BA treating phobias

• Systematic desensitisation efficacy- Gilroy et al (EVAL POINT)

  • Followed up 42 patients who had been treated for spider phobia in 3 45 minute sessions of SD
  • Spider phobia assessed using a spider questionnaire, assessed responses to a spider
  • Control group -> treated by relaxation without exposure
  • At 3 months and 33 months after treatment, the SD group were less fearful than control
  • Shows how SD is impactful for long-term treatment
• What is a strength of SD to patients? (appropriate)

  • Flooding and CBT are not suited for all patients, some suffer from anxiety or learning difficulties which makes it difficult to engage in the therapy
  • Also hard to understand what is happening which is needed for it to be effective
  • SD is therefore probably most appropriate and can be used on a diverse range of patients, improving the likelihood their QOL will be improved
• What is a strength of SD to patients (2)?

  • Most patients prefer it as it is less traumatic than flooding
  • Also involves pleasant relaxing procedures will makes the therapy more bearable and effective as sufferers will engage properly
  • Reflected in the low refusal rates and low attirtion rates
• What is systematic desensitisation?

  • A behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning
  • Aims for sufferers to learn a new response to the stimulus (counterconditioning)
• What is counter conditioning?

  • Where the sufferer using the therapy learns a new response to the phobic stimulus
  • Usually relaxation instead of anxiety/fear
• What is reciprocal inhibition?

  • Where one emotion prevents the other
  • It is impossible to be afraid and relaxed at the same time so SD aims to use relaxation to prevent the anxiety
• What are the 3 processes involved in SD?

  • Anxiety hierarchy
  • Relaxation
  • Exposure
• How is an anxiety hierarchy used?

  • A list of situations related to phobic stimulus that provoke anxiety
  • Least frightening to most frightening
  • The top is usually enduring/exposure to the stimulus
• How is relaxation used in SD?

  • Therapist teaches patient relaxation techniques to use when encountering phobic stimulus
  • Breathing exercises, use of imagination, grounding techniques, meditation
  • Drugs such as valium can also be used
  • Patient learns these techniques to prevent and replace anxious feelings
• How is exposure used in SD?

  • Patient is exposed to the phobic stimulus whilst in a relaxed state
  • Several sessions, starting from the bottom of the anxiety hierarchy
  • When the patient can stay relaxed in presence of lower levels of the phobic stimulus, they can move up
  • Treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy
• What is flooding?

  • A behavioural therapy in which exposure to phobic stimulus is extreme and immediate
• How does flooding work?

  • Aims to teach the patient that the phobic stimulus is harmless through extreme exposure, removes the option for avoidance behaviour which maintains phobia
  • Known as extinction, where a learned response is extinguished when the CS (phobic stimulus) is encountered without the UCS (fear of it/scenario happening)
  • the conditioned stimulus should no longer produce the conditioned response of fear
  • Patient may achieve relaxation by being exhausted by their fear response
• Ethical safeguards of flooding?

  • Patients must be able to give fully informed consent and are fully prepared before the session