behavioural approach to treating phobias

• systematic desensitisation is gradually exposing patient to the phobia using an anxiety hierarchy, relaxation and exposure
• flooding is intense exposure to the phobic stimulus with no way of escape so avoidance cannot take place. It is not ethical so it is important for patients to give informed consent. For example a person with arachnophobia receiving flooding treatment may have a spider crawl over their hand until they can fully relax
• One strength of systematic desensitisation is that there is evidence of effectiveness. Gilroy et al. followed up 42 people who had systematic desensitisation for spider phobia. At follow-up, the systematic desensitisation group were less fearful than the control group. In recent review, Wechsler et al. concluded that systematic desensitisation is effective for specific phobia, social phobia and agoraphobia. This means that systematic desensitisation is likely to be helpful for people with phobias
• One strength of systematic desensitisation is its usefulness for people with learning disabilities. Main alternative to systematic desensitisation are unsuitable for people with learning disabilities, like cognitive therapies require a high level of rational thought and flooding is distressing. Systematic desensitisation doesn't require understanding or engagement on a cognitive level and is not a traumatic experience. This means that systematic desensitisation is often the most appropriate treatment for some people
• One strength of flooding is that it is cost effective. A therapy is described as cost effective if it is clinically effective and not expensive. Flooding can work in as little as one session. Even with a longer session this makes flooding more cost effective than alternatives. This means that more people can be treated at the same cost by flooding than by systematic desensitisation or other therapies
• One limitation of flooding is that it is traumatic. Schumacher et al. found that both participants and therapists rated flooding as more stressful than systematic desensitisation. Thus there are ethical concerns about knowingly causing stress, and the traumatic nature of flooding also leads to higher attrition rates than systematic desensitisation. This suggests that, overall, therapists may avoid using this treatment