1.1 This is a
the principle of
1.2 Essentially a new response to the phobic
stimulus is learned by pairing it with
relaxation instead of anxiety. This learning of
a different response is called
1.3 There are 3 processes involved in SD.
1.3.1 1. The anxiety hierarchy - a list of
situations related to the phobic stimulus
that provoke anxiety arranged in the
order of least to most frightening.
1.3.2 2. Relaxation - therapist teaches
the patient to relax as deeply as
possible e.g. breathing exercises
or mental imagery techniques. It
can also be achieved using drugs
such as Valium.
1.3.3 3. Exposure - exposed to the
phobic stimulus whilst in
relaxed state, working their
way up the hierarchy across
several sessions. They move
up the hierarchy if they can
stay relaxed in the lower
levels. Treatment is successful
when the patient can stay
relaxed in situations high on
the anxiety hierarchy.
1.4 It is effective in the treatment of specific phobias. Gilroy et
al. found that after three 45-minute sessions, 3 months later
and 33 months later they were less fearful than a control
group. This is a strength because it shows that SD is helpful
in reducing anxiety and the effects are long lasting.
1.5 It is suitable for a diverse range of patients
e.g. those with learning disabilities also may
find flooding difficult.
1.6 It is more acceptable to patients as they prefer it more. This
is because it does not involve the same degree of trauma as
flooding and it involves some pleasant relaxation
procedures. This is reflected by low refusal rates and low
attrition rates (number of patients dropping out of
2.1 Involves exposing phobic patients to their phobic
stimulus without a gradual build up of anxiety.
Patients are immediately expose to a very
2.2 Flooding sessions are typically longer than SD, one session
often lasting 2-3 hours. Sometimes only one session is needed
to cure a phobia.
2.3 Flooding stops phobic responses very
quickly. This may be because, without the
option of avoidance behaviour, the patient
quickly learns that the phobic stimulus is
2.3.1 In classical conditioning
terms this process is
called extinction - a
learned response is
extinguished when the
conditioned stimulus is
encountered without the
The result is that the CS
no longer produces the
conditioned response of
2.4 Flooding is not unethical per
se but it is unpleasant so it is
important that patients give
fully informed consent.
2.5 It is as effective as other treatments which is a
strength as it means that patients are free of
symptoms as soon as possible and makes the
2.6 It is less effective for some types of
phobias e.g. social phobias which have
cognitive aspects. These types of phobias
may benefit more from cognitive therapies
which tackle irrational thinking.
2.7 It is a very traumatic experience
and often patients are unwiling
to see it through to the end. This
means time and money is often
wasted on preparing patients
only to have them refuse to start
or complete treatment.