Explain the techniques used in behavior therapy.

The techniques used in behavior therapy;--

Technique # 1. Systematic Desensitization:

It is based on the principle of reciprocal inhibition, which holds that prior establishment of an appetitive physiological response can prove capable of blocking a conditioned avoidance response.

Systematic desensitization as given by Wolpe (1958) involve the following three stages;

i. Training the patient to relax

ii. Constructing with the patient a hierarchy of anxiety-arousing situation.

iii. Presenting phobic items from the hierarchy (a sequence of phobic stimuli in an increasing order) in a graded way, whilst the patient inhibited the anxiety by relaxation.

(a) Relaxation Techniques:

There are many methods of relaxation which are used before starting desensitization e.g., Jacobson’s muscular relaxation techniques (e.g., successful tensing and then relaxing various pairs of muscles throughout the body) or Yoga or use of Methohexitone. The advantages of using these techniques are that firstly they are useful for those patients who are unable to relax, secondly all anxiety techniques are that firstly they are useful for those patients who are unable to relax, secondly all anxiety disappears and lastly, they make the technique of systematic desensitization as more economical in time.

(b) Hierarchy:

It is a sequence of phobic-stimuli from the least to the most phobic one. In systematic desensitization, it is started from the least phobic to the most phobic stimuli in sequence.

(c) Systematic Desensitization:

It is based on the pairing of a pleasurable physiological state such as relaxation, sexual arousal or eating, with progressive hierarchical exposure to the feared situation or object. The elicitation of anxiety requires return to a prior step (in hierarchy). The basic mechanism at work appears to be the phenomenon of extinction i.e. the gradual elimination of a response such as anxiety, when it is no longer reinforced.

When the sensitization is being done in imagination, the length of the session is generally about 40 minutes, depending on how long it takes to get the patient relaxed; moving up steps in the hierarchy rarely extends beyond 30 minutes. The number of sessions required varies from say, 10 to 100 depending on the complexity of the problem and on the number of hierarches to be worked through. Patients are expected to practise at home what they have learned in the clinical session.

When the desensitization is carried out in vivo, the patient is instructed how to relax and how and when to use relaxation beforehand in the consulting room but the actual desensitization is done in the real relaxation. Most of this ‘homework’ will actually be done while the patient is accompanied by a relative.

The main use of desensitization in vivo is that when the patients have difficulty in imagining situations or do not feel anxious or they fail to relax. But the main disadvantages are that it is tedious, time consuming, impossible to device situations precisely as represented in hierarchy and in certain situations e.g., crowded streets, it is difficult to remove the patient.

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