1. Old Travel & Tourism building. (LC160/162)
Mock re-sit
Old Travel & Tourism building. (LC160/162)

2. What we need to know Behavioural explanation for phobias
Behavioural treatments for Phobias
Biological explanations for OCD
Biological treatments for OCD
Cognitive explanations for Depression
Cognitive treatments for Depression

3. Starter: create a question for the word
Classical conditioning Supporting evidence (Watson and Raynor) Operant conditioning Application Nurture reductionism Individual differences

4. Activity: evaluation point
Each choose an evaluation point to elaborate on
One strength of the behaviourist explanation of phobias comes from research evidence…
One strength of the behaviourist explanation is its application to therapy….
One criticism of the behaviourist explanation is that it is reductionist and overly simplistic…

5. Overview: evaluation points
One strength of the behaviourist explanation of phobias comes from research evidence…Watson & Raynor (1920) demonstrated the process of classical conditioning in the formation of phobias in Little Albert, who was conditioned to fear white rats. This supports the idea that classical conditioning is involved in acquiring phobias.
One strength of the behaviourist explanation is its application to therapy. The behaviourist ideas have been used to develop effective treatments, including systematic desensitisation and flooding. Systematic desensitisation helps people to unlearn their fears, using the principles of classical conditioning, while flooding prevents people from avoiding their phobias and stops the negative reinforcement from taking place. Consequently, these therapies have been successfully used to treat people with phobias, providing further support to the behaviourist explanation.

6. Overview: evaluation points
Point: One criticism of the behaviourist explanation is that it is reductionist and overly simplistic. Explain: The behaviourist approach ignores the role of cognition (thinking) in the formation of phobias and cognitive psychologists suggest that phobias may develop as a result of irrational thinking, not just learning. For example, sufferers of claustrophobia (a fear of confined space) may think: ‘I am going to be trapped in this lift and suffocate’, which is an irrational thought and not taken into consideration in the behaviourist explanation. Counter-argument: Furthermore, the cognition approach has also led to the development of cognitive behavioural therapy (CBT), a treatment which is said to be more successful than the behaviourist treatments.

7. Use the frame for guidance
Plan an answer to…
Describe and Evaluate The Behavioural Approach to Explaining Phobias (16 marks)
Use the frame for guidance

8. Modal answer

9. Behavioural treatments and phobias
Systematic Desensitisation
Flooding

10. There are two behaviourist therapies used to treat phobias… systematic desensitisation and flooding. Both therapies use the principles of classical conditioning to replace a person’s phobia with a new response – relaxation.

11. Systematic desensitisation
Systematic desensitisation uses reverse counter-conditioning to unlearn the maladaptive response to a situation or object, by eliciting another response (relaxation).
There are three critical components to systematic desensitisation:
Fear hierarchy
Relaxation training
Reciprocal inhibition
Firstly, the client and therapist work together to develop a fear hierarchy, where they rank the phobic situation from least to most terrifying.
For example:

12. Systematic desensitisation
Thereafter, an individual is taught relaxation techniques, for example breathing techniques, muscle relaxation strategies, or mental imagery techniques.
The final component of systematic desensitisation involves exposing the patient to their phobic situation, while relaxed.
According to systematic desensitisation, two emotional states cannot exist at the same time, a theory known as reciprocal inhibition.
A person is unable to be anxious and relaxed at the same time and the relaxation should overtake the fear.
The patient starts at the bottom of the fear hierarchy and when the patient can remain relaxed in the presence of the stimulus, they gradually progress onto the next level. The patient gradually moves their way up the hierarchy until they are completely relaxed in the most feared situation; at this point systematic desensitisation is successful.

13. Use the following terms to outline Systematic Desensitisation
Classical Conditioning
Reciprocal Inhibition
Counter- conditioning
Exposed
Anxiety reduction
Hierarchy

14. Starter

15. Flooding
Watch these video clips of flooding (a behavioural treatment for phobias) and answer the questions below:
How do you think the therapy works?
Can you link this to the processes of classical/operant conditioning?
What advantages can you see with using this therapy?
What disadvantages can you see with using this therapy?

