Behavioural approach to Phobias

• what is a phobia?

  an intense and irrational fear of a stimulus which includes an object or situation
• what does behavioural mean?

  ways in people act
• what are all phobias characterised by?

  excessive fear and anxiety triggered by a place , object or situation
• what is the latest version of DSM-5 categories of phobia?

  1. Specific phobia - object (eg animal) or situation (eg having injections)
  2. Social anxiety (phobia) - phobia of social sitch e.g public speaking or use of public toilet
  3. Agoraphobia - phobia of being outside or public place
• what are the behavioural characteristics of phobias?

  1. Panic - panic may involve a variation of behaviours such as crying etc . reaction slight diff for children e.g having a tantrum
  2. Avoidance - put in effort to prevent coming into contact with the phobia
  3. Endurance - alternative response to avoidance which occurs when the person chooses to remain in the presence of the phobic stimulus
• what are the emotional characteristics of phobias?

  1. Anxiety - classed as anxiety disorders as they have an emotional response of anxiety , an unpleasant state of high arousal which prevents a person from relaxation
  2. Fear - immediate + extremely unpleasant response when encountering/thinking of the phobic stimulus
  3. Emotional response is unreasonable - reaction is much greater than 'normal'
• what does having selective attention to the phobic stimulus mean (cognitive characteristic of phobias)?

  the person cannot concentrate / look away from the phobic stimulus (usually a good thing when people keep their attention on danger but not when the fear is irrational)

  • e.g person with arachnophobia will struggle to concentrate when a spider is in the room
• what does having irrational beliefs to the phobic stimulus mean (cognitive characteristic of phobias)?

  having unrealistic thoughts in relation to phobic stimulus which increases the pressure to perform well in social situations e.g 'i must always sound intelligent'
• what does having cognitive distortions to the phobic stimulus mean (cognitive characteristic of phobias)?

  perceptions of a person with a phobia may be innacurate and unrealistic e.g someone with a mushroom phobia may see them as digusting
• Examples of specific phobias:

  Arachnophobia - spiders

  Coulrophobia - clowns

  Xanthophobia - yellow
• what is the difference between fear and anxiety as emotional characteristics of phobias?

  fear is an immediate response and usually more intense; experienced for a shorter period whereas anxiety is long term and is an continuous feeling of unease
• what is the two-process model by Mowrer?

  based on the behavioural approach to phobias

  1. acquired (learnt) through classical conditioning
  2. maintained through operant conditioning
• how are phobias maintained through operant conditioning?

  avoiding the phobic stimulus = reduces the anxiety that the person wouldve experienced if they didnt avoid the stimulus = increases frequency of behaviour = phobia is maintained
• Strength : Mowrer's two-process model

  P - real - world application in exposure therapies e.g systematic desensitisation

  E - phobias are maintained by avoidance , explains why people with phobias benefit from exposure to phobic stimulus

  E - phobia is the avoidance behaviour so when it is prevented the phobia is cured

  L - shows value of two-process model ,identifies a means of treating phobia
• Limitation : Mowrer's two - process model

  P - doesnt account for cognitive aspects of phobias

  E - people hold irrational belief about their phobias which is a cognitive characteristic of OCD

  E - the two -process model explains avoidance behaviour but does not offer an adequate explanation for phobic cognitions

  L - hence two-process model doesnt completely explain the symptoms + aspects of phobias
• Strength : two-process model

  P - evidence or link between bad experiences and phobias

  E - Little Albert study , frightening experience (loud noise whilst playing with rabbit)

  E - led to phobia of white fluffy objects (conditioned stimulus) as he showed signs of distress at the sight of these

  L - confirms the association between a traumatic experience can lead to the development of a phobia

  COUNTERPOINT - doesnt apply to all phobias where the phobic stimulus is not very common
• Limitation : two-process model

  P - limited explanation

  E - e.g preparedness (Seligman) - tend to acquire phobias of things that have presented danger in our evolutionary past (snakes + darkness)

  E - the evolutionary theory may be better as an explanation for general aspects of phobias

  L - two-process model may be limited as an explanation
• what is systematic desensitisation?

  a behavioural therapy designed to reduce a phobic anxiety through the principle of classical conditioning as the person is taught to maintain relaxation whilst in the presence of the phobic stimulus
• what is an anxiety hierarchy (1st part of SD)?

  a list of situations in relation to the phobic stimulus that provoke anxiety , put together by the client and therapist , which is arranged in the order from least to most frightening
• what does the 'relaxation' part of SD involve (2nd part)?

  the client is taught relaxation techniques as it is impossible to be relaxed and afraid at the same time so relaxation prevents the anxiety/fear in the presence of the phobic stimulus (reciprocal inhibition)
• what does the 'exposure' part of SD involve (3rd part)?

  client is exposed to the phobic stimulus whilst in a relaxed state which takes place across several sessions each moving up the anxiety hierarchy when the client can remain relaxed in the previous stage.
• how do we know when SD has been a successful treatment?

  when client can remain relaxed in situations high on the anxiety hierarchy
• what is flooding?

  a behavioural therapy where the client is immediately exposed to an extreme form of a phobic stimulus to reduce anxiety triggered by that stimulus
• which sessions lasts long SD or flooding?

  flooding can last two to three hours
• what is extinction (flooding)?

  flooding works through this method as there is not option for avoidance behaviour so the client soon realises the phobic stimulus harmless
• what is another way other than extinction a person with a phobia can overcome their fear as a result of flooding?

  client may achieve relaxation simply because they get exhausted by their own fear response
• what are some ethical safeguards that are taken place before flooding?

  client must give their full informed consent to this traumatic procedure and are fully prepared . They are given a choice between flooding and SD
• Strength : SD

  P - effectiveness

  E - Lisa Gilroy followed up 42 people with arachnophobia in 3 45 min sessions and found that SD group were less fearful than a control group teated by relaxation w/o exposure

  E - SD has a higher chance of successfully working as a treatment for phobias

  L - SD likely to be helpful with phobias
• Strength :SD

  P - helpful for people with learning disabilitiees

  E - the main alternative to SD such as cognitive therapies require rational thought

  E - may not be suitable for client as they may feel more overwhelmed

  L - SD most appropriate method for people w learning disabilities who also have phobias
• Limitation : SD

  P - low external validity

  E - Wechsler et al found that VR exposure less effective than real exposure

  E - lacks mundane realism

  L - validity of SD can be questioned as it may not be accurate / applicable to real-world sitch

  COUNTERPOINT- cost -effective and avoid dangerous sitch e.g heights
• Strength : flooding

  P - highly cost -effective

  E - can work in one session as opposed to 10 sessions of SD to achieve the same result

  E - both clinical effective and not expensive = cost -effective

  L - more people can be treated at the same cost with flooding than SD or other therapies
• what is clinical effectiveness ?

  how effective a therapy is at treating symptoms
• Limitation : flooding

  P - highly unpleasant experience

  E - Schumacher et al found pps and therapists rated flooding as significantly more stressful than SD

  E - raises ethical issues alongside attrition rates (loss of pps overtime) will be higher than SD as it takes longer

  L - therapists may avoid using this treatment despite given informed consent
• Limitation : Flooding

  P - only masks and acts as substitute for symptoms and do not tackle causes of phobias

  E - Persons(1986) reported case of woman with fear of death declined but fear of being criticised increased

  E - may heighten / worsen other underlying issues rather than eradicating initial issue

  L - may not be an effective treatment for phobias alone suggesting it would be more beneficial if it was paired with another treatment such as therapy