Behavioural explanations and treatments of phobias - PowerPoint Presentation

Slide1

Behavioural explanations and treatments of phobiasSlide2

Starter

Complete behaviourism and phobias worksheetSlide3

Behavioural explanation: Two-process model (acquisition-maintenance)

Acquisition-Phobia acquired via classical conditioning

Maintenance-Phobia

is maintained via operant conditioning and

negative reinforcement.Slide4

Application of the two-process model

As a child, Ali was bitten by a small dog when he was playing in the park. He had noticed the dog and reached out towards it. Unfortunately the dog attacked Ali’s outstretched hand. Although the dog was quickly brought under control by its owner, the dog bite was considered serious and Ali needed a number of stitches on the palm of his hand. As a teenager Ali has fear of all breeds of dog and becomes anxious when near dogs, especially if they are not on a lead. He never visits a friend’s home if they own a dog and will leave the park if a dog if off their lead.

Possible exam

question:

Suggest how the behavioural approach might be used to explain Ali’s phobia of dogs (4 marks

).

Step

1: Classical conditioning

Apply this concept of classical conditioning to Ali’s fear of all breeds of dog

.

Step 2: Operant conditioning

Using the concept of negative and positive reinforcement, explain Ali’s continued fear and subsequent avoidance of dogs

.Slide5

Answer

Previously Ali was not scared of dogs as he reached out his hand to

one (it was a

neutral

stimulus)

so he acquired his phobia through classical conditioning. Him being bitten and having to have stitches (unconditioned stimulus)caused him pain which was an unconditioned response. This means that dogs immediately became a conditioned stimulus with the

conditioned

response being his dog phobia. This phobia was maintained through negative reinforcement as he avoids going to peoples houses or dogs not on a lead in order to avoid the unpleasant feeling of anxiety he feels. He keeps doing this

every time

he sees a dog and avoids feeling anxious and so his phobia is maintained.

What will he need to do then to try and get rid of his phobia according to this explanation?Slide6

Evaluation of the two-process modelSlide7

Exam skills:

How do we evaluate explanations of behaviour?

Evidence – supporting/contradicting

Evaluation of supporting evidence

What are the limitations of the explanation? E.g. Does it fail to explain any aspect of the behaviour?

Why is this a good explanation?

Practical/useful applications

Comparison of explanation with another

Relevant issues and debatesSlide8

Developing extended writing

Complete the activity sheet.Slide9

Evidence

Sue et al (1994)

found that people with phobias often recall a specific incident when their phobia appeared e.g. being bitten by a dog or experiencing a panic attack in a social situation.  

Barlow & Durand (1995)

report that 50% of those with specific fear of driving remember a traumatic experience while driving (e.g. an accident) as having caused the onset of the phobia, e.g. some people become intensely afraid of driving a car after a serious accident (associate car with accident

)

Is just writing down the findings from a study enough??

No – you need to also explain how the findings support/contradict the explanation of

behaviour

– we call this ‘grounding’Slide10

Which of the following statements provide the best ‘grounding’ and why?

Sue et al (1994)

found that people with phobias often recall a specific incident when their phobia appeared e.g. being bitten by a dog or experiencing a panic attack in a social situation.  

This supports the explanation because it shows how phobias result from bad experiences.

This supports the model because it shows how people learn phobias through associating fear with an object/situation.

This supports the model as it shows people who have had a negative experience with a previously neutral stimulus will lead to a new and consistent fear response.Slide11

Over to you!

On MWBs:

Write an explanation for how

Barlow &

Durand’s study supports the two-process model.

Barlow & Durand (1995)

report that 50% of those with specific fear of driving remember a traumatic experience while driving (e.g. an accident) as having caused the onset of the phobia, e.g. some people become intensely afraid of driving a car after a serious accident (associate car with accident)Slide12

Alternative explanations?

What explanation could there be for the results shown below?Slide13

Ost

(1987)

notes that many people with severe fears of snakes, germs, aeroplanes & heights have had no particularly unpleasant experiences with any of these objects or situations

.

Dinardo

(1988)

found participants in a control group without a phobia of dogs, experienced a similar proportion of fearful incidents with a dog but had not developed a phobia

.What does this research suggest about behavioural explanations of phobias?

What other explanations could there be for the findings?Slide14

Biological preparedness (Seligman)

Seligman argued that animals, including humans, have evolved to be fearful of potentially life-threatening stimuli because having such phobias are adaptive.

In our evolutionary past, our ancestors have survived because they have avoided dangerous situations or objects. Therefore, this biological preparedness has been selected into our genes.Slide15

Usefulness

Eloise has a fear of buttons, she refuses to wear any clothes with buttons and even refuses to go to any clothes shop. When Eloise was at school, she had to wear lost property which had buttons that pinched her a left a bruise.

How

would you

treat Eloise’s phobia using classical conditioning

?

