Phobia treated by reciprocal inhibition.

A case report of the treatment of a severe lice phobia using systematic desensitization procedures suggested by Wolpe. The training portion of the procedures required 5 sessions, while the therapy sessions proper required 11 sessions. Following treatment, the patient reported almost complete remission of symptoms. A posttherapy MMPI showed a dramatic shift towards normality when compared to a pretherapy MMPI. A 3-mo. follow-up was conducted; the patient reported further improvement with no evidence of any symptom substitution. Trainees were present in the treatment room 60% of the therapy sessions with apparently no adverse effects upon the course of treatment. It is noted that systematic desentization therapy provides an unusual opportunity to teach psychotherapy in a direct and effective manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group systematic desensitization versus covert positive reinforcement in the reduction of test anxiety.

Compared modified versions of systematic desensitization and covert positive reinforcement to a no-treatment control condition in the reduction of test anxiety in 27 undergraduates. Both experimental groups received 8 treatment sessions, and the systematic desensitization group received 2 additional sessions devoted to relaxation training. The 2 treatments were comparable and generally superior to the control group in pretest-posttest and pretest-follow-up changes as measured by the Suinn Test Anxiety Behavior Scale and the Alpert-Haber Achievement Anxiety Test. On an anagrams performance test, the covert reinforcement and control groups were superior to the desensitization group. No significant differences occurred in subjectively experienced anxiety during the performance test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of nonphobic anxiety disorders: A comparison of nondirective, cognitive, and coping desensitization therapy.

The present study compared the efficacy of nondirective therapy, coping desensitization, and cognitive therapy in the treatment of generalized anxiety disorder and panic disorder. All clients received 12 sessions of progressive relaxation training in addition to one of these three treatments. Pretherapy and posttherapy assessments, as well as 6-month and 12-month follow-up measurements, indicated that the group as a whole showed significant and continued improvement on a variety of self-report questionnaire, daily diary, and psychiatric assessor instruments. No differences were found between the three conditions. As was found in a previous investigation, the degree to which clients experienced relaxation-induced anxiety during relaxation training sessions predicted poorer outcome. The outcome results are compared with those of previous investigations of these anxiety disorders, and directions for further research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Active and placebo treatment effects on moderate insomnia under counterdemand and positive demand instructions.

Assigned 48 sleep-disturbed college students to 1 of 4 conditions: relaxation training, single-item desensitization, placebo, and no treatment. Counterdemand instructions were given during the 1st 3 sessions: Ss were told that improvement in sleep disturbance would not occur until after the 4th session. Relaxation and desensitization procedures produced significantly greater reports of improvement in latency of sleep onset than placebo and no treatment during the counterdemand period, while all 3 treated groups reported significantly greater improvement than no treatment after the 4th (positive demand) session. Results support the effectiveness of relaxation therapy in the treatment of moderate insomnia. Demand characteristics may contribute to S reports, but the use of counterdemand instructions allows for valid comparisons among therapy conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of three methods of reducing test anxiety: Systematic desensitization, implosive therapy, and study counseling.

Administered the Alpert-Haber Achievement Anxiety Test to 39 undergraduates. Finger sweat prints were also included as anxiety measures. Ss were assigned to 4 groups: systematic desensitization, implosive therapy, study counseling, and a no-treatment control group. Groups met for 4 1-hr sessions for 2 wks. Results suggest that systematic desensitization is more effective in reducing debilitating anxiety than either implosive therapy or study counseling and that implosive therapy is more effective than study counseling, which was not significantly different than no treatment. No significant differences between treatments were found on the physiological measure of anxiety, GPAs (compared before and after treatment), or facilitating anxiety. Findings support previous studies comparing desensitization and study counseling. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy and desensitization theory using free association in the treatment of inpatients.

