✏️The behavioural approach to treating phobias
One way to treat phobias is based on classical conditioning and is called systematic desensitisation.
This attempts to help reduce anxiety by counterconditioning. Phobias are learned so that the
conditioned stimulus causes a conditioned response of fear. In this treatment, the conditioned
stimulus, the phobia, is paired with a new conditioned response of relaxation. This involved
reciprocal inhibition because it is not possible to be relaxed and afraid at the same time, and so one
emotion prevents the other. The client and therapist might form an anxiety hierarchy. This involves
listing the fearful stimuli from least to most frightening. A person with arachnophobia might say that
seeing a picture of a small spider is at the bottom of their hierarchy, and holding a tarantula at the
top of their hierarchy. Relaxation is practised at each stage of the hierarchy, using techniques such
as meditation and deep breathing. A person will work their way through their anxiety hierarchy, and
become relaxed by the stimulus at each stage. This treatment will take place over multiple sessions,
starting at the bottom of the hierarchy and working upwards. Treatment is considered successful
when a person can stay relaxed in high-anxiety situations.
Another way of treating phobias is a technique called flooding. This involves exposing a person to
their phobia in a sudden way without a gradual-build up. A person with a phobia of spiders might
have a large spider crawl over their hand until they are comfortable with it. Without the option to
avoid the phobia, the person would quickly realise that the phobia is harmless and therefore their
fear would disappear, known as extinction. Although flooding is not unethical, it isn't a pleasant
experience and so it's important people fully understand what they are taking part in, and what to
expect.
A strength of systematic desensitisation is that it is shown to be effective. One researcher followed
40 people who had systematic desensitisation for a fear of spiders. The researcher found that the
systematic desensitisation was less fearful than the control group. A more recent study found that
systematic desensitisation can be useful for specific phobias, social phobias and agoraphobia. This
means that systematic desensitisation is useful to help treat people with phobias.
Another strength is that systematic desensitisation is proven to be useful for people who have
learning difficulties. The main alternatives to systematic desensitisation are not suitable for people
who have learning difficulties. Cognitive therapies require a lot of rational thought, and flooding can
be distressing. However, systematic desensitisation doesn't require any understanding or cognitive
engagement and won't be distressing to clients. Therefore systematic desensitisation is the most
appropriate treatment for some people.
A strength of flooding is that it is cost-effective. Flooding can show effects in only one session. Even
with longer sessions, it is more cost-effective than a treatment like systematic desensitisation which
requires multiple sessions over a longer time. This means that people can be treated for phobias at a
cheaper cost with flooding than with other treatment types.
However, a limitation is that it is traumatic. A researcher found that both clients and therapists rated
flooding as more stressful than systematic desensitisation. There are ethical concerns causing stress,
and the fact that flooding leads to higher attrition levels. This suggests that therapists might avoid
giving this treatment, for both themselves and the clients' stake.
One way to treat phobias is based on classical conditioning and is called systematic desensitisation.
This attempts to help reduce anxiety by counterconditioning. Phobias are learned so that the
conditioned stimulus causes a conditioned response of fear. In this treatment, the conditioned
stimulus, the phobia, is paired with a new conditioned response of relaxation. This involved
reciprocal inhibition because it is not possible to be relaxed and afraid at the same time, and so one
emotion prevents the other. The client and therapist might form an anxiety hierarchy. This involves
listing the fearful stimuli from least to most frightening. A person with arachnophobia might say that
seeing a picture of a small spider is at the bottom of their hierarchy, and holding a tarantula at the
top of their hierarchy. Relaxation is practised at each stage of the hierarchy, using techniques such
as meditation and deep breathing. A person will work their way through their anxiety hierarchy, and
become relaxed by the stimulus at each stage. This treatment will take place over multiple sessions,
starting at the bottom of the hierarchy and working upwards. Treatment is considered successful
when a person can stay relaxed in high-anxiety situations.
Another way of treating phobias is a technique called flooding. This involves exposing a person to
their phobia in a sudden way without a gradual-build up. A person with a phobia of spiders might
have a large spider crawl over their hand until they are comfortable with it. Without the option to
avoid the phobia, the person would quickly realise that the phobia is harmless and therefore their
fear would disappear, known as extinction. Although flooding is not unethical, it isn't a pleasant
experience and so it's important people fully understand what they are taking part in, and what to
expect.
A strength of systematic desensitisation is that it is shown to be effective. One researcher followed
40 people who had systematic desensitisation for a fear of spiders. The researcher found that the
systematic desensitisation was less fearful than the control group. A more recent study found that
systematic desensitisation can be useful for specific phobias, social phobias and agoraphobia. This
means that systematic desensitisation is useful to help treat people with phobias.
Another strength is that systematic desensitisation is proven to be useful for people who have
learning difficulties. The main alternatives to systematic desensitisation are not suitable for people
who have learning difficulties. Cognitive therapies require a lot of rational thought, and flooding can
be distressing. However, systematic desensitisation doesn't require any understanding or cognitive
engagement and won't be distressing to clients. Therefore systematic desensitisation is the most
appropriate treatment for some people.
A strength of flooding is that it is cost-effective. Flooding can show effects in only one session. Even
with longer sessions, it is more cost-effective than a treatment like systematic desensitisation which
requires multiple sessions over a longer time. This means that people can be treated for phobias at a
cheaper cost with flooding than with other treatment types.
However, a limitation is that it is traumatic. A researcher found that both clients and therapists rated
flooding as more stressful than systematic desensitisation. There are ethical concerns causing stress,
and the fact that flooding leads to higher attrition levels. This suggests that therapists might avoid
giving this treatment, for both themselves and the clients' stake.
