You are a licensed therapist seeing a client who has ataxophobia. a fear of disorder or messiness. Identify the different behavioral techniques you could use to treat this person, and explain how each technique would be applied to treat the phobia. Identify which technique you think is the best and defend your choice.

Question

What will be an ideal response?

Answer 1

Exposure therapies, including flooding and systematic desensitization, are typically used to treat anxiety disorders, especially phobias and PTSD. Exposure therapies involve a client coming into direct confrontation with the feared object. Flooding involves the person confronting the feared object or situation. A person with ataxophobia would be placed in an extremely messy environment that would initially produce high levels of fear, but eventually, as nothing bad happened, the fear would start to fade; the person would stay in the messy room until the anxiety subsided and they found they could be in the situation without negative consequences. Systematic desensitization is also called graduated exposure therapy, because the feared object/situation is addressed through small, graduated steps. Systematic desensitization involves three stages: (1) Relaxation training, where clients learn to relax their bodies (2) developing an anxiety hierarchy, which is a list of everything that scares them about a particular object or situation, ranked from least to most scary (for ataxophobia, the lower levels of the hierarchy would include images of messy/disorganized rooms, then an actual room with some small messes, and at the highest level of the hierarchy, a room in complete disarray); and (3) gradual exposure, where clients are exposed to the lowest item in the hierarchy, either through visualization, virtual reality, or actual physical contact with the feared object. Clients then use the relaxation techniques to keep their bodies calm. When the client can face that step without anxiety, they are ready to move on to the next step in the hierarchy, until eventually they are able to face, in the case of ataxophobia, a room in complete disarray while remaining calm.
Aversion therapies are based on the principles of classical conditioning, where unwanted behaviors are paired with aversive or uncomfortable conditions, so the person will associate the old behavior with something bad and eventually stop the unwanted behavior. Aversive stimuli can include things like nausea, offensive smells, startling sounds, electric shocks, unpleasant thoughts, or anything else that makes a person feel uncomfortable. Aversion therapies are used most commonly to treat sexual deviance and substance abuse, disorders that are extremely resistant to treatment. This type of therapy would not be appropriate with ataxophobia, because the person is already experiencing an aversive state when exposed to a messy, disorganized situation.
Operant therapies are based on the principles of operant conditioning, proposing that behavior can be changed through the use of reinforcement and punishment, known as contingency management programs because rewards and punishments are "contingent" on the client's behavior. One contingency management program is a token economy. In a token economy, good behavior receives a toke that can later be exchanged for a reward. A person with ataxophobia would receive a token when they face their fear and spend time in a messy room. A behavior contract would be created to reward desired behavior, calmly staying in a messy room. A behavior contract, outlining roles, responsibilities, rules, behaviors, and consequences, would be written. If a parent is suffering from ataxophobia, the contract would involve their not yelling at family members, and instead receiving a token for responding appropriately (e.g., asking the person to pick up their items in a calm, reasonable voice). Once the parent earns a specified number of tokens, they would receive a reward identified in the behavior contract.
Answers will vary about which approach is best to deal with a phobia, but they should include a clear justification for why the approach was chosen to deal with ataxophobia.