Stcmpsy



A Behaviourist therapy: Systematic Desensitisation (pg 22-3)

Note: In the textbook, there are two behaviourist therapies covered. We will be studying in depth the therapy of systematic desensitisation. The other therapy is aversion therapy which is used to treat addiction. I would recommend reading the chapter on aversion therapy, as it s a practical application of classical conditioning and therefore could be used when you evaluate the approaches. In the exam you will be asked about both therapies, but you only need to write about one1; systematic desensitisation.

TASK

• What is a phobia? Create a definition. How can behaviourist theories explain how phobias form? What do you think the most common phobias are?

• Who did we learn about who was given a phobia?

_____________________________________________

The behaviourist view of phobias

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.

TASK

• Fill in the gaps below to show how a phobia could have been conditioned. Chose one of the following:

o John has a phobia of dogs. This is because he was once attacked by a dog

o If you have a phobia yourself, explain how a negative experience caused that phobia

o Make up a phobia, and explain how it came about

Before conditioning

UCS UCR

(____________________) (____________________)

NS No response

(____________________)

During conditioning

UCS NS UCR

(____________________) (____________________) (____________________)

After conditioning

UCS UCR

(____________________) (____________________)

Systematic Desensitisation

Systematic desensitisation (SD) was first developed by Wolpe (1958) and is used in the treatment of phobias. Often when people have phobias, they will avoid the thing that they are scared of. For example, someone with a phobia of dogs may cross the road every time they see a dog, therefore receiving negative reinforcement which will maintain the phobia. However, if a person is exposed to the thing that they are scared of, they may learn that the thing is not so fearful after all, and over time the phobia will be unlearned. While forcing someone into a inescapable situation where they have to face their fears, such as locking a dog phobic in a room full of dogs until they stop being scared (this therapy is known as flooding) can be effective, SD introduces the feared stimulus to the person gradually, and so could be seen to be more ethical and less stressful.

AIM:

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

• How does this link with the assumptions of the behaviourist approach? The behaviourist approach assumes that all behaviour is learned from the environment. Therefore, we can unlearn conditioned responses by manipulating the environment.

MAIN FEATURES:

TASK

• Using the information on pg 22, describe Reciprocal Inhibition:

The process of SD has a number of stages.

1. The subject is given training in deep muscle relaxation techniques.

2. The therapist and the client work together to construct a hierarchy of fear. This is a series of imagined scenes, each one causing a little more anxiety than the previous one. For example, a hierarchy of fear for a phobia of spiders might look like this:

1. Think about spider

2. See the word “spider”

3. See picture of spider

4. Be in same room as spider in glass tank

5. Sit next to glass tank with the lid closed

6. Sit next to glass tank with the lid open

7. Put hand in tank

8. Hold spider in hands

3. The patient gradually works his/her way through the hierarchy, starting with the least fearful stimuli. They visualise each anxiety provoking situation while utilising the relaxation techniques. Due to reciprocal inhibition, they should after a while be able to visualise the stressful situation while remaining relaxed. This event no longer causes them stress.

4. The client then moves on to the next step in the hierarchy, again remaining relaxed while they visualise the stressful situation. Once this is mastered they move on again and so on. The therapy moves at the pace decided by the client. If they feel that they are unable to proceed, they can move back a stage until they feel more confident

5. Eventually, the client will reach the top of the hierarchy, and will have mastered the fearful situation which caused them to seek help in the first place

Using behaviourist methodology, we can demonstrate how SD works. This procedure is known as counter conditioning.

Before Therapy

CS CR

(Dog) (Fear)

During therapy

CS Relaxation relax-

(Dog) Techniques ation

After therapy

NS No response

(Dog)

In Vitro or In Vivo?

There are two subtypes of SD. In vivo desensitisation is when the client has to relax while directly experiencing the feared stimuli; for example, they have to relax while a real dog is in the room. In vitro desensitisation is when the client has to visualise the feared stimuli; for example by imagining that a dog is in the room. Research has found that in vivo techniques are more successful than in vitro (Menzies and Clarke 1993). However, there may be practical reasons why in vitro may be used.

TASK

• Name some phobias which you would use in vivo and in vitro for.

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

• 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 (another assumption of the behaviourist approach).

• 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.

TASK

• Create a hierarchy of fear for any phobia. State whether you would use in vivo or in vitro for this treatment.

FINDINGS FROM RESEA

TASK

• Using the information on pg 23, complete the following

What did Capafons et al (1998) find?

What did Klein et al (1983) find?

McGrath (1990) found that SD is successful for a wide range of anxiety disorders, with 75% of patients with phobias responding to treatment.

Exam Focus: Signpost sentences

2: Describe how the behaviourist approach has been applied in either systematic desensitisation or aversion therapy (12)

This question is AO1, testing your knowledge and understanding. Your answer should be 400-450 words long, which is roughly a side of A4 to a side and a half, depending on the size of your handwriting. The examiner is looking for some very specific things when marking this answer. Look back at the question. Notice how it is worded? You don’t just have to describe the therapy, but you need to make a specific link between the therapy and the assumptions of the behaviourist approach. If you do not make this link, the most you can get for this answer is 6/12. If you look at both the section on page 31 in the textbook, and the rest of this handout, these links have been made explicit.

You also need to describe the aims and the main features of the therapy. To add detail and depth to your answer, you can give examples to elaborate your points, and you can use research to demonstrate the effectiveness of the therapy.

When writing an answer, the best way you can alert the examiner to the specific content of the answer is to use some key phrases to signpost what you are about to talk about. Also, there is no harm in underlining certain words to ensure that these signposts are clear.

TASK

• Using the signpost sentences above (as well as the “How to answer exam questions” handout), complete an answer to the following question.

o 2: Describe how the behaviourist approach has been applied in either systematic desensitisation or aversion therapy (12)

• You can use these signpost sentences as they are, or alter the wording. You can use them in any order, but try to make your essay flow so that one point leads into the next.

• Underline the words that will allow the examiner to easily see which point you are making.

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In Vivo In Vitro

Going further...

• Read about Little Peter, one of the first people to have a phobia cured this way

• Can you think of any phobias that could not be cured this way?

• How might operant conditioning sustain a phobia?

• Watch the following video about treatment for phobias

• What strengths and weaknesses can you see with SD? Think about time and cost. How ethical is it?

This therapy links to the assumptions of the behaviourist approach by . . .

The aim of this therapy is . . .

The main features of the therapy are as follows . . .

An example of this is . . .

Research into the effectiveness of this therapy was carried out by . . .

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