Behavioural treatments for phobias

• What is systematic desensitisation?


  Therapeutic technique for reducing anxiety by gradually exposing a person to feared stimuli. Mainly used to treat phobias. Uses reverse inhibition - can't feel anxious and calm at the same time.
• Who developed systematic desensitisation?

  Joseph Wolpe.
• What are the steps of systematic desensitisation?

  • Patient is taught relaxation techniques
  • Therapist & patient construct a desensitisation hierarchy, a series of imagines scenes each more distressing than the previous
  • Patient works their way up the hierarchy whilst practising relaxation techniques
  • Once mastered one step & relatively relaxed, move onto the next one. Patient eventually masters phobic stimulus.
• Strengths of systematic desensitisation:

  • Appropriateness - Quick & easy in comparison to other therapies. Can be used for individuals with specific learning difficulties.
  • Effectiveness- successful in treating a variety of anxiety disorders. E.g. Gilroy: patients with arachnophobia had 3 x 45 min sessions of SD. Fear tested in various methods and compared to a control group. CG taught relaxation techniques but not exposed to a spider. After 3 and 33 months, SD group were less fearful than control group.
• Weaknesses of systematic desensitisation:

  • Symptom substitution - SD may appear to resolve problems but elimination or suppression of symptoms may result in other symptoms appearing
  • Reduced effectiveness for some phobias - Ohman et al found SD not effective in treating anxieties that have an evolutionary survival component e.g. fear of dangerous animals
• What is flooding?

  Immediate, complete and prolonged exposure to the feared stimulus (2-3 hours). Patient cannot escape the stimuli, just have to deal with it. High state of arousal of sympathetic pathway can't last forever. No relaxation techniques taught. Maximum opportunity for association between stimulus and fear response to be extinguished.
• What study backs up effectiveness of flooding?

  Keane et al. 24 Vietnam veterans with PTSD were exposed to 14-16 flooding therapy sessions. Tested before, after and 6 months later for symptoms of PTSD. Compared to control group, flooding group had fewer terrifying flashbacks & less anxiety and depression. Shows flooding can extinguish phobias.
• What did Sarah Schumacher et al find?


  Participants and therapists rated flooding as significantly more stressful than systematic desensitisation.
• What is counterconditioning?


  A new association is taught to the client (stimulus - relaxation) that is the opposite to the original association (stimulus - fear).
• What is reciprocal inhibition?


  As two opposite emotions cannot exist at the same time, one overrides the other, in this case, feeling of relaxation inhibit the feeling of anxiety.,