Behavioural Treatments for Phobias

Systematic Desensitisation (SD)

• Wolpe developed the SD technique for the treatment of phobias of specific objects e.g. snakes, enclosed spaces.
• Based on the basis that what has been learned (conditioned) can be unlearned.
• Based on classical conditioning. Idea is to replace the anxiety/ fear with feelings of relaxation.
• New response to a phobic stimulus is learned (Phobic stimulus is paired with relaxation instead of anxiety). This is called counter conditioning. 
• Impossible to be afraif and relaxed at the same time, so one emotion prevents the other. This is called reciprocal inhibition. 

Three main processes are involved in SD:

Relaxation

Techniques are taught to the patient these include:

• Focussing on breathing and taking slow, deep breaths as when we are anxious we breathe quickly so slowing this down helps us to relax. [7/11]
• Being mindful of the 'hear and now' [mindfullness]
• Focussing on a particular object or visualising a peaceful scene.
• Progressive muscle relaxation is also used where one muscle at a time is relaxed.

Hierarchy

• At the beginning of therapy, the therapist and the patient create a hierarchy from most to least fearful stimuli. 

Gradual Exposure

• SD works by gradually exposing the patient to fearful situations one step at a time. At each stage the client practices relaxation so the situation becomes mroe familar and their anxiety reduces.
• Treatment is successful when the patient can remained relaxed in situations high on the hierarchy.

Step 1: Relaxation techniques are taught.

Step 2: Construct a hierarchy of fear.

Step 3: Start at the bottom of the hierarchy. Practice relaxation techniques. 

Step 4: Move up the hierarchy.

Step 5: Eventually the fear of phobia is replaced…