The behavioural approach to treating phobias

• Systematic desensitisation (SD)


  A behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning
• Systematic desensitisation


  • If a person can learn to relax in the presence of the phobic stimulus they will be cured
  • A new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety)
  • This learning of a different response is called counterconditioning
• Processes involved in systematic desensitisation

  1. Anxiety hierarchy is put together by client and therapist

  2. Therapist teaches client to relax as deeply as possible

  3. Client is exposed to the phobic stimulus while in a relaxed state
• Reciprocal inhibition


  when it is impossible to be afraid and relaxed at the same time, so one emotion prevents the other.
• Strength of systematic desensitisation


  • is the evidence base for its effectiveness

  • Gilroy followed up 42 people who had SD spider phobia in 3-40 minutes lessons.

  • At 3 and 33 months, the SD group were less fearful that a control group treated by relaxation without exposure.

  • means that SD is likely to be helpful for people with phobias.
• Flooding involves exposing people with a phobia to their phobic stimulus but without a gradual build-up in an anxiety hierarchy
• Flooding involves immediate exposure to a very frightening situation
• Flooding sessions are typically longer than systematic desensitisation sessions, one session often lasting two to three hours
• How flooding works


  1. Stops phobic responses very quickly

  2. Client quickly learns that the phobic stimulus is harmless

  3. Learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus

  4. Client may achieve relaxation in the presence of the phobic stimulus because they become exhausted by their own fear response
• It is important that clients give fully informed consent to the flooding procedure and that they are fully prepared before the flooding session
• A client would normally be given the choice of systematic desensitisation or flooding
• Strength of flooding 


  • highly cost effective.

  • flooding can work in as little as one session as opposed to, say 10 sessions for SD to achieve the same results.

  • means that more people can be treated at the same cost with flooding than with SD.
• Limitation of flooding


  • highly unpleasant experience.

  • Sarah Schumacher found that participants/therapist rated flooding as significantly more stressful than SD.

  • raises an ethical issue for psychologists, but is not a serious issue provided they obtain informed consent.

  • Suggest that therapist may avoid using this treatment.