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Outline and evaluate the behavioural approach to treating phobias
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A level psychopathology 16 marker full mark essay
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Outline and evaluate the behavioural approach to treating phobias. (16 marks)There are two therapies, based on the behavioural approach, which help to treat phobias.
The first behavioural treatment for phobias is systematic desensitisation (SD). Systematic
desensitisation was developed in 1958 by Joseph Wolpe and is a technique that helps to
introduce the phobia gradually to the phobic individual.
The basis of SD is counterconditioning. This is when the patient is taught a new association
that runs counter to the original association. The patient is taught, through the process of
classical conditioning, to associate the phobic stimulus with a new response, for example
replacing fear with relaxation. In this way, the slowly become desensitised to the phobia.
Wolpe also called this ‘reciprocal inhibition’ because the response of relaxation inhibits the
response of anxiety.
In order for the patient to counterconditon their association of the phobia with relaxation
instead of fear, they must be taught a serious of relaxation techniques. This can be achieved
by helping the patient to focus on their breathing, taking deep, slow breaths as this helps to
relax the anxious response of breathing quickly. Other ways to help the patient relax is show
them how to use mindfulness to be ‘here and now’, as well as focusing on particular objects
and being aware of their senses.
Once relaxation techniques are taught, the phobia is gradually introduced to the patient
using a desensitisation hierarchy. This ensures that the patient isn’t overwhelmed and can
focus on using their relaxation techniques at each stage until the situation becomes more
familiar and their anxiety reduces. The desensitisation hierarchy is constructed together
with the patient and therapist and is worked through slowly until anxiety is no longer
present at each stage. The last stage involves tackling the actual phobia and once the
patient feels relaxation, their phobias has been fully treated.
An alternative behavioural treatment for phobias is flooding. This is one long session where
the patient experiences their phobia to the full extent whilst practicing relaxation
techniques. The session continues until the individual is fully relaxed. Flooding can be
practiced in vivo (actual exposure) or in vitro (using virtual reality) and the procedure usually
lasts 2 to 3 hours. A person’s fear response has a time limit, therefore, as adrenaline levels
decrease, a new stimulus-response link can be learned between the feared stimulus and
relaxation.
A strength of the systematic desensitisation method of treating phobias is that it is
extremely effective. Research has found that SD is successful for a range of phobic disorders.
In 1990, McGrath et al reported that about 75% of patients responded well to SD. The key to
success tended to lie with actual contact with the stimulus rather than using in vitro
techniques. With SD, there is often several techniques involved such as in vivo, in vitro, and
even modelling, in which the patient would watch someone else cope with the feared
stimulus. This enables all patients to find something that works best for them, rather than
only using one technique which only works for some. However, although SD is successful for
a range of phobias, it is not successful for all. Öhman et al. suggest that SD may not be as
effective in treating phobias that have an underlying evolutionary survival component, for
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