exposure therapy & aversive therapy lecture 18. exposure therapies n for fear/anxiety &...
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Exposure Therapy &
Aversive Therapy
Lecture 18
Exposure Therapies
For fear/anxiety & other negative CERs Intense, maladaptive, or
inappropriate Some strong fears adaptive
Based on Extinction Fear-provoking events (CS+) Safe environment (no US) ~
Exposure Therapies Models
Brief/graduated exposure therapy Short exposure periods Gadually increase intensity of CS
Prolonged/intense Lengthy exposure periods Immediate exposure to intense CS
Mode of exposure on continuum Imaginal ---------------------- in vivo ~
Exposure Therapies:Techniques
Direction of therapy Therapist directed Self-managed
Additional procedures Competing responses Response prevention Exaggerated scenes ~
Systematic Desensitization
Brief/Graduated Exposure Therapy Fear & relaxation incompatible Developed by Wolpe
3 components Relaxation Training Fear Hierarchy Graded Pairing ~
Systematic Desensitization Relaxation Training
Identify & tense muscle groups Relaxing the muscle groups
Fear Hierarchy List of fear-provoking situations Rank from least to most intense
Graded Pairing CS for fear with muscle relaxation Thru hierarchy: lowest highest In vivo vs. Covert desensitization ~
Systematic Desensitization: Other competing responses
Emotive imagery Pleasant thoughts replace fear
Humor/laughter No learning required Coping with disease ~
Systematic Desensitization: Other Target Behaviors
Anger Asthmatic attacks Insomnia Motion sickness Nightmares Problem drinking
Sleepwalking Speech disorders Body image
disturbances Racial Prejudice
Systematic Desensitization: Theoretical Explanations
Counterconditioning Substitution of competing response
Reciprocal inhibition Neurophysiological processes Parasympathetic vs Sympathetic
Extinction Cues present but no danger (US)
Cognitive factors ~
Flooding Prolonged/Intense Exposure Therapy
Also called implosive therapy In vivo or imaginal
Treatment for Phobias Obsessive-compulsive disorder Post-traumatic stress disorder Agoraphobia ~
Flooding
Aversive CS escape/avoidance Limits opportunity for extinction
Confront individual w/ fear-provoking situations/ images No relaxation Not graded Extinction process
Potential for intensifying fear ~
Modeling
Vicarious learning Observing therapists encounter
with fear-provoking stimuli e.g., Peter watching other child
handle rabbit Extinction of fear response
Observe absence of danger ~
Modeling
Participant modeling Or Guided participation
Construct fear hierarchy Start with least feared stimulus Therapist experiences first Then client ~
Aversive Therapy Punishment of target behaviors
Instrumental conditioning Raversive stimulus E.g., chronic vomiting shock
Problems Avoidance of therapy (drop out) Disruptive CERs punishment of others Ethics concerns ~
“More Acceptable” Punishers
Snap rubber band on wrist
Cigarette smoke Bitter substance Water mist sprayed
in face Loud noise Mild mouthwash
Trichotillomania (Pulling out hair)
Compulsive eating Nail biting Face slapping
Bruxism Biting other children
Target Behavior Punisher
Aversive Therapy: Covert Sensitization
Classical & instrumental conditioning Use of imaging
Therapist describes behavior & aversive outcome
Advantages Safe & more acceptable to clients Clients can self-administer in vivo
Effectiveness equivocal ~
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