Behavioural approach to treating phobias

• What is systematic desensitisation

  therapy that aims to gradually reduce anxiety through counterconditioning:

  • phobia is learned so that phobic stimulus (CS) produces fear (CR)
  • CS is paired with relaxation and this becomes the new CR
• what is reciprocal inhibition: desensitisation 


  when its not possible to be relaxed at the same time to one emotion prevents another
• formation of an anxiety hierarchy: desensitisation

  • client and therapist design an anxiety hierarchy - fearful stimuli arranged in order from lead to most frightening
  • a person with arachnophobia might identify seeing a picture of a spider as low on their anxiety hierarchy and holding a tarantula as the final item
• relaxation is practiced at each stage of desensitisation

  • person with phobia is first taught relaxation techniques such as deep breathing and/or mediation
  • person then works through the anxiety hierarchy. at each level the person is exposed to the phobic stimulus in a relaxed state
  • this takes place over several sessions starting at the bottom of the hierarchy. treatment is successful when the person can stay relaxed in high anxiety situations
• what is flooding

  • a person with a phobia to the phobic object without a gradual build up.
  • a person with arachnophobia receiving flooding treatment may have a large spider crawl over their hand until they can relax fully
• flooding leads to extinction

  without the option of avoidance behaviour, the person quickly learns that the phobic object is harmless through the exhaustion of their fear response.
• ethical safeguards: flooding


  flooding is not unethical but it is an unpleasant experience so its important the people being treated give informed consent. they must be fully prepared and know what to expect.
• what are the 2 treatments for phobias

  1. flooding
  2. Systematic desensitisation
• one strength of systematic desensitisation is evidence of its effectiveness

  Gilroy (2003) followed up 42 people who had SD for spider phobias. at follow up, the SD group were less fearful than a control group. in a recent review Wechsler (2019) concluded that SD is effective for a specific phobia, social phobia and agoraphobia. this means that SD is likely to be helpful for people with phobias
• another strength of SD is usefulness for people with learning difficulties 


  main alternatives to SD are unsuitable for people with learning difficulties e.g. cognitive therapies require a high level of rational though and flooding is distressing. SD on the other hand, doesnt require understanding or engagement on a cognitive level and is not a traumatic experience. this means that SD is often the most appropriate treatment for some people.
• one strength of flooding it that its cost effective. 


  a therapy is described as cost effective if its clinically effective and not expensive. flooding can work in as little as one session. even with a longer session e.g. 3 hours, this makes flooding more cost effective than alternatives. this means that more people can be treatment at the same cost by flooding than by SD or other therapies
• one limitation of flooding is that its traumatic 


  Schumacher (2015) found that both participants and therapies rates flooding as more successful than SD. thus there are ethical concerns about knowingly causing stress (offset by informed consent), and the traumatic nature of flooding also leads to higher attrition rates than for SD. this suggests that overall, therapists may avoid using this treatment