BEHAVIORAL

Emphasize active control to change behavior.

THERAPIES
Learning can be effective in changing or eliminating maladaptive behaviors.
The counselor serves as a consultant, teacher, advisor, reinforcer, facilitator as
well as a model to learn, unlearn and relearn behavior .
Well defined achievable therapeutic goals are set for clients.
Empirical methods are used to bring change in behaviors.
The success of the methods used is periodically assessed and a change in
therapeutic program is done accordingly.
Aim at making adjustments to life circumstances and achieving personal as
well as professional goals.

Behavioral therapies
General behavioral
techniques
Reinforcement
Schedules of
reinforcement

Specific behavioral
techniques
Systematic
desensitization
Assertiveness
training

Shaping
Extinction

Flooding and
implosive
therapy

Punishment
Modeling etc.

SYSTEMATIC
DESENSITIZATIO
N
developed by Joseph Wolpe (1958)
based on the principle of classical
conditioning

JOSEPH
WOLPE

was designed to treat patients who

suffered from extreme anxiety or fear
toward specific events, people, or objects or
had generalised fears.

General Idea
Clients imagine successively more anxiety
arousing situations, while simultaneously
engaging in a behavior that competes with
that anxiety. This behavior is relaxation
technique.
Relaxation is being repeatedly paired with
imagining of anxiety inducing situations
and as a result of this:
Gradually, and systematically, clients
become less sensitive (desensitized) to the
anxiety-arousing situation.

PROCEDURE
Before implementing the desensitization
technique, therapist conducts an initial
interview to identify specific information about
anxiety and to gather relevant background
information about the client.
It involves questions regarding particular
circumstances that elicit conditioned fears.
The client is also asked to self monitor to
observe & record situations during that timespan that elicit anxiety.
A questionnaire can be accompanied to gather

McNeil and Kyle (2009) described

steps in the use of systematic
desensitization.
1.Relaxation training;
2.Development of the anxiety
hierarchy ; and,
3.Proper desensitization

1.RELAXATION TRAINING

1.Relaxation training
progressive
muscle
relaxation
was
first
developed by Jacobson (1938).
It involves tensing, and then relaxing muscle
groups, including arms, face, neck, shoulders,
chest, stomach, and legs to achieve deeper and
deeper levels of relaxation.
Clients are given a set of instructions to follow
& they assume a relaxed position in a quiet
environment while alternately contracting and
relaxing muscles.
Deep and regular breathing is also carried out.
The therapist uses a very soft & pleasant voice

 Clients have to experience tension building up,

notice their muscles getting tighter & to
experience this tension fully and then
gradually, relax and experience the difference
between a tense and a relaxed state.
In the relaxed state, clients are taught to
visualize various parts of their bodies, with
special emphasis on facial muscles followed by
the head, neck and shoulders.
Imagery of pleasant & peaceful scenes, such as
sitting by a lake, is also created.

Continued practice of relaxation throughout the

course of therapy can yield in pairing of
relaxation with imagined anxious situations.
Relaxation training are used in combination
with a number of other behavioral techniques like
assertion training, hypnosis, self-management
programs etc.

2.ANXIETY
HIERARCHIES

2. Anxiety hierarchies

Detailed and highly specific information about

events that cause a client to become anxious is the
essence of constructing an anxiety hierarchy.
The events that elicit anxiety are listed by the
clients in order from least to most anxiety evoking by
assigning a number from 0-100 to each event:

0 denoting total relaxation or

indifference;
100 representing extremely high
anxiety.

This develops a subjective units of discomfort scale

(SUDs) for that specific client.
Often, several hierarchies representing fears are
constructed .

The therapist constructs a ranked list of

situations that elicit increasing degrees of
anxiety or avoidance. The hierarchy is arranged
in order from the worst situation the client can
imagine down to the least anxiety triggering
situation.
As the desensitization progresses, events that
originally had high SUD ratings have lower SUD
ratings.

A typical example of an anxiety

hierarchy

3.PROPER
DESENSITIZATION

3. Proper Desensitization
Enough time must be given to the clients to practise
relaxation and to construct their anxiety hierarchies
before beginning with the desensitization process.
The process begins with the client reaching a
complete relaxation with eyes closed.
The client is asked to imagine a neutral scene
presented. If the client remains relaxed, he/she is
asked to imagine the least anxiety arousing scene
on the developed hierarchy of situations.
The therapist progressively moves up the
hierarchy until the client signals that he/she is
experiencing anxiety, at which the scene is
terminated and relaxation is induced. The scene is

Treatment takes place when the client is able to

remain in a relaxed state while imagining the
scene formerly arousing high anxiety.
The core of the technique is: repeated exposure
to anxiety evoking stimulus in the imagination,
paired with relaxation, causing absence of any
negative reaction to that stimulus, be it fear,
anxiety etc.

Conclusion
Homework and follow up are essential
components of successful desensitization.
Clients can practise relaxation procedures daily.
This can provide an insulation from anxiety as a
response to daily life situations (hassles).
Systematic desensitization can be used to relieve
a variety of problems like anxiety, phobias, anger,
asthmatic attacks, insomnia, motion sickness,
nightmares, speech disorders, problem drinking
etc.

THANK
YOU!