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Treatment of PHOBIAS

Treatment of PHOBIAS. Bahire Akartürk 1664200. Outline. Definition of Specific Phobias Aetiology of Specific Phobias Treatment of Specific Phobias Systematic Desensitization . Definition of Specific Phobias.

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Treatment of PHOBIAS

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  1. Treatment of PHOBIAS Bahire Akartürk 1664200

  2. Outline • Definition of Specific Phobias • Aetiology of Specific Phobias • Treatment of Specific Phobias • Systematic Desensitization

  3. Definition of Specific Phobias • An excessive, unreasonable, persistent fear triggered by a specific object or situation • Phobic individual will usually develop a set of avoidance responses • Fear is driven by a set of dysfunctional phobic beliefs that the sufferer has developed

  4. DSM-IV-TR Criteria for Specific Phobia

  5. DSM-IV-TR Criteria for Specific Phobia • (1) Animal Type: animals such as dogs, cats, spiders, bugs, mice, rats, birds, fish, and snakes. • (2) Natural Environment Type: fears of heights, storms, and being near water. • (3) Blood-Injection-Injury Type: seeing blood, receiving a blood test or injection, watching medical procedures on television, and for some individuals, even just talking about medical procedures. • (4) Situational Type: situations such as driving, flying, elevators, and enclosed places. • (5) Other Type: These include other specific fears, including fears of choking or vomiting after eating certain foods, fears of balloons breaking or other loud sounds, or fears of clowns

  6. AETIOLOGY OF SPECIFIC PHOBIAS • Psychoanalytic accounts • Classical conditioning & phobias • Evolutionary accounts of phobias • Multiple pathways to phobias

  7. Psychoanalytic Explanations • Phobias are the product of unresolved conflicts between the id and the superego. • Psychoanalysts generally believe that the conflict originated in childhood, and was either repressed or displaced onto the feared object. • The object of the phobia is not the original source of the anxiety.

  8. Classical Conditioning & Phobias – The ‘Little Albert’ Experiment • Albert was an 11-month- old child. • Researchers attempted to condition him to fear to white rat • Paired rat (CS) and with a loud noise (UCS) • After several pairing of rat with noise, Little Albert become to fear when he encounter to white rat without loud noise.. • CC explains the acquisition of some phobias where the pobic event or object has been associated with with a traumatic experience.

  9. Evolutionary Accounts of Phobias Non-Associative Fear Acquisition • Argues that fear of a set of biologically relevant stimuli develops naturally after early encounters in childhood • Following repeated exposure to these stimuli, fear would normally habituate • Explains why most children go through developmental stages where they fear a range of stimuli • Adult phobias are instances where these childhood phobias have failed to habituate

  10. Evolutionary Accounts of Phobias Biological Preparedness: • Evolutionary selection pressures have developedbiological predispositions in us • These predispositions enable us to learn to quickly fear certain stimuli that were dangerous to our ancestors (e.g. heights, snakes, water, etc.)

  11. Multiple Pathways to Phobias • Different types of phobias may be acquired in quite different ways. • Processes involved may include: • Classical Conditioning • The Disgust Emotion • Misinterpretation of Bodily Sensations & Panic

  12. Classical Conditioning • There is evidence that the following phobias are caused by traumatic classical conditioning: • Dog Phobia (Doogan & Thomas, 1992) • Dental Phobia (Davey, 1988) • Accident Phobia (Kuch, 1997) • NOT height, water and most animal phobias such as snake

  13. Disgust Emotion and Phobias • High levels of disgust have been associated with: • Small Animal Phobias (Ware, Jain, Burgess & Davey, 1994) • Spider Phobia (Mulkens, de Jong & Merckelbach, 1996)

  14. Catastrophic Misinterpretation of Bodily Sensations • Factors associated with panic and panic disorder may be associated with some situational phobias: • Height Phobia • Claustrophobia • Water Phobia • Some Forms of Flying Phobia

  15. The Treatment of Phobias • Successful treatments include: • Exposure therapies, including: • Flooding • Counter-conditioning • Systematic desensitization

  16. The Treatment of Phobias Flooding: • A treatment in which the client learns to tolerate the feared object or situation through exposure to a high level of that stimulus. • A patient is confronted by the fear object for an extended length of time without the opportunity to escape. • The goal of this method is to help the individual face their fear and realize that the fear object will not harm them.

  17. The Treatment of Phobias • Counter- Conditioning: • Therapist teach client a new response to the fear object ratherthan panic in case of facing the feared object or situation. • The client learns relaxation techniques to replace anxiety and fear. • This new behavior is incompatible with the previous panicked response, so the phobic response gradually fades. • Counter-conditioning is often used with patients who are unable to handle exposure treatments.

  18. Systematic Desensitisation Treatment • Systematic desensitization is a type of behavioral therapy bases the principle of classical conditioning. • This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning.

