ANXIETY treatment Flashcards
(14 cards)
behavioural therapy - mary cover jones and little peter case
4 years after watson rayner 1920 demo fears can be learned via classical conditioning
own reserach into behavioural theraph for chidlren w phobias jones 1924
initally encouraged peter to play w older kids in presence of rabit
after time in hospital fears returned
counter conditioning
sat peter in highchair and let him eat candy his fav treat
placed rabbit in cage near highchair while ate
over several visits to lab moved rabbit clsoer as he ate
eventually he ate candy w uncaged rabbit next to him
systematic desensitisation
1950s south african joseph wolpe developed mary jones’ work
created SD
combined feature of fear heirarchy and reciprocal inhibition
successful in helping people w wide range of specific phobias
sneakes to feather
also agoraphobia
wolpe 1958
reciprocal inhibition
way in which relaxation and fear responses cancel eachother out
wolpe 1968 taughts phobic ps to relax use muscle relaxation before first exposure to feared obj or sitch
sometimes anti anxiety drugs used to achieve relation lipsedge et al 1973
fear hierarchy
stages of fear
most and least feared stimulus
go from least to most distressing in contact
over like 6 sessions
can be in vivo or in vitro
only move up hierarchy when confident can tolerate current sitch wo distress
saavedra and silverman button phobia core
SD strength validity
supported by animal exps
wolpe 1976
conditioned cats to fear CR a specific cafe CS
using electric shocks UCS
counter conditioned them by giving food pellets UCS
series of cages increasingly similar to original feared cage
@ first cats showed fear to similar cages bc generalisation
grad eat food
over time prev fear response extinct
now entrered original cage wo fear bc new association w food
in contrast to earlier electric shocks
important study as animal exps can be more tightly controlled than human exps
increasing validity
SD strength validity longitudinal
lipsedge et al 1973
efficacy of SD w and wo use or barbiturate drugs to create deep relaxation during exposure sessions
ps 60 outpatients w severe agoraphobia
self reported and clinician rated measures of anxiety and avoidance collected b4 and after 8 weeks treatment
greatest improvement = people w barbiturate drug before exposures
standard SD more effective in reducing anxiety and avoidance than no treatment
suggest SD can be effective treatment for agora
as well as specific obj or sitch phobias
SD weakness
fear hierarchy may be unncessary
takes longer than other forms of therapy
may not be as cost effective
eg…flooding implosive therapy involves confronting person w most distressing sitch
w no gradual buildup
can be highly effective in just one session
this said SD is arguably more ethical as it does not cause the client as much distress
SD reductionism vs holism
further weakness of SD for agora
reductionist
ignores role of conscious and unconscious beliefs
about world and one’s place within it
eg…cynthia shilkret believes avoidant behaviour maintained bc irrational beleifs
eg world dangerous place and i dont deserve better life
shilkret 2002
behaviour therapy involving exposure like SD and flooding important
but many ppl left w residual symptoms
only 50% show substantial improvement
advocates use of cognitive-bhevaioural and psychodynamic therapies
over longer term
to reduce residual symptoms
important alt perspective
demos more holistic approach to therapy
may lead to longer lasting outcomes
psychological therapy
cognitive behavioural therapy CBT
applied tension
CBT
CBT approach to treatment of anxiety and fear has similarities
CBT practitioners believe fear and or anxiety result from dysfunctional thinking patterns
challenging systematically
aim to change way ppl think feel behave
course of CBT limtied to 20 sessions max usually
contrast to other therapy dont spend time trying to find reason for behaviour
but solutions to problems faced in daily life
exposure therapy used w cognitive
beck’s cogntiive resteuctirng use psychoeduction
encourage them to provide evidence to dispite
cognitive traid
hw important
practice skills and strategies between sessions and report back on experiences
cognitive fear structures
networks of stored info
> similar to bartlett’s concept of schema
about threatening stimuli (kaczkurkin and foa 2015)
eg person w phobia of dog has cogitive fear structure for dogs tjat have concepts like big teeth fierce aggressive dangerous
memory of bodily sensations associated w dogs
rapid heart rate
trigger further associations w heart attacks hospital and even death
CBT on cognitive fear structures
attempt to disconfirm inaccurate beliefs about feared stimuli
through exposure
w aim of replacing fear structure w new pos memories
applied tension
developed specifically for the treatment of blood injury injection phobias BII
characterised by slightly diff pattern of symptoms to other specific phobias
so applied tension is required as an additional technique that can be combined w other CBT strategies
