Behavioural approach to treating phobias

• systematic desensitisation (SD) 1


  if phobias learned, they can be unlearned (counter conditioned) - treat client step by step to replace learned sensitivity or fear response with harmless response - impossible to be afraid and relaxed at same time so 1 emotion prevents other (reciprocal inhibition) - teaches client deep relaxation techniques
• systematic desensitisation (SD) 2


  anxiety hierarchy developed starting with least fearful situation at bottom and most fearful situation at top - client learns to associate deep relaxation with least provoking situation then once achieved moves up hierarchy until most fearful situation is associated with relaxed response
• SD EVALUATION - effective at treating phobias


  SD shown to be extremely successful therapy for range of different phobias - McGrath found 75% of patients showed improvement in symptoms after SD - seems to work in most cases and client is in control
• SD EVALUATION - beneficial for economy 


  estimated mental health issues cost English economy around £22.5 billion a year and any effective treatment for mental illness can reduce this - e.g. SD might reduce unnecessary healthcare costs on treatments fro phobias that don't work - SD may have economic benefits
• SD EVALUATION - ethical issues

  asking person with major fear to confront object of anxiety may be criticised for lack of protection from harm even if exposure is gradual - e.g. asking someone with fear of flying to work towards taking flight may cause excessive anxiety when other therapies may be less stressful - goes against ethical code of conduct
• SD EVALUATION - sufferers tend to prefer SD to flooding


  SD doesn't cause same degree of trauma as flooding and includes elements that can be pleasant (relaxation techniques) - evidence from low refusal rates of SD and low attrition rate (people dropping out low) - clearly acceptable treatment for patients
• flooding


  one long session where phobia experienced at its worst while practicing relaxation - session continues until patient feels completely relaxed in presence of phobic stimulus - therapist encourages patient to use relaxation techniques until anxiety disappears - can last 2-3 hours - stops phobic behaviour very quickly as sufferer is unable to demonstrate avoidance behaviour and quickly learns stimulus is harmless (extinction) - learned response extinguished when conditioned stimulus encountered without unconditioned stimulus
• FLOODING EVALUATION - effective treating phobias


  shown to be at least as effective as SD for patients who choose flooding - Choy found flooding more effective than SD at treating phobias - seems to work if patients stick with it for duration of session
• FLOODING EVALUATION - cost effective 


  relatively cheap - only requires one session compared to SD that requires multiple sessions - many therapists favour flooding for this reason
• FLOODING EVALUATION - ethical issues


  directly confronting most extreme aspect of patients anxiety may be criticised for lack of protection from harm - e.g. asking someone with phobia of spiders to have a spider crawl on them seen as inappropriate when alternative therapies may be less stressful - goes against ethical code of conduct
• FLOODING EVALUATION - not effective for all phobias


  argued complex phobias like social phobias can't be treated effectively with flooding - e.g. argued flooding can only treat simple phobias not social phobias which have cognitive aspects (unpleasant thoughts) - limited to only treating specific types of phobias