Treatment of anxiety through systematic desensitization in therapy groups.

The effects of short-term treatment by modified systematic desensitization in time-limited intensive therapy groups were evaluated in a matched groups design. 10 chronically anxious college males, treated by the group method, were evaluated on the basis of personality and anxiety scales against an "own-control" period, and 4 equated groups of 10 Ss each. 1 group served as an untreated control for evaluating extra-treatment effects on college grade-point average, as an objective, public criterion. Ss in the remaining groups received 1 of the following individual treatments: systematic desensitization, insight-oriented psychotherapy, or an attention-placebo treatment. The group method produced several significant improvements, suggesting that combined group desensitization offers an efficient and effective treatment for social-evaluative anxiety. (27 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental desensitization of phobia.

24 snake phobic Ss participated in an experimental investigation of systematic desensitization therapy. Ss who experience desensitization showed a greater reduction in phobic behavior (as measured by avoidance behavior in the presence of the phobic object and self-ratings) than did nonparticipating controls. Ss tended to hold or increase therapy gains at a 6-month follow-up evaluation, and gave no evidence of symtom substitution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of insomnia using a variant of systematic desensitization.

Describes the treatment of a case of severe insomnia. The treatment, a variant of systematic desensitization, was short and apparently quite successful. The primary difference between usual desensitization procedures and those employed in this case was the absence of a fear hierarchy. A trainee-O was present during several training and early therapy sessions. He observed 2 therapy sessions and then became the therapist. He was directly supervised for 2 more therapy sessions and then continued treatment singly. The case illustrates the flexibility of behavior therapy in both procedural variations and in training of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychoanalytic reinterpretation of the effectiveness of systematic desensitization: Experimental data bearing on the role of merging fantasies.

Subjected 10 women with insect phobias to a variant of systematic desensitization in which a procedure aimed at stimulating a fantasy of "merging with mother" was substituted for muscle relaxation. The procedure consisted of the tachistoscopic subliminal exposure of the verbal stimulus MOMMY AND I ARE ONE during the visualization part of desensitization, whenever the S's anxiety rose above a specified level. A control group of 10 other women with insect phobias underwent the same procedure except that the subliminally exposed message was the neutral stimulus PEOPLE WALKING. On measures of both phobic behavior and anxiety, the experimental group manifested significantly more improvement than the controls. This supports the proposition that (part of) the effectiveness of systematic desensitization resides in its activating unconscious merging fantasies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth.

This article examined sociodemographic and clinical characteristics of child treatment completers, and noncompleters who received exposure-based cognitive-behavioral treatment. A total of 137 children (46% girls) and their parents (predominantly Euro-American and Hispanic/Latino) participated in this study (106 completers, 31 noncompleters). The majority of noncompleters, received an average of 5 sessions. Findings were generally consistent with past research in terms of lack of differences between completers; and noncompleters. Results are discussed in the context of previous child attrition research and directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pilot study on the effectiveness of systematic desensitization with neurologically impaired children with phobic disorders.

A modified version of J. Wolpe's systematic desensitization therapy involving direct confrontation with the fear-inducing stimulus was attempted with 30 neurologically impaired children with phobic symptoms. 2 hypotheses were tested: (a) a nonverbal therapeutic technique not requiring motivation will produce successful symptom reduction for these Ss, and (b) awareness of therapeutic procedure is not necessary for successful results. Both hypotheses were confirmed. (23 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of two phobic patients on the basis of learning principles.

"The treatment of two phobic patients has been described. Case 1 manifested an excessive fear of going out on her own; Case 2 displayed disabling symptoms in the form of an excessive fear of going into enclosed and crowded places. Both cases had blackouts of unknown nature. The treatment program for both cases was mainly based on the principle of primary stimulus generalization. Owing to the more "diffuse" nature of the anxiety displayed by Case 2, an additional simple conditioning technique was employed." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group composition and group therapy for complicated grief.

This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher the percentage of patients in a therapy group who had a history of relatively mature relationships, the better the outcome for all patients in the group, regardless of the form of therapy or the individual patient's quality of object relations score. The findings have direct clinical implications for composing short-term therapy groups for outpatients with complicated grief and possibly for other types of group therapies and patient problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group climate development in cognitive and interpersonal group therapy for social phobia.

This study was designed as a longitudinal study of 80 participants in cognitive group therapy (RCT, n = 40) and interpersonal group therapy (RIPT, n = 40) for social phobia during 10 weeks of residential therapy. The aim was to investigate the patterns of group climate development and its impact on treatment outcome. Data were collected using MacKenzie's Group Climate Questionnaire (GCQ) 4 times during treatment, and a multilevel (mixed) model approach was used in the analyses. Engagement in RCT groups showed a linear increase during treatment in contrast to a linear decline among patients in RIPT groups. This divergence might be explained by the focus on extragroup and intragroup relationships in RCT and RIPT, respectively. Neither conflict nor avoidance followed the expected pattern, nor did their mean levels influence outcome. However, when 6 extreme values of conflict were removed, there was support for a low–high–low pattern of conflict. In general, these results do not support MacKenzie's generic model of group climate development but suggest that sample characteristics, treatment models, and setting can play major roles in determining the group climate. Of the group climate variables, only the mean level of engagement predicted a change in social anxiety over the course of treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of Cognitive therapy of anxiety disorders: Science and practice.

