Systematic desensitization

Abstract: This article reports the findings of two experimental tests of self-efficacy theory of behavioral change. The first study investigated the hypothesis that systematic desensitization effects changes in avoidance behavior by creating and strengthening expectations of personal efficacy. Thorough extinction of anxiety arousal to visualized threats by desensitization treatment produced differential increases in self-efficacy. In accord with prediction, microanalysis of congruence between self-efficacy and performance showed self-efficacy to be a highly accurate predictor of degree of behavioral change following complete desensitization. The findings also lend support to the view that perceived self-efficacy mediates anxiety arousal. The second experiment investigated the process of efficacy and behavioral change during the course of treatment by participant modeling. Self-efficacy proved to be a superior predictor of amount of behavioral improvement phobics gained from partial mastery of threats at different phases of treatment.

Abstract: The advent of behavior therapy was heralded by the appearance of Wolpe's book Psychotherapy By Reciprocal Inhibition in 1958. In contrast to freudian psychotherapy, behavior therapy did not arise out of empirical observations in the clinical situation from which a theory was then induced, but rather from a deliberate attempt to apply to the treatment of patients laboratory-derived learning theory which has so preoccupied American psychology for 50 years. Wolpe, as might be expected from a physician, worked largely within a framework of pavlovian learning theory and his technique or systematic desensitization has earned a solid place in the treatment of neurosis. However, the more recent developments in behavior therapy, especially with psychotic patients and children, have involved the application of that peculiarly American branch of learning theory—operant conditioning—and, in the process, behavior therapy has undergone a change of name to

Abstract: People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.