Systematic desensitization therapy is a type of behavioral
therapy used to treat anxiety disorders, post-traumatic stress
disorder (PTSD), phobias, and a fear of things like snakes or
spiders. The aim of this therapy is to change the way you
respond to objects, people, or situations that trigger feelings of
fear and anxiety. You will learn coping tools to help you stay
relaxed and calm.
Outlook
Systematic desensitization therapy is an evidence-based
therapy. When a treatment is evidence-based, it means it's
gone through documented scientific testing and extensive
research, and has been shown to be successful. Studies point to
the effectiveness of systematic desensitization therapy for
anxiety disorders, phobias, and post-traumatic stress disorder.
For example:
combination of anxiety management training and
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standard exposure (SE) or virtual reality exposure (VRE)
treatments was found to be successful in treating 93% of
patients who experienced fear of flying. All the people who
got successful treatment had flown within 6 months after
their treatment.
rolonged exposure therapy has been shown to be an
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effective first-line treatment for veterans and military
personnel with post-traumatic stress disorder. It also helps
with other feelings people may be having such as anger,
guilt, depression, and negative health perceptions.
How Does Systematic Desensitization Therapy Work?
S ystematic desensitization therapy has three main steps. First,
you’ll learn ways to relax your muscles. Next, you’ll make a list
of your fears and rank them based on how intense your fears
are. Last, you’ll start exposing yourself to your fear in stages so
you get more and more comfortable dealing with it.
Step 1: Deep muscle relaxation techniques. In the first stage of
the treatment, people with anxiety and fears are taught
breathing exercises and muscle relaxation techniques.
Relaxation techniques are generally these types:
Autogenic relaxation. You repeat words, phrases, or
suggestions in your mind that create a feeling of relaxation
and calm. The repetition in the mind leads to the muscles
of your body getting more and more relaxed.
rogressive muscle relaxation. You learn to slowly tense
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and relax each muscle group. You normally start from your
toes and work your way up to your neck and head muscles.
isualization. You imagine a journey to a peaceful and calm
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situation, place, or setting, like a seashore or a garden. This
aids muscle relaxation and feelings of relaxation.
Learning muscle relaxation techniques is important
because of a principle called ‘reciprocal inhibition.’ The
idea behind reciprocal inhibition is that you can’t be
relaxed and fearful at the same time. When you're feeling
relaxed, it’s hard to feel tense. Tension is what you feel
when you’re experiencing a phobia. Relaxation
techniques can help you learn a different way of
responding to your phobias.
Step 2: Creating a fear hierarchy. In the second stage,
you create a list where you write out all your fears and
rank them on a scale of 1 to 10. First you list your level-10
fear, which causes you the highest amount of anxiety that
you can imagine. Next, you list your level-1 fear, which
causes you the least amount of anxiety. After this, you
brainstorm the remaining fears and list them in order
from 2 to 9.
Once your list is done, you discuss your fears with your
therapist and work on exposing yourself to them. You start from
the fear that is the least frightening and work yourself up to
your level-10 fear.
Step 3: Working up through the fear scale through
exposure. The process of exposure can be done in two ways:
In vitro – the patient imagines being exposed to the object
of fear in the mind's eye.
In vivo - the patient is actually exposed to the fear.
A third type of exposure therapy called virtual reality exposure
therapy (VRET) has become popular in recent years. Virtual
Reality (VR) technology mimics real-life situations in a
computer-generated environment. Virtual reality exposure
therapy helps you work through your fears in a safe and
controlled place.
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to-know-systematic-desensitization-therapy
Contingency Management
Contingency management refers to a type of behavioural
therapy in which individuals are ‘reinforced’, or rewarded, for
evidence of positive behavioural change.
Contingency management interventions are based on principles
of basic behavioural analysis. A behaviour that is reinforced in
close temporal proximity to its occurrence will increase in
frequency. Thus, if you give a child a small toy or sticker each
time he makes his bed, the child will start making his bed more
often. Behavioural principles of positive reinforcement are
widely applied in everyday settings (childrearing, employment,
pet training), as well as clinical settings (autism, conduct
disorder in adolescents, intellectual disability).
Token Economy
A token economy is a system in which the learner earns tokens
by engaging in a targeted behavior. Token economies have three
major components: 1) a behavior or behaviors that we wish to
reinforce, 2) tokens earned for engaging in those behaviors,
and 3) exchanging tokens for a choice of reinforcing rewards.
This system provides positive reinforcement to increase desired
behaviors. A token economy system is ideal to use for school-
aged children in the classroom or at home. It is flexible enough
to modify based on the individual and their setting and can be
used in a variety of different ways. The goal is always to
increase desired behaviors.
