Abnormal Psychology

Foundations of Treatment 123

Habituation

The process by which the emotional response

to a stimulus that elicits fear or anxiety

is reduced by exposing the patient to the

stimulus repeatedly.

Exposure

The behavioral technique that involves

repeated contact with a feared or arousing

stimulus in a controlled setting.

lead him to feel anxious. The consequences of his avoidant behavior include relief

from the anticipatory anxiety.

The therapist assigns homework, important tasks that the patient completes

between therapy sessions. Homework for Leon, for instance, might consist of his

making eye contact with a coworker during the week, or even striking up a brief

conversation about the weather. To prepare for this task, Leon might spend part

of a therapy session practicing making eye contact or making small talk with his

therapist. The success of behavior therapy is measured in terms of the change in

frequency and intensity of the maladaptive behavior and the increase in adaptive

behaviors.

The Role of Classical Conditioning in Behavior Therapy

As we saw with Little Albert in Chapter 2, classical conditioning can give rise to

fears and phobias and, more generally, conditioned emotional responses. To treat

the conditioned emotional responses that are associated with a variety of symptoms

and disorders and to create new, more adaptive learning, behavioral therapists may

employ classical conditioning principles.

Treating Anxiety and Avoidance A common treatment for anxiety disorders, partic-

ularly phobias, is based on the principle of habituation: The emotional response

to a stimulus that elicits fear or anxiety is reduced by exposing the patient to

the stimulus repeatedly. The technique of exposure involves such repeated contact

with the (feared or arousing) stimulus in a controlled setting, and usually in a

gradual way. The patient fi rst creates a hierarchy of feared events, arranging them

from least to most feared (see Table 4.3), and then begins the exposure process by

having contact with the least-feared item on the hierarchy. With sustained expo-

sure, the symptoms diminish within 20–30 minutes or less; that is, habituation to

the fear- or anxiety-inducing stimuli occurs. Over multiple sessions, this process is

repeated with items higher in the hierarchy until all items no longer elicit signifi -

cant symptoms.

Exposure—and therefore habituation—to fear- or anxiety-related stimuli does

not normally occur outside of therapy because people avoid the object or situation,

If Leon constructed a hierarchy of his fears and avoidance of social situations, it might look

something like this completed form. The “Fear” column contains the rating (from 0 to 100, with

100 = very intense fear) that indicates how the patient would feel if he or she were in the given

situation. The “Avoidance” column contains the rating (from 0 to 100, with 100 = always avoids

the situation) that indicates the degree to which the person avoids the situation. Although

Leon avoids almost all the situations on the completed form, some situations arouse more

fear than others.

Situation Fear Avoidance

Give a 1-hour formal lecture to 30 coworkers 100 100

Go out on a date 98 100

Ask a colleague to go out on a date 97 100

Attend a retirement party for a coworker who is retiring 85 100

Have a conversation with the person sitting next to me on the bus 70 100

Ask someone for directions or the time 60 99

Walk around at a crowded mall 50 98

Answer the telephone without checking caller ID 30 85

Source: Adapted from Antony & Swinson, 2000, p. 171.

Table 4.3 • Sample Hierarchy of Fear and Avoidance for Social Situations