Systematic Desesitisation - Behaviorist Approach 🧥

What concept is systematic desensitisation based on?

Counter-conditioning

Aims of SD

To unlearn a phobia through counter-conditioning, to associate phobic stimuli with relaxation, leading to extinction of fear response

What is reciprocal inhibition?

two opposing emotions cannot be felt at the same time. A state incompatible with anxiety/fear (e.g. relaxation) is evoked at the same time as an anxiety-provoking stimulus is presented. A new response to the stimulus is learned

What is in-vivo exposure?

Exposure to phobic stimuli in real life (actual exposure to the stimuli)

What is in-vitro exposure?

Client imagines the phobic stimuli

What is step 1 of SD?

Teaching the client a relaxation technique that must be mastered

What types of relaxation techniques may be taught to the client in Step 1?

Imagery, progressive muscle relaxation

How does ‘imagery’ as a relaxation technique work?

Thinking of a calming place or environment that the client may have visited in the past. By closing their eyes and imagining themselves in their ‘happy place’ - they will begin to have the calm feelings associated with it

How does progressive muscle relaxation work as a relaxation technique?

The client works from the bottom of their body (feet) up to the top of their body (head). Taking each body part in turn, the client squeezes the muscles in this area for 5-10 seconds before relaxing and moving on to the next body part. At the end, the physical tensing and relaxing of muscles should bring about a calm response

What is step 2 of SD?

Construction of anxiety hierarchy

What does an anxiety hierarchy involve?

A series of ‘levels’ - of scenes or images that cause anxiety, starting with the least feared scenario to the most feared

Who creates the anxiety hierarchy?

The client and therapist together

What is step 3 of SD?

Gradual exposure - working through anxiety hierarchy

What must the client do at each stage of the anxiety hierarchy?

Employ the relaxation technique learned in step 1 in the presence of the phobic stimuli. The client must demonstrate a calm, relaxed response at one level of the hierarchy before moving to the next

When is SD said to be ‘complete’?

When the client can remain calm at the highest level of the anxiety hierarchy