Play desensitization of fear of darkness in preschool children.

Systematic desensitization therapy (SDT) is considered to be a technique of established effectiveness in reducing monosymptomatic fears (Paul, 1969a, 1969b), yet little systematic research has been done to investigate the merit of desensitization procedures in modifying children's behavior. The few available controlled studies (Miller et al., 1972; Obler and Terwilliger, 1970; Oliver, 1971) on desensitization with children have produced equivocal results. Although imagery and relaxation have been reported of benefit when used separately (Graziano and Kean, 1971; Lazarus and Abramovitz, 1962), evidence suggests that the usual combination of imagery and relaxation is not effective in reducing children's fears (Miller et al., 1972). Investigators in this area have often modified traditional SDT to include alternatives to imagery such as pictures, drawings, play (Cassell, 1965; Lazarus, 1960; Obler and Terwilliger, 1970; Patterson, 1965), or in vivo exposure to the feared stimulus (Obler and Terwilliger, 1970). Relaxation has often been replaced with other responses thought to be incompatible with anxiety such as eating (Jones, 1924). Another deviation from traditional SDT has been the delivery of positive reinforcement (food, praise, or toys) contingent upon the child's approaching the feared object (Obler and Terwilliger, 1970; Patterson, 1965). On the basis of such varied techniques, it is impossible to determine which of these procedures constitutes an effective treatment method for children. In the following study, three desensitization procedures involving graded exposure to the feared stimulus (darkness) through symbolic play, were compared to no-treatment and placebo control groups under differing instructional sets. Treatments were designed to determine the therapeutic efficacy of play as a method of stimulus presentation with children, and to determine whether reciprocal inhibition, extinction, operant reinforcement, or instructional set contribute to fear reduction in desensitization with children.