  19. Stages of Systematic Desensitisation Step 1.  Anxiety Hierarchy: The therapist helps client to construct a ranked list of events that cause increasing fear or anxiety. Step 2.  Relaxation Training:The client is trained in the use of relaxation techniques. Therapy proceeds as the individual is exposed to anxiety-provoking situation at the bottom of the hiearchy and learns to relax in that situation. Step 3.  Desensitization Sessions: Once the client feels quiet relax with this, then therapy moves on to relaxation in the presence of the next highest ranked situation on the fear hierarchy

  20. Step 1:The Anxiety Hierarchy •  The most disturbing item is placed at the bottom of the list and the least disturbing at the top.   • The hierarchy provides a framework for desensitization, through relaxation, of progressively more anxiety-producing situations. 

  21. Examples of Fear Hierarchy Target Behavior: The fear I want to work is: fear of spider Phobia • Talking about them • Imaginemyself holding a picture of a spider. • Seeing a picture of a fake spider that I am holding. • Holding a picture with a real spider on it. • Seeing someone else holding a non-poisonous spider who is • comfortable doing so from 5 feet away. • Seeing someone else holding a non-poisonous spider who is • comfortable doing so from 1 foot away • Touching a non-poisonous spider with my finger

  22. Step 2: Relaxation • Clients are desensitized to the anxiety-evoking items on their hierarchy by stopping the anxiety with relaxation.  • In order to do this, they first learn to relax completely, and also learn how to achieve this relaxation at will.

  23. Deep Muscle Relaxation • The technique which behavior therapists use to relax patients is known as deep muscle relaxation.    1.This technique will help the client to achieve a very deep and thorough state of relaxation 2.Help clients to quickly rediscover the distinctions between relaxation and tension of various muscle  3. To enable client to progress through the desensitization of their hierarchy.

  24. Step 3.The Desensitization Sessions • The goal of this process is the individual to learn how to cope with, and overcome the fear in each step of the hierarchy. • The process of  imagine the situation described by an item imagining it in vivid and realistic detail while trying to maintain a state of complete relaxation.   • The item is repeatedly imagined until the client is able to imagine it with feelings of complete relaxation and comfort • When the client is able to imagine a given item with complete relaxation, then move on to the next item and repeat the process 

  25. Step 3.The Desensitization Sessions • The therapist and client then meet up again, and the therapy begins with the therapist asking the client to imagine (or visualise) the least feared situation involving the phobic stimulus, while at the same time relaxing. • The client is asked to rate how much anxiety s/he is experiencing. • When the client says that s/he is experiencing no anxiety, the therapist goes to the next most feared situation and the process is repeated (i.e. the process is systematic). • The therapy is complete when the client can imagine the most feared situation without experiencing any anxiety (i.e. the client is desensitised). At the point, the client is considered to be cured.

  26. As a Conclusion, • Definition of Specific Phobias • Aetiology of Specific Phobias -Psychoanalytic accounts -Classical conditioning & phobias -Evolutionary accounts of phobias -Multiple pathways to phobias • Treatment of Specific Phobias - Flooding - Counter -conditioning • Systematic Desensitization - Fear/ Anxiety Hierachy - Relaxation - Desensitization

  27. References • American Psychiatric Association. (2000) Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition Text Revision) Washington, DC: American Psychiatric Association. • Davey, G., (2011). Psychopathology: Research, Assesment and Treatment in Clinical Psychology. United Kingdom, UK, Blackwell Publishing. • Davey, G.C.L. (1988).Dental Phobias and anxieties. Evidence for Conditioning processes in the acquisition and momadalitation of a learned fear .Behavior research and therapy , 27, 51-58. • Doogan, S., & Thomas, G. V. (1992). Origins of fear of dogs in adults and children—therole of conditioning processes and prior familiarity with dogs. Behaviour Researchand Therapy, 30(4), 387–394 • Kuck, K.(1997). Accident Phobia. In G.C.L. Davey (Ed). Phobias: Ahandbook of theory, research and treatment. • Mulkens, S.N.D., de Jung, P. J.& Merckelbach, H. (1996). Disgust and Spider Phobia. Journal of Abn ormal Psychology,105, 464-468.. • Poulton, R., & Menzies, R. G. (2002). Non-associative fear acquisition: a review of theevidence. from retrospective and longitudinal research. Behaviour Research andTherapy, 40, 127–149. • Rachman, S. Systematic Desensitization. Psychological Bulletin 67:2, 93-103 • Seligman, M. E. (1971). Phobias and preparedness. Behavior Therapy, 2(3), 307–320 • Ware, J. Jain, Burgess K. & Davey,.I(1994). Factor analysis of common animal fear. Support for diseaese avoidance model. Behaviour Researchand Therapy, 32, 57-63.

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