Psychopathology : Behavioural Approach To Phobias (treating)

Question 1

Whats the counter-conditioning principle?

Answer 1

a new response is leant to the phobic stimulus, pairing it with relaxation instead of anxiety

Question 2

Systematic Desensitisation - What is it?

Answer 2

Patients learn to respond to a feared stimuli with relaxation instead of anxiety.

Question 3

Systematic Desensitisation - The 3 processes

Answer 3

• the anxiety hierarchy
• relaxation
• gradual exposure

Question 4

Systematic Desensitisation - Reciprocal inhibition

Answer 4

Fear and relaxation cannot co-exist

Question 5

Systematic Desensitisation - Anxiety hierarchy

Answer 5

involves the client and the therapist designing a list/ hierarchy of frightening, stressful events or objects.

Question 6

Systematic Desensitisation - Relaxation

Answer 6

The client is taught deep muscle relaxation involving breathing exercises, meditation, mental imagery and sometimes drugs (eg. Valium) or hypnosis

Question 7

Systematic Desensitisation - Gradual exposure

Answer 7

The therapist helps the client work up the anxiety hierarchy while maintaining deep relaxation

Question 8

Systematic Desensitisation - advs

Answer 8

• supportive evidence to demonstrate effectiveness → McGrath et al (1990) reported that 75% of phobic patients responded to SD.
→ Gilroy et al (1990) examined 42 patients with arachnophobia using 3x45 min sessions and found fear reduced 33 months later, compared to control group (only relaxation)
• more ethical → doesn’t cause same levels of distress as when presented with phobia immediately. They’re considered better for those suffering severe anxiety, etc as it can be positive and pleasant.
• more accessible → those with learning disabilities often struggle with cognitive therapies that require complex rational thought. They may aso feel confused and distressed by the traumatic experience of flooding
• can be used virtually → sessions can take place remotely at first before exposure is needed which can make individuals more comfortable to be in their preferred location. Additionally, VR can be used to avoid dangerous situations (eg heights) and is cost effective as the psychologist + client don’t need to leave the consulting room) → but there is evidence suggesting it’s less effective as it lacks realism (Wescler et al 2019)

Question 9

Systematic Desensitisation - Disadvs

Answer 9

• isn’t suitable for diverse phobia types → patients with fears developed by classical conditioning (not developed through personal experience) are not effectively treated with SD as since their phobia wasn’t learnt, it cant be unlearnt

Question 10

Flooding - What is it?

Answer 10

immediate exposure of the phobic patient to the phobic stimulus, without a gradual build up to prevent avoidance. Sessions are longer than SD’s - usually lasting 2-3 hours (sometimes only one session is needed to cure a phobia)

Question 11

Flooding - how does it work?

Answer 11

stops phobic responses quickly as it prevents avoidance - patient learns phobic stimulus is harmless (extinction). A learned response is extinguished when the conditioned stimulus is encountered without fear as the association is broken. In some cases, patients man achieve relaxation because they have become exhausted.

Question 12

Flooding - advs

Answer 12

• cost effective + efficient → least effective but most cost effective. Ougrin (2011) compared flooding to cognitive therapies and found flooding’s highly effective + quicker, therefore patients are free from symptoms asap. Though this has implications for the economy as it could reduce NHS intake

Question 13

Flooding - disadvs

Answer 13

• traumatic → Schumacher (2015) found patients and therapists rated flooding as significantly more stressful than SD. There aren’t really ethical problems as there’s clear informed consent, but patients are often unwilling to see it through due to distress. Therefore it can lead to high attrition rates (drop outs) and can make phobias worse if not completed.
• not appropriate for all phobias → phobias involving high levels of cognition, such as social phobias as they’re accompanied by anxiety and unpleasant intrusive thoughts. Therefore, for more complex phobias, cognitive therapies are more effective.

Question 14

What is reductionism?

Answer 14

the behaviours explanation is overly simplistic as it reduces complex behaviour to stimulus-response association, and ignores the role of cognition

Question 15

What is determinism?

Answer 15

the behavioural explanation ignores the role of free will, impluing environmental determinism. Not every person bitten by a dog develops a phobia, so other processes must exist

Question 16

What is the Nomothetic vs Idiographic approach?

Answer 16

the behavioural explanation suggests a nomothetic approach, implying universal laws. But it individual cognition plays a part, a more idiographic approach is better.