Treating phobias - Behavioural approach

• Systematic desensitisation - A behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning
• Systematic desensitisation:

  Essentially a new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety)

  • This learning of a new response is called counterconditioning
• There are three processes involved in SD:

  1. The anxiety hierarchy
  2. Relaxation
  3. Exposure
• SD (1): The anxiety hierarchy

  • Put together by a client with a phobia and a therapist
  • A list of situations related to the phobic stimulus that provoke anxiety in order from least to most frightening
• SD (2): Relaxation

  • The therapist teaches the client to relax as deeply as possible eg breathing exercises or mental imagery techniques
  • Or relaxation achieved using drugs
• SD (2): Relaxation

  • Reciprocal inhibition - It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other
• SD (3): Exposure

  • The client is exposed to the phobic stimulus while in a relaxed state
  • Takes place across several sessions, starting at the bottom of the anxiety hierarchy
  • When client stays relaxed in presence of lower levels of phobic stimulus they move up the hierarchy
• SD (3): Exposure

  • Treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy
• Flooding - Immediate exposure to a very frightening situation
• Flooding - A behavioural therapy in which a person with a phobia is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus

  • Takes place across a small number of long therapy sessions
• Flooding:

  • Instead of a step-by-step approach, patients go straight to the top of the hierarchy and imagine, or have direct contact with, their most feared situations
• Flooding:

  • Patients cannot make their usual avoidance responses and anxiety peaks at such high levels they cannot be maintained and eventually subside
• Flooding: Extinction

   A learned response is extinguished when the conditioned stimulus (eg a dog) is encountered without the unconditioned stimulus (eg being bitten)

  • The result is that the conditioned stimulus no longer produces the conditioned response (fear)