Extension: Do you see any problems with this treatment?Slide16

Essay writing skills and practice

Describe and evaluate the

Behavioural

approach to explaining phobias (16marks

)

Big boards:

How do many marks do you think you get for describe? How many for evaluate?

Write down 5 key points you would include for ‘describe’

Now plan the ‘evaluate’ part:

Your plan must include at least 2 evaluation points.

Use the burger sheets to help you plan each of the evaluation paragraphs – remember this is a plan so keep it to key words/phrases.Slide17

Behavioural treatments: Flooding & SD

Use the following terms to outline Systematic Desensitisation:

Classical Conditioning

Reciprocal Inhibition

Counterbalancing

Exposed

Anxiety reduction

Hierarchy Slide18

Effective outline of SD

Systematic desensitisation uses the principles of

classical conditioning

to gradually reduce a fear response in the patient. SD works by pairing

the phobic

stimulus with a relaxation response, this

counterconditioning

therefore allows for a new response to the object or situation to be learnt. It also works due to

reciprocal inhibition

which is the idea that it is impossible to be both relaxed and fearful at the same time.

Relaxation techniques are taught to the patient to enable them to feel relaxed in the presence of the phobic stimulus. Examples of techniques used are getting the patient to visualise a peaceful scene and progressive muscle relaxation

where one muscle at a time is relaxed. The therapist and patient then create a hierarchy from most to least fearful stimuli for example thinking about a spider would be at the bottom of the hierarchy whereas touching a spider would be at the top. The patient is then gradually exposed to each stimuli on the hierarchy a step at a time and practices relaxation until their anxiety reduces. The treatment is completed when the patient feels relaxed when exposed to the situation at the top of the hierarchy Slide19

Cut this down to between 3-5 key wordsSlide20

How to evaluate treatments

Effectiveness- What do you think this means?

Does it work? Is there any evidence to support the success of the treatment?

Appropriateness- What do you think this means?

How long does it take? Are their side effects? Is suitable for all sufferers?

Comparison with other treatments?Slide21

Evaluating treatments

Beginner

evaluation

:

One strength is that research has found SD is successful at treating a range of phobic disorders.

Intermediate evaluation:

One strength is that research has found SD is successful at treating a range of phobic disorders. For example, McGrath et al reported that about 75% of patients with phobias responded to this treatment

High evaluation:

One strength is that research has found SD is successful at treating a range of phobic disorders. For example, McGrath et al reported that about 75% of patients with phobias responded to this treatment. This means that SD could be considered an effective treatment for phobias however it is important to note that 25% of patients did not respond to the treatment which suggests it may not be effective for all phobias or different types of people suffering from phobias

.Slide22

Evaluation of treatments

You will all need a piece of paper for this.

There are 8 evaluation points

stuck around the

room, 4 for

each treatment.

In pairs,

work your way around the room and look at least 2 points for SD and 2 for flooding.

For the ones you look at you have to:

Decide if it is to do with effectiveness of appropriateness

Write a summary of exactly what this point shows us about the effectiveness of the treatment for e.g- does it show SD is an effective treatment? Is it successful for all participants?

Finished? Draw a Venn diagram (look this up if you are not sure what this is) on the showing the similarities and differences of flooding and systematic desensitization.Slide23

Evaluation of treatments

In

pairs,

choose 2 evaluation points for SD and 2 for flooding.

For the ones you have chosen, you have to:

Decide if it is to do with effectiveness of appropriateness

Write a summary of exactly what this point shows us about the effectiveness of the treatment for

e.g

-

does it show SD is an effective treatment? Is it successful for all participants?Finished? Draw a

Venn diagram (look this up if you are not sure what this is) on the showing the similarities and differences of flooding and systematic desensitization.Slide24

Essay WritingSlide25

Outline and Evaluate behaviourist treatments for phobias

1) How are the marks awarded?

Outline = 6 marks Evaluate = 10 marks

2) How long do you have to plan the essay?

3) How long do you have to write the essay?

4

) Understanding the question. What are the key words in the question and what does each word mean?

Outline

Evaluate

Behaviourist treatment

sPhobiasSlide26

Outline and Evaluate behaviourist treatments for phobias

Outline the treatments

Which two treatments should we use?

What would this get out of 6?

One treatment is flooding, this is where the psychiatrist floods the patient with the phobic stimulus so that they are no longer scared of it. The longer they are exposed to it the less their anxiety becomes. Another treatment is systematic desensitisation where the patient develops a hierarchy of fears and works their way through them until they get to the top, when they reach the top they should be over their phobia.Slide27

One treatment is flooding, this is where the psychiatrist floods the patient with the phobic stimulus so that they are no longer scared of it. The longer they are exposed to it the less their anxiety becomes. Another treatment is systematic desensitisation where the patient develops a hierarchy of fears and works their way through them until they get to the top, when they reach the top they should be over their phobia.Slide28

On big white boards – develop this

One treatment is flooding, this is where the psychiatrist floods the patient with the phobic stimulus so that they are no longer scared of it. The longer they are exposed to it the less their anxiety becomes.

