Treatments of phobias

• What are the 2 types of treating phobias?

  • Systematic desensitisation
  • Flooding
• What is systematic desensitisation?

  A form of behaviour therapy used to treat phobias and other anxiety disorders.

  • A client is gradually exposed to (or imagines) the threatening situation under relaxed conditions until the anxiety reaction is extinguished.
• What is the basis of systematic desensitisation?

  The basis of this therapy is counterconditioning because the patient is taught a new association that runs counter to the original association.

  • The patient is taught, through classical conditioning, to associate the phobic stimulus with a new response (i.e., relaxation instead of fear).
• How does systematic desensitisation work?

  1. Patient is taught relaxation techniques (e.g., visualising a peaceful scene, taking deep breaths).
  2. Therapist and patient create a desensitisation hierarchy - a series of imagined scenes, each one causing a little more anxiety than the previous one.
  3. Patients work through hierarchy, and practises relaxation at each stage.
  4. Once the patient has mastered one step in the hierarchy, they move on to the next.
  5. Patient eventually masters the feared situation that caused them to seek help in the first week.
• What is a strength for systematic desensitisation as a treatment for phobias?

  Effective

  • McGarth et al. reported that about 75% of patients with phobias respond to SD.
• What is a limitation for systematic desensitisation as a treatment for phobias?

  Not appropriate for all phobias

  • Research suggests SD may not be as effective in treating phobias that have an underlying evolutionary survival component (e.g., fear of the dark, fear of heights), then in treating phobias which have acquired because of personal experience.
• What is flooding?

  A form of behavioural therapy used to treat phobias and other anxiety disorders.

  • A client is exposed to an extreme form of the threatening situation under relaxed conditions until the anxiety reaction is extinguished.
• How does flooding work?

  One-long session (not gradual like SD).

  • For example, a person who is afraid of clowns is placed in a room full of clowns.

  Rationale -> a person’s fear response (and the release of adrenaline underlying this) has a time limit. As adrenaline levels naturally decrease, a new stimulus-response link can be learned. The feared stimulus is now associated with a non-anxious response.
• What is a strength for flooding as a treatment for phobias?

  Effectiveness

  • Choy et al. reported that both SD and flooding were effective, but flooding was more effective of the two at treating phobias.
• What is a limitation for flooding as a treatment for phobias?

  Individual difference

  • Flooding is not for everyone. It is very traumatic, and patients are made aware of this beforehand. However, they may quit during the treatment, which reduces its effectiveness.
• What is a strength for both behaviour therapies?

  Faster and cheaper and require less effort on the patient's part compared to other psychotherapies

  • CBT requires a willingness for people to think deeply about their mental problems, which is not true for behavioural therapies.
  • This lack of thinking means that the technique is useful for people who lack insight into their motivations or emotions, such as children or patients with learning difficulties.
  • It can also be self-administered - CBT can't
• What is a limitation for both behaviour therapies?

  Symptom substitution

  • Behavioural therapies may not work with certain phobias because the symptoms are only the tip of the iceberg.
  • If the symptoms are removed, the cause still remains, and the symptoms will simply resurface, possibly in another form.
  • For example, Freud recorded the case of Little Hans who had a phobia of horses. The actual problem was an intense envy of his father, but he could not express this directly and his anxiety was projected onto the horses.
  • This demonstrates the importance of treating underlying causes of phobias rather than just the symptoms.