Behavioural approach to treating phobias

• what is flooding?

  a form of behavioural therapy used to treat phobias- a client is exposed to or imagines an extreme form of the threatening situation under relaxed conditions until anxiety reaction is extinguished
• what is systematic desensitisation?

  form of behavioural therapy used to treat phobias- client is gradually exposed to threatening situation under relaxed conditions until the anxiety reaction is extinguished
• describe the process of SD

  Wolpe developed this technique:

  • counterconditioning- new association counters original one. Phobic stimulus associated with new response of relaxation. reciprocal inhibition- relaxation response inhibits anxiety response
  • relaxation- practises techniques like muscle relaxation, slow breathing, imagining calming images, being mindful of the "here and now"
  • desensitisation hierarchy- introduction of the feared situation one step at a time. Client can not move on until they feel comfortable at the present stage. Situation becomes more familiar, less overwhelming
• describe how therapist would take a client through SD

  • Patient taught how to relax completely through relaxation techniques
  • therapist and patient construct desensitisation hierarchy (DH)
  • starts with the stimulus at its lowest form (eg- a picture of it)
  • gradually works their way through DH while engaging in relaxation. Cannot move on until ready to/mastered the current step at the hierarchy
  • ends with most extreme form of stimulus (eg- actual presentation of the stimulus) and overcomes fear
• describe the principles of flooding

  • client immersed in the phobia during one long session, continues until anxiety has disappeared
  • instructed to do so while practising relaxation techniques
  • can be conducted in vivo/virtual reality can be used
  • works because of rationale- fear response has a time limit, as adrenaline levels naturally decrease, new stimulus response link can be learned- a non-anxious response instead
• describe how a therapist would take a client through flooding

  • patient taught relaxation techniques
  • patient and therapist select most extreme form of phobia to encounter, with patient's consent
  • patient can be told if they want to withdraw they can as it can be traumatic
  • mastery of fear over the situation is accomplished in one long session
• evaluation of SD?

  • 😊successful- McGrath et al- 75% of patients with phobias respond to SD. Contact with stimulus is more successful that just pictures/images. range of exposure techniques (in vivo, in vitro, and modelling) is more effective in establishing new response
  • ☹️doesn't work for all phobias- Ohman et al-not suitable for ones with underlying evolutionary survival component (eg fear of dangerous animals)
  • ☹️symptom substitution- symptoms can be removed but cause may remain- then symptoms resurface eg Little Hans only cured from horse phobia when he accepted feelings abt father
• evaluation of flooding?

  • ☹️ethical issues and individual diffs- flooding can be highly traumatic, patients can quit treatment, reducing effectiveness
  • 😊effective and quick treatment compared to CBT- flooding more effective than CBT in treating phobias (Choy et al), very effective, less time consuming
  • ☹️symptom substitution- symptoms can be removed but cause may remain- then symptoms resurface eg Little Hans only cured from horse phobia when he accepted feelings abt father consciously (Freud)