Behavioural approach to treating phobias

• Systematic Desensitisation:

  • Therapy aims to gradually reduce anxiety through counterconditioning: Phobia learnt so that phobic stimulus produces fear, CS paired with relaxation and this becomes new CR.
  • Reciprocal inhibition: can't be relaxed and afraid at same time, so one emotion prevents another.
  • Formation of Anxiety hierarchy: client and therapist arrange fearful stimuli from least to most frightening.
  • Relaxation practiced at each level: Taught relaxation techniques. Works through hierarchy. Several sessions. Treatment successful when person can stay relaxed in high anxiety situations.
• ++Evidence for effectiveness of systematic desensitisation. Gilroy et al. (2003) followed up 42 people who had SD for spider phobia. At follow up, SD group less fearful than control group. This means that SD is likely to be helpful for people with phobias.
• ++ SD's usefulness for people with learning disabilities. Main alternatives to SD unsuitable for people with learning disabilities. SD doesn't require understanding or engagement on a cognitive level and is not traumatic. SD often most appropriate treatment for some people.
• ++ The exposure part of SD can be done in virtual reality, making it cost effective and therefore more accessible.
• Flooding

  • Immediate exposure to phobic stimulus.
  • Very quick learning through extinction : Without option of avoidance, person quickly learns phobic object is harmless through exhaustion of fear response, known as extinction.
  • Ethical safeguards: Isn't an unpleasant experience, must get informed consent, must be fully prepared.
• ++Flooding is cost effective. Flooding can work in as little as one session. This means that more people can be treated at the same cost by flooding than by SD or other therapies.
• --Flooding is traumatic. Schumacher et al. (2015) found both participants and therapists rated flooding more stressful than SD. Therefore there are ethical concerns. Therapists avoid using this treatment.
• --Symptom substitution: Behavioural therapies do not treat causes so symptoms reappear.