Behavioural approach to treating phobias

• What do behavioural therapists assume?

  Behaviourist therapies assume phobias are learnt associations and attempt to replace the fear association with relaxation.
• What is reciprocal inhibition?

  Reciprocal inhibition: fear and relaxation are two antagonistic emotions, as you can't feel two opposite emotions simultaneously.

  If the therapist can help the client hold the phobic object without fear, they have been successfully counter-conditioned.
• What are the two techniques a behavioural therapist may use to treat phobias

  -Systematic desensitisation

  -Flooding
• What is systematic desensitisation, what is the technique?

  Systematic Desensitisation (SD)

  1) therapist teaches the client relaxation techniques like

  breathing exercises.

  2) The client creates an anxiety hierarchy, a list of feared

  situations with the phobic object, from the least to the

  most feared.

  3) The client is exposed to each level of the anxiety

  hierarchy, starting with the least anxiety-producing level

  of the anxiety hierarchy. Importantly, the client must

  relax at each stage, and the therapist moves to the next

  step only when the client is fully relaxed.

  4) When the client can hold the phobic object without fear,

  the association is extinct, and a new association with

  relaxation is formed.
• What is flooding?

  -Flooding attempts to counter condition a phobia by

  immediate and full exposure to the maximum level of phobic

  stimulus. (e.g. the top level of the previous anxiety hierarchy).

  -Immediate exposure is expected to cause an extreme panic

  response in the client (cry/scream).

  -The therapist's job is to stop the client from escaping the situation.

  -A fear response takes energy. Eventually, the client will

  become exhausted and calm down in the presence of the

  phobic object.

  -If the client ends the treatment before this point, anxiety will

  decrease due to removing the stimulus, and the phobia will

  have been reinforced.
• Evaluation for systematic desensitisation - Economy

  -SD can be seen as beneficial for the economy:

  -It is estimated that mental health issues cost the English economy around £22.5 billion a year and any effective treatments for mental illness could help to reduce this. -For example, an effective therapy for phobias such as SD might reduce unnecessary healthcare costs on treatments for phobias that do not work.

  -This is positive because it means SD may not only have a positive impact on sufferers' lives, but also have economic benefits too
• Evaluation for systematic desensitisation - Effective

  -SD is not an effective treatment for all phobias:

  -This means that it has been argued that phobias with an underlying evolutionary component (i.e. fears that are more instinctive and beneficial for survival) are not as easily treated by SD as phobias that have been learned through experience. -For example, it is argued that fears of the dark, of heights or of a dangerous animal that may be the result of evolution are harder to treat through SD.

  -This is a problem because SD might be limited to only treating specific types of phobia.
• Evaluation for flooding - Cost effective

  -Another strength of flooding is that it is cost-effective:

  -This means that flooding is relatively cheap.

  -For example, flooding only requires one session rather than SD which requires multiple sessions.

  -This is positive as many therapists favour flooding for this reason, even if it may not always be as acceptable or preferable for many patients as SD.
• Evaluation for Flooding - Effective treatment

  -However, flooding is not an effective treatment for all phobias:

  -This means that it has been argued that complex phobias such as 'social phobias' cannot be treated effectively with flooding. -For example, it is argued that flooding can only treat 'simple phobias' and not social phobias which have cognitive aspects (unpleasant thoughts in addition to the anxiety response). -This is a problem because flooding might be limited to only treating specific types of phobia..