1. One treatment for phobias based on classical conditioning
Systematic
desensitisation

2. Systematic desensitisation
A behavioural therapy based on classical conditioning
Developed by Joseph Wolpe in the 1970s
Based on original work by Mary Jones in the 1920s
AKA graduated exposure therapy

3. What does it involve?
the client is gradually (systematically) introduced to feared object in a non-threatening environment (desensitised)
assumes that if phobias are acquired through classical conditioning, the same processes can be used to unlearn old associations and create new ones 

4. Fear hierarchy the client creates a fear hierarchy
feared object at the top
going down in as many stages as they want
bottom of hierarchy = something related to their feared object which they feel they could tolerate

5. Example of a fear hierarchy for Arachnophobia
stage 1: place the picture of the dot on the other side of the room
stage 2: legs could be drawn onto the dot, then it could be moved closer gradually
stage 3: a photo of a small spider is used in a similar way
stage 4: a real tiny spider is used in the same way
Stage 5: a bigger spider
Stage 6: the person is able to be in close proximity to a relatively large spider
Stage 7: handle a spider

6. Reciprocal inhibition
A technique based on the idea that certain physiological responses are incompatible with each other
For example it is not possible to relax and be anxious at the same time
The technique is used to teach a new reaction to the anxiety-provoking stimulus

10. Spiders

11. Relaxation strategies
The therapist will teach the client relaxation strategies, e.g. meditation, using positive affirmations, aromatherapy, etc
once the client is able to maintain feelings of relaxation and is ready to face the first stage on the fear hierarchy (the black dot)
the object is paired with the relaxation techniques
through classical conditioning the client begins to associate the black dot, (the first point on the fear hierarchy) with relaxation

12. What happens next?
the therapist repeats procedure using each point on the fear hierarchy until the client is able to tolerate the feared item (big live spider out of the tank)
at this point, the old fear response will have become extinct
they have experienced the conditioned stimulus enough times for the maladaptive stimulus/response unit (spider/terror) to become unlearnt
they have stayed in contact with the once feared object instead of avoiding it (which created negative reinforcement and encouraged further avoidance)

13. Evaluation: Studies Little Peter, (Jones, 1924)
Case study of a successfully cured little boy with a phobia of rabbits
Jones gradually introduced him to a rabbit over a period of several days while he ate his dinner
the rabbit was brought closer and closer each day
eventually the boy began to stroke the rabbit and his fear was unlearnt.

14. Capafons (1998)
successfully cured fear of flying in a sample of 20 clients
Pps in the treatment group gave more positive self reports and interviews and showed less bodily stress responses when exposed to their feared situation (a flight simulator) than an untreated control group
TASK: See what extra APFC details you can find out about this study

15. Competing arguments
Can you think of any competing arguments to counter either of these pieces of evidence?
If you are able to think of problems with this evidence, what does this tell us about systematic desensitisation as a therapy for phobias?

16. Practical issues: FOR can be used with wide range of specific phobias
can be a highly effective and relatively quick technique;
client feels empowered as they are in charge of creating the fear hierarchy (in flooding the client is less empowered)
they can understand why the therapy should work as it is a plausible explanation

17. Practical Issues: AGAINST
Some patients can’t maintain relaxation as effectively
may need anti-anxiety drugs to get them into a suitable state for the therapy to be effective

18. Alternatives: Flooding
Flooding involves removing the graduated aspect and simply ‘throwing the person in the deep end’
works on basis that full scale fight or flight response cannot be maintained for extended periods as it uses energy which will eventually run out
once the person experiences their anxiety falling the stimulus/response unit will become unlearnt

19. Two extra therapies for you!
You don’t need to know about the next two in any depth, although they might be helpful for Paper 3 synopticity. If you have time and want to extend your knowledge by all means , see what else you can find out about them 

20. Use of drugs anti-anxiety drugs such as benzodiazepines
They increase brain’s ability to make use of GABA, the neurotransmitter which inhibits anxiety and makes a person feel calmer
have some positive effect in treating phobias

21. Psychoanalysis
Uses techniques such as free association and dream analysis to access unconscious memories and desires which may reflect conflict between id and superego thus explaining the latent (underlying) cause of the person’s anxiety

22. Psychoanalysis cont’d
Freud explains phobias in terms of defence mechanisms
e.g. fear of castration in the Oedipus complex is displaced onto some other object or situation
as the white horse in the Little Hans case study

23. Applied question
Gladys has a terrifying fear of pineapples. She has been offered a free holiday to the Caribbean but the thought of going fills her with horror in case she comes across a pineapple. Explain one treatment/therapy that could be used to help Gladys. (4)

24. Evaluate one treatment or therapy for phobias (8)
Essay Question
Evaluate one treatment or therapy for phobias (8)

25. Harder essay
Gladys has a terrifying fear of pineapples. She has been offered a free holiday to the Caribbean but the thought of going fills her with horror in case she comes across a pineapple.
To what extent might the learning theories the biological psychology help Gladys to overcome her phobia? (12)