Reviews the book, Cognitive therapy of anxiety disorders: Science and practice edited by David A. Clark and Aaron T. Beck (2009). Drs. Clark and Beck’s book Cognitive therapy of anxiety disorders: Science and practise is a comprehensive review of cognitive therapy for anxiety from its empirical theoretical foundation to its clinical application to disorders. Although the focus of the text is ultimately on the cognitive treatment of anxiety, the rich theoretical background that is interwoven throughout makes this book of interest to academics and graduate students as well as clinicians. The book is divided into three parts, each with several chapters: 1) cognitive theory and research on anxiety; 2) assessment and intervention techniques used in cognitive therapy for anxiety; and 3) the application of cognitive therapy to specific anxiety disorders (e.g., panic disorder, obsessive– compulsive disorder [OCD]). Overall, this book is an excellent resource for researchers and clinicians working in the field of anxiety disorders. The reference section alone makes it a valuable addition to one’s bookshelf, and the authors have done an excellent job of organising a vast, and at time disparate, body of research into a cohesive review of cognitive theory as it applies to anxiety. Although the treatment chapters may be a bit overly ambitious in attempting to review both the research and the application of the cognitive model to the treatment of specific disorders, the book in its entirety is clearly an essential text for those interested in obtaining a comprehensive understanding of cognitive therapy and anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expectancy, false galvanic skin response feedback, and systematic desensitization in the modification of phobic behavior.

Compared systematic desensitization and 2 pseudotherapy manipulations with and without false galvanic skin response feedback after every session suggesting improvement in the modification of intense snake and spider fear. Ss were 36 spider- and snake-phobic 18-59 yr old women. Results indicate no consistent differences between the 3 treatment groups, although all treatments were significantly more effective than no treatment in modifying physiological, behavioral, and self-report measures of fear. A 4-mo follow-up showed stability in fear reduction on self-report measures for the 3 treatment groups. Overall results contradict a traditional conditioning explanation of systematic desensitization. An alternate explanation for the operation of systematic desensitization emphasizing the motivational as opposed to conditioning aspects of the procedure is discussed. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Effectivenss of automated desensitization with normal volunteers and phobic patients.

Compared the effects of live and automated desensitization on 21 clinical patients and 21 college students reporting various fears. Taking the sample as a whole, those subjected to live and to automated desensitization improved more than controls but were not significantly different from each other. Further analysis showed, however, that the 2 treated groups of college students improved more than student controls under both treatment conditions; neither of the treated groups of patients differed significantly from the patient control group. It is noted that the difference between live and automated treatment may be less than the difference between the time-limited, single-technique approach used in analog studies and the more varied, responsive treatment employed by clinical behavior therapists. (French summary) (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Cognitive-behavioural therapy in groups.

Reviews the book, Cognitive-behavioural therapy in groups by Peter J. Bieling, Randi E. McCabe, and Martin M. Antony (2006). With increasing pressure to make effective treatments more accessible and cost effective, many psychologists and health care professionals are being asked to provide CBT in a group format. This book aims to provide a bridge between manualized CBT and the theory and knowledge of group process factors. Although some of the material presented is based primarily upon clinical experience rather than empirical work, this is a reflection of the relatively underdeveloped research literature related to optimal CBT group structure and process. Overall, the reviewer believes it is difficult to identify any significant weaknesses in the book, and recommends it highly. Chapters on group CBT for specific disorders cover significant amounts of useful information that will be helpful to practitioners familiar with individual treatment of the disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Critique of Obler and Terwilliger's "Systematic desensitization with neurologically impaired children with phobic disorders."

Criticizes M. Obler and R. Terwilliger's (see pa, vol. 44:15121) study for (a) confounding of behavioral treatments, (b) unsystematic administration of primary and secondary reinforcers, (c) lack of clarity concerning the therapist's role, (d) absence of behaviorally based pre- and posttreatment measures, (e) inadequate and unsupported definition of awareness, and (f) the use of subjective and retrospective parental ratings. Alternative methodological procedures are suggested and the implications for behavioral research are noted. (25 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Habituation model of systematic desensitization.

Discusses the relevance of habituation as a model for response decrement in desensitization. A discussion of the relationship between habituation and extinction leads to the view that there are no sound reasons for explaining desensitization as an extinction rather than as a habituation phenomenon. The maximal habituation theory of desensitization proposed by M. H. Lader and A. M. Mathews (1968) is discussed and relevant evidence reviewed. Finally, a revised habituation theory of desensitization, based on the dual-process theory of habituation, is elaborated, and the role in desensitization of relaxation, stimulus intensity, stimulus lengths, and interstimulus interval lengths are discussed in the context of this theory. It is suggested that relaxation and an incremental stimulus hierarchy may reduce sensitization rather than facilitate habituation. (60 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy of obesity and eating disorders.

Difficulties associated with eating behavior, existing on a broad continuum from uncomplicated overeating to psychopathologically disordered eating, is a growing area of concern within the medical and mental health communities. Psychologists are often called upon to conduct diagnostic assessments in order to identify issues or disorders that may require attention and provide psychotherapeutic interventions ranging from supportive to more intensive therapy. Over the past several years, there have been increased efforts to develop safe and efficacious pharmacologic treatments for obesity and eating disorders. This article provides psychologists with a review of the most currently used pharmacologic interventions for eating dysfunction. (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)     

The use of homework in behavior therapy for anxiety disorders.

In this article, the authors discuss the role of homework in behavior therapy for the anxiety disorders. First, the authors describe the essential components of behavior therapy that include exposure to feared consequences and cessation of all avoidance behaviors. Then, the authors briefly review the literature on the relationship between homework compliance and treatment outcome. Next, the authors discuss the way that homework is used in terms of self-monitoring and exposure exercises during the course of treatment. Finally, the authors discuss the practicalities of encouraging homework compliance and managing noncompliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)