
• Derives from classical and operant conditioning and based on counter conditioning.
• Fear of phobic stimulus is replaced with a new response which is incompatible with fear.
• Clients given training in deep relaxation until they can rapidly achieve muscle relaxation when instructed to do so.
• Concept that fear and relaxation don’t go together. Reciprocal inhibition. Fear is extinguished.

Question 2

Processes within Systematic Desensitisation

Answer 2

1. Anxiety Hierarchy - therapist and client work together to form a hierarchical list of feared situations, starts with least anxiety aroused working to most anxiety aroused.
2. Relaxation - client achieves deep relaxation through breathing exercises, mental imagery and meditation taught by therapist.
3. Exposure - client asked to imagine or confronted by least threatening situation in hierarchy. Repeatedly happens until anxiety is no longer provoked. Repeated for all situations in hierarchy. Only move to next stage of it when they have managed to stay calm at previous stage.
   - New association has been made between phobic stimulus and fear.

Question 3

Evaluation of Systematic Desensitisation - effective treatment

Answer 3

• Gilroy et al followed up 42 patients who had been treated for arachnophobia in 3 45 minute sessions of SD. Control group that was treated with relaxation without exposure. At both 3 months and 33 months after treatment, SD group less fearful than relaxation group.
• Strength - shows that SD is helpful in reducing anxiety in spider phobia and effects are long lasting.

Question 4

Evaluation of Systematic Desensitisation - Diverse Range of Patients

Answer 4

• Suitable for lots of patients as the alternative to SD, flooding is not suitable for all patients.
• Some sufferers of phobias have learning difficulties.
• Strength - having a learning difficulty can make it difficult for them to understand what is happening in flooding. SD is most appropriate.

Question 5

Evaluation of Systematic Desensitisation - High Relapse Rate

Answer 5

• Research suggests that SD has a high relapse rate of regaining a phobia.
• Craske and Barlow found high relapse rate.
• Weakness - suggests that SD is a short term solution for a long term problem.

Question 6

Evaluation of Systematic Desensitisation - Animal Research

Answer 6

• Therapies have roots in learning theory which is based on animal research.
• Behaviourist approach focuses on animal studies such as Pavlov and Skinner. Ethical Issues. Generalisation.
• Weakness - humans do not express anxiety in the same way as animals therefore questioning the validity of the theory.

Question 7

Flooding Technique

Answer 7

• Based on Classical Conditioning.
• Quicker and more effective than SD.
• Client exposed to extremely fear provoking situation, often repeatedly.
• Client initially overwhelmed by fear and anxiety.
• Physiologically it is not possible to maintain a state of anxiety for long period and reaction is so severe that response is exhausted and fear starts to diminish.
• New association is formed between stimulus and feeling relaxed.
• Stimulus satiation - phobic stimulus presented in an extreme way to try to lessen the abnormal response and client soon learns that phobic stimulus is harmless and this is called extinction.

Question 8

Evaluation of Flooding - cost effective

Answer 8

• Studies compared flooding to cognitive therapies and found flooding to be highly effective and quicker than SD.
• Strength - patients are free from symptoms as soon as possible and makes treatment cheaper for NHS or patient paying privately.

Question 9

Evaluation of Flooding - Supporting Research

Answer 9

• Hogen and Kitchener studies 21 people with a rat phobia. Asked to imagine themselves having fingers nibbled and being clawed at by rats. After treatment, 20 were able to open a rats cage and 14 were able to pick it up suggesting that flooding is effective.
• Strength - suggests therapy is effective and allows patients to cope better with everyday life.

Question 10

Evaluation of Flooding - less effective for complex phobias

Answer 10

• Some complex phobias such as social phobia has some cognitive aspects such as not only experiencing anxiety but unpleasant thoughts about the social situation.
• Weakness - cannot be used for all phobias, mag benefit from cognitive therapies due to lacking irrational thinking.

Question 11

Evaluation of Flooding - Traumatic for Patients

Answer 11

• Behavioural therapies can be critiqued for being traumatic and highly upsetting for the patient.
• Facing worst fears - arachnophobic being in a room full of spiders. Despite giving informed consent, they will feel very distressed.
• Weakness - amount of time and money sometimes wasted preparing a patient only for them to refuse the therapy or stop continuing it.