Behavioural approach to treating phobias

• Systematic desensitisation

  = A behavioural theory designed to gradually reduce phobic anxiety through the principle of classical conditioning. 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= counterbalancing
  • Involves drawing up a hierarchy of anxiety- provoking situations related to a phobic stimulus, teaching them to relax and exposing them to phobic situations.
• 1 Anxiety hierarchy

  = List of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
• 2- Relaxation

  = Therapist teaches the client to relax as deeply as possible. (Impossible to be afraid and relaxed at the same time) So one emotion prevents the other= reciprocal inhibition.
• 3- Exposure

  =Exposed to phobia stimulus in a relaxed states takes place across several sessions, starting at the bottom of the hierarchy. When the client stays relaxed in presence of lower levels of phobic stimulus they move up. Successful when client can stay relaxed.
• Evaluation- SD, evidence of effectiveness

  Gilroy followed up 42 people who had Systematic Desensitisation for spider phobia.

  -At both 3 and 33 months, the SD group were less fearful than the control group treated by relaxation without exposure.

  -Wechsler concluded that SD is effective for specific phobia, social phobia and agorophobia.

  -So SD is likely to be helpful with phobias.
• Evaluation- SD, people with learning disabilities

  strength

  • Some people requiring treatment for phobias also have a learning disability. Main alternatives to SD aren't suitable.
  • People with learning disabilities often struggle with cognitive therapies that require a high level of rational thoughts.
  • May also feel confused and distressed by traumatic experience of flooding so SD is most appropriate.
• Flooding

  = Exposing people with a phobia to their phobic stimulus without a gradual build up in an anxiety hierarchy.

  • Exposed to an extreme form of a phobic stimulus.
• How flooding works

  =Flooding stops phobic responses quickly- because without the option of avoidance behaviour, the client quickly learns the phobic stimulus is harmless= extinction

  • A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus- so the conditioned stimulus no longer produces the conditioned response (fear)
  • Ethics= unpleasant experience- must give consent and be prepared.
• Evaluation- flooding, cost-effective

  = Clinically effective and not expensive

  • Flooding can work in 1 session rather than 10 for SD, to achieve the same result.
  • Allowing for a longer session is more cost effective
  • More people can be treated at the same cost with flooding than with SD.
• Evaluation- flooding, traumatic

  Limitation= highly unpleasant

  • Confronting a phobic stimulus in an extreme form provokes tremendous anxiety.
  • Schumacher found participants and therapies rated flooding as significantly more stressful than SD.
  • Raises ethical issues- causing stress to clients, not an issue if given consent.
  • Traumatic nature of flooding means attrition (dropout) rates are higher than for SD.
  • Overall therapists may avoid this treatment.