5710087
| Question | Answer |
| Drug therapies for phobias; Ao1- Benzodiazepines (Bz's) such as Valium and Librium are minor tranquilizers designed to reduce levels of anxiety by inhibiting the nervous system causing muscle relaxation and an overall calming effect. As anxiety's a core symptom of phobia, BZ's are often used. They enhance the action of GABA which acts to balm brain activity in response to arousal (during panic attacks or normal anxiety). They have been used in the treatment of social phobia and agoraphobia but only for short-term help wait a patient waits for another treatment for the LT. They may also be prescribed to help reduce the symptoms of panic associated with specific phobias. | Ao2- effective?! Several research studies support the claim that BZ's, BB's and AD's are effective in reducing feelings of anxiety and panic in phobias. Kahn et al found BZ's to be more effective than a placebo in reducing anxiety and Liebowitz found that BBs can also be effective in reducing the feeling of anxiety. Similarly, AD's are effective at relieving symptoms of anxiety e.g. research suggests that SSRI's are effective in the treatment of people with social phobias. A survey of research by Aouizerate et al conclude that SSRI's provide relief for social phobics 50-80% of cases. As such, research studies show that drugs are effective in reducing anxiety in phobics. |
| Ao1- Antidepressants such as Prozac have been used to treat people with phobic disorders possibly because these patients often have high levels of depression as well as high anxiety. They affect the availability of serotonin and noradrenaline thus reducing panic and other depressive symptoms. There are several types which have been used to treat phobias particularly social phobia and agoraphobia. MAOIs work by blocking the action of an enzyme that breaks down mono-amines therefore increasing their levels in the nervous system. SSRI's work by increasing the availability of serotonin in the brain-these have been effective in reducing panic in people with agoraphobia and social phobia by aiming to improve our moods with the boost in serotonin levels. | Ao2- Effective?! Anti-anxiety drugs have been used to treat phobic disorders but results on how effective they are have been inconclusive as research suggests drugs are no more effective than placebo effect. Taylor found that BZ's worked only marginally better than placebo. Similarly, Turner et al found no difference between a BB and placebo groups in terms of reducing heart rate, feelings of nervousness etc. However, although drugs have been found effective in reducing anxiety, their effectiveness is questioned on groups of risks of hypertension and other side effects. Whether or not drugs work cannot be considered from the perspective of comparisons with placebo only. Therefore the effectiveness of drugs as biological therapies is unclear. |
| Ao2- Appropriate?! While drug therapies are seen as effective during treatment, there are only ST benefits and those are lost very quickly afterwards which leads patients to relapse. Liebowitz et al carried out a follow up study of patients who had received either drug therapy or CBT. 6 months later 0 receiving CBT suffered a relapse during that period compared to 33% of those who had received drug therapy. This shows that drugs treat the symptoms not the cause, psychologists argue that biochemical imbalance is the result not the case for anxiety. Also, each anxiety disorder has its own specific underlying mechanisms yet the same antianxiety and antidepressant drugs are prescribed to patients regardless of their specific anxiety drugs. Such approach is not likely to cure the underlying problems beyond symptoms. It can be concluded that drug therapy for phobias is palliative rather than curative as it only treats the symptoms without curing thus dealing with the cause of the phobia. | Ao2- Appropriate?! Some psychologists argue that drugs are dehumanising and remove any sense of personal responsibility or control from the individual. There is an ethical issue of lack of informed consent. People who are seriously anxious may not be in the best frame of mind to give full informed consent about their treatment as clinicians sometimes do not fully inform the patients about the comparative success of drugs vs placebo thus letting them expose themselves to side effects with slim chances of being cured. Following on from that, clinicians do not explain to the patients what their side-effects will be/the different ways they may be affected by the drugs. As such, clinicians should go through cost-benefit analysis to make an informed decision whether or not the therapies are appropriate. |
