Systematic Desensitisation

Question 1

What is a phobia?

Answer 1

An exaggerated fear of an object or situation. We’re not born with phobias and are irrational. Phobias can be learnt from family members.

Question 2

What is the behaviourist’s view on phobias?

Answer 2

Behaviourists argue that phobias, just like other behaviour, come about through learning. People are not born with phobias, but develop them due to a negative experience. We can use classical conditioning to explain how a fear response has been learned in response to a previously neutral stimulus.

Question 3

Who and when developed systematic desensitisation?

Answer 3

Wolpe in 1958

Question 4

What is flooding?

Answer 4

Where someone Is locked in a room with their phobia, in order for them to get over it.

Question 5

How can you compare SD with ‘flooding’?

Answer 5

SD introduces the feared stimulus to the person gradually, and so could be seen to be more ethical and less stressful.

Question 6

What is the aim of SD?

Answer 6

This therapy aims to extinguish a phobia by eradicating an undesirable behaviour (fear) and replacing it with a more desirable one (relaxation).

Question 7

What is the principle of reciprocal inhibition?

Answer 7

it is impossible for a person to experience extreme fear at the same time as being relaxed.

Question 8

Explain the stages of SD

Answer 8

1. The subject is given training in deep muscle relaxation techniques.
2. The therapist and client work together to make an hierarchy of fear.
3. The client patiently gradually works their way through there hierarchy at a pace that suits them. They visualise the least fearful situation while using the relaxation techniques. They need to be able to do this while being relaxed (reciprocal inhibition)
4. They move on when they feel relaxed with the stimuli and at their own pace. If they feel they cannot move on, they can move back steps; whatever feels comfortable for the client.
5. Eventually the client would have completed the hierarchy and would be now comfortable with thew phobia.

Question 9

What is in vivo desensitisation?

Answer 9

When the client has to relax while directly experiencing the feared stimuli

Question 10

What is in vitro desensitisation?

Answer 10

When the client has to visualise the feared stimuli

Question 11

What SD technique is seen to be more effective?

Answer 11

In vivo

Question 12

How does this therapy link with the assumptions of the behaviourist approach?

Answer 12

• SD uses principle of classical conditioning or learning through association. Stimuli which have been previously associated with fear are conditioned through therapy to be associated with relaxation. This will lead to extinction of the fear response
• SD also uses generalisation. It is impossible during therapy for the therapist to account for every possible fearful situation that the client may encounter, but the relaxation responses learned in response to one set of stimuli, should be generalisable to other similar stimuli.
• Operant conditioning principles also feature in this therapy. When the client successfully feels relaxed in the presence of the phobic object, this is rewarding, and such positive reinforcement encourages the client to move up the hierarchy to more feared situations.

Question 13

What is a strength of effectiveness in SD?

Answer 13

• Behavioural therapy is a moderately effective therapy. Smith et al (1980) found that behavioural therapy was as effective as other major forms of therapy. Subsequent reviews of literature have suggested that behavioural therapy and cognitive behavioural therapy are more effective than psychodynamic therapy.
• There is research supporting that SD can be effective. Capafons et al (1998) found that clients who completed a 12-25 week treatment period involving both in vitro and in vivo techniques showed less physiological signs of fear and reported lower fear levels whilst in a flight simulator.

Question 14

What is a strength of ethical issues in SD?

Answer 14

• SD is considered to be more ethical in its approach compared to other forms of behavioural therapies e.g. flooding and aversion therapy. In SD each step is carried out at a slow pace and the client is only able to progress only when the therapist has observed the client being relaxed at each step. Therefore anxiety shouldn’t be an issue.
• Informed consent: SD is mainly used with phobias and not with other disorders such as depression or schizophrenia. Therefore the client experiencing SD is in touch with reality and is able to understand what the therapy will entail. Therefore they are able to consent to undertaking this type of therapy. The client is also able to attend of their own free will and is able to withdraw at any point.

Question 15

What is a disadvantage of effectiveness in SD?

Answer 15

• Some research suggests that SD is not effective for more generalised fears e.g. agoraphobia. Also some researchers believe that the therapy is not suitable for ‘ancient’ fears which tend to have evolved through evolutionary past e.g. snakes, heights, and strangers. According to the evolutionary approach these fears have evolved as an adaptive response to danger and threatening situations. Bregman (1934) supports this concept of biological preparedness. He failed to condition a fear response in infants aged between 8-16 months by pairing a loud bell with wooden blocks. It could be that fear responses are only learned with living things that were a danger in our evolutionary past.
• A major criticism associated with behavioural therapies, is that they fail to address the underlying causes of a disorder. This can result in ‘symptom substitution’ e.g. removing a phobia through behavioural techniques will simply result in a new phobia emerging. Other approaches e.g. psychodynamic therapies claim to treat the underlying reason for the phobia (you can make a comparison here with psychodynamic therapies).

Question 16

What is a weakness of ethical issues in SD?

Answer 16

Some would argue that SD does involve some degree of stress as the client is exposed to the object/situation that they have feared for many years. Anxiety can therefore be experienced during this therapy.