Treating phobias

• Systematic desensitisation


  Gradually reduce phobic anxiety through counterconditioning( uses classical conditioning)

  Phobic stimulus is paired with relaxation(new cr)

  Impossible to be afraid and relaxed at the same time, so one emotion prevents the other= reciprocal inhibition.
• Anxiety hierarchy


  Patient and therapist list fearful stimuli from least to most terrifying
• Relaxation techniques


  E.g: breathing techniques, meditation

  work through hierarchy patient exposed to phobic stimulus in a relaxed state.

  Process is repeated at each step of the hierarchy starting from bottom.

  The treatment is considered successful when they can remain relaxed in situations at the top of the hierarchy.
• Strength of systematic desensitisation

  Effective

  E.g: Gilroy et al patients with a fear of

  spiders. Each patient was treated using three 45‐minute SD sessions.

  When examined three months and 33 months later, the SD group were less fearful than a control group (who were only taught relaxation techniques)

  Shows that the gradual exposure element of SD is crucial to the effectiveness of treating phobias and also suggests SD is an effective long term treatment for phobias.
• Limitation of systematic desensitisation


  Not effective in treating all phobias.

  E.g: Patients with phobias which have not developed through a personal experience (classical conditioning) not effectively treated using SD

  Psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning. SD is ineffective in treating evolutionary phobias which

  have an innate basis.
• Strength of systematic desensitisation

  Favoured as a treatment for phobias in comparison to flooding, as it is more ethical in nature.

  E.g: in comparison to flooding ,many patients report a

  preference for SD as it does not cause the same levels of distress

  This is reflected in the high number of patients who persist with SD providing low attrition rates.

  Considered a more appropriate treatment for those who may have learning difficulties or suffer from severe anxiety disorders since learning the relaxation techniques can be a positive and pleasant experience.
• Flooding


  Involves immediate and direct exposure to the phobic stimulus

  No option of avoidance behaviour so patient learns phobic stimulus is harmless through exhaustion of fear response (extinction)

  Need informed consent
• Limitation of flooding


  Less effective for some types of phobia

  e.g: social phobia - are caused by irrational thinking(cognitive aspect) not caused by an unpleasant experience (or learning

  through classical conditioning).

  More complex phobias cannot be treated by behavioural

  treatments and may be more responsive to other forms of treatment like CBT which tackles irrational thinking
• Strength of flooding


  Cost‐effective treatment for phobias.

  Research has suggested that flooding is equally effective to other treatments, including SD and

  cognition therapies but takes much less time in achieving these positive results.

  ;) patients cure their phobias more quickly and it is therefore more cost‐effective for health service providers who do not have to fund longer options.
• Limitation of flooding


  Highly traumatic

  As purposefully elicits a high level of anxiety.

  Although it is not unethical as patients provide

  informed consent, many do not complete their treatment because the experience is too stressful.

  Therefore, initiating flooding treatment is sometimes a waste of time and money if patients do not complete the full course of their treatment and seen as not effective