Explainig and treating phobias

• Behaviourist therapies


  Based on the idea that phobias are learnt through association to fear, so therapies attempt to replace the fear association with one of relaxation/calm
• Systematic desensitisation

  1. Break the phobia down into an anxiety hierarchy, ranking presentations of the stimulus from least feared to most feared

  2. Teach relaxation techniques such as breathing exercises

  3. Encourage clients to relax at each stage in a stepped approach

  4. Gradual exposure leads to the extinction of the fear association and formation of a new association with relaxation
• Reciprocal inhibition


  Idea that fear and relaxation are opposite emotions and cannot coexist at the same time
• Flooding

  1. Immediate full exposure to the maximum level of phobic stimulus

  2. Scenario adjusted to make it safe

  3. Temporary panic in the client while they are bombarded with fear

  4. Prevent avoidance by preventing the client from ending the treatment

  5. Fear will be extinguished due to exhaustion
• Flooding can be in vivo (real life stimulus) or in vitro (situation is imagined by patient)
• Systematic desensitisation is effective in treating phobias
• McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation with in vivo techniques
• Gilroy et al. (2002) examined 42 patients with arachnophobia. Each patient was treated using three 45-minute systematic desensitisation sessions. When examined three months and 33 months later, the systematic desensitisation group were less fearful than the control group (who were only taught relaxation techniques). This provides further support for systematic desensitisation, as a long-term treatment for phobias.
• Systematic desensitisation is not effective in treating all phobias, especially those not developed through personal experience like a fear of heights
• Patients with phobias which have not developed through personal experience (classical conditioning), for example, a fear of heights, are not effectively treated using systematic desensitisation
• Some psychologists believe that certain phobias, like heights, have an evolutionary survival benefit and are not the result of personal experience, but the result of evolution
• These phobias highlight a limitation of systematic desensitisation which is ineffective in treating evolutionary phobias
• Systematic desensitisation is often thought to be more successful than flooding as the client is in control of their progress, not the therapist
• Flooding is not appropriate for older people, people with heart conditions, children, or abuse victims due to ethical concerns
• Systematic desensitisation is ethically suitable for almost all people
• There are ethical concerns as flooding exposes participants to emotional harm, and it could also end up reinforcing the phobia if treatment is ended too soon
• One strength of flooding is it provides a cost-effective treatment for phobias
• Research has suggested that flooding is comparable to other treatments, including systematic desensitisation and cognition therapies, however, it is significantly quicker
• This is a strength because patients are treated quicker and it is more cost-effective for health service providers
• Although flooding is considered a cost-effective solution, it is highly traumatic for patients and causes a high level of anxiety
• Many patients do not complete their treatment because the experience is too stressful and therefore flooding is sometimes a waste of time and money as many patients do not finish their therapy
• Systematic desensitisation has a higher completion rate, perhaps because it is a more pleasant experience
• Although flooding is highly effective for simple (specific) phobias, the treatment is less effective for other types of phobia, including social phobia and agoraphobia
• Some psychologists suggest that social phobias are caused by irrational thinking and are not caused by unpleasant experiences (or learning through classical conditioning). Therefore, more complex phobias cannot be treated by behaviourist treatments and may be more responsive to other forms of treatment, for example, cognitive behavioural therapy (CBT), which treats the irrational thinking
• Alternative treatments for phobias exist, such as drug treatments
• Examples of drug treatments for phobias

  • Anxiety disorder tranquilisers such as Benzodiazepines
  • Beta blockers such as Propranolol
  • Antidepressants
• Drug treatments are often used as a short-term solution before talking therapies
• All of these drugs simply suppress the symptoms without addressing the underlying cause, and can also cause side effects
• As talking therapies are more effective in the long term, they are the preferred treatment plan
• Both systematic desensitisation and talking therapies take a number of sessions to complete and require one on one time with the therapist, resulting in a substantially higher cost than for drug treatments
• Behaviourist model for explaining phobias

  • Phobias are learnt via experience
  • Two-process model: Phobias are first acquired via association (classical conditioning) and then maintained via reinforcement (operant conditioning)
• Acquisition (classical conditioning)


  1. Phobic object(s) are at first neutral stimulus

  2. Neutral stimulus becomes conditioned stimulus

  3. Fear is passed onto other stimuli via generalisation
• Maintenance (operant conditioning)

  1. Phobic person avoids situations bringing them into contact with phobic object

  2. Anxiety is reduced by avoiding situations, acting as negative reinforcement
• Social learning theory

  1. Learning can happen vicariously by observing models

  2. Observing fear response in others can result in the same fear display
• Watson and Rayner (1920) used little Albert to induce phobias in a child by making loud noises when presenting a white rat, generalising fear to other white fluffy objects
• Menzies and Clarke (1993) found that only 2% of children with a fear of water could recall a traumatic experience with water, suggesting behaviourist explanation cannot account for all phobias
• Phobias of snakes, birds, and dogs may have an evolutionary origin as early ancestors could have been hunted/attacked by these creatures
• Behaviourist theories of phobia formation have led to effective counter-conditioning treatments such as flooding and systematic desensitisation