The Behavioural Approach To Treating Phobias

Question 1

Definition of Systematic Desensitisation:

Answer 1

Behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning. If the sufferer can learn to relax in the presence of the phobic stimulus they will be cured. Learning a different response is called counterconditioning. One emotion can prevent another: reciprocal inhibition.

Question 2

Process of SD:

Answer 2

1. Anxiety hierarchy: put together by the patient and therapist. List of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
2. Relaxation: Teaches them how to relax as deeply as possible. Breathing exercises, mental imagery techniques or drugs.
3. Exposure: Patient is exposed to the phobic stimulus while in a relaxed state. Once the patient can stay relaxed in the presence of the lower levels of the phobic stimulus, they can move by the hierarchy.

Question 3

How does flooding work?

Answer 3

1. Flooding stops phobic responses very quickly. Without the option of avoidance behaviour, they learn that phobic stimulus is harmless.
2. In CC, this is called extinction. The learned response is extinguished, when the conditioned stimulus (dog) is experienced without the UCS (being bitten).

Question 4

Ethical Safeguards:

Answer 4

It is not unethical, but it is an unpleasant experience so they must give informed consent to the procedure.

Question 5

E: Effective (SD)

Answer 5

1. Research shows SD is effective.
2. Gilroy et al followed up 42 patients who had treated for spider phobia in three 45 minute sessions of SD. Several measures were used to assess spider phobia including the Spider Questionnaire and by assessing response to a spider.
3. A control group was treated by relaxation without exposure.
4. At both 3 months and 33 moths the SD group were less fearful than the relaxation group. Effects are long-lasting.

Question 6

E: Suitable for Many (SD)

Answer 6

1. The alternatives of SD, flooding and cognitive therapies, are not well suited to some patients.
2. Some sufferers of anxiety disorders like phobias have learning difficulties. Make it very difficult for some patients for understand what is happening during flooding or to engage with cognitive therapies that require the ability to reflect on what you are thinking about.

Question 7

E: It is acceptable to patients (SD)

Answer 7

1. Patients prefer it. Those given the choice of SD or flooding, tend to prefer SD.
2. Does not cause the same degree of trauma as flooding.
3. SD includes some elements- learning relaxation procedures- that are pleasant.
4. Reflected in the low refusal rates and low attrition rates (dropping out) of SD.

Question 8

E: Cost effective F

Answer 8

1. Flooding is at least as effective as other treatments for specific phobias.
2. Ougrin compared flooding to cognitive therapies and found that flooding is highly effective and quicker than alternatives.
3. Free of symptoms quicker, makes it cheaper. SD requires 10-12 sessions.

Question 9

E: Less effective for some phobias F

Answer 9

1. Highly effective for treating simple phobias, less so for complex phobias, social phobias.
2. Social phobias have cognitive aspects. Not only have an anxiety response, but thinks unpleasant thoughts about the situation.
3. May benefit more from cognitive therapies because such therapies tackle the irrational thinking.

Question 10

E: Traumatic F

Answer 10

1. Highly traumatic experience.
2. The problem is not that flooding is unethical, but that patients are often unwilling to see it through to the end, high attrition rate.
3. Time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment. Compare to SD, low refusal and attrition rates.