Systematic desensitization

Nonpharmacologic interventions are classified as behavioral interventions and include relaxation, biofeedback, self-hypnosis, cognitive distraction, guided imagery, and systematic desensitization. 

Systematic desensitization. Gradual exposure done in small steps over a period of time. 

Available evidence indicates that systematic desensitization and in vivo exposure are the most effective treatment methods available. Pharmacological treatment has not been well investigated, but studies involving antidepressants suggest that TCAs and MAOIs are ineffective ( 85, 86 and 87). In addition, three studies suggest that sedative-hypnotic anxiolytics may undermine the behavioral treatment of specific phobias (88, 89 and 90). In another study, volunteers with animal phobias were exposed to their phobic object 1.5 hours after administration of either tolamolol, diazepam, or placebo in a double-blind crossover design. Tolamolol abolished the stress-induced tachycardia but had no beneficial behavioral or subjective effects ( 91). 

For patients with simple complaints, perhaps related to food or beverage consumption, avoidance or moderation of dietary intake may be preferable. Nonpharmacologic interventions are classified as behavioral interventions and include relaxation, biofeedback, self-hypnosis, cognitive distraction, guided imagery, and systematic desensitization. 

Brodsky CM Psychological factors contributing to somatoform diseases attributed to the workplace. Journal of Occupational Medicine 25 459-464,1983 Furst JB, Cooper A Failure of systematic desensitization in 2 cases of obsessive-compulsive neurosis marked by fears of insecticide. Behav Res Ther 8 203-206, 1970... 

Systematic desensitization and exposure techniques are used to assist those who suffer from anxiety symptoms however, this technique is generally regarded as the treatment of choice for specific phobias (Plaud Vavrovsky, 1998). Using this in combination with in vivo techniques (real-life experiences) appears to have an even greater effect than that produced by simulating an experience in the office setting only (Marshall,... 

Utilizing behavioral therapy that involves exposure and response prevention can be particularly effective in reducing panic symptoms (O Sullivan Marks, 1990). Where systematic desensitization has been used some clients find it particularly helpful when exposure to the anxiety-producing stimuli has been long enough to allow the anxiety to be markedly reduced (Marshall, 1996). Similarly, exposure to the feared stimulus is thought to be most effective when internal and external distractions from the phobic object or situation are minimized (Foa Kozak, 1986). Treatment of this type requires that the client be systematically exposed to the object or situation that provokes the fear and the subsequent avoidance. 

Wolpe, J. et al. (1973). The current status of systematic desensitization. American Journal of Psychiatry 130 961-65. 

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