Treated 36 male psychiatric inpatients with implosive therapy, a desensitization procedure using free association, or standard hospital milieu treatment. Ratings of achievement of individualized behavioral goals, the MMPI, and the Mooney Problem Check List were administered before and after treatment and at 6 mo. following treatment. Employment and hospitalization status were recorded during the year following treatment. Both individually treated groups showed immediate outcomes superior to controls; the implosive group was superior on more measures and maintained improvement better at 6 mo. As predicted, the implosive group reported more anxiety-related physiological stress (e.g., heart pounding, butterflies in stomach) during therapy sessions than Ss in the desensitization group. Support was not obtained, however, for the hypothesis that the degree of self-reported stress during therapy sessions is related to behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group therapy of phobic disorders by systematic desensitization.

Phobic patients were placed in groups receiving either insight or desensitization (Wolpe, 1958) therapy. In approximately 20 sessions, 13 of 18 Ss treated by Wolpe's method were able to tolerate the fantasy of their phobic situation as well as to live through the experience outside of therapy without experiencing anxiety. Only 2 patients were symptom free in a comparable number of hours of insight-oriented group therapy. The 15 non-symtom-free Ss in the latter group were then placed in densensitization groups: 10 improved in 10 sessions. The implication of the results were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Importance of hierarchy content in the self-control of anxiety.

Used speech anxiety as the target behavior in a study which compared 2 self-control desensitization procedures: one with a hierarchy relevant to speech anxiety and the other with a hierarchy totally unrelated to public speaking situations. A 3rd treatment condition involved the prolonged exposure of the hierarchy relevant to speech anxiety in the absence of relaxation. 42 speech-anxious community residents volunteered to participate in the program and were seen in groups for 7 therapy sessions. Using a variety of different outcome measures, consistent anxiety reduction was found after each of the 2 desensitization treatments. These were equally effective, indicating that the generally accepted procedure of using hierarchies reflecting target behavior may be an unimportant component of desensitization, at least as presented within a self-control framework. Although the 2 desensitization procedures were somewhat superior to the prolonged exposure, the latter also resulted in anxiety reduction. (1 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Real-life exposure as a primary therapeutic factor in the desensitization treatment of fear.

Conducted a 2 * 3 factorial study to assess the theory and efficacy of systematic desensitization and to identify the factors responsible for its effects. 54 female undergraduate aquaphobics received 1 of 6 treatment conditions administered individually by trained psychologists and psychological assistants: (a) systematic desensitization with/without repeated exposure, (b) predesensitization with/without repeated exposure, and (c) no office treatment with/without repeated exposure. Results reveal considerable subjective and behavioral improvement associated primarily with the repeated exposure treatment, which consisted of sessions of graded exposure to real water situations. Reduction of anxiety to the imagined stimuli in systematic desensitization showed little transfer to the real situations in the absence of exposure, suggesting that actual exposure may be a primary therapeutic factor in the desensitization treatment of fear. A follow-up evaluation revealed the durability of the aquaphobic improvements, and evidence of beneficial side effects which appeared primarily attributable to training in self-relaxation. (38 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Successful desensitization to dapsone for Pneumocystis carinii prophylaxis in an HIV-positive patient

OBJECTIVE: To report a case of successful desensitization to dapsone for Pneumocystis carinii pneumonia (PCP) prophylaxis in a patient unable to tolerate trimethoprim/sulfamethoxazole (TMP/SMX) desensitization or dapsone at standard doses. CASE SUMMARY: A 37-year-old HIV-positive African-American man was treated for pneumonia with TMP/SMX and then continued on the drug for PCP prophylaxis. After experiencing a pruritic maculopapular rash with TMP/SMX, both at standard doses and after attempting a desensitization regimen to the drug, he was started on dapsone for PCP prophylaxis. He experienced a rash and fever after taking dapsone at standard PCP prophylactic doses. At this time, an 18-day oral dapsone rechallenge by dose escalation was attempted, and it was well tolerated. CONCLUSIONS: This case suggests that utilization of a dapsone desensitization regimen may permit a viable treatment option in patients previously thought to be intolerant to the agent. More regimens of this type should be attempted and the results published, using both dapsone and TMP/SMX, so that standard desensitization treatment guidelines may eventually be adopted.     

Physiological effects of relaxation training and hypnotic suggestion.