Example:

One treatment that is

based on the behaviourist assumptions of classical conditioning

is flooding. Flooding

involves the patient being

continually exposed

to an extreme form of a phobic stimulus

, essentially forcing them to face their

fear. Although initially the patient experiences high levels of anxiety, this cannot

be maintained for a long period of time so will eventually subside. Flooding sessions normally last between 2-3 hours. Sometimes only one long session is needed to cure the phobia.Slide29

Another treatment is systematic desensitisation where the patient develops a hierarchy of fears and works their way through them until they get to the top, when they reach the top they should be over their phobia.

Example:

Another treatment using the

assumptions of classical conditioning is Systematic Desensitisation (SD).

In

a process known as counter conditioning, a

new response to a phobic stimulus is learned

as the phobic

stimulus is paired with relaxation instead of anxiety. This leads to reciprocal inhibition as it is impossible to be relaxed and anxious at the same time. Relaxation techniques are taught to the patient, these

include: focussing on breathing, visualising a peaceful scene and progressive muscle relaxation techniques. 

At the beginning of therapy, the therapist and the patient create a hierarchy from most to least fearful stimuli. The patient is then gradually exposed to fearful situations one step at a time. At each stage the client practices relaxation so as the situation becomes more familiar and their anxiety reduces. The treatment is completed when the patient is at the top of the hierarchy and is completely relaxed, maybe after a dozen or so sessions over a period of weeks.Slide30

Evaluation tips

Before we evaluate – signpost that this is what you are about to do (in other words, let the marker know):

“When evaluating treatments, it is useful to consider the appropriateness and effectiveness of each procedure…”

Also use ‘linking words’- However, Additionally, In contrast, FurthermoreSlide31

Evaluation using P.E.S

P-A study that shows the effectiveness of flooding is Kaplan.

E-

What might we write here?

E-They found that 65% of patients with a specific phobia were cured in a single session and showed no symptoms 4 year later.

S-This shows us that flooding works very quickly and is effective long term which are both strengths of the treatment.

SS-However it also shows that it is not effective for everybody as 35% of patients in the study weren’t cured so therefore a limitation of the therapy is that it doesn’t work for everybody. Slide32

Examples of P.E.S

P-A strength of flooding is that it works quickly.

E- This is because evidence shows you can be cured in one single session and is effective at treating phobias.

S- So this means it is the most

appropriate for

people

whose daily life

is

really

effected by their phobia as it is not a time consuming treatment. It also is more cost-effective that other methods such as CBT or SD which can take many sessions. SS- However it is not appropriate for children and those who have very high levels of anxiety linked to their phobia as this can cause ethical issues, anxiety, and distress. Slide33

Over to you

Pick one of the evaluation points on effectiveness/appropriate from the sheet you were given and write out your own PES paragraph evaluating the behaviourist approach to treating phobias.Slide34

Over to you

Pick one of the evaluation points on effectiveness/appropriate from around the room and use the burger sheets to write out your own PES paragraph evaluating the behaviourist approach to treating phobias.Slide35

Thomas does not want to go to a friend’s birthday party as his friend is having an outdoor circus party and there will be a clown there. Thomas is really afraid of clowns.

His mother and father are discussing how they can help him overcome his phobia so he can go to this party and potentially other parties too.

His dad says ‘I think I will take him to the party and sit with him in the car outside until he calms down. Then we could go and sit in the living room of the house and watch the clown do his tricks with the other children through the window. Maybe then he might be able to go outside and join the party’.

His mum replies ‘I really think the only way he will overcome this fear is for us to just make him go to the party and meet the clown’

Discuss two

behavioural

treatments for phobias. Refer to the conversation above in your answer. [16 marks]Slide36

Mark scheme

Discuss

Use of evidence to support/challenge effectiveness

Ethical

issues (in flooding especially)

Issue

of

generalisation

outside of the clinical setting

Reasoned discussion of time, cost implications More likely to be effective for specific phobias Theoretical underpinnings – classical conditioning; principle of extinction Comparison between the two treatments

Comparison with alternatives eg drugs, psychodynamic therapy, etc. Can’t do this one yet! Slide37

Peer assess

With a different coloured pen:

1.

Underline any comments that relate to

the conversation in the question.

2. Underline any grounded research evidence used to support/challenge the treatment.

3.

Circle

any

key terms comparing treatments for phobias.4. Annotate the whole answer to identify P (point), E (evidence), S (so what – expansion and link).Slide38

Plenary

Design an experiment to compare the effectiveness of flooding and SD.

Include:

IV and DV

Operationalise the variables

Experimental design

Potential extraneous variables (which ones do you think could be confounding variables?)