DISORDERS a. Clinical Characteristics b. Explanations c. Treatments HEALTH & CLINICAL PSYCHOLOGY G543

Behavioural Treatments  Basic Philosophy:

The Behavioural Model  At birth we are born with a tabula rasa (like a blank sheet) and consequently all behaviour is learned in same way.  For behaviorists Abnormal behaviour is the consequence of abnormal learning from the environment.

The Behavioral Model  There is no difference, in the learning, between normal and abnormal behaviours – they are learned in the same ways. This is by:- Classical conditioning Operant conditioning Social learning This is carried out via Stimulus and response training.

Treatments Behavioural Treatments

Behavioural Treatment  Based on principles of Classical Conditioning  CC involves automatic reflexive responses or feelings (UCR) Most common UCR to situations of danger is fear/anxiety Through association can lead to fear of specific thing/situation Anxiety disorder, e.g. phobia  Aim of Behavioural Therapy is to ?

Technique 1: Systematic Desensitisation (Wolfe, 1958) Counter Conditioning  replacing fear response with an alternative and harmless response.

Anxiety Hierarchy  Packing luggage  Making reservations  Driving to the airport  Realizing you have to make a flight  Checking in  Boarding the plane  Waiting for boarding  In-flight service  Moving around the cabin  Climbing to cruising altitude  Descending  Waiting for departure  Taking off  Landing  Turbulence Anxiety Grade Low Anxiety 1–19 Medium Low Anxiety 20–39 Medium Anxiety 40–59 Medium High Anxiety 60–79 High Anxiety 80–100

Summary Questions: BEHAVIOURAL McGrath, 1990 What was the aim of this study?  What are the details of the sample? Who was the participant in McGrath’s study on systematic desensitization? Aims Sample Background What is systematic desensitisation? Results What happened after the first treatment session? What happened in subsequent treatment sessions? What was Lucy able to do by the end of her treatment? What research method was used in this study? What happened? How many sessions did Lucy have to have before she became less fearful? Method & Procedures Evaluation

2b. Summary Information: BEHAVIOURAL McGrath, 1990 Aim To treat a girl with noise phobia using systematic desensitisation. Background Fear of loud noises is common in children but for some it impacts on normal life. Lucy, the girl in this study, could not go to parties and school trips or anywhere where fireworks might go off. Sample Lucy was a nine-year old of low average intelligence (IQ97). She showed as averagely depressed, fearful and anxious when she was tested and therefore was felt her fear of noise was not part of a wider condition and could be treated.

2b. Summary Information: BEHAVIOURAL McGrath, 1990 Method Systematic desensitisation was used and written up as a case study. Procedure Lucy was taught to relax and then she created a hierarchy of feared noises including doors banging, cap-guns popping, balloons bursting and unexpected explosions of party poppers. Imaging herself at home with her toys and her bed and deep breathing was used to control fear. She also used a gear thermometer, rating her fear from 1 to 10. As she was given the feared object, she paired it with the relaxation and imagery she had learnt until she was calm. Results & Conclusion Balloon bursting was the first fear to be tackled and by the fourth session, Lucy could bear it being popped 10 metres away quite calmly. In the fifth session she was able to pop the balloon herself. The other feared objects were then introduced and by the tenth session her fear thermometer scores had dropped from 7/10 to 3/10 for balloons popping and fear of the cap gun from 8/10 to 5/10.

Describe a behavioural treatment for one disorder (10)  Plan (10 minutes)  Write (10 minutes / 15 minutes ET)

Strengths and Weaknesses of using behavioural treatments  Strengths  Weaknesses Refer to Effectiveness (How likely is it that the patient will improve?) Acceptability (will the patient complete the treatment?) Relapse (likelihood of relapse) Side effects (any unintended consequences?) Debates?