behavioural approach to treating phobias

• systematic desensitisation


  behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning

  if a person can learn to relax in the presence of the phobic stimulus they will be cured

  3 processes
• Counterconditioning 


  a new response to the phobic stimulus is learned (relaxation instead of anxiety)
• 3 processes of systematic desensitisation

  1. anxiety hierachy
  2. relaxation
  3. exposure
• the anxiety hierachy

  • put together by client and therapist
  • list of situations related to phobic stimulus which provoke anxiety
  • from least to most frightening
  • eg. person scarde of spiders may put a picture of a small spider as low on their anxiety hierachy and holding a spider at the top
• relaxation

  • therapist teaches client to relax as deeply as possible as it is impossible to be scared and relaxed at the same time, one emotion prevents the other
  • this is called reciprocal inhibition
  • breathing excercises or client may learn mental imagery techniques
  • client taught to imagine themselves in relaxing situations eg. lying on a beach
  • they may learn meditation
  • alternative relaxation can be from drugs eg. Valium
• exposure

  • client is exposed to phobic stimulus while in a relaxed state
  • takes place over several sessions
  • start at bottom of anxiety hierachy
  • when the client can learn to stay relaxed in the lower levels of the phobic stimulus, they move up the hierachy
  • successful when client can stay relaxed in high situations on the anxiety hierachy
• Flooding


  behvaioural therapy in which a person is immediately exposed to their phobic stimulus in order to reduce anxiety triggered by that stimulus

  sessions are typically longer than SD sessions, with one session lasting 2-3 hours

  phobia can sometimes be cured in one long session
• how does flooding work

  • stops phobic responses very quickly
  • without the option of avoidance behaviour, client quickly learn that the phobic stimulus is harmless
  • this is called extinction
  • a learned response is removed when the conditioned stimulus(eg. dog) is encountered without the unconditioned stimulus(being bitten). The conditoned stimulus no longer produces the conditioned response(fear)
  • in some cases the client may acheive relaxation in the presence of the phobic stimulus as they become exhausted by their own fear response
• ethical safeguards


  flooding is not unethical, but is an unpleasant expirence so it is important that clients give full informed consent to this traumatic procedure and that they are fully prepared before the session.

  a client is normally given the choice of SD or flooding to help treat their phobia
• A03- SD - effectiveness

  • a strength of SD is that there is evidence for it being effective
  • Gilroy et all follwed up 42 people who used SD for acracnephobia in 3, 45 minute sessions.
  • At both 3 and 33 months, the 42 people were less scared of their phobias than a control group who were treated by relaxation without exposure
  • means that SD is likely to be helpful for people with phobias
• A03 - SD - people with learning disabilities

  • can be used to help people with learning disabilities
  • main alternatives for SD are not suitable
  • may stuggle with cognitive therapies which require complex rational thought
  • they may feel confused and distressed by the traumatic expirence of flooding
  • means that SD is the most appropriate treatment for phobias for people who have learning disablilities
• A03 - flooding - cost effective

  • can work in one session compared to SD which occurs over lost of session making it expensive
  • means that more people can be treated at a cheaper cost compared to other therapies
• A03 - flooding - traumatic

  • highly unpleasant expirence
  • raises ethical concerns for psychologists of knowlingly causing stress to clients