Systematic desensitisation (SD)

• Based on classical conditioning, counterconditioning and reciprocal inhibition 


  The therapy aims to gradually reduce anxiety through counterconditioning:

  • Phobia is learned so that phobic stimulus (CS) produces fear (CR)
  • CS is paired with relaxation and this becomes the new CR

  Reciprocal inhibition - not possible to be afraid and relaxed at the same time, so one emotion prevents the other.
• Formation of an anxiety hierarchy

  Client and therapist design and anxiety hierarchy - fearful stimuli arranged in order from least to most frightening. 

  A person with arachnophobia might identify seeing a picture of a small spider as low on the hierarchy and holding a tarantula as the final item.
• Relaxation practised at each level of the hierarchy 


  Person with phobia is first taught relaxation techniques such as deep breathing and/or medication. 

  Person then works through the anxiety hierarchy. At each level the person is exposed to the phobic stimulus in a relaxed state. 

  This takes place over several sessions starting at the bottom of the hierarchy. Treatment is successful when the person can stay relaxed in high-anxiety situations.