5.4 Behavioural approach to treating phobias

5.4 Behavioural approach to treating phobias

1. Systematic Desentitisation

   • SD is a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning. Essentially, a new response to the phobic stimulus is formed. This is called counter conditioning. There are three processes.
   • 1. Anxiety Hierarchy
     • The hierarchy is put together by client and therapist. This is a list of situations that provoke anxiety, related to the phobic stimulus.
   • 2. Relaxation
     • Therapist teaches the client to relax as deeply as possible; It is impossible to be scared and relaxed at the same time, so one emotion prevents the other. This is better known as reciprocal inhibition. Alternative relaxation can be achieved with drugs like Valium.
   • 3. Exposure
     • Client is finally exposed to phobic stimulus during relaxed state, taking place across several sessions moving up the anxiety hierarchy. Treatment is successful once the client can stay relaxed in high anxiety situations.
   • Evaluation
     • Strengths:
       • Evidence to it's effectiveness. Gilroy et al (2003) followed up 42 people who had SD for arachnophobia in 3 45 minute sessions. At both 3 and 33 months, the SD group were much less fearful.
       • Can be used to treat people with learning disabilities. People with LD often struggle with cognitive therapies therefore SD is the most appropriate form of treatment.

2. Flooding

   • Flooding also involves exposure to the phobic stimulus. Unlike SD flooding is immediate exposure to a frightening situations. These sessions are typically longer than SD sessions.
   • Flooding stops phobic responses very quickly, due to there not being the option of avoidance. In CC terms this is called extinction. A learned response is extinguished when the conditioned stimulus is encountered with the unconditioned stimulus, resulting the conditioned stimulus no longer producing the conditioned response.
   • Unethical.
   • Evaluation
     • Strengths:
       • Cost effective. Flooding can work in as little as one session so is both clinically and cost effective. This means more people can be treated at the same cost with flooding than with SD.
     • Weaknesses:
       • Traumatic. Confronting one's phobic stimulus in an extreme form provokes heightened levels of anxiety, raising ethical issues.