SYSTEMATIC DESENSITISATION
– This is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning.
– If the sufferer can learn to relax in the presence of the phobic stimulus they will be cured.
– Essentially a new response to the phobic stimulus is learned and this is called counterconditioning.
– It addition it is impossible to be afraid and relaxed at the same time, so one emotion prevents the other.
-This is called reciprocal inhibition.
There are three processes involved in SD:
THE ANXIETY HIERARCHY
– This is put together by the patient and therapist.
– This is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening.
RELAXATION
– The therapist teaches the patient to relax as deeply as possible.
– This might involve breathing exercises or, alternatively, the patient might learn mental imagery techniques.
EXPOSURE
– The patient is exposed to the phobic stimulus while in a relaxed state.
– This takes places across several sessions, starting at the bottom of the anxiety hierarchy and moving up.
– Treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy.
EVALUATION OF SYSTEMATIC DESENSITISATION
STRENGTHS
Effective
– Research shows that SD is effective in the treatment of specific phobias.
– For example, in 2003 Gilroy followed up 42 patients who had been treated for spider phobia in three 45 minute sessions of SD.
– A control group was treated by relaxation without exposure.
– At both three months and 33 months after the treatment the SD group were less fearful than the relaxation group.
– This is a strength because it shows that SD is helpful in reducing the anxiety in spider phobia and that the effects are long-lasting.
Alternatives are not as good
– Flooding and some cognitive therapies are not well suited to some patients.
– For example, those with learning difficulties.
– As this can make it very hard for some patients to understand what is happening during flooding or to engage with cognitive therapies that require the ability to reflect on what you are thinking.
– For these patients SD is probably the most appropriate treatment.
LIMATION
Not Appropriate for all Phobias
– SD may not be effective against all phobias
– Ohman et al suggests that SD may not be as effective in treating phobias that have an underlying evolutionary survival component than in treating phobias which have been acquired as a result of personal experience
– This means SD might only be effective in tackling some phobias
FLOODING
– Flooding involves immediate exposure to a very frightening situation
– Flooding sessions are typically longer than SD sessions as one can usually last two or three hours.
– Sometimes only one long session is needed to cure a phobia.
– Classical conditioning terms this process as extinction.
– A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus.
– The result is that the conditioned stimulus no longer produces the conditioned response.
– Flooding is not unethical but it is an unpleasant experience so it is important that patients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding session.
EVALUATION OF FLOODING
STRENGTHS
Cost-Effective
– Highly effective and quicker than alternatives
– This quick effect is a strength because it means that patients are free of their symptoms as soon as possible
– That makes this treatment cheaper.
LIMITATIONS
Less Effective for More Complex Phobias
– Less effective at treating phobias like social phobias
– This may be because social phobias have cognitive aspects.
– This type of phobia may benefit more from cognitive therapies because such therapies tackle the irrational thinking.
Highly Traumatic
-The problem is not that flooding is unethical but that patients are often unwilling to see it through to the end.
– This is a limitation because time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment.