behavioural treatment - phobias

• 2 main ways of treating phobias

  • systematic desensitisation
  • flooding
• systematic desensitisation is the behavioural therapy designed to gradually reduce phobic activity - through using principles of classical conditioning (association)

  • when sufferer can learn to associate relaxation with stimulus it means their phobia will be cured - new response then learned (phobic stimulus paired with relaxation rather than anxiety)
• learning of new response - counterconditioning
• reciprocal inhibition - impossible to be afraid and relaxed at same time - one emotion prevents the other
• 3 processes involved in systematic desensitisation

  1. anxiety hierarchy - list of situations put together by patient and therapist showing least frightening to most frightening situations
  2. relaxation - therapist teaches patient to relax deeply as possible (relaxation methods) - drugs are alternative to relax
  3. exposure - patient then exposed to stimulus whilst in relaxed state - start off at bottom of hierarchy then move up
• systematic desensitisation treatment seen as successful when patients can stay in relaxed state throughout all situations on anxiety hierarchy
• evaluation for systematic desensitisation as treatment for phobias

  • effective (+)
  • suitable for diverse range of patients (+)
  • largely accepted by patients (+)
• effective (+) as eval point for SD as treatment for phobias

  • therapy used within SD is seen to be effective
  • example - supporting research looked at 42 patients who were treated for spider phobias using SD compared with control group who was treated with relaxation but NO exposure
  • findings found after 3 months and 33 months after treatment - SD group were less fearful than relaxation group (control)
  • research support shows SD is helpful as long lasting + effective treatment of specific phobias
• suitable for diverse range of patients (+) as eval point for SD as treatment for phobias

  • strength of SD is that treatment is suitable for wide range of patients
  • some alternative treatments like flooding aren't suitable for all patients
  • however - SD works well on ranges of individuals and therefore is seen as appropriate treatment for many individuals
• largely accepted by patients (+) as eval point for SD as treatment of phobias

  • patients prefer SD as wat to treat phobias as result of it not causing the same level of trauma as opposed to alternative such as flooding
  • preference has been shown through low refusal rates and low attrition rates (most tend to finish full treatment rather than dropping out)
• flooding is a form of treatment used to expose phobic patients to phobic stimulus with immediate exposure to frightening situation
• flooding sessions tend to take longer than SD sessions (2-3 hours)

  • however sometimes only 1 session is needed to cure phobia
• flooding works by stopping phobic stimulus responses very quickly

  • extinction - without option of avoidance behaviour the patient learns phobic stimulus isn't harmful
  • learned response is extinguished when conditioned stimulus is encountered without unconditioned stimulus - resulting in conditioned stimulus no longer producing conditional response (fear)
• following is not unethical but it is an unpleasant experience - essential patients give informed consent + fully prepared for session
• evaluation for flooding as treatment for phobias

  • traumatic for patients (-)
  • cost effective (+)
  • less effective for some types of phobias (-)
• traumatic for patients (-) as eval point for flooding as treatment

  • due to instant exposure - flooding is highly traumatic experience
  • although patients give full consent - most wont see it through to end due to traumatic
  • as result - money and time is wasted as result of preparing patients only for them to refuse the start treatment or stop continuation
  • limitation as further therapy may be needed as result fo trauma as well as having negative effect on economy - money being used and 'wasted'
• cost effective (+) as eval point for flooding as treatment for phobias

  • flooding seen as cost effective when compared with alternative treatments for phobias
  • only needed a few flooding sessions to treat phobias - found flooding is effective as well as quicker than alternatives
  • strength as phobia can be treated within few sessions compared to SD were multiple sessions are needed for gradual process
  • makes flooding cost effective if treatment is followed to end - positive impact on health system
• less effective for some types of phobias (-) as eval point for flooding

  • flooding seen to be effective for treating simple phobias but is less effective for more complex - social phobias
  • may be because social phobias have cognitive aspects so are more likely to benefit from cognitive therapies
  • limitation as it restricts who has access to this form as way to treat their phobias