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Unformatted text preview: ully in clinical practice. The major behavioral approaches
to treating them are desensitization, flooding, and modeling. Together, these approaches are
called exposure treatments because in all of them individuals are exposed to the objects or situations they dread.
People treated by systematic desensitization, a technique developed by Joseph
Wolpe (1997, 1987, 1969), learn to relax while gradually facing the objects or situations
they fear. Since relaxation and fear are incompatible, the new relaxation response is
thought to substitute for the fear response. Desensitization therapists first offer relaxation
training to clients, teaching them how to bring on a state of deep muscle relaxation at
will. In addition, the therapists help clients create a fear hierarchy, a list of feared objects
or situations, ordered from mildly to extremely upsetting.
Then clients learn how to pair relaxation with the objects or situations they fear.
While the client is in a state of relaxation, the therapist has the client face the event
at the bottom of his or her hierarchy. This may be an actual confrontation, a process
called in vivo desensitization. A person who fears heights, for example, may stand on
a chair or climb a stepladder. Or the confrontation may be imagined, a process called
covert desensitization. In this case, the person imagines the frightening event while the
therapist describes it. The client moves through the entire list, pairing his or her relaxKyle Green/Roanoke Times (abcnews.go.com, 2008;
Szegedy-Maszak, 2005) Recovering lost revenues
These children scream out as they experience a sudden steep drop from the top of
an amusement park ride called Super Shot.
Several parks offer behavioral programs
to help customers overcome their fears of
roller coasters and the new wave of horror
rides. After “treatment,” some clients are
able to ride the rails with the best of them.
For others, it’s back to the relative calm of
the Ferris wheel. ComFun6e_Ch04_C!.indd 112 12/10/09 11:16:18 AM Anxiety Disorders ation responses with each feared item. Because the first item is only mildly frightening,
it is usually only a short while before the person is able to relax totally in its presence.
Over the course of several sessions, clients move up the ladder of their fears until they
reach and overcome the one that frightens them most of all.
Another behavioral treatment for specific phobias is flooding. Flooding therapists
believe that people will stop fearing things when they are exposed to them repeatedly
and made to see that they are actually quite harmless. Clients are forced to face their
feared objects or situations without relaxation training and without a gradual buildup.
The flooding procedure, like desensitization, can be either in vivo or covert.
When flooding therapists guide clients in imagining feared objects or situations,
they often exaggerate the description so that the clients experience intense emotional
arousal. In the case of a woman with a snake phobia, the the...
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