Systematic Desensitization Therapy: An Analysis of Results in Twenty-seven Patients

1966 ◽  
Vol 112 (484) ◽  
pp. 295-307 ◽  
Author(s):  
J. D. Hain ◽  
R. H. G. Butcher ◽  
I. Stevenson

The need for the development of shorter and more effective techniques of psychotherapy justifies a careful investigation of any methods which offer this possibility. A number of therapeutic techniques (7, 15, 18, 20) now often subsumed under the heading of Behaviour Therapy (4) and based on various principles of learning theory call for examination, since their exponents claim that these methods can make therapy both shorter and more effective than can other methods, e.g., those based on psychoanalytic theory. Published reports of results with behaviour therapy to date consist largely of the assessment of results made by a therapist on his own patients, e.g., Wolpe (20, 21), Lazarus (9), Rachman (12). Cooper (2) studied results achieved by other therapists on thirty patients treated with various techniques of behaviour therapy. His survey included a comparison, using “blind” independent assessors, of a group of patients treated with behaviour therapy and a matched group of patients treated by other techniques. Cooper concluded that this comparison showed a definite advantage for behaviour therapy in the symptomatic treatment of phobias, but he could find no evidence supporting the claim of a superiority of the methods of behaviour therapy over conventional techniques in producing general changes. Unfortunately Cooper does not report the experience level of the therapists in his study except to say that they were a “variety of student and staff psychologists”. Evidence for a superiority of behaviour therapy must derive from a controlled comparison of matched groups of patients treated with techniques of behaviour therapy and with other techniques by therapists of comparable competence. But, pending judgment from such a controlled study, we believe ample evidence exists that techniques of behaviour therapy do bring comparable improvements more rapidly than do other treatments in some patients. The greater precision and shortening of therapy for these patients would alone constitute a very notable advance in psychotherapy, apart from claims of a wider or general applicability of these techniques. For this reason we believe it important to investigate these various techniques in as much detail as possible. Wolpe describes the most important of them as systematic desensitization (20, 21).

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023623 ◽  
Author(s):  
Suvi Sippola ◽  
Juha Grönroos ◽  
Ville Sallinen ◽  
Tero Rautio ◽  
Pia Nordström ◽  
...  

IntroductionRecent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking.Methods and analysisThe APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals.Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference.Ethics and disseminationThis protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT03234296; Pre-results.


1970 ◽  
Vol 27 (3) ◽  
pp. 787-794 ◽  
Author(s):  
Stuart B. Litvak

A distinction is made between desensitization techniques carried out in vivo and other modes of desensitization therapy (flooding, implosion, and systematic desensitization) which rely upon mental operations or processes. Research is reviewed and points are discussed which support a position supporting a relationship between variables and phenomena found in the desensitization therapies and those found in hypnosis. This relationship appears to be greatest in those desensitization therapies basing treatment upon the utilization of mental operations. Some new lines of research are then proposed.


1982 ◽  
Vol 10 (4) ◽  
pp. 346-355 ◽  
Author(s):  
William R. Lindsay ◽  
Bertram E. Stoffelmayr

Several writers have been interested in the extent to which behaviour therapy techniques are derived from the principles of learning. The present paper reviews this issue with respect to stimulus generalization and response generalization in behaviour therapy. Generalization has been a problem because many therapists have reported that newly learned skills and behaviours have not transferred outside the treatment situation to settings in the patients' or clients' life. Reviewing the literature on stimulus generalization it is concluded that in research on learning theory, stimulus generalization is shown to occur along a single stimulus dimension while in the behaviour therapy literature researchers often attempt to produce generalization across many stimulus dimensions simultaneously and as a result generalization may be poor. It is suggested that subsequent therapy and research should be designed so that treatment situations and generalization situations differ on as few stimulus dimensions as possible, thus maximizing the probability of generalization. With respect to response generalization it is felt that the concept is weak as an explanation for behaviour change and it may be more useful to consider that behaviours are functionally related, so that changes in behaviour A will produce changes in behaviour B or that covert responses may account for changes in untreated behaviours. Finally, a recommendation is made that therapists be more precise about the stimulus dimensions along which they wish behaviour to generalize.


1993 ◽  
Vol 21 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Jean Cottraux ◽  
Philippe Messy ◽  
Isaac M. Marks ◽  
Evelyne Mollard ◽  
Martine Bouvard

Fisher's stepwise discriminant analysis was carried out on 10 baseline variables searching for posterior prediction of success in a sample of sixty DSM-III obsessive-compulsive patients. The patients' median score on Hamilton rating scale of depression was 19. In a controlled study they were randomized into three groups: fluvoxamine with antiexposure, fluvoxamine with exposure, or placebo with exposure. In the whole sample, five variables accounted for 76% of the correctly classified patients: avoidance score of the behavioural avoidance test, behaviour therapy expectations, fluvoxamine expectations, Beck depression inventory and rituals repetition. High avoidance score predicted 68% of the correctly classified patients in the whole sample. The discriminant function classified correctly 70% of the patients in the antiexposure with fluvoxamine group, versus 75% in the exposure with fluvoxamine group, and 85% of the patients receiving exposure with placebo (χ2, d.f.2, NS).


1995 ◽  
Vol 167 (5) ◽  
pp. 635-641 ◽  
Author(s):  
Jean Cottraux ◽  
Ivan-Druon Note ◽  
Charly Cungi ◽  
Patrick Légeron ◽  
François Heim ◽  
...  

BackgroundThis multicentre study compared a 16-week buspirone treatment with placebo in patients presenting with panic disorder with agoraphobia and also receiving cognitive behaviour therapy (CBT).MethodDouble-blind testing was maintained until week 68, but not tested; 91 patients were included; 14 placebo-responders excluded; 77 patients randomised; 48 reached week 16 and 41 reached week 68.ResultsAt week 16, within-group analysis showed significant improvements in agoraphobia, panic attacks, and depression in both groups. Generalised anxiety improved only in CBT + buspirone. Between-group comparisons showed buspirone to have an effect on generalised anxiety and agoraphobia. Changes in degree of agoraphobia and depression were correlated in subjects on CBT + buspirone only. A significantly higher proportion of women, and of subjects showing high avoidance dropped out. Positive expectations regarding medication predicted success in both groups. At week 68, improvement was retained without significant buspirone effect.ConclusionBuspirone enhanced the effects of cognitive behaviour therapy on generalised anxiety and agoraphobia in the short term.


2002 ◽  
Vol 97 (10) ◽  
pp. 2585-2588 ◽  
Author(s):  
Daniel DiCesare ◽  
Herbert L. DuPont ◽  
John J. Mathewson ◽  
David Ashley ◽  
Francisco Martinez-Sandoval ◽  
...  

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