Systematic desensitisation

• counterconditioning


  learning relaxation techniques

  aim is to require a new stimulus-response,removes the feared response to relaxation

  new association that runs counter to original association

  Wolpe-'reciprocal inhibition',relaxation inhibits anxiety
• Desensitisation hierarchy 


  series of gradual steps determined at beginning of therapy.

  Step1-patient is taught to relax their muscles

  Step2-patient and therapist construct hierarchy-series of imaged scenes,each causing more anxiety than the last.

  Step3-gradually works way through hierarchy,visualising each anxiety-evoking event while engaging in relaxation response

  Step4-once mastered a step they can move onto the next

  Step5-eventually masters the feared situation that caused them to seek help
• Different forms of SD


  in vivo(early days)- learning to relax in the presence of the objects

  in vitro(now)-imagine the presence of a feared object

  Menzies and Clarke-in vivo tech are more successful

  Comer-often all techniques are used also with modelling-client watches someone else who is coping well with the feared stimulus

  Humphrey-Self-administered,successful for social phobias
• Effectiveness-Research support


  successful when the problem is a learned one,specific phobias

  Capafons et al-clients with a fear of flying showed less physiological signs of fear whilst in a flight simulator after 12-25 weeks of treatment using both in vivo and in vitro tech
• Effectiveness-Not appropriate for all phobias


  not effective for generalised fears or ancient fears.

  Seligman-animals are genetically programmed to rapidly learn an association between fear and life threatening stimuli(ancient fears)-those dangerous in the past.

  It was adaptive to rapidly avoid such stimuli
• Effectiveness-Research support for biological preparedness


  explains why people are less likely to develop fears of modern day objects eg-toasters,they were not a danger in our evolutionary past.

  Bregman-failed to condition a fear response,in infants 8-16 months by pairing a loud bell with wooden blocks-not an ancient fear
• Effectiveness-Symptom substitution 


  if you remove the symptoms the cause still remains and symptoms can resurface in another form.

  Freud-little Hans,had a phobia of horses.The fear was actually of his father but he projected it onto horses.His phobia was cured once he accepted his feelings about his father.If only his fear of horses was treated then his fear of his father would have remained and may have re surfaced to something else.
• Ethical issues-Anxiety controlled


  SD is considered more ethical than other therapies

  Doesnt involve flooding techniques,which rapidly expose the client to the phobia.

  In SD,each step is conducted slowly and the pace is directed by the client

  This helps the therapist know when the client is fully relaxed,the client doesnt have to worry about anxiety,only move up DH when ready
• Ethical issues-Able to provide valid consent 


  Clients are able to provide valid consent.

  The therapy treats phobias not mental health problems,the client is healthy and in touch with reality.

  Client attend to therapy at their own free will so can withdraw at any point.

  Still an element of stress,client is exposed to a phobia they have had for a long time,so avoiding anxiety is impossible