| Psychological therapies for phobias Ao1- systematic desensitization This method developed by Wolpe was designed specifically to counter-condition phobias and anxiety. It's based on the classical conditioning and assumption that phobic disorder is caused by a negative association between two stimuli. Therefore, it follows that treatment will involve breaking this faulty association. Clients must learn to associate the feared stimulus with a pleasant experience rather than traumatic one-SD involves client confronting the feared object or situation in a peaceful, relaxing, non-threatening environment until the phobia disappears due to new association. Covert or in-vivo. 1) Relaxation 2) Hierarchy 3) Visualising 4)Working up 5) Phobia is unlearnt. | Ao2- Effective?! Behavioural therapies are successful in treating phobic disorders. McGrath et al found SD was effective for around 75% of people with specific phobias. The key to success appears to lie with actual contact with feared stimuli so in-vivo techniques are more successful. Ost et al conducted a study where 20 patients with spider phobas were treated using SD in a single session that lasted over several hours. They found that no matter how sever the phobia was 90% were much improved or completely recovered at 4 year follow up. This suggests that SD is an effective behavioural theory for at least phobias. |
| Ao2- Effective?! Research also suggests that SD may not be effective treatment for all types of phobia. Ohman et al suggest that SD may not be as effective in treating phobias that have an underlying evolutionary survival component (e.g. fear of heights or fear of snakes) than phobias which have been acquired due ot personal experience (e.g. fear of clowns or fear of dogs). These phobias may be more resistant to treatments as evolutionary theory proposes that phobias are innate and help for survival purposes and are more deeply engrained in a person's memory. As such, SD isn't an effective therapy for all phobias. | Ao2- appropriateness; SD is relatively quick in contrast to psychodynamic therapy that can last for years, there are less side-effects in comparison to drugs and SD deals with avoidance. It has been shown that improvements can occur after a single session of SD (Ost) in comparison to drugs mental functioning isn't as affected and there's no dependancy issue However, there are problems, it has been claimed that SD has significant drop out rates as it requires tiem and motivation which could be fear inducing. Some clients lack the motivation for practicing relaxation techniques which could put them off. SD has been criticised for being inappropriate as it deals with symptoms only not causes. This suggests that t is an appropriate treatment to aj extent however is palliative rather than curative. |
| Ao2- appropriate?! It could be argued that SD is not an appropriate therapy as it appears to resolve a problem but only eliminates symptoms which can cause symptom substitution. Langevin however claims that there is no evidence to support this objection.n Similarly, it is suggested that the success of SD is more to do with exposure than relaxation it may be that the expectation of being able to cope with feared stimulus is most important. As such, SD's not an appropriate theory as it is not curative. | BLANK. |
| CBT ao1- CBT began in the 60s and there are now several types. Beck developed a cognitive therapy and Ellis founded REBT. The aim of REBT is to help the client identify irrational, negative thoughts about the phobic object or situation and place with rational realistic and more positive ones. Ellis claimed that a specific event (A) activates irrational thoughts and beliefs (B) which in turn lead to negative emotions and undesirable behaviour (C). People maintain negative and self-defeating beliefs by constantly telling themselves how inadequate they are and constantly looking for confirming evidence that they are inadequate. So REBT works by; A) identifying the activating event B) recognising the belief is irrational C) the consequences that the irrational beliefs produce. D) disputing/challenging beliefs E) effect F) new Feelings. | Ao2- effectiveness Cognitive therapies have proved successful in treatment of phobias. REBT has been found effective in outcome studies. C;arl et al found that the enhances version of cognitive therapy was substantially more effective that SD in the treatment of social phobia and there was still a large difference between the two forms of therapy at a 1 year follow up. Ellis claimed a 90% success rate taken on average of 27 sessions. By contrast, some researchers suggest that CBT's not as effective in all phobias. Choy found that dental phobic patients who had received cognitive therapy showed LT reductions in anxiety however many of them still avoided seeking dental treatment. Emmelkemp concluded that REBT was less effective than in-vivo exposure treatments at least in treatment of agoraphobia. This suggests that enhanced versions of cognitive therapy are effective in treating certain types of phobia but not all. |
