P: The behavioural approach to treating phobias Flashcards
(17 cards)
What two therapies are discussed?
What do they involve?
- Systematic desensitisation & flooding.
- Involve counterconditioning, whereby a fear response to an object or situation is replaced with a relaxation response. This is a form of classical conditioning.
How is conditioning achieved in the two therapies?
When is the treatment complete?
- Either a slow process of gradual exposure or one single intense exposure.
- The treatment is complete when the patient can relax in the presence of their most feared stimulus.
What is flooding?
- A method used to treat phobias.
- Instead of introducing the phobic object in a gradual progression using a hierachy (as in systematic desensitisation), the person with a phobia is immersed in the experience in one long session, experiencing their phobia at its worst.
- The session continues until the patient’s anxiety has disappeared.
Give an example of Flooding?
- A person who is afraid of clowns is placed in a room full of clowns.
- A person who is afraid of spiders has to sit with a large hairy spider on their hand.
- The person with the phobia remains in position until they have become calm.
What are the two ways that the flooding procedure can be conducted?
- Vivo (actual exposure)
- Virtual reality can also be used.
Rationale
What does a personals fear response & the release of adrenaline underlying this have?
What happens as adrenaline levels naturally decrease?
A limit!!
A new stimulus response link can be learned- the feared stimulus is now associated with a non-anxious response.
Systematic desensitisation
What is one of the reasons that phobias may persist?
Phobics avoid the phobic stimulus and therefore there is no opportunity to learn that their fear stimulus is not so fearful after all.
Systematic desensitisation
What is the basis of the therapy?
Counterconditioning- because the patient is taught a new association that runs counter to the original association.
Systematic desensitisation
What happens in Counterconditioning?
What did Wolpe call this?
- The patient is taught, through classical conditioning, to associate the phobic stimulus with a new response i.e. relaxation instead of fear.
- In this way their anxiety (related to sensitivity) is reduced- they are desensitised.
Called this ‘reciprocal inhibition’ because the response of relaxation inhibits the response of anxiety.
Who came up with Systematic desensitisation?
Joseph Wolpe, 1958
Relaxation
What is the first thing that a therapist teaches the patient?
How can this be achieved?
- Teach the patient relaxation techniques.
- Patient focussing on their breathing & taking slow deep breaths. (When we are anxious we breathe quickly, so slowing this down helps us to relax.
- Being mindful of ‘here and now’ can help, as well as focussing on a particular object or visualising a peaceful scene.
- Progressive muscle relaxation is also used where one muscle at a time is relaxed.
How does the Desensitisation hierachy work?
- Works by gradually introducing the person to the feared situation one step at a time so it is not as overwhelming.
- At each stage, the patient practises relaxation so the situation becomes more familiar, less overwhelming and their anxiety diminishes.
Systematic desensitisation
What are the steps in this process?
- Patient is taught how to relax their muscles completely. (A relaxed state is incompatible with anxiety.)
- Therapist & patient together construct a desensitisation hierachy - a series of imagined scenes, each one causing a little more anxiety than the previous one.
- Patient gradually works his/her way through the desensitisation hierachy, visualising each anxiety- evoking event while engaging in the competing relaxation response.
- Once the patient has mastered one step in the hierachy, (i.e. they can remain relaxed while imagining it), they are ready to move onto the next.
- Patient eventually masters the feared situation that caused them to seek help in the first place.
How does flooding work- what is the process?
Step 1: Patient is taught how to relax their muscles completely.
Step 2: Patient masters the feared situation that caused them to seek help in the first place. This is accomplished in one long session.
Write a PEEL paragraph about the effectiveness of systematic desensitisation:
P - Research found it successful for range of phobias.
E - 1990 research reported that 75% of patients with phobias respond to SD and the key to this success seems to be with actual contact with feared stimulus (as opposed to pictures).
E - However, it is not appropriate for all phobias - (1975) research suggest SD may not be appropriate in treating phobias with evolutionary survival component - eg fear of the dark, heights, dangerous animals etc.
L - SD only has limited external validity.
Write a PEEL paragraph about the effectiveness of flooding:
P - Can be effective for those that commit and is relatively quicker than CBT.
E - 2007 research reported that both SD and flooding were effective but flooding was the more effective of the two, but another review said the two were equally effective.
E - However, flooding is not for every patient/therapist. It is highly traumatic, so some patients may quit during treatment (eventhough they were warned beforehand) - reduces the ultimate effectiveness.
L - Flooding is an effective therapy, albeit just one of several options but individual differences in responses thereofre limit the effectiveness of the therapy - also, cannot guarantee to protect ppt from harm.
Write a PEEL paragraph about
P - The success of both SD and flooding might be more to do with exposure to the feared situation than relaxation.
E - Might also be that expectation of being able to cope with feared stimulus is most important. For example, Klein (1983) compared SD with supportive psychotherapy for patients with either social or specific phobias.
E - Found no difference in effectiveness, suggesting that the ‘active ingredient’ in SD or flooding may simply be the generation of hopeful expectancies that the phobia can be overcome.
L - Suggests cognitive factors are more important than the behavioural approach generally acknowledges.
