The behavioural approach to treating phobias

Question 1

What are the two behavioural approaches to treating phobias?

Answer 1

Systematic desensitisation and flooding

Question 2

What is systematic desensitisation?

Answer 2

A behavioural therapy designed to gradually reduce phobic anxiety to a stimulus through classical conditioning

Question 3

How can systematic desensitisation cure phobias?

Answer 3

If the sufferer can learn to relax in the presence of the phobic stimulus they will be cured

Question 4

What causes systematic desensitisation?

Answer 4

Counterconditioning

Question 5

What is counterconditioning?

Answer 5

Learning a new response to a phobic stimulus (replacing anxiety with relaxation)

Question 6

What does counterconditioning lead to?

Answer 6

Reciprocal inhibition

Question 7

What is reciprocal inhibition?

Answer 7

Feeling afraid and relaxed at the same time, so one emotion prevents the other

Question 8

What are the three processes involved in systematic desensitisation?

Answer 8

1) The anxiety hierarchy
2) Relaxation
3) Exposure

Question 9

What is the anxiety hierarchy?

Answer 9

A list of situations related to the phobic stimulus that provoke anxiety, arranged in order from least to most frightening

Question 10

What is relaxation?

Answer 10

When the therapist teaches the patient to relax as deeply as possible

Question 11

What are the four ways relaxation can be achieved?

Answer 11

1) Breathing exercises
2) Mental imagery techniques
3) Meditation
4) Drugs, e.g. Valium

Question 12

What is exposure?

Answer 12

When the patient is exposed to the phobic stimulus while in a relaxed state

Question 13

How is exposure carried out?

Answer 13

Across several sessions, starting at the bottom of the hierarchy
When the patient can stay relaxed in the presence of the lower levels of the phobic stimulus they can move up the hierarchy

Question 14

When is systematic desensitisation successful?

Answer 14

When the patient can stay relaxed in situations high on the anxiety hierarchy

Question 15

Give an example of research showing that systematic desensitisation is effective?

Answer 15

Gilroy et al (2003) followed up 42 patients who were treated for spider phobia in three 45-minute sessions of systematic desensitisation
They were assessed by the Spider Questionnaire and by their responses to a spider
Results were compared to a control group which was treated by relaxation without exposure

Question 16

What were the findings of Gilroy’s study?

Answer 16

At both 3 and 33 months after the treatment, the systematic desensitisation group were less fearful than the control group

Question 17

Why is this research a strength of systematic desensitisation?

Answer 17

It shows that it is helpful in reducing anxiety in specific phobias and the effects are long-lasting

Question 18

Why is systematic desensitisation better than flooding and cognitive therapies?

Answer 18

It is suitable for a diverse range of patients, including those with learning difficulties

Question 19

Why are flooding and cognitive therapies less effective in patients with learning difficulties?

Answer 19

Learning difficulties can make it hard to understand what is happening during flooding or to engage with cognitive therapies that require reflection

Question 20

What is the biggest strength of systematic desensitisation?

Answer 20

It is acceptable to patients and patients prefer it over other treatment options

Question 21

Why do patients prefer systematic desensitisation?

Answer 21

It doesn’t cause the same degree of trauma and flooding and it includes some pleasant elements, e.g. learning relaxation procedures

Question 22

How is this preference reflected?

Answer 22

There are low refusal and attrition rates

Question 23

What is flooding?

Answer 23

A behavioural therapy in which phobic patients are exposed to their phobic stimulus without gradual build-up in an anxiety hierarchy, to reduce anxiety triggered by that stimulus

Question 24

Why is flooding a much quicker treatment?

Answer 24

It involves an immediate exposure to a very frightening situation and the sessions usually last longer

Question 25

How does flooding work?

Answer 25

It stops phobic responses very quickly because patients don’t have the option of avoidance behaviour, so they quickly learn that the phobic stimulus is harmless and their anxiety is reduced

Question 26

What is this process called?

Answer 26

Extinction

Question 27

How is a learned response extinguished?

Answer 27

When the conditioned stimulus is encountered without the unconditioned stimulus, so the conditioned stimulus no longer produces the conditioned response (fear)

Question 28

What are the ethical safeguards of flooding?

Answer 28

Flooding isn’t unethical but it is an unpleasant experience so patients must give informed consent to this traumatic procedure and must be fully prepared before the session

Question 29

What is a strength of flooding?

Answer 29

It is cost-effective?

Question 30

Why is flooding cost-effective?

Answer 30

Studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives, meaning that patients are free of their symptoms quicker and the treatment becomes cheaper

Question 31

What are the two limitations of flooding?

Answer 31

1) It is less effective for some types of phobia
2) The treatment is traumatic for patients

Question 32

Why is flooding less effective for some types of phobia?

Answer 32

More complex phobias (e.g. social phobias) because they have cognitive aspects, e.g. irrational thoughts so they will benefit more from cognitive therapies

Question 33

Why is the traumatic treatment a problem?

Answer 33

Patients give consent but are often unwilling to see it through to the end so time and money are sometimes wasted preparing patients only for them to start or complete treatment