Treatment of phobias

• Systematic desensitisation 

  Key term: a therapy aimed to extinguish an undesirable behaviour, fear, by replacing it with a more desirable one relaxation. This uses the principles of classical conditioning to form new associations, relaxation, with the condioned stimulus 
• Systematic desensitisation 

  Steps

  1. Functional analysis - conversion between therapist and client to identify the nature of anxiety and possible triggers 
  2. Develop anxiety hierarchy - work with therapist to identify hierarchy of fear from least to most
  3. Relaxation training - client is taught relaxation techniques that suit them best e.i breathing exercises, meditation, yoga, mindfulness 
  4. Gradual exposure - work through anxiety hierarchy slowly starting with least feared and only moving on when client feels relaxed in its presence, real or imagined confrontation.
• How does systematic desensitisation work 

  • at the beginning there are relaxation techniques 
  • At the end the aim in to be able to respond to the feared object or situation with relaxation and not fear
  • Is known as reciprocal inhibition. It is reciprocal because two are related as relaxation increases anxiety decreases 
  • Inhibition as the new relaxation technique inhibits the anxiety 
• How would you know you’re relaxed

  • people are taught to relax muscles, imagine a happy scenario, meditate and try to change their thinking about the phobic object or situation 
  • These ideas focus on reducing anxiety and replacing with a relaxed response 
  • Biofeedback is pulse and breathing rate which individual can learn to control 
• Flooding 

  Physically placing client in the situation with their feared object/situation 
• Flooding Steps:

  • The fear must be quickly presented continuously where an escape is not possible 
  • The fear is a biological reaction high glucose levels making the body act on high alert, pulse and breathing rate, once all energy is used up and no more us available the nervous system fear response will eventually be replaced by calm
• Classical conditioning and flooding: idea is that repeated, constant exposure the client will see as less fear producing. Their body will eventually become calm once they get tired as the body can only be at alarm stage for so long. The person will associate that a calmer response is linked to the object they were phobic about 
• Implosion is a type of flooding therapy 

  • Where person imagines phobic stimulus 
  • Good for treating ptsd
  • Is used when you can’t put a person in the traumatic situation again e.i war, assault 
• Evaluation Systematic desensitisation 

   Gilroy et al (2003) SD is effective when treating specific phobias. They compared clients receiving SD for spider phobia with a control group. At both 3 months and 33 months, after treatment, the treatment group were less fearful than the control group.
• strength of Systematic desensitisation: This has been shown to have real life application e.g. Capafons et al (1998) 90% success rate treating a fear of flying using SD.

  • It is Ethical because it is a gradual process that works at the clients pace using their hierarchy.

  • It is supported by research which shows you can learn a response by association eg W&R or Pavlov.
• Weakness of desensitisation:

  However:

  • Research which supports Flooding may be used to refute SD

  • It may not last as a treatment and Spontaneous Recovery of the phobia may occur.

  • Lacks real life application for some social phobias and some individuals. E.g. It is not useful for such mental health issues as psychosis (need to be able to relax). (see textbook, pg147)
• Evaluation of flooding 

  Strengths:

  • Application Ougrin et al found that Flooding is more effective and faster than cognitive therapies.
  • Wolpe (1973) was able to use flooding to help a girl afraid of cars.
  • Supported by research using CC eg W&R or Pavlov.
• Evaluation of flooding Limitations:

  • Research supporting SD may be used to refute Flooding
  • Ethics Flooding can be stressful/traumatic as the alarm reaction cant be maintained for long.
  • Research support is is mixed Barrett Used therapy on college students with phobia of snakes,many started suffering from insomnia.
  • Real life application is limited due to evidence of spontaneous recovery of the phobia.
  • Compared with SD extinction may be less complete, new association of ‘calm’ in Flooding is not a strong as SD ‘relaxation’ . suggests flooding is short-lived in its effectiveness