Evaluated the comparative effects of hypnotic suggestion and brief relaxation training with regard to reduction of subjective tension and distress(anxiety differential) and physiological arousal (heart rate, respiratory rate, tonic muscle tension, skin conductance). 3 groups (N = 20 each) of undergraduate females participated individually for 2 sessions, 1 wk. apart, receiving: (1) abbreviated progressive relaxation training as used in systematic desensitization therapy; (2) a hypnotic induction emphasizing direct suggestions of relaxation, heaviness, warmth, drowsiness, and sleep; or (3) a self-relaxation control procedure, included to evaluate the effects of merely resting quietly for an equal period of time with instructions to relax. Both relaxation training and hypnotic suggestion produced significantly greater effects than controls, and relaxation training resulted in significantly greater effects than hypnotic suggestion. The superiority of relaxation training was most pronounced in response systems not under direct voluntary control. (37 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of contextual cues on the efficacy of desensitization and a credible placebo in alleviating public speaking anxiety.

Investigated the extent to which contextual cues mediated the effectiveness of systematic desensitization and a plausible placebo in alleviating public speaking anxiety. After participating in a public speaking situation that allowed the collection of self-report, physiological, and behavioral manifestations of anxiety, 67 undergraduates were randomly assigned to receive 5 sessions of either desensitization, "T scope" therapy, or no treatment. Each of these conditions was conducted in a context that either stressed the clinical relevance of the procedure or presented the procedure as a laboratory investigation of fear without therapeutic implications. Analysis of changes both between groups and within individuals indicated that desensitization reduced public speaking anxiety in both contexts, whereas the placebo was effective only in the therapeutic setting. The superiority of desensitization was most pronounced on the physiological variables. Results are interpreted as indicating support for a counterconditioning rather than an expectancy interpretation of desensitization. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of two short-term desensitization methods in the treatment of test anxiety.

2 short-term desensitization methods, accelerated massed desensitization and anxiety management training, were compared with standard systematic desensitization in terms of reducing self-reported test anxiety in 44 high test-anxious undergraduates. Posttreatment scores on the Suinn Test Anxiety Behavior Scale indicate that all 3 treatment procedures significantly reduced test anxiety as compared with a waiting-list control group. However, self-reported anxiety following treatment for the anxiety management training group was higher than for the standard desensitization and accelerated massed desensitization groups, and the standard desensitization procedure was significantly more effective than anxiety management training. Anxiety management training, a general or nonspecific program for anxiety control, reduced test anxiety with just 1 hr of direct training in counteracting anxiety. It did not, however, reduce other salient fears as measured by scores on a fear survey schedule. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapy for vaginismus: in vivo versus in vitro desensitization

OBJECTIVE: To verify the effectiveness of desensitization exercises with dilators in the treatment of vaginismus, while comparing 2 therapeutic variations with differing instruction procedures ("in vivo" versus "in vitro") during the desensitization exercises. METHOD: A consecutive random sample of 44 female outpatients in sexual therapy were divided into groups for either treatment on a random basis. All patients were treated until the symptoms abated on the basis of a structured therapy program. The stability of the therapeutic success was verified through follow-up interviews. RESULTS: Forty-three (97.2%) of the patients were able to have sexual intercourse after an average of 6.3 therapeutic sessions. One-third reported an increase in their sexual desire. Thirty-four of 39 patients (87.2%) would be prepared to repeat the therapy. There were no significant differences in the success and the required number of consultations for the cure between the 2 groups investigated. CONCLUSIONS: Desensitization through exercises with dilators is an effective method for treating vaginismus. The choice of instruction procedure can be left to the patient.     

Therapist warmth as a factor in automated systematic desensitization.

Assigned each of 23 female snake-phobic Ss to 1 of 3 treatment conditions: warm automated therapist procedure, cold automated therapist procedure, or no-treatment control. All groups were equated with respect to their pretest behavioral avoidance scores, and the 2 desensitization groups were equated in their pretherapy instructions, number of therapy sessions, and automated procedure. The only procedural difference between these 2 groups was the manner in which the taped therapist verbalized the treatment procedure. Ss in the warm automated therapist group improved significantly more than Ss in either the cold automated therapist or control groups, and there was no significant difference between the cold automated therapist and control groups. This relationship was largely maintained during the follow-up evaluation. Results are discussed in terms of the role of relationship variables in successful systematic desensitization. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modality, self-disclosure, and gender as determinants of psychotherapeutic attraction.

