treating phobias

• systematic desensitisation:

  • behavioural therapy designed to gradually decrease phobia anxiety through classical conditioning
  • if person can learn to relax in presence of stimulus theyll be cured
  • counterconditioning: new response to phobia is learnt
• 1st process of systematic desensitisation:

  • construction of anxiety hierarchy - list of words related to stimulus in order from least to most frightening e.g picture of spider, holding a tarantula
• 2nd process of systematic desensitisation:

  • relaxation
  • client is taught techniques e.g breathing exercises, mental imagery, meditation. alternative = use of drugs e.g valium
  • reciprocal inhibition: impossible to feel afraid and relaxed at same time, one emotion prevents another
• 3rd process of systematic desensitisation:

  • exposure to phobia stimulus
  • exposed when in a relaxed state, starting at bottom of hierarchy to top when client can stay relaxed in presence of lower levels of stimulus
• flooding:

  • behavioural therapy involving immediate exposure to phobia stimulus
  • extinction = learned response is extinguished when conditioned stimulus is encountered without unconditioned stimulus
• effects of flooding:

  • may experience exhaustion - body cannot maintain high levels of arousal for long period of time
  • parasympathetic branch of the ANS returns or client may have a heart attack
  • ETHICS: client must provide informed consent prior to traumatic procedure
• EVALUATION: effectiveness of systematic desensitisation

  • gilroy et al - followed 42 people who had sd for arachnophobia (3x 45 mins) - at both 3 and 33 months, sd group were less fearful than control group treated with relaxation and no exposure
  • wechsler et al - sd is effective for specific, social and agoraphobia
  • sd is helpful for people with phobias
• EVALUATION: flooding is cost effective

  • therapy = clincally effective if its clinically effective (tackles symptoms) and isnt expensive
  • can work in 1 session opposed to other e.g cbt or sd -even allowing for a longer session makes flooding more cost effective
  • more people can be treated at same cost with flooding rather than with sd or other therapies
• EVALUATION: flooding is traumatic

  • confronting phobia in extreme form provokes extreme anxiety - ethical issues e.g knowingly causing stress. not big issue if obtained with informed consent
  • traumatic nature means attrition (dropout) rates are higher than sd - serious impact on effectiveness if not fully engaged
  • therapists may avoid using treatment
• EVALUATION: symptom substitution (makes symptoms, dont tackle underlying issues)

  • if symptoms removed cause still remains and symptoms will resurface in other forms
  • child dealing with bereavement can display anxiety about death onto something more tangible and easy to deal with e.g fear leaving house - real source of anxiety needs to be treated not displaced
  • most say phobias come out of conditioning - lack of focus on causes can be problematic and limiting of behavioural therapies