This document contains revision notes for behavioural treatment of phobias for the psychopathology topic in paper 1 of psychology AQA A level. All content follows the AQA specification.
Counter-conditioning unlearns the maladaptive response to the phobia, by eliciting another
response.
1. Fear Hierarchy: Client and therapist develop an anxiety hierarchy, ranking phobic
situations from least to most terrifying.
2. Relaxation Training: Client is taught relaxation and breathing techniques, mental imagery
techniques, muscle relaxation strategies.
- Can be achieved using drugs (Valium).
- According to SD, a person cannot be anxious and relaxed at the same time,
relaxation should overtake fear – reciprocal inhibition.
3. Gradual Exposure: Client is exposed to the phobic stimulus in a relaxed state. Starting at
the bottom of the hierarchy. When the patient remains relaxed in the presence of the lower
levels of the hierarchy they move up the hierarchy. Treatment is successful when the
patient stays relaxed at the highest list.
P: Systematic desensitisation is effective.
E: Gilroy et al. followed 42 patients treated for spider phobia in three 45 minute sessions of
SD. Spider phobia was assessed by Spider Questionnaire, assessing response to a spider.
Control group was treated by relaxation without exposure.
J: At 3 and 33 months after treatment the SD group were less fearful than the relaxation
group. SD helps reduce anxiety in spider phobia, effects are long-lasting.
P: SD is acceptable to patients.
E: Patients prefer SD as it does not cause the same degree of trauma as flooding and has
elements like learning relaxation procedures that are useful.
J: Patients prefer SD, reflected in low refusal rates and low attrition rates.
Flooding: extreme behavioural therapy for phobias. Immediate exposure to phobic stimulus:
in vivo (actual exposure) in vitro (imaginary exposure)
A patient is taught relaxation techniques and applies them to the most feared situation
either through direct exposure, or imagined exposure.
P: Cost effective. Flooding is effective as other treatments for specific phobias.
E: Studies comparing flooding to cognitive found flooding is highly effective and quicker than
alternatives (Ougrin).
J: Patients are free of their symptoms as soon as possible, making the treatment cheaper.
P: Flooding is a traumatic experience.
E: Not unethical (patients give consent) but are unwilling to see it through to the end.
J: Time and money wasted preparing clients only for them to refuse to complete treatment.
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