treating phobias

• systematic desensitisation

  • therapist trains client in deep relaxation techniques as an alternative response to feared situation
  • aims to replace fear response with relaxation through a classical conditioning procedure called counterconditioning
  • it's impossible to be afraid and relaxed at the same time so relaxation acts as a reciprocal inhibition for fear
• systematic desensitisation - anxiety hierarchy

  • therapist asks client to list situations from leas to most fearful
  • lowest - seeing picture of phobia
  • highest - holding the item
• systematic desensitisation - relaxation

  • therapist asks client to visualise last feared situation while perfoming deep relaxation procedures (breathing excercises or music)
• systematic desensitisation - exposure

  • when the client feels relaxed, they are asked to imagine the next sitaution in the hierarchy
  • the same procedure is repeated, increasing the exposure level
• systematic desensitisation - overview

  • over series of sessions, clients will cope with every hierarchy level
  • they can then stop and restart at a lower level
  • eventually, they will cope with most of the feared situations at the top of the hierarchy
• systematic desensitisation strengths

  • appropriatness - behaviour therapies are quick and require less effort than psychotherapy
  • effectiveness - SD is successful for a range of anxiety disorders
• systematic desensitisation limitations

  • may appear to solve problems but instead suppressing symptoms may lead to symptom substitution (other symptoms appearing). LANGEVIN (1983) claims no eviodencd to support this objection
  • OHMAN (1975) claims SD is not as effective in treating anxieties that have ubderlying evolutioanry survival component (fear of dangerous animals) than in treating phobias due to personal experience
• what is flooding?

  • immediate exposure to the phobic stimulus but without any gradual build up in using an anxiety hierarchy
  • prevents avoidance
  • learns the stimulus is harmless
  • no longer produces conditioned fear response
  • e.g. having a spider crawling on you
• flooding strengths

  • cost effective - compared to congnitive therapies it's highly effective and quicker
  • ethical - full informed consent
• flooding limitations

  • less effective for some phobias: not uiseful for social phobias as it has cognitive aspects (unpleasant thoughts rather than anxiety response)
  • treatment is traumatic for patients