Systematic desensitization is then less dramatic and as the name suggests more systematic. It is argued that relaxation and anxiety cannot co-exist and the therapy begins with the patient being encouraged to relax. In this state the anxiety producing object or event is slowly introduced, whether through imagining the fearful situation, watching a film or actually experiencing the fearful situation. The therapist designs a hierarchy to work through with the patient with easier tasks to overcome at the bottom and the ultimate goal at the top. They patient and therapist then systematically work through this hierarchy.
From operant conditioning the therapy of token economies has been developed. A token economy changes behaviour by reinforcing good behaviour with ‘tokens’. The token is a secondary reinforcer, which is later exchanged for a primary reinforcer, for example a chocolate bar or other treat.
These behavioural therapies are appropriate for a number of disorders, in particular anxiety disorders such as phobias and OCD. Token economies are also particularly suited to treating eating disorders. Flooding and Implosion however are not suitable for children.
A benefit of both classical and operant conditioning therapies, are that they are short in duration making them cheaper and more accessible to people unlike treatments such as psychoanalysis under the psychodynamic model which take a long time. These therapies can also be tailored to suit an individual patients needs.
Because of the nature of the behavioural model which measure specific behaviours in precise terms such as how many times a negative behaviour is performed, improvements can be accurately measured. Which in turn means therapies effectiveness can also be measured. The classical conditioning therapies have been proved to be effective by Wolpe who found an 80-90% success rate with these therapies. Barlow and Lehmen also found a success rate of 77% following treatment. However medication can interfere with systematic desensitization because medication suppresses anxiety. Operant conditioning is also based on scientific principals proven to be effective by Azrin who examined female patients in a mental hospital who were incapable of doing everyday tasks. Using token economies, positive behaviour in these women increased. However studies looking at children and students by Lepper and Deci also found that rewarding intrinsic interests actually reduces behaviour.
A strength of the classical conditioning therapies is that the patients have a high level of control. In token economies however patients have very little control over their therapies. This raises ethical issues as informed consent is not achieved for token economies, instead they are enforced with or without the patients consent. Token economies are also open to abuse and can be deemed as a form of social control. Classical conditioning therapies also raise ethical issues in terms of putting their patients at risk of emotional harm.
Other problems with classical conditioning therapies include the fact that some patients may not have a vivid enough imagination for flooding, and social desensitization may be difficult to arrange and control, whereas token economies are practical as they can be done anywhere. A problem with token economies though, is that changes are due to external rewards and not an innate desire to change and so if the rewards are removed the positive behaviour may cease.
Finally debate will also continue whether the treatments provided by the behavioural model only treat the symptoms and not the causes, and if only the symptoms are treated, does it matter?
