4.1.11 - treatments for phobias based on theories of learning Flashcards
(23 cards)
what are two ways that phobias can be treated?
flooding and systematic desensitisation
what is flooding?
exposing the individual to the most fearful situation
how does flooding work?
extinction of the fear occurs following exhaustion (fear levels reach a peak and go down, leaving the client feeling calm which replaces the fear response)
what does flooding prevent?
maintenance of the anxiety through negative reinforcement (avoiding the phobic object)
what is systematic desensitisation?
gradually exposing the individual to the feared object or situation in a controlled and relaxed environment
what is the aim of systematic desensitisation?
to gradually remove the fear response of a phobia and substitute it with a relaxation response to the conditioned stimulus using counter-conditioning
what are the two types of desensitisation?
in vitro = client imagines exposure to phobic stimulus
in vivo = client is actually exposed to phobic stimulus
what are the three phases of systematic desensitisation treatment?
- relaxation training
- establishment of anxiety hierarchy
- gradual exposure
what happens in the first stage of systematic desensitisation (relaxation training)?
the individual learns relaxation techniques like deep breathing and progressive muscle relaxation, which are practiced until the individual can achieve a consistently relaxed state on command
based on reciprocal inhibition, one response is inhibited because it is incompatible with another (tension involved in fear is incompatible with relaxation)
what happens in the second stage of systematic desensitisation (establishment of anxiety hierarchy)?
the individual and therapist create a list of fear-inducing situations which are ranked from least to most anxiety-provoking (functional analysis = careful questioning to discover the nature and triggers of anxiety)
what happens in the third stage of systematic desensitisation (gradual exposure)?
starting with the least anxiety-provoking situation, the individual is exposed to each level of the hierarchy while using relaxation techniques
they only move up the hierarchy when they can remain relaxed at the current level
over time, the anxiety response to the phobic stimulus diminishes
how does systematic desensitisation link to classical conditioning?
the conditioned fear response is replaced by a new learned association between relaxation and the conditioned stimulus
what are similarities between flooding and systematic desensitisation?
- both require exposure to feared object/situation
- both enable phobia to be overcome - fear is unlearned as extinction occurs
- both based on classical conditioning - feared stimulus becomes associated with being relaxed
what are differences between flooding and systematic desensitisation?
- in flooding the feared object/situation is introduced all at once, while in systematic desensitisation it is introduced gradually
- flooding only uses the most feared object/situation while systematic desensitisation uses a hierarchy of increasing fear
- in flooding the calm response is forced (fear reaches peak and recedes) while in systematic desensitisation the individual brings about the calm response by using relaxation techniques
what points can be considered when evaluating treatments (TEARS)?
- Time
- Effectiveness
- Acceptability
- Success rate
- Side effects
(or can use SCOUT)
strengths of SD - acceptability?
more acceptable and ethical than flooding as exposure to phobic stimulus is gradual so client has more control
strengths of SD - time?
treatment length can be varied based on severity of phobia - some people may have 4-6 sessions while others may have 12+
weaknesses of SD - effectiveness?
- relies on relaxation which not everyone can do, or some may struggle to learn
- not always effective in treating phobias which haven’t been acquired through exposure eg. heights
strengths of SD - supporting evidence?
Barabasz (1973) - group SD is effective in reducing test anxiety in elementary school students with high test anxiety (measured with galvanic skin response, an objective physiological measure)
weaknesses of SD - contradictory evidence?
- Toozandehjani (2011) allocated 32 pps to 4 conditions
- assertiveness training, SD, SD and assertiveness training, control
- used interview and self report to gather data on effectiveness of treatments immediately after and after 3 month follow up
- all effective at time (pre and post intervention scores for SD showed significant difference), however effects didn’t last
- combined treatments also better than individual treatments
strengths of flooding - supporting evidence?
- Wolpe (1973) - girl with fear of cars was driven around in a car for 4 hours and after this time she no longer experienced anxiety when sitting in cars so her phobia was deconditioned
- Hogan and Kirchner (1969) - imaginal flooding (in vitro) reduced fear of rats in phobic college students (exposure doesn’t have to occur in real life which may be more ethical)
weaknesses of flooding - acceptability?
- treatment may not be seen as acceptable as it can cause lots of stress to pps (but can be justified if it is effective at reducing fear)
- may not be seen as ethical - to make it more ethical informed consent and right to withdraw need to be ensured
weaknesses of flooding - effectiveness?
- may not be effective at reducing fear as could actually make it worse
- this would cause more harm to pp and disruption to their life
- won’t know if it has this effect until it is tried - may just be better to use alternative treatment eg. SD
