Behavioural Therapies for Phobias

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Starter:
Fill in the gaps:
Little Albert was trained using ____________ conditioning.
This means that he developed an ________________
between the white rat and fear response (which was
___________). For Little Albert the white rat was the
_______________ stimulus and the loud noise that he heard
was the _______________ stimulus. The conditioned
response was ____________. The unconditioned response
was___________.
Extension:
A way of incorporating operant conditioning might be:
Behavioural Therapies
Based on your understanding of behaviourist
principles, how might they go about treating a
phobia?
Systematic desensitisation is based on the
behaviourist assumption that the phobia has
been learned wither through association
(classical conditioning) or reinforcement (operant
conditioning) and so can be unlearned based on
the same principles.
Phobias can be removed by counterconditioning
– learning a new response to the feared stimulus.
This is the principle behind Systematic
Desensitisation.
How it works:
In the presence of the therapist, the client confronts each item in the
hierarchy while they are in a state of deep relaxation. They start with
the least feared item and move on once they feel relaxed and unafraid
in its presence. This confrontation may be real or imagined. The
process continues until they reach the top of the hierarchy and feel
relaxed in the presence of all the items.
Clients are taught relaxation techniques:
1
2
3
If the systematic desensitisation works, clients have been counter-conditioned – they
have learnt a new response to a stimulus - relaxation. They no longer associate the
object or situation with fear.
McGrath (1990)
**Behavioural perspective = behaviour is learnt and so has little to
do with the individual and more to do with the situation they are
in**
• Behaviours such as phobias could be unlearnt (counterconditioned)
• By pairing the phobic stimulus with something pleasant or
relaxing, the treatment of phobias should be effective, and is
known as systematic desensitisation
• In terms of classical conditioning the fear response can be
replaced by a conditioned response of calm
• The stimulus that causes the fear is presented with something
that makes the patient feel calm
• Research by McGrath shows how successful the treatment can
be for reducing phobias in a case study of a girl with a phobia of
loud noises (ligyrophobia)
Aim
To treat a girl with specific noise phobias
using systematic desensitisation
Method: case study
Design: single-participant
Participant :
• Lucy, a 9 year old girl who had a fear of
sudden loud noises. These included balloons,
party poppers, guns, cars backfiring and
fireworks.
• She had lower than average IQ, and was not
depressed, anxious or fearful (tested with
psychometric tests), so only had one specific
phobia.
Procedure
Lucy was brought to the therapy
session,
Programme explained to parents
They gave chosen for further session
Session 1: Lucy constructed a
hierarchy of feared noises.
Inc: doors banging, guns, balloons and
unexpected party poppers.
• Taught breathing and
imagery to relax
• Told to imagine herself in
bed at home with her toys
• She had a hypothetical
fear ‘thermometer’ to rate
her level of fear from 1-10
As she was given the stimulus loud noise,
she paired her feared object (loud noise)
with relaxation, deep breathing and
imagining herself at home with her toys.
They started with the least fear inducing
and worked up to the most.
After 4 sessions she had learnt to feel calm
when the noise was presented.
She did not need to imagine herself at home
with her toys anymore.
Findings
Session 1:
• At the end of the first session, Lucy was
reluctant to let balloons be burst even at
the far end of the corridor. When the
therapist burst the balloon anyway, Lucy
cried and had to be taken away.
• She was encouraged to breathe deeply
and relax.
4th Session
• By the end of the 4th session, Lucy was able to
signal a balloon to be burst 10 metres away,
with only mild anxiety
Session 5
• Lucy held a deflated balloon, then a slightly
inflated balloon and eventually was able to
allow a small balloon to be burst in the
consulting room. At the end of the session,
Lucy was able to pop the balloons herself
6, 7 & 8
• Party poppers introduced and Lucy went from
not allowing them into the consulting room to
being able to pop one if the therapist held it
• Cap guns were then introduced and were used
outside, but Lucy was quickly able to agree to
one being fired in the consulting room
Session 10
• By Lucy’s 10th and final session, her fear
thermometer scores had gone from 7/10 to
3/10 for balloons popping and 9/10 to 3/10
for party poppers; the cap gun had gone from
8/10 to 5/10
Lucy had control – she could say when and where
noises were made, and controlled the use of inhibitors
of the fear response which included relaxation and a
playful environment.
