Assessing the process of desensitization therapy: Five practical measures

Assessment of phobic behavior has included self-report, physiological, and in vivobehavioral measures. While self-report measures are convenient, they suffer from subject bias and a low predictive validity. Physiological and in vivobehavioral measures are often too cumbersome to implement in standard clinical practice. The current study investigated the validity of five convenient measures of phobic behavior during the process of desensitization therapy. Responses of 14 clinically phobic patients were compared on phobic and neutral scenes presented within the context of systematic desensitization therapy. Phobic scenes resulted in less clarity of scene visualization, a longer latency to clear scene visualization, higher subjective units of discomfort (SUDs) at clear visualization, a longer latency to relaxation, and higher SUDs at relaxation. The measures seemed to reflect accurately the process and stages of desensitization therapy and showed low to high intercorrelations. The pragmatic value of these measures is discussed, as well as suggestions for future validational research.     

Modification of extreme social isolation by contingent social reinforcement

Two socially isolated patients were placed on a program where social reinforcement from staff members was made dependent on social interaction with other patients or staff members. This procedure was imposed in a setting where only limited control was possible. The level of social interaction and a concomitant alternate behavior in each patient was increased when the contingency for social reinforcement was imposed. The study provides another example of the efficacy of social reinforcement where there is little control over other reinforcers. Implications for use of similar procedures to increase generalization in the community are discussed.