Behavioural Treatments Of Phobias

Question 1

Systematic desensitisation- based on classical conditioning - counterconditioning and reciprocal inhibition

Answer 1

SD aims to reduce anxiety through counterconditioning:

• Phobia learned so that a phobic stimulus (CS) produxes fear (CR)
• CS is paired with relaxation and relaxation becomes the new CR

Reciprocal inhibition - not possible to be afraid and relaxed at the same time, so one emotion prevents the other.

Question 2

Systematic desensitisation- Formation of an anxiety hierarchy

Answer 2

Designed by patient and therapist - list of fearful stimuli arranged in order from most to least frightening

E.g. an arachnophobe may have a tarantula at the top of their hierarchy, and several very small spiders at the bottom.

Question 3

Systematic desensitisation- Relaxation practice at each hierarchy level.

Answer 3

Patient taught relaxation techniques such as deep breathing and/or meditation.

Then, working through hierarchy- at each level the patient is exposed to the stimulus at that level whilst in a relaxed state.

This takes place in several sessions starting at the bottom of the hierarchy and working upwards. Treatment is considered successful when the patient can stay relaxed in situations high up on the hierarchy.

Question 4

Flooding - immediate exposure to the phobic stimulus

Answer 4

Flooding

Involves bombarding the phobic patient with the phobic stimulus without any gradual build up
An arachnophobe may have a large tarantula placed in their hand until they can relax fully

Question 5

Flooding - very quick learning through extinction

Answer 5

Since avoidance is not an option in the flooding process - the patient should quickly learn that the phobic stimulus is harmless through the exhaustion of the initial fear response. This is known as extinction

Question 6

Flooding - ethical safeguards

Answer 6

Flooding is not unethical, but it is a highly unpleasant experience so it is important that patients give informed consent.
They must be fully prepared and know exactly what to expect

Question 7

✅AO3- systematic desensitisation is effective

Answer 7

Gilroy et al (2003)

Followed up 42 patients who had gone through SD for arachnophobia in 3 45 minute sessions

At both 3 and 33 months after the SD,

Question 8

✅AO3- SD is suitable for a diverse range of patients

Answer 8

Alternatives such as flooding or cognitive therapies are unsuited to some patients.

Learning difficulties are common amongst phobic patients - and patients such as this may find it very hard to understand what is happening during flooding, or to engage with the reflection techniques of cognitive therapies. For these patients - SD may be the most appropriate.

Question 9

✅AO3 - SD is usually an acceptable process to patients

Answer 9

Patients tend to prefer SD over flooding when given the choice.

This is because compared to flooding - the degree of trauma that SD entails is very low. It also includes pleasant elements as well as the exposure such as talking time with a therapist.

Reflected in SD’s low refusal rates and low attrition rates.

Question 10

❌AO3- flooding is less effective for some forms of phobias

Answer 10

Flooding has been seen to be the most effective in treating simple phobias, but appears to be far less effective in treating complex phobias such as social phobias.

Possibly due to the cognitive aspects of social phobias - sufferers not only experiencing anxiety but also unpleasant thoughts about their situation.

For these types of phobia, cognitive therapies may be more effective as they aim to tackle the irrational thinking.

Question 11

❌AO3 - flooding can be traumatic

Answer 11

Flooding is a highly traumatic experience. Whilst not unethical (pts give informed consent), the treatment has extremely high attrition rates due to its traumatic nature.

This is a weakness as it means flooding is often ineffective, a waste of time, and a waste of money - as patients may be prepared but then refuse to begin or complete the treatment.