Behavioural Treatments for Phobias

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Background information to behavioural treatments:

Phobias may persist because people avoid their phobia. This means that they never get a chance to learn that their feared stimuli is not so scary after all. Treatments therefore allow patients to unlearn negative associations and replace them with a positive response through the process of relaxation (counter conditioning).


Systematic desensitisation (SD):

The individual initially constructs an anxiety hierarchy which consists of imagined situations linked to their phobia. These situations are ordered from the least to most anxiety provoking.

Relaxation training is then given with the aim of achieving complete relaxation.

The patient is asked to imagine, as vividly as possible, the scene at the bottom of the hierarchy and is told to relax at the same time. When they feel fully relaxed, they will work their way up the anxiety hierarchy. This is known as graded pairings. Another approach is to use graded pairing of the real stimulus. This is almost always more effective and longer lasting than the imagined technique.


Evaluation of systematic desensitisation:

  • The patient does not have to experience intense anxiety as they are in control i.e. they only move up the anxiety hierarchy when they feel relaxed and are ready to do so.

  • SD has a high success rate of 75% with simple phobias and 90% for blood-injection phobias after 5 sessions of graded exposure. The treatment is most successful when real stimulus are used rather than imagined

  • SD is relatively fast and requires less effort from


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