Starter Task:
In pairs choose one of the following scenarios. Explain how using
behaviourist techniques one of these people could be treated.
•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
•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
•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.
Cognitive Therapies
for Phobias and
Evaluation of
Explanations
LOs:
To understand cognitive therapies of phobias
Evaluate Ost and Westling
Evaluate the explanations of phobias
Recap of cognitive assumptions
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Behaviour is the result of information processing
Comparison between minds and computers
Input/output
Limited capacity
Impose order and meaning on events
Atypical feelings reflect atypical or faulty processing of
information
• Use of schemas
Cognitive behavioural therapy:
• There is a range of treatments for abnormal
behaviour that are grouped together under the
‘cognitive’ umbrella.
• What they tend to have in common is that they try
to alter abnormal behaviour by challenging and
changing the maladaptive thinking processes that
underlie it.
• Cognitive-Behaviour Therapy
• One set of therapeutic techniques is called cognitive
behaviour therapy. As its name suggests, this
therapy combines elements of the behavioural
model of abnormality. The therapy has two parts.
The cognitive part
The cognitive part of the therapy involves identifying the faulty
or irrational thinking processes that are affecting the client. This
is done through questioning and getting the client to give
examples of situations, what they would think and what they
would do. During the cognitive part, the therapist develops ideas
about what the client’s irrational beliefs are but does not
challenge these directly.
The behaviour part
The behaviour part of the therapy involves setting homework for
the client to do. The therapist gives the client tasks that will help
them challenge their own irrational beliefs. The idea is that the
client identifies their own unhelpful beliefs and then proves
them wrong. As a result, their beliefs begin to change.
Cognitive Treatment
Study: Ost & Westling
Aim
To compare cognitive behaviour therapy (CBT) with applied
relaxation as therapies for panic disorder.
Method
A longitudinal study with patients undergoing therapy for
panic disorder.
Design
Independent design with patients being randomly assigned to
either applied relaxation or CBT.
Participants
38 patients with DSM diagnosis of panic disorder, with or
without agoraphobia. Recruited through referrals from
psychiatrists and newspaper advertisements.
26 females and 12 males, mean age 32.6 years (range 23–45
years). From a variety of occupations and some married,
some single and some divorced.
6
• Applied relaxation is a way of teaching you how
to release the tension in your body and relax
your muscles. This helps to calm your mind. It
doesn't involve taking any drugs.
• Most people having this treatment have weekly
sessions with a therapist over 12 to 15 weeks.
Week by week the therapist teaches you to relax
your body and your mind. You also learn how to
relax in difficult situations instead of getting
stressed or avoiding them.
Pre-treatment: baseline assessments of panic attacks, using a variety of
questionnaires (e.g. the Panic Attack Scale, Agoraphobic Cognitions
Questionnaire, etc.).
Patients recorded details of every panic attack in a diary. Each patient was
then given 12 weeks of treatment (50–60 minutes per week), with
homework to carry out between appointments.
Applied relaxation was used to identify what caused panic attacks, and
then relaxation training started with tension-release of muscles. This was
gradually increased so that by session 8 rapid relaxation was used and
patients were able to practise their techniques in stressful situations.
Procedure
CBT was used to first identify the misinterpretation of physical symptoms
and then to generate an alternative cognition in response. For example,
not to feel panic when something stressful happened, but to come up
with an alternative explanation (e.g. my heart racing is not a heart attack
but a normal physical reaction to stress and it will slow down in a minute).
This was then tested in situations where participants had panic situations
induced, but were not allowed to avoid them, so that eventually they had
to accept that their restructured thoughts were right.
Patients were then reassessed on the questionnaires.
After one year a follow up assessment using the questionnaires was
carried out.
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Findings
Applied relaxation showed 65% panic-free patients after
the treatment, 82% panic-free after one year. CBT showed
74% panic-free patients after the treatment and 89%
panic-free after a year. These differences were not
significant. Complications such as generalised anxiety and
depression were also reduced to within the normal range
after one year.
Conclusion
Both CBT and applied relaxation worked at reducing panic
attacks, but it is difficult to rule out some cognitive
changes in the applied relaxation group even though this
is not focused on in this research.
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Evaluation group task.
Use the issues and debates page in your
booklet to prompt you.
We will then share as a class.
Evaluation
Strengths
Weaknesses
Evaluation of the explanations
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Each group has an A3 sheet.
1. eval of biological explanation of phobias
2. eval of cognitive explanation of phobias
3. eval of behavioural explanation of phobias
Please set this up on your sheet.
Now I will time 3 minutes and each group must add as much as
they can.
We will then rotate. If stuck – elaborate or respond to other
points.
Biological Approach
Evaluation of Explanation
•.
Cognitive explanations of PHOBIAS
Evaluation
They will
all laugh
at me!
Behavioural Explanation
Evaluation
Strengths
Limitations
Homework
• Continue your essay
plan