The behavioural approach to explaining treating phobias: systematic desensitisation and flooding - PSYCHOPATHOLOGY
The behaviourist approach to treating phobias:
SYSTEMATIC DESENSITSATION (SD):
SD a behavioural therapy based on the principles of classical conditioning, and is built on the idea that we cannot be relaxed and afraid at the same time – if we can stay relaxed in the presence of the thing we fear, we will no longer fear it.
SD a behavioural therapy based on the principles of classical conditioning, and is built on the idea that we cannot be relaxed and afraid at the same time – if we can stay relaxed in the presence of the thing we fear, we will no longer fear it.
The therapist
will teach the patient a series of relaxation techniques – such as breathing
exercises or mental imagery processes (eg. imagine yourself lying on a beach).
The therapist and
patient then construct a ‘hierarchy of fears’: a range of situations, starting
from what causes the least anxiety to what causes the most. (eg. stage one:
looking at a picture of a dog, final stage: having a dog sit on your lap).
The patient will
start at the first scenario, and gradually move up the hierarchy – they have to remain completely relaxed at each stage in order to move to the next one.
EVALUATION OF SD:
Strength:
There is plenty of supporting evidence –an example of this being Wolpe (1964). Wolpe used SD to treat an 18 year old with a severe hand-washing compulsion, which involved an irrational fear of contaminating others with urine. This treatment successfully treated his phobia – and when he was followed-up 4 years later, they found he was still in complete remission of his compulsive behaviours. This demonstrates that SD is helpful in the treatment of the phobia, and the effects are long-lasting.
There is plenty of supporting evidence –an example of this being Wolpe (1964). Wolpe used SD to treat an 18 year old with a severe hand-washing compulsion, which involved an irrational fear of contaminating others with urine. This treatment successfully treated his phobia – and when he was followed-up 4 years later, they found he was still in complete remission of his compulsive behaviours. This demonstrates that SD is helpful in the treatment of the phobia, and the effects are long-lasting.
Strength:
A further strength is that the client has some control over the therapy, which may factor into the effectiveness of the treatment. For example, the patient will decide on the stages of the hierarchy, and only move onto the next level when they feel like they are ready to. This is a strength as it respects the patient’s autonomy and helps them feel less anxious, which could lead to a more effective treatment.
A further strength is that the client has some control over the therapy, which may factor into the effectiveness of the treatment. For example, the patient will decide on the stages of the hierarchy, and only move onto the next level when they feel like they are ready to. This is a strength as it respects the patient’s autonomy and helps them feel less anxious, which could lead to a more effective treatment.
Weakness:
This form of treatment isn’t successful in treating all phobias – such as social phobias. This suggests that there may be other factors involved in the cause of phobias (such as cognition) which this behavioural therapy doesn’t account for – therefore demonstrating that it isn’t 100% effective, because some phobias are a result of unconscious issues that SD cannot cure.
This form of treatment isn’t successful in treating all phobias – such as social phobias. This suggests that there may be other factors involved in the cause of phobias (such as cognition) which this behavioural therapy doesn’t account for – therefore demonstrating that it isn’t 100% effective, because some phobias are a result of unconscious issues that SD cannot cure.
Flooding:
This is a process of extinction, which directly exposes the client to the object/situation they fear, with no gradual build up. It involves repeatedly exposing them to their feared stimulus, to allow them to see that there is no basis for their fear. For example, someone with a fear of heights is taken to the top of the tower block and encouraged to stay there.
This is a process of extinction, which directly exposes the client to the object/situation they fear, with no gradual build up. It involves repeatedly exposing them to their feared stimulus, to allow them to see that there is no basis for their fear. For example, someone with a fear of heights is taken to the top of the tower block and encouraged to stay there.
Whilst it is
technically not unethical – it is an unpleasant experience for the patient, and
so full-written consent must be obtained prior to the sessions starting.
EVALUATION:
Strength:
Flooding is cost effective. Studies have found that flooding is highly effective and quicker than alternative treatments, like SD. This is because sometimes only one session is required to remove the phobia, and it has been suggested that it is equally as effective as SD – so why would you spend more money and time to achieve the same results?
Flooding is cost effective. Studies have found that flooding is highly effective and quicker than alternative treatments, like SD. This is because sometimes only one session is required to remove the phobia, and it has been suggested that it is equally as effective as SD – so why would you spend more money and time to achieve the same results?
Weakness:
Despite it not being unethical, flooding is a traumatic experience for the patient and so there are high drop-out rates for this form of treatment. This suggests that even if it an effective treatment, many patients won’t experience these effects because the nature of the treatment is too distressing for them to endure – suggesting that it is not the most useful form of therapy as it provides a fully-effective treatment for few individuals – and those who leave the treatment before completion risk strengthening their phobia, opposed to weakening it. As well as all this, it can be a waste of money and time if the patients do not complete the therapy.
Despite it not being unethical, flooding is a traumatic experience for the patient and so there are high drop-out rates for this form of treatment. This suggests that even if it an effective treatment, many patients won’t experience these effects because the nature of the treatment is too distressing for them to endure – suggesting that it is not the most useful form of therapy as it provides a fully-effective treatment for few individuals – and those who leave the treatment before completion risk strengthening their phobia, opposed to weakening it. As well as all this, it can be a waste of money and time if the patients do not complete the therapy.
Weakness:
This form of treatment isn’t successful in treating all phobias – such as social phobias. This suggests that there may be other factors involved in the cause of phobias (such as cognition) which this behavioural therapy doesn’t account for – therefore demonstrating that it isn’t 100% effective, because some phobias have cognitive aspects which this process fails to acknowledge.
This form of treatment isn’t successful in treating all phobias – such as social phobias. This suggests that there may be other factors involved in the cause of phobias (such as cognition) which this behavioural therapy doesn’t account for – therefore demonstrating that it isn’t 100% effective, because some phobias have cognitive aspects which this process fails to acknowledge.
Evaluation point for both SD and Flooding:
According to the psychodynamic approach, people develop phobias because of defence mechanisms. For example, Little Hans was scared of horses when, according to Freud, his actual problem was his envy of his father. This phobia was only cured when he accepted his feelings – if the therapist would’ve used SD or flooding, only the phobia of horses would’ve been treated and not the underlying cause – suggesting that it doesn’t affect cure the true phobia.
According to the psychodynamic approach, people develop phobias because of defence mechanisms. For example, Little Hans was scared of horses when, according to Freud, his actual problem was his envy of his father. This phobia was only cured when he accepted his feelings – if the therapist would’ve used SD or flooding, only the phobia of horses would’ve been treated and not the underlying cause – suggesting that it doesn’t affect cure the true phobia.
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