• Conclusion:
It appears that noise phobias in children are
amenable to systematic desensitisation.
Evaluation
• You will have evaluated the study for hwk.
• In groups of 3, share your evaluations of the study.
• Think about:
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Method
Sample
Issues – qual/quan, long/snap, ethics
Reliability
Validity
Debates – free will/det, hol/reduc, nature/nur, ethno, psych a
science
• Usefulness
Method & Data Collection
• Case study – in depth and detailed
• Case study – unique to Lucy
• Controlled for extraneous/confounding
variables such as depression, anxiety etc.
• Did not manipulate the IV
• Self-report, Lucy’s subjective experience
• Self-report, may be subject to social
desirability/demand characteristics. This
lowers the internal validity of the study.
• Used observation and self-report:
triangulation of data – increases validity
Sample
• Unique case study on one participant,
therefore cannot be generalised to all phobia
sufferers
Issues
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•
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Ethics:
Consent from parents
Lucy in control
Put in stressful situation
Issues
• Longitudinal vs snapshot
• Longitudinal – able to see changes over time
and the gradual removal of her fear
Issues
• Qualitative/ Quantitative
• Both used
• Rating scale (thermometer) subjective and
open to interpretation
• Replicable method
• Observation: able to see her immediate
response and see if her self-report and
observations were in agreement
Issues - validity
• Low ecological validity
• Not a natural environment – we do not know
if the benefits transfer out of the clinical
setting and into real life, where Lucy is not in
control and stimuli are not predictable
Issues - reliability
• Cannot exactly replicate it as unique case
• Thermometer and procedure is relatively
standardised so could be replicated
Debates
• Nature vs nurture
• Lends support to behavioural approach to
phobias
• They assume that nurture i.e. learning and
environmental factors are the reason behind
behaviour
Reductionism
• Reductionist as it boils down to stimulusresponse and does not take into account
thought processes or feelings
• This may be a good thing though, as Lucy was
successfully treated
Usefulness
• Suggests that phobias can be counterconditioned and treated using systematic
desensitisation
• SD is in fact used to treat phobias
• You have 2 useful info hand outs
• The first one is a diagram that you should keep for
your revision as it sums up the behavioural approach
to phobias very neatly
• The second one is an overview of the therapies used
by behavioural psychologists and you can use it to
help you with the following task.
G1
Activity
Extension:
evaluate your
treatment plan
• Jen is terrified of cats
• Her granny had a grumpy old cat, who used to bite and scratch
her whenever she went round
• She is desperate to be a vet, so she really needs to address the
problem
• Firstly – using the behavioural approach, explain why Jen is
afraid of cats
• Secondly – suggest a course of treatment for Jen
G2
Extension:
evaluate your
treatment plan
• Daniel has been terrified of dogs for over 7 months now. This is difficult for him
as several of his friends have dogs and he finds he is avoiding going to their
houses, so that he won’t encounter their dogs.
• The last time he saw a dog was when one bounded towards him on his way
home from school. As the dog got near him he froze; his face was white and he
could not move. When the dog had gone he burst into tears and ran home.
• Ever since that day he has avoided that road and taken a long way round that
adds a mile to his walk home.
• Firstly – using the behavioural approach, explain why Daniel is afraid of cats
• Secondly – suggest a course of treatment for Daniel
G3
Extension:
evaluate your
treatment plan
• Cara is scared of loud noises
• When she was younger, she ran out into the road
• Luckily she was unhurt as the driver held his horn
down and there was a piercing sound that alerted
her
• She was extremely startled and shaken by the
sound
• Firstly – using the behavioural approach, explain
why Cara is afraid of cats
• Secondly – suggest a course of treatment for Cara
Homework
• Plan the reliability and validity 15 mark questions
using the resources provided.
• You have a week to do this.
• You do not have to write the essay. I will check your
plans first and then you will choose one to write.
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