The behavioural approach to treating phobias - Systematic desensitisation

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  • Systematic desensitisation
    • 1. Anxiety hierarchy
      • Least to most frightening
      • List of situations related to phobic stimulus that provoke anxiety
    • 2. Relaxation
      • Therapist teaches patient to relax as deeply as possible
      • Drugs like valium
      • Breathing exercises or mental imagery techniques
    • 3. Exposure
      • Across several sessions
      • Patient is exposed to the phobic stimulus while relaxed
      • Patient moves up hierarchy when in the presence of stimulus
      • Treatment successful when patient can stay relaxed in situations high on the hierarchy
    • Behavioural therapy designed to gradually reduce phobic anxiety via classical conditioning
    • Impossible to be afraid and relaxed at the same time so one emotion prevents the other (reciprocal inhibition)
    • Counterconditioning (New response to phobic stimulus is learned - paired with relaxation instead of anxiety)
    • If the sufferer can learn to relax in the presence of the phobic stimulus, they will be cured
    • Evaluation
      • It is effective
        • Gilroy et al. (2003) followed uo 42 patients treated for spider phobia in 3 45 minute SD sessions
        • Phobia assessed with spider questionnaire and response to spiders
        • Control group was treated by relaxation without exposure
        • At both 3 and 33 months SD group were less fearful than relaxation group
        • Shows SD is helpful in reducing anxiety is spider phobia + long lasting
      • It is acceptable to patients
        • Patients prefer it - those given a choice between flooding or SD tend to choose SD
        • Doesn't cause the same degree of trauma as flooding
        • SD includes pleasant elements (relaxation)
        • Reflected in low refusal/attrition rates of SD
      • It is a suitable for a diverse range of patients
        • Flooding and cognitive therapies are not well suited to some patients
        • Some patients have learning difficulties
        • Hard to understand what is happening in flooding or to engage in CT (requires ability to reflect)
        • SD is probably the most appropriate treatment


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