Wolpe, 1990). It is impossible to feel both anxiety and relaxation at the same time , so easing the client into deep relaxation helps inhibit any feelings of anxiety. What is important is that there is consistency • Successful outcome of systematic desensitization is more likely when skill deficits are not causing the anxiety. within the reports of a single client: a situation assigned a value of 50 today should produce the same amount of discomfort Martin & Pear (1998) note: "When the client finishes the last scene is the hierarchy, he/she can generally encounter the actual their subjective assessments. Sarafino, 1996). Again she is left with the scene for 5 seconds.). Note that Nancy would not have to learn to laugh, which is an advantage of using humor rather than relaxation as the competing response. good progress on it (Sarafino, 1996). feared objects without undue distress. If so, then SUD values can be more confidently used to assess the efficacy There are two behaviourist therapies used to treat phobias, systematic desensitisation and flooding. responses, which helps the therapist monitor the client's progress and ultimately provides an objective measure of the outcome. The competing response need not be relaxation. While some authors now question the role of relaxation as a critical component in the desensitization process, [perhaps from significant others] then helps maintain continued interactions with the stimuli that previously elicited you may have noticed from, For clients for whom multiple hierarchies were constructed, the therapist may work with up to four of them in any given The theme of her hierarchy could be called "fear of speaking in class." Systematic desensitization(a guided reduction in fear, anxiety or aversion ) can then be achieved by gradually approaching the feared stimulu… Desensitization is a part of cognitive therapy treatment, or conditioning, that targets a specific phobia without addressing the causes of that phobia. second theme. complete, and requires that clients practice at home twice a day for 10 to 15 minutes. SUD values are not necessarily consistent between clients: a value of 50 for one client may be indicative of more discomfort than a relevant point that is ignored during a discussion within her study group.". Systematic desensitisation uses reverse counter-conditioning to unlearn the maladaptive response to a situation or object, by eliciting another response (relaxation). Throughout the process, a record is kept of all of the client's from the previous session for which anxiety was not reduced to zero; if anxiety to the last scene was reduced to zero, then the In beginning sessions there may be time for only eight to ten presentations, but later on - Systematic desensitization is a form of behaviour therapy. What is the end result? presentation in his office" could be "Write down questions about presentation to be asked to professor in his Over time clients become increasingly confident in The question feared situation. (. situations related to the problem. meditation, yoga, and electromyographic biofeedback (Wolpe, 1990). Questionnaires may also be employed. situation in Nancy's hierarchy was assigned a SUD value of 30. For example, although Nancy had never than a situation assigned a value of 50 yesterday. Since its first practice in the mid-20th century, systematic desensitization has routinized the treatment and management of many phobias. He might present scenes to her with details that elicit (, Usually, presenting a scene three or four times will suffice to bring the client's anxiety level to zero, but Wolpe (1990) advises that while there is no sacred sequence, the one adopted should remain Items might include: "Being awarded a C+ for what she feels is an excellent essay" and "Making intense, debilitating fear." It is the 20th May, exactly a month before despite their and their therapist's best efforts, cannot achieve deep muscle relaxation. of treatment over time for that client. As soon as a scene is clear in your mind, indicate it by raising therapist presents the scene next highest on the hierarchy (Wolpe, 1990) (Others have Systematic desensitization requires that the client make known to the therapist his or her discomfort level to various Suppose the lowest anxiety-arousing Then, the Systematic desensitization usually starts with imagining yourself in a progression of fearful situations. Success has ", The hierarchy should contain evenly spaced items according to their SUD values, their distance being no more than 5 to 10 SUDs (, The hierarchy is based on relative SUD value assigned to each situation by the client and not on common sense. Here are some key points to keep in mind about anxiety hierarchies: After the client has learned deep muscle relaxation (or another competing responses) and has constructed a hierarchy of Here are some other general guidelines and quantitative considerations concerning the desensitization procedure. Systematic Desensitization vs. Other Therapies. recommended that each new session begin with the last scene fully desensitized in the previous session: being devalued by others." For example, a less fear-provoking situation than "Ask professor questions about serious student in her class is making a funny face at the teacher (cf., Ventis, 1973). psychophysiological parameters of anxiety, such as peripheral vasoconstriction and heart rate. After a pausing 20-30 seconds with renewed relaxation instructions, the scene lowest on the anxiety hierarchy is presented. from Jacobson (1938), consumes about a third of a session, takes about six lessons to Both therapies use the principles of classical conditioning to replace a person’s phobia with a new response – relaxation. her therapist may reveal that not only does she have a "fear of speaking in class," but she also has "fear of Systematic desensitization consists of gradual, imaginal exposure to stimuli organized on a hierarchy constructed using SUDS ratings. THERAPIST: I am now going to ask you to imagine a number of scenes. During therapy sessions the client is Once you can successfully manage your anxiety while imagining fearful events, you can use the technique in real-life situations. In fact, it was not even part of Mrs. C's anxiety hierarchy. The scale ranges from zero to 100. she is ordered to stop visualizing and to focus on relaxing. purposefully neutral and functions to gauge the client's abilities to visualize and relinquish control. Alternative competing responses have included sexual arousal, assertive behaviors, Why was it presented? Around the same time that relaxation training begins, the therapist and client engage in discourse in order to identify (, The interval between scenes is usually between 10 and 30 seconds Secondly the client is taught techniques that produce deep relaxation.
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