| Ao2- effective Research suggests that combing therapies from different approaches does not always bring more improvements than apllying one particular therapy alone. Burke et al conducted a studyw tih agorphobucs to wther SD alone was more or less effective than CBT and SD. They found that CBT and SD did not prove to be more of an effective treatment then SD lone. Furthermore, Beurs et al conducted a similar study and found that CBT combined with SD wasn't better than SD lone. This suggests that combining approaches in the treatment of phobias isnt always the most effective way of treating phobias. | Ao2- appropriate Research suggests that there are important differences in the cognitions of phobics and healthy controls. Phobics undoubtedly possess cognitive biases that need to be dealt with rational reasoning in REBT. E.g. phobic individuals attentional biases lead them to focus too much on themselves in social situations, interpretive biases lead them to exaggerate the inadequacies of their social behaviour and catastrophizing lead them to overestimate harm or danger of objects/situations. Since CBT focuses on giving the client a more realistic outlook it can be considered an appropriate therapy for phobic disorders as it is able to meet patients cognitive needs. On the other hand, REBT does not see to be suitable for all people. It doesn't seem to work for those who simply want direct advice and not get involved with cognitive effort. As such appropriateness of REBT largely depends on personality of patients. |
| Ao2- appropriate?! Some beliefs are not cognitive biases but simply real-life rational and accurate thoughts and it may be inappropriate to use REBT to challenge and change those beliefs. One problem with REBT is that it fails to appreciate the fact that some negative thoughts are based on a rational and accurate perception of reality. e.g. some social phobics have poor social skills and are away thus other therapies e.g. social skill training may offer more appropriate forms of treatment than REBT. In addition, Alloy and Abrahmson found that depressed people gave more accurate estimates of the likelihood of a disaster than normal people. In conclusion some so called irrational and negative beliefs may just be realistic thus REBT wouldn't be an appropriate theory. | BLANK. |
| Ao1-psychodynamic therapy The psychodynamic approach claims that phobias are only a symptom and occur as a result of protecting the individual from repressed conflicts that are too painful to confront. In dream analysis the client is asked to recount their dreams and the analyst helps them interpret the hidden meaning (latent by examining manifest). Free association is when the client is asked to free flow his/her feelings thoughts or images and then express them in words which reflects internal, unconscious conflicts that may be discussed with a client later on. Lastly, for projective tests the client is requires to impose their thoughts emotions anxieties on sme stimulus material once completed the content revealed by the client is analysed and interpreted. | Ao2- effectiveness; It is difficult to assess whether psychoanalysis is an effective therapy as it usually spans over several years. The point at which the client's functioning is assessed may be crucial when determining its efficacy in treating phobias. Corsini and Wedding explain that its difficult to measure its effectiveness as there are too many variable involved to be able to measure effectiveness in a controlled and statistically valid study. Comparisons may be made at the beginning and the end of treatment but because treatment's over a long period of time there may be other factors occurring in the clients life which may impact upon the outcome. This suggests that the effectiveness of psychoanalysis is difficult to assess. |
| Ao2- effective? It has been claimed that there is no robust evidence that psychoanalytic therapy is effective for people with phobic disorders. Eysenck argues that empirical evidence is anecdotal and psychoanalysis simply doesn't work. He refers to a meta-analysis published in 91 . Researchers made an overview of 19 studies comparing psychoanalysis with no treatment no difference was found in outcome one year after the treatment. There's a lack of empirical evidence for the effectiveness in dealing with with phobias. | Ao2- appropriate?! It is argued that psychoanalysis is not an appropriate theory for several reasons. Traditional psychodynamic therapy is generally conducted over a number of years which makes it time consuming and expensive compared with other theories which makes it rather inappropriate for majority of phobic individuals. People suffering with anxiety typically seek a quick fix and as such psychoanalysis may be inappropriate for their needs. Additionally, the cost involved would be high as it is conducted over many years. As such, traditional sychalalsysi is abel to treat underlying causes which is inappropriate for phobic patients who want a quick fix and lack financial aid. |
| Ao2- appropriate? Recent innovations in psychoanalysis has made it more appropriate treatment for some phobias. More modern, brief psychodynamic therapies have emerged where the focus has been much more on current. rather than past concerns. These brief therapies (dozen sessions) can produce quick improvements in patient functioning. This new type of psychotherapy has made psychoanalysis more practical and more affordable for the wider population. As such, modern psychoanalysis is able to meet the needs of people thus making it more of an appropriate therapy for treating phobias. | BLANK. |
Want to create your own Flashcards for free with GoConqr? Learn more.