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 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 6 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 Participants Independent design with patients being randomly assigned to either applied relaxation or CBT. 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.

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.

8 Procedure 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. 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.

9 FindingsApplied 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. ConclusionBoth 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.

Evaluation group task. Use the issues and debates page in your booklet to prompt you. We will then share as a class.

Evaluation StrengthsWeaknesses

Evaluation of the explanations 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

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