Behaviourist treatments of phobias

• Behaviourist approach to treatment

  Psychologists are interested in explaining why phobias develop but also in understanding how to treat them

  The specification identifies two behavioural methods used in the treatment of phobias:

  • Systematic desensitisation
  • Flooding
• Behavioural treatments

  In his two-process model of phobia acquisition, Mowrer suggests that phobias are acquired as a result of classical conditioning and maintained by operant conditioning. 

  Behavioural treatment therefore aims to:

  1. Reduce phobic anxiety through the principle of classical conditioning whereby a new response to the phobic stimulus is paired with relaxation instead of anxiety - counterconditioning 

  Reduce phobic anxiety through the principle of operant conditioning whereby there is no option for avoidance behaviour
• Systematic desensitisation 

  • Wolpe (1958) – two competing emotions cannot occur at the same time, so if fear is replaced with relaxation the fear cannot continue
  • Systematic desensitisation aims to teach a patient to learn a more appropriate association and is designed to reduce an unwanted response, such as anxiety, to a stimulus 

  Reciprocal inhibition is the process of inhibiting anxiety by substituting a competing response.
• AO3 - Evaluation

  (+) It is effective

  These techniques have proven most effective with specific phobias when a particular phobic object/situation can be identified- less effective with agoraphobic and social phobias.

  (+) It is acceptable to patients

  When given the choice between SD and flooding, more often patients choose SD as it does not cause the same degree of trauma and actually involves a pleasant aspect (the relaxation techniques)
• Flooding

  This involves overwhelming the individual’s senses with the item or situation that causes anxiety so that the person realises that no harm will occur. 

  No relaxation techniques or step by step build up. 

  Individual is exposed repeatedly and in an intensive way with their phobia. 

  Individual has their senses flooded with thoughts, images and actual experiences of the object of their phobia.
• How does it work?

  Flooding stops phobic responses very quickly

  Without the option for avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless – this process is called extinction

  A learned response is extinguished when the conditioned stimulus (e.g. a dog) is encountered without the unconditioned stimulus (e.g. being bitten)

  The result is that the conditioned stimulus no longer produces the conditioned response (fear)
• Ethics

  Flooding is not unethical as patients give their 

  informed consent so they know exactly what is 

  involved

  It is of course an unpleasant experience and a patient has to be properly prepared

  A patient would normally be given the choice of systematic desensitisation or flooding
• AO3 - Evaluation

  (+) It is cost-effective

  The quick effect that flooding can have means that patients are free of their symptoms as soon as possible and this makes the treatment cheaper than alternatives 
• AO3 - Evaluation

  (-) It is less effective for some types of phobia

  Flooding is less effective for treating more complex phobias like social phobias. This may be because social phobias have cognitive aspects – an individual does not simply experience an anxiety response but thinks unpleasant thoughts about the social situation

  (-)The treatment is traumatic for patients

  Flooding produces high levels of fear and this can be very traumatic and as a result many patients refuse to start or complete treatment