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1 Research Worker, Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
2 Senior Lecturer, Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
1. The components of systematic desensitization were studied by treating multi-phobic patients by one of the following methods: (a) pseudo-therapy (Rp)—which combined relaxation and talking about items unrelated to the patients' phobias; (b) hierarchies only (H)—desensitization conducted without training or instruction in relaxation; (c) systematic desensitization (SD)—conventional desensitization conducted with the assistance of relaxation training; (d) psychotherapy (P)—combining insight therapy with rational therapy.
There were 8 patients in each of the above groups, making a total of 32. The groups were matched as far as possible on two clinical and two other variables.
2. Treatment consisted of twice-weekly sessions lasting from forty-five to sixty minutes. An upper limit of thirty sessions for desensitization was fixed in advance, and patients in the other groups were matched accordingly. This did not present any serious problem, as most patients needed between twenty and thirty sessions to complete their desensitization treatment. There were 6 replacement patients and 2 failures.
3. Assessment procedures included ratings made by the patients, therapists and an independent assessor. Personality tests, behaviour avoidance tests and psychophysiological assessments were also included. All the measurements were taken on three occasions—before treatment, after treatment and at a three-month follow-up point.
4. Rating scales proved to be the most useful measure for providing information about clinical outcome. Overall, patients who received desensitization (with or without relaxation training) showed the best clinical outcome. Both forms of desensitization treatment appeared to give superior results to either psychotherapy or pseudotherapy results.
5. The clinical results are similar to those reported by Gelder, Marks and Wolff (1967) in a comparable out-patient population.
6. Avoidance test results were disappointing and provided only one significant result. The amount of time spent in the feared situation was longer for patients who had been desensitized than for those who had received other forms of treatment. The fear thermometer ratings obtained during the conduct of the behavioural avoidance test were consistent with this finding, i.e. desensitized patients expressed significantly reduced anxiety after treatment.
7. On the fear thermometer ratings made during the presentation of fear items in imagination, there were no significant differences between desensitization administered with or without relaxation. In both variations of the treatment the improvements were superior to those observed in the pseudo-therapy group.
8. Psychophysiological measurements, including those of habituation to auditory stimuli, failed to produce any significant results.
Submitted on April 11, 1973
This article has been cited by other articles:
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M. Gelder Behaviour Therapy for Neurotic Disorders Behav Modif, October 1, 1979; 3(4): 469 - 495. [Abstract] |
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