Investigated the effects of therapy modality, self-disclosure tendency, and gender of Ss on therapeutic attraction. 80 undergraduates—40 high and 40 low scorers on a modified version of the Self-Disclosure Questionnaire—were asked to rate audiotapes of simulated therapy sessions on several dimensions. Primary results are as follows: (a) High self-disclosers preferred client-centered therapy, whereas low self-disclosers preferred systematic desensitization. (b) Client-centered therapy was perceived as providing a greater opportunity for self-exploration, whereas systematic desensitization was perceived as more effective. (c) Low self-disclosing males and high self-disclosing females rated the therapists as attractive but ineffective. (d) Females were more attracted to systematic desensitization, whereas males were more attracted to client-centered therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of implosive therapy and systematic desensitization in the treatment of test anxiety.

Administered I. G. Sarason's 21-item Test Anxiety Scale as a pre- and posttest measure of the comparative efficacy of 2 techniques for reducing test anxiety in 34 undergraduates. Both desensitization and implosive therapy resulted in significant decreases in scores. However, the desensitization group also demonstrated a significant reduction in state anxiety assessed during simulated testing sessions and a significant increase in GPA, while the implosive therapy group showed no comparable improvement. Results are discussed in relation to a number of conceptual and methodological issues that have received relatively little empirical attention in behavior therapy research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Qualitative Case Study of the Process and Impact of Filial Therapy with an African American Parent.

This qualitative case study examined an African American parent's perceptions of the process and impact of filial therapy. Findings included adequate treatment acceptability with regard to the structure of filial therapy training; however, the parent evidenced difficulty fully accepting the content of the filial therapy training. Particular difficulty was self-reported in maintaining a permissive and nondirective manner during the play sessions. This finding, as it relates to cultural factors, is discussed. Positive changes in the parent, child, and parent-child relationship were reported by the parent and observed by the researcher as a result of participation in filial therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Desensitization and self-control in the treatment of test anxiety.

Studied M. R. Goldfried's (see record 1972-09080-001) recommendations for enhancing the self-control features of desensitization by changing both the rationale and the procedure followed in this approach. 98 test-anxious (Test Anxiety Questionnaire) college students were assigned to 4 treatment groups, a placebo group, or an untreated control group. The 4 treatment groups resulted from the combination of 2 treatment rationales (active coping and passive reciprocal inhibition) and 2 treatment procedures (self-control and standard). The treatment groups were found to be equally effective in reducing debilitative test anxiety. However, the self-control variant of desensitization combining both the rationale and procedural modifications recommended by Goldfried required fewer scene exposures and treatment sessions than standard desensitization and yet was more effective at enhancing facilitative test anxiety and test performance. Finally, it appeared that the active rationale was more effective than the passive rationale in bringing about persistent changes in Ss' academic performance subsequent to treatment. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strike while the iron is hot: Can stepped-care treatments resurrect relapsing smokers?

The efficacies of 2 group counseling step-up treatments for smoking cessation, cognitive-behavioral/skill training therapy (CBT) and motivational interviewing/supportive (MIS) therapy, were compared with brief intervention (BI) treatment in a sample of 677 smokers. Differential efficacy of the 2 step-up treatments was also tested in smokers at low and high risk for relapse (no smoking vs. any smoking during the first postquit week, respectively). All participants received 8 weeks of nicotine patch therapy. BI consisted of 3 brief individual cessation counseling sessions; CBT and MIS participants received BI treatment and 6 group counseling sessions. Neither CBT nor MIS treatment improved long-term abstinence rates relative to BI. Limited support was found for the hypothesis that high-risk smokers would benefit more from MIS than CBT. Other hypotheses were not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)