Treating Phobias
Systematic Desensitisation
A behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning. The basis of the therapy is called counterconditioning where the patient is taught a new association that runs counter to the original association. It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other - reciprocal inhibition.
Relaxation: The first stage of therapy is where the therapist teaches the patient relaxation techniques e.g., deep breathing.
Anxiety Hierarchy: the therapist and client establish the least to most fearful situation of the phobic stimuli.
Exposure: The patient is exposed to the phobic stimulus while in a relaxed state. this takes place across several sessions, starting at the bottom of the anxiety hierarchy. The patients words through the hierarchy.
Evaluation - SD
(-) Supported by evidence: Gilroy et al - spider phobia
(+) Less effort: relatively fast and requires less effort - CBT requires a lot of time and effort to master the techniques that change dysfunctional thinking
(+) No side effects: only focusses on learning there are no biological side effects at all
(-) Only works with some phobias: evidence shows it is not effective with social phobias such as agoraphobia
(-) Not effective for everyone: Not effective for every person with a phobia - particularly true for children - not everyone can master relaxation techniques nor face particular situations, so for these people it will not be effective.
Flooding
There is no graduation of the phobic stimulus and the highest fear is confronted immediately. Up to 3 hours long but in many cases only one session is needed to cure the phobias.
Works because of extinction - conditioned stimulus in encountered without the unconditioned stimulus and therefore is removed.
A persons fear response has a time limit. As adrenaline levels naturally decrease a new stimulus response link can be learned between feared stimulus and relaxation.
Ethical issues with flooding because the initial stages may be unpleasant or traumatic.
Evaluation
(+) Cost effective: Ougrin compared flooding to CBT and found that it is highly effective and quicker at removing some phobias
(-) Not suitable for all phobias: this may be because social phobias have cognitive aspects. this type of phobia may benefit more from cognitive therapies because these therapies tackle the irrational thinking.
(-) Traumatic experience: Patients are obviously made aware of this before the treatment and so informed consent is obtained however some people believe because patients are vulnerable and distressed.