the biological approach to treating phobias

• systematic desensitisation

  systematic desensitisation is a 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. a new response to the phobic stimulus is learned (relaxation). this is called counterconditioning.
• process of SD

  1. the anxiety hierarchy = this is put together by the patient and therapist. it is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
• process of SD

  2. relaxation = the therapist teaches the patient to relax as much as possible. This might involve breathing exercises or the patient might learn mental imagery techniques. patients can be taught to imagine themselves in relaxing situations or they might learn mediation.
• process of SD

  3. exposure = the patient is then exposed to the phobic stimulus while in a relaxed state. this takes place across several sessions, starting at the bottom of the anxiety hierarchy. when the patient can stay relaxed in the presence of the lower levels they move up the hierarchy. Treatment is successful when a patient can stay relaxed in situations high on the hierarchy
• flooding

  flooding involves exposing phobic patients to their phobic stimulus but without a gradual build-up. instead it involves immediate exposure to the situation. flooding sessions are typically longer than SD. sometimes only one long session is needed to cure a phobia
• how does flooding work?

  flooding stops phobic responses very quickly. this may be because without the option of avoidance behaviour the patients learns quickly that the stimulus is harmless. a learned response is extinguished when the conditioned stimulus (e.g. dog) is encountered without the unconditioned stimulus (being bitten). the result is that the conditioned stimulus no longer produces the conditioned response (fear)
• ethical safeguards of flooding

  flooding is not unethical but is an unpleasant experience so it is important that patients give fully informed consent and that they are fully prepared before flooding sessions. A patient would normally be given the choice of SD or flooding
• A03 SD- it is effective

  • research shows SD is effective in the treatment of specific phobias
  • Gilroy had 42 patients who had been treated for spider phobia in three 45 minute sessions of SD
  • spider phobia was assessed on several measures such as questionnaires and assessing response to spider
  • a control group was treated with by relaxation without exposure
  • at both 3 months and after 33 months after the treatment the SD group were less fearful than the relaxation group
• A03 SD- it is suitable for a diverse range of patients

  • the alternatives to SD are not well suited to some patients
  • e.g. sufferers of anxiety disorders also have learning difficulties which can make it hard for patients to understand what is happening during flooding
  • therefore SD is probably the most appropriate treatment
• A03 SD - it is acceptable to patients

  • patients prefer this treatment
  • when given the choice between SD and flooding they tend to prefer SD
  • this is because it does not cause the same degree of trauma as flooding and SD also includes pleasant elements such as relaxation techniques
• A03 flooding - it is cost effective

  • studies comparing flooding to other cognitive therapies have found that it is highly effective and quicker than alternatives
  • this is a quick effect as it means patients are free of their symptoms as soon as possible and that makes treatment cheaper
• A03 flooding - it is less effective for some types of phobia

  • it appears to be less effective for complex phobias like social phobias
  • this may be because social phobias have cognitive aspects e.g. a sufferer of a social phobia does not simply experience anxiety response but thinks about unpleasant thoughts about the situation
• A03 flooding - the treatment is traumatic

  • it is a highly traumatic experience for patients
  • it isn't that flooding is unethical but patients are often unwilling to see it through to the end
  • this is a limitation because time and money are sometimes wasted preparing patients only to have them refuse or complete treatment