To create an effective token system, it is important to first
establish what the learner is working for, using the tokens as a
currency to exchange for the reinforcer. To determine
preference for motivating reinforcers, therapists can perform
preference assessments with the learner, which help determine
what types of stimuli a person prefers ( i.e. what the learner
finds most reinforcing). We can also work from a list of
preferred items and ask the child what they want to work for.
Once we’ve determined the appropriate reinforcers, we provide
the learner with a token economy chart that places the
reinforcer icon in the designated space along with the
predetermined number of tokens or stickers the learner must
receive in order to earn that reinforcer. An example might be a
chore chart: a child earns star stickers (tokens) for completing a
chore. When the required number of stars are earned, they are
exchanged for the preferred reward.
For a token economy intervention to be effective and
successful, it is essential to pre-determine a consistent
reinforcement schedule. It is also important to use continuous
reinforcement when introducing a new intervention. Initially, a
token and verbal praise to the learner can be delivered for each
correct performance. For example, in class, a child receives a
token and praise (“Great answer,” Good job”) each time she
responds to a question correctly. Once a certain number of
tokens are received, the child gets to exchange them for a
preferred, reinforcing item or experience.
Our goal with this intervention is to ultimately fade out the
need for tokens, so the learner works for verbal praise, social
reinforcement, and the intrinsic reward that comes from
completing a task.
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economy-system/
Schedules of reinforcement are the rules that determine how
often an organism is reinforced for a particular behavior. The
particular pattern of reinforcement has an impact on the
pattern of responding by the person.
A schedule of reinforcement is either continuous or partial.
There are four basic partial schedules of reinforcement. These
different schedules are based on reinforcing the behavior as a
function of (a) the number of responses that have occurred or
(b) the length of time since the last reinforcer was available.
The four partial schedules are:
Fixed ratio
Variable ratio
Fixed interval
Variable interval
The continuous schedule of reinforcement involves the
occurrence of a reinforcer every single time that a desired
behavior is emitted. Behaviors are learned quickly with a
continuous schedule of reinforcement and the schedule is
simple to use. As a rule of thumb, it usually helps to reinforce
the child every time it does the behavior when it is learning the
behavior. Later, when the behavior is well established, the
parent/teacher/therapist can switch to a partial or intermittent
schedule.
With a partial (intermittent) schedule, only some of the
instances of behavior are reinforced, not every instance.
Behaviors are shaped and learned more slowly with a partial
schedule of reinforcement (compared to a continuous
schedule). However, behavior reinforced under a partial
schedule is more resistant to extinction.
Partial schedules of reinforcement are based on either a time
interval passing before the next availability of a reinforcer or it
is based on how many target behaviors have occurred before
the next instance of the behavior is reinforced. Schedules
based on how many responses have occurred are referred to as
ratio schedules and can be either fixed-ratio or variable-ratio
schedules. Schedules based on elapsed time are referred to as
interval schedules and can be either fixed-interval or variable-
interval schedules.
Fixed Ratio schedules involve reinforcement after a certain
number of responses have been emitted. The fixed ratio
schedule involves using a constant number of responses. For
example, if the child is reinforced after displaying a desired
behavior exactly 5 times, this would be an FR 5 schedule.
Variable Ratio schedules involve reinforcement after an
average number of responses have occurred. For example, the
Fire Chief Rabbit's lever pulling, which made it appear that it
was operating the fire truck, was reinforced on a variable-ratio
schedule. Reinforcement occurred after an average of 3 pulls
on the lever. Sometimes the reinforcer was delivered after 2
pulls, sometimes after 4 pulls, sometimes after 3 pulls, etc. If
the "average" was about every 3 pulls, this would be a VR 3
schedule. Variable ratio schedules maintain high and steady
rates of the desired behavior, and the behavior is very resistant
to extinction.
Interval schedules involve reinforcement of a desired behavior
after an interval of time has passed. In a fixed interval
schedule, the interval of time is always the same. The Brelands
and the Baileys did not use this type of schedule in their work.
However, if Buck Bunny had been on an FI 30-second schedule,
then the bunny would be reinforced the first time that a coin
was placed in the bank after a 30-second interval had passed.
Interval schedules involve reinforcement of a target behavior
after an interval of time has passed. In a variable interval
schedule, the interval of time is not always the same but
centers around some average. If Buck Bunny is on a VI 30
seconds schedule, then the bunny would be reinforced the first
time that a coin is placed in the bank after, on average, a 30-
second interval has passed. Sometimes the bunny would be
reinforced after the first coin drop after 25 seconds, sometimes
after 35 seconds, etc. After an animal learns the schedule, the
rate of behavior tends to be more steady than with a fixed
interval schedule. Once again, the Brelands and the Baileys did
not use this type of schedule.
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