Areas of Specialization - Adults
Systematic Desensitization for Specific Fears (Phobias) Treatment What is cognitive behavioral therapy for specific phobias? Phobias are typically treated with systematic desensitization. This effective behavior therapy process relies upon counterconditioning techniques, such that the individual is trained to substitute a relaxation response for the fear response when confronted with the phobic stimuli. Since being relaxed is incompatible with feeling scared or anxious, the relaxation response is viewed as countering the fear reaction. This counterconditioning is applied methodically to very gradually introduce the feared stimulus in a step by step manner known as systematic desentization. This desensitization involves three steps: 1) training the client to physically relax;
2) creating a hierarchy of feared situations from the least to the most anxiety provoking;
3) counter-conditioning relaxation as a response to each feared stimulus beginning with the least anxiety provoking stimulus and moving to the next least anxiety provoking stimulus until all of the situations listed on the anxiety hierarchy have been mastered.
The third step of successfully confronting anxiety provoking situations typically begins with the use of imagery and cognitive rehearsal. The client imagines a difficult situation and the therapist guides him through the step-by-step process of facing and successfully coping with it. The client then works on practicing, or rehearsing, these steps mentally. Following the mastery of anxiety control in imagery exercises, the client advances ahead on their anxiety hierarchy to more challenging real life situations. Systematic desensitization is frequently combined with modeling, in which the client observes others in the presence of the phobic stimulus who are responding with relaxation rather than fear. Thereby the client is encouraged to imitate the coping model and in this manner ease their fears. The treatment of a blood/injection/injury phobia requires special consideration. The most common complication with this phobia is the avoidance of important medical procedures, such as blood tests or immunizations, because the person fears fainting in the doctor's office. While systematic desensitization will reduce the individuals fear, it will not prevent them from fainting. These individuals faint as a result of significant decreases in their blood pressure in response to the sight of blood. However, there are techniques that reduce the probability of fainting. Applied tension is one method to prevent fainting which entails slightly tensing the major muscles of the body while maintaining steady breathing. This tension restricts the blood vessels from dilating to reduce the blood pressure. Thus an individual is taught to tense their body while keeping the arm from which the blood is drawn relaxed to minimize the pain of the needle insertion. This example illustrates how an individualized treatment plan is necessary for optimal results. Regardless of the type of phobia, cognitive behavioral therapy is customized to target the individuals specific fears as the clients needs, strengths, and goals are integrated into the overall treatment plan.
back to adults main page>>
|
