Systematic Desensitization

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  • Created by: Yurisa1
  • Created on: 27-01-17 10:47

Systematic Desensitization- Counterconditioning

Joseph Wolpe developed a technique in the 1950s where phobics were gradually introduced to a feared stimulus – systematic desensitisation. 

The process begins with learning relaxation techniques, to acquire a new stimulus—response link, moving from responding to a stimulus with fear, to responding to the feared stimulus with relaxation. This is called counterconditioning, because the client is taught a new association that runs counter to the original association.Wolpe based this on his idea of 'reciprocal inhibition’ - that we cannot easily experience two contrasting states of emotion at the same time. It is called reciprocal inhibition because the relaxation inhibits the anxiety.

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Systematic Desensitisation - Desensitisation hiera

A series of gradual steps that are determined at the beginning of therapy when the client and therapist work out a hierarchy of feared stimuli from least fearful to most fearful.

The problem: Patient is terrified whenever she sees a spider.

The Result: After SD, the patient has overcome her fear of spiders and feels relaxed in their presence.     

Step 1: Patient is taught how to relax their muscles completely.

Step 2: Therapist and patient together construct a desensitisation hierarchy a series of imagined scenes each one causing a little more anxiety than the previous one.

Step 3: Patient gradually works his/her way through desensitisation hierarchy.

Step 4: Once the patient has mastered one step in the heirarchy (i.e. they can remain relaxed while imagining it), they are ready to move onto the next.

Step 5: Patient eventually masters the feared situation that caused them to seek help in the first place.

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Systematic Desensitisation - Different forms of SD

In the early days of SD, clients would learn to confront their feared situations directly by learning to relax in the presence of objects or images that would normally arouse anxiety. 

Research has found that actual contact with the feared stimulus is most successful, so in vivo techniques are more successful than covert ones (Menzies and Clarke, 1993). 

Often a number of different exposure techniques are involved - in vivo, in vitro (covert) and also modelling, where the client watches someone else who is coping well with the feared stimulus (Comer, 2002).

An alternative is self-administered SD, where someone gradually exposes themselves more and more to a feared stimulus without the intervention of a Psychologist. Humphrey (1973) reports that this proved effective with for example, social phobia.

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Systematic Desensitization- Evaluation

1) Research support: A strength of systematic desensitisation is that generally SD has been proven to be successful when the problem is a learned one, for specific phobias. For example, Capafons et al. (1998) found that clients with a fear of flying showed less physiological signs of fear and reported lower fear levels , where both in vitro and in vivo techniques were used. 

2) Not appropriate for all phobias Some research suggests that SD is not effective for more generalised fears. A weakness of SD is that the therapy may not be suitable for ‘ancient fears’. This is the concept of biological preparedness – that we are biologically predetermined to fear certain stimuli. Biological preparedness would explain why people are much less likely to develop fears of modern objects such as toasters and cars that are much more of a threat than spiders. Such items were not a danger in our evolutionary past. 

3) Symptom substitution: Behavioural therapies may not work with certain phobias because the symptoms are only the tip of the iceberg. If you remove the symptoms the cause still remains, and the symptoms will simply resurface, possibly in another form.Therefore, behavioural therapies may appear to resolve a problem but simply eliminating or suppressing symptoms can result in other symptoms appearing. 

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Systematic Desensitization- Ethical Issue

 Anxiety is controlled: Generally SD is considered to be more ethical than other forms of behavioural therapies, such as ‘flooding’ techniques, which involve rapidly exposing the client to their most feared phobia. Therefore the therapist is able to gauge whether the client is fully relaxed at each stage of the therapy. The therapist must only attempt to move up the hierarchy when the client is completely comfortable — therefore, anxiety should not be an issue.

 Able to provide valid consent: SD is used mainly with phobias, and not with problems such as depression and schizophrenia. This means that clients are 'in touch’ with reality and in ‘healthy’ enough frame of mind to understand the aims of the therapy and what the therapy will entail. This means they are able to provide valid consent to the therapy.

Causes Some Anxiety: However, some would argue that there is still an element of stress involved as the client is exposed in one way or another to an object/situation that they may have spent many years, or decades, feeling anxious about, and therefore avoiding mild levels of anxiety is impossible.

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