Treating phobias

• What is systematic desensitisation as a behavioural treatment of phobias?

  • Behavioural therapy designed to gradually reduce phobic anxiety using classical conditioning
  • Counterconditioning: teaching patient a new response to the phobic stimulus by pairing it with relaxation over anxiety
  • Reciprocal inhibition: one emotion (relaxation) prevents the other (fear), becoming the new response
• What are the 3 processes involved in systematic desensitisation?

  1. Anxiety hierarchy: a list of anxiety-provoking situations put together by client and therapist arranged in order from least to most frightening - in vitro (imagination) to in vivo (real-life)
  2. Relaxation: patient is taught to relax as deeply as possible, including breathing exercises, mental imagery, drugs, etc.
  3. Exposure: patient is exposed to the phobic stimulus while in a relaxed state, starting from the bottom of the hierarchy and only moving up if they stay relaxed

  Treatment only becomes successful once the patient can stay relaxed in situations high on the anxiety hierarchy
• What is one strength of systematic desensitisation?

  • Research support for effectiveness: Gilroy et al. (2003) followed up 42 people who had SD for a spider phobia
  • Found that at both 3 and 33 months, this group were less fearful of spiders than a control group who were treated by relaxation without exposure
  • Shows it is highly likely to be successful in treating people with phobias
• What is another strength of systematic desensitisation?

  • Learning disabilities: people with learning disabilities may struggle with cognitive therapies that require complex rational thought and could feel distressed by the traumatic experience of flooding
  • Means that SD is often the most appropriate treatment for people with learning disabilities that want to be cured of their phobias, showing good accessibility for different types of people
• What is flooding as a treatment for phobias?

  • Being immediately exposed to phobic stimuli WITHOUT a gradual build-up in an anxiety hierarchy
  • Extinction: stops phobic responses quickly as without the option of avoidance behaviour, the client learns that the phobic stimulus is harmless
  • Patient can even achieve relaxation as they become exhausted by their own fear response
• What is one strength of flooding as a treatment for phobias?

  • Cost-effective: a therapy is considered cost-effective if it is clinically effective at tackling symptoms and not expensive
  • Flooding can work in as little as 1 session as opposed to 10 for SD to achieve the same result
  • Means more people can be treated at the same cost with flooding than with SD or other therapies, increasing its' usefulness
• What is one limitation of flooding as a treatment for phobias?

  • Traumatic: it is a highly unpleasant experience and confronting one's phobic stimulus in an extreme form provokes tremendous anxiety
  • Schumacher et al. (2015) found that participants and therapists rate flooding as significantly more stressful than SD, meaning attrition rates (dropping out) are also significantly higher
  • Suggests that overall therapists may avoid using this treatment
• What is another limitation of flooding?

  • Symptom substitution: behavioural therapies only mask symptoms and don't tackle the underlying causes of phobias
  • Persons (1986) reported the case of a woman with a phobia of death who was treated with flooding - although her fear of death declined her fear of criticism became worse
  • Shows flooding may be an inadequate treatment for phobias as a whole as it only tackles surface-level symptoms rather than the root cause