Please enable JavaScript.
Coggle requires JavaScript to display documents.
Behavioural approach to treating phobias. - Coggle Diagram
Behavioural approach to treating phobias.
There are two types:
Flooding.
Systematic desensitisation.
They focus on counterconditioning. he conditioning is achieved either through a slow process of gradual exposure or one single intense exposure.
Systematic Desensitisation.
Joseph Wolpe 1958 developed a technique where phonics were introduced to the feared stimulus gradually.
Counterconditioning.
The patient is taught a new association that runs counter to the original association.
It is taught through classical conditioning.
The patient will pair the feared object or situation with a new association of relaxation.
For example:
A person who has a phobia of spiders will have previously learnt to feel afraid when a spider is present.
The therapist systematically teachers the person a new response to the spider.
Basic concept:
The key concept of SD is
reciprocal inhibition
. It means that it is impossible for a person to feel two opposite emotions for example fear and relaxation at the same time.
Relaxation:
The patient is taught relaxation techniques.
This can be achieved by the patient focusing on their breathing and taking slow deep breaths.
This is especially helpful as when we are stressed we tend to breathe quickly.
Desensitisation Hierarchy.
SD works by gradually introducing the person to the feared situation.
Each step they complete the closer the patient gets to the confronting the full scale situation that they originally feared.
For example (spider phobia.)
Start off with, holding a stuffed animal spider.
Holding a realistic rubber spider.
Watching a spider in a cage.
Observing someone holding a spider.
Holding a live spider.
Flooding.
Instead of gradually introducing the fear the phobia is introduced in one long session.
The session continues until the patient's anxiety has disappeared.
For example (clowns.)
A person who has a phobia of clowns is placed in a room with clowns until they clam down.
Rationale.
A person's fear response has a time limit.
As adrenaline levels naturally decrease, a new stimulus- response link can be learned.
The feared stimulus is now associated with a non anxious response.
Evaluation.
Very effective.
A strength of Systematic Desensitisation is that it can be a very effective treatment.
Barlow et al 2002.
They found success rates of between 60-90% when patients committed to the phobias and stuck to the regime.
This is positive because this therapy is effective at removing the symptoms of a disorder without the need for potentially damaging drugs (anti-anxiety drugs would be given within the Biological approach) which often cause many side effects (e.g. drowsiness, risk of addiction).
Further supported by McGarth et al 1990 who found a 75% success rate in SD.
Ethical issues.
Behavioural therapies such as SD and Flooding raise major ethical issues.
For example:
Patients are subject to their most feared situations in techniques such as SD/Flooding causing some clients to experience very high levels of distress.
This is a weakness because clients may not stay in therapy and may actually leave the therapeutic situation in a worse state than when they began due to the potential for high levels of distress.
Not always effective.
Behavioural techniques are not effective for more complex phobias.
Ohman et al 1975.
He claimed that SD might not be as effective in treating anxieties that have an underlying survival component. Such as fear of snakes or heights. These are phobias that have not developed through a personal experience.
This is a problem because by only focussing on the removal of symptoms rather than on identifying the underlying cause.
The disorder may only be removed temporarily therefore, reoccur at a later date.
This is called symptom substitution.
Long term solution.
Further support comes from Gilroy et al. 2002 who examined 42 patients with fear of spiders.
Each patient was treated using three 45-minute systematic desensitisation sessions.
The control group where only taught relaxation techniques while the other group went through SD.
They were examined after three and thirty three months.
The SD group were considerbaility less fearful that the control group.