Therapist Variables in the Desensitization of Clinically Phobic Patients

Abstract

Research into desensitization usually draws a distinction between what are termed specific factors and what are termed nonspecific factors. Specific factors are those which form part of the definition of the procedure: graded presentation of stimuli, relaxation, active visualization, and so on. Nonspecific factors make up the somewhat ill-defined class of elements where the common property of each is simply its exclusion from the class of specific factors. Of all nonspecific factors, those involving relationship with a therapist have been thought to be the most important of those in need of investigation. The argument that desensitization success derives from the therapist - patient relationship has, however, been steadily and systematically eroded. Early controlled studies, albeit with nonclinical volunteer phobics, have shown that factors accruing from continuous relationship with a therapist are not sufficient conditions of success in desensitization. LANG and LAZOVIK (1963), LANG et al. (1965) and PAUL (1966) all utilized some variety of placebo control. The argument base on relationship in its strongest form has been dismissed as a result of these studies. Instead, the debate centres on whether relationship is a necessary condition of success; or, if not necessary, the extent to which it may be facilitatory.