Behavioural approach: treating and explaining Phobias

• The behaviourist explanation for phobia is known as the two-process model, because it involves two different learning processes: classical conditioning (learning by association) and operant conditioning (learning from consequences).
• - Mowrer suggested that a combination of classical and operant conditioning can explain how phobias are learned and why they are difficult to extinguish
• 1)    acquisition of phobia through classical conditioning − a fear response is associated with a stimulus which should be neutral but which becomes a conditioned stimulus due to being paired with a ‘threatening’ stimulus.
• Acquisition of Phobia :

  A dog is initially a neutral stimulus (NS) (something that doesn’t produce any response). Being bitten is an unconditioned stimulus (UCS) that automatically produces a fear response - this does not have to be conditioned so it is called an unconditioned response (UCR). Once the dog and the bite have been paired, any dog causes the fear response directly - the dog is now a conditioned stimulus (CS) and fear has become a conditioned response (CR).
• 2) Maintenance of phobia through operant conditioning maintains the fear response. Avoidance behaviours strengthened through the reduction in unpleasant feelings.
•  Maintenance of Phobia: Operant conditioning is learning from the consequences that follow from our actions (called operants in behavioural theory). If we do something, and it brings us a positive reward, or takes away an unpleasant feeling, we will be more likely to repeat the behaviour in the future (called reinforcement). Similarly, when we do something that has  unpleasant consequences, we are less likely to do it in the future (punishment).
• With phobias, operant conditioning is occurring as the action of avoiding something scary is reinforcing (negative reinforcement because it takes away an unpleasant feeling). This is an automatic, unconscious process that the individual has little or no control over. 
• Evaluation of Behaviourist explanation

  + Watson and Raynor (1920) “Little Albert"

  -“Albert” who was induced to have a fear of white rats through classical conditioning.

  -He initially showed no fear when he played with the rat (NS), but after pairing the rat with a loud noise (UCS) which made Albert flinch in fear (UCR), the rat became CS with the CR of fear

  -Although ethics are highly questionable, the study shows how classical conditioning can be involved of the acquisition of a phobia.
• Evaluation of two process model: - genetic vulnerability − people experience the same incident, but not all develop phobia.
• Evaluation of two process model: Behaviourist theories can’t explain why some phobias are more common than others. For example, spider phobia is very common in the UK, yet the spiders here are harmless, while car phobia is very rare, though many people are involved in car accidents. The reason may be evolutionary - we have a “biological preparedness” to learn fears about things that would have been dangerous in our ancestral environment.
• There are two main treatments for phobias: systematic desensitisation and flooding
• SYSTEMATIC DESENSATISATION:

  1.   Learning relaxation and breathing techniques

  2.   Creating an anxiety hierarchy

  3.   Gradual exposure to phobic stimulus
• FLOODING – a form of behavioural therapy that can be completed in as little as one session. The patient is simply exposed to their feared object, and prevented from their usual avoidance behaviour. They may be taught relaxation techniques to help them deal with the level of anxiety they experience. The fear response has limited duration, and eventually it will subside, leading to the extinction of the conditioned response, and its replacement with relaxation.
• Systematic desensitisation:

  Firstly, they are taught deep muscle relaxation techniques that they use in the following sessions.

   They are then asked to create a hierarchy of fear, running from situations that are only mildly stressful to the most terrifying thing they can imagine. For example, some one with a fear of spiders might start with pictures of spiders and go up to allowing a tarantula to crawl on them.

  They work through the hierarchy step-by-step until they can encounter the feared object. 
• Evaluation of treatment: + Flooding is an extremely straightforward process, which can have long-lasting results in a single 3 hour session. For this reason, it is highly cost-effective.
• Evaluation of treatments: - Flooding only works if avoidance is prevented for as long as it takes to bring the anxiety levels back down. This involves enduring huge amounts of anxiety, and is likely to be too much for many patients, especially children or other vulnerable groups. If the treatment is not completed, it will lead to further reinforcement of the phobia.
• Evaluation of treatment: + Systematic desensitisation has lower attrition (dropout rates) and higher completion than flooding, as it is a slower, step-by-step process that is more manageable for someone with anxiety.
• Evaluation of treatment: One weakness of SD is that it relies on the client’s ability to be able to imagine the fearful situation. Some people cannot create a vivid image and thus SD is not effective.Another weakness is that while SD might be effective in the therapeutic situation, it may not work in the real world.
• Evaluation of treatment: + Both SD and Flooding have been shown to be effective for the treatment of specific phobias. McGrath reported that 75% of patients respond to SD.