systematic desensitisation

• who first developed the treatment for phobias?

  Joseph wolpe 1958 based on the principles of classical conditioning
• what is counter conditioning?

  learning behaviours which appose previous learning. in this case learning to associate the phobic object/situation with relaxing
• what is reciprocal inhibition?

  we can't feel 2 of the opposite emotions at the same time therefore fear is replaced by a state of relaxing
• what are anxiety hierarchies?

  a model that the client produces - a list of situations describing the increasing levels of anxiety the phobia will create e.g bottom looking at a picture of a spider top holding a spider
• what relaxation techniques are used?

  learning progressive muscle and breathing techniques
• what is exposure in this application?

  exposing the client to the anxiety hierarchy slowly - achieve state before moving on to the next.
• what are the 4 main features of the treatment?

  • relaxation
  • anxiety hierarchy
  • exposure
  • reinforcing of achievement & self efficacy
• what is in vivo exposure?

  directly confronting the phobia if possible
• what is in vitro exposure?

  rather than actually exposing the client directly to the feared object or situation the client uses imagery to imagine it
• what is reinforcing achievement and self efficacy?

  rewarding the state of relaxation with each item of fear. intention to create self efficacy
• what is self efficacy

  belief that they can and are in control of the outcome of the situation
• How many patients did Wolpe 1998 claim he cured or improved after 25-30 sessions?

  80-90%
• how many patients did McGarth et al 1990 claim he cured?

  75% individuals responded well to the therapy
• what was the good appropriateness for the treatment of phobias?

  only appropriate for some of the treatments - like simple phobias
• what was the bad appropriateness for the treatment of phobias?

  not appropriate for other mental health disorders or not simple phobias - generalised anxiety disorder and schizophrenia
• what is the good practicality?

  • easy to train people to deliver systematic desensitisation and easy to treat people with the straight forward phobias
  • also less traumatic than flooding as a treatment - so less likely rto drop out of the treatment
• what is bad practicality?

  practical problems with the vivo exposure - social phobias, you cant take the therapist to the social event
• what is the conclusion for appropriateness and the practicality

  appropriateness for the individual must be considered

  also can consider in vitro exposure if vivo doesn't work with phobia
• what is the positive effectiveness for the this therapy?

  McGrath had 75% people respond effectively to his therapy - this type of therapy takes only weeks compared to the psychodynamic approach
• what was the bad effectiveness?

  • the ability to deal with the phobic object or situation may not generalise beyond the therapeutic setting
  • the phobic response will be relearnt and could then cause spontaneous recovery of the phobia
• what are the ethics of this treatment method?

  • deliberately exposing an individual to a setting/situation that will make them anxious
  • but on the other hand - the individual has not been forced to do this treatment an therefore they don't have to do anything they don't want to do
  • there are no side effects
• what is the conclusion for the ethics?

  • a cost-benefit analysis is needed to be done for each client
  • if the cost of not having the treatment is high then the outcome will outweigh the treatment and amount of stress it will induce