16. Flooding Extreme behavioural therapy is flooding.
Rather than exposing a person to their phobic stimulus gradually, a person is exposed to the most frightening situation immediately.
For example, a person with a phobia of dogs would be placed in a room with a dog and asked to stroke the dog straight away.
With flooding, a person is unable to avoid (negatively reinforce) their phobia and through continuous exposure, anxiety levels decrease.
Flooding can take one of two forms:
in vivo (actual exposure)
in vitro (imaginary exposure)
A patient is taught relaxation techniques and these techniques are then applied to the most feared situation either through direct exposure, or imagined exposure.

17. How to evaluate treatments
Effectiveness
-look at research studies that show us how successful the treatment has been
Appropriateness
how long does it take? (timescale)
Side effects?
Suitable for all sufferers?
Comparison with other treatments

18. Individually…
Find at least 2 pieces of research evidence using your packs and Books
Systematic Desensitisation
Flooding
Do these studies evidence effectiveness or appropriateness?

19. Evaluation of systematic desensitisation
One strength of systematic desensitisation comes from research evidence which demonstrates the effectiveness of this treatment for phobias.
McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation, when using in vivo techniques (see below). This shows that systematic desensitisation is effective in treating phobias.
Gilroy et al. (2002) examined 42 patients with arachnophobia (fear of spiders). Each patient was treated using three 45-minute systematic desensitisation sessions. When examine three months and 33 months later, the systematic desensitisation group were less fearful than a control group (who were only taught relaxation techniques). This provides further support for systematic desensitisation, as a long-term treatment for phobias.

20. Evaluation of systematic desensitisation
However, systematic desensitisation is not effect in treating all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning) for example, a fear of heights, are not effectively treated using systematic desensitisation. Some psychologists believe that certain phobias, like heights, have an evolutionary survival benefit and are not the result of personal experience, but the result of evolution. These phobias highlight a limitation of systematic desensitisation which is ineffective in treating evolutionary phobias.

21. Evaluation of flooding
One strength of flooding is it provides a cost effective treatment for phobias. Research has suggested that flooding is comparable to other treatments, including systematic desensitisation and cognition therapies (Ougrin, 2011), however it is significantly quickly. This is a strength because patients are treated quicker and it is more cost effective for health service providers. Although flooding is considered a cost effective solution, it is highly traumatic for patients and causes a high level of anxiety. Although patients provide informed consent, many do not complete their treatment because the experience is too stressful and therefore flooding is sometimes a waste of time and money, if patients do not finish their therapy. Finally, although flooding is highly effective for simple (specific) phobias, the treatment is less effective for other types of phobia, including social phobia and agoraphobia. Some psychologists suggest that social phobias are caused by irrational thinking and are not caused by an unpleasant experiences (or learning through classical conditioning). Therefore, more complex phobias cannot be treated by behaviourist treatments and may be more responsive to other forms of treatment, for example cognitive behavioural therapy (CBT), which treats the irrational thinking.

22. Examples of evaluating treatments
Beginner level evaluation: One strength is that research has found SD is successful at treating a range of phobic disorders.

23. Intermediate level 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

24. Higher level 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.

25. Group task
Research the following in your small groups 1.Support for effectiveness of SD 2. Support for effectiveness of Flooding 3. Challenge for the effectiveness of SD 4. Challenge for the effectiveness of Flooding 5. Support for appropriateness of SD 6. Support for appropriateness of Flooding 7. Challenge for appropriateness of SD 8. Challenge for appropriateness of Flooding

26. Debate Group one- Systematic Desensitisation Group two - Flooding
You have 10 mins to consolidate your argument and organise the group
We will then debate the best type of treatment for a specific case study

27. You will be marked on: Gain marks: Loose marks Application
Elaborated evaluation point
Use of research
Loose marks
Shouting out
Interrupting

28. Debate
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]

29. 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!

30. Essay Plan Complete based on this weeks sessions
For Thursday- Read from the pack the explanation for OCD
For Monday- Finish the Plan