The behavioural approach to treating phobias

Question 1

What is systematic desensitisation?

Answer 1

A behavioural therapy designed to reduce an unwanted response, such as anxiety

Question 2

What are the 3 stages of systematic desensitisation?

Answer 2

1) Anxiety hierarchy (list of situations related to phobic stimulus, arranged from least to most frightening)
2) Relaxation (provide relaxation techniques: breathing exercises, mental imagery techniques, medication, drugs)
3) Exposure (exposure to stimulus whilst in relaxed state- when client remains relaxed, they move onto the next stage of the anxiety hierarchy)

Question 3

STRENGTH-
I= Evidence for effectiveness

Systematic desensitisation

Answer 3

D= Gilroy et al studied 42 people who were treated by SD for spider phobias. Followed up after 3, then 33 months. SD group were less fearful than a control group (relaxation, no exposure). Weschler concluded that SD is effective for specific and social phobias, and agoraphobia
E= SD is helpful for people with phobias

Question 4

STRENGTH-
I= Used to help people with learning disabilities

Systematic desensitisation

Answer 4

D= People with learning disabilities sometimes find cognitive therapies difficult, as they require complex thought. They may feel confused and distressed by the trauma of flooding
E= Means SD is most appropriate for those with learning disabilities

Question 5

EVALUATION EXTRA-
I= SD in virtual reality

SD

Answer 5

D= Exposure using VR can avoid dangerous situations, such as heights, and is cost-effective as psychologists and clients remain in the consulting room. For phobias such as flying, this is more efficient than real world exposure. But, the advantage of SD in the real world is its realism. Weschler- evidence that real world exposure is more effective than VR exposure in treating social phobias
E= Some phobias are best treated using VR, and others using real world exposure

Question 6

What is flooding?

Answer 6

A behavioural therapy in which a person with a phobia is exposed to an extreme form of a phobic stimulus to reduce anxiety triggered by the stimulus

Question 7

How does flooding work?

Answer 7

• Flooding almost immediately stops phobic responses
• Without the option of avoidance, the client learns the stimulus is harmless (extinction)
• Learned response of fear is extinguished when the CS and UCS come into contact
• CS no longer produces CR (fear)
• Client may even achieve relaxation when presented with stimulus as their fear has exhausted them

Question 8

What are the ethical issues surrounding flooding?

Answer 8

• Flooding is not unethical but it is an unpleasant experience and can be traumatising, so informed conset must be obtained prior to the procedure

Question 9

STRENGTH-
I= Cost-effective

Flooding

Answer 9

D= A therapy is cost effective if it is both clinically effective and not expensive. Flooding can work in a minium of 1 session vs 10 for SD. Flooding allows for longer sessions (3 hours), which makes flooding more cost-effective
E= Means more people can be treated at the same cost with flooding than with alternatives

Question 10

LIMITATION-
I= Traumatic experience

Flooding

Answer 10

D= Confronting one’s stimulus in extreme forms can provoke high anxiety levels. Schumacher et al= participants rated flooding as more stressful than SD. This raises ethical issues of knowingly inflicting stress, so researchers must gain informed consent. Trauma means dropout rates are higher
E= Suggests therapies may avoid this treatment and may choose alternatives

Question 11

EVALUATION EXTRA-
I=Symptom substitution

Flooding

Answer 11

D= Flooding masks symptoms and fails to tackle underlying causes of phobias= symptom substitution. Persons reported a case of a women with a phobia of death- her phobia declined, but her fear of criticism increased. But, evidence of symptom substitution only comes from case studies. Case study method is flawed, as it does not generalise (i.e. to all phobias)
E= Largely a theoretical idea, with poor supporting evidence