An experimental investigation of desensitization in phobic patients

Abstract

The components of systematic desensitization were studied by treating multiphobic patients by one of the following methods: pseudotherapy, which combined relaxation and talking about items unrelated to the patients' phobias; hierarchies only, desensitization conducted without training or instruction in relaxation; systematic desensitization, conventional desensitization conducted with the assistance of relaxation training; psychotherapy, 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 2 clinical and 2 other variables. Treatment consisted of twice weekly sessions lasting from 45 to 60 min. An upper limit of 30 sessions for desensitization was fixed in advance, and patients in the other groups were matched accordingly. Most patients needed between 20 and 30 sessions to complete their desensitization treatment. There were 6 replacement patients and 2 failures. Assessment procedures included ratings made by the patients, therapists and an independent assessor. Personality tests, behavior avoidance tests and psychophysiological assessments were also included. All the measurements were taken on 3 occasions: before treatment, after treatment and at a 3 mth follow up point. 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. 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 behavioral avoidance test were consistent with this finding, i.e. desensitized patients expressed significantly reduced anxiety after treatment. 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 pseudotherapy group. Psychophysiological measurements, including those of habituation to auditory stimuli, failed to produce any significant results.