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Possible mechanisms for why desensitization and exposure therapy work
1Department of Psychology, Fordham University, Bronx, NY 10458-5198, USA. wtryon@fordham.edu
Clinical Psychology Review
|December 15, 2004
Summary
Psychology should focus on empirically supported principles of change (ESPs) rather than trademarked treatments. A connectionist learning-memory mechanism offers a promising explanation for therapeutic effectiveness, supporting this principle-based approach.
Area of Science:
- Psychology
- Behavioral Science
- Neuroscience
Background:
- The debate between empirically supported treatments (ESTs) and empirically supported principles (ESPs) in psychology is ongoing.
- ESTs may allow for the creation of new, potentially ineffective therapies by adding inert components to existing treatments.
- Systematic desensitization and exposure therapy are early examples of ESTs with attempts at explanatory mechanisms.
Purpose of the Study:
- To review and evaluate proposed mechanisms underlying the effectiveness of systematic desensitization and exposure therapy.
- To demonstrate the utility of focusing on ESPs over specific treatment packages.
- To propose a connectionist learning-memory mechanism as a unifying explanation for therapeutic change.
Main Methods:
- Literature review of existing explanations for systematic desensitization and exposure therapy.
- Critical analysis of proposed mechanisms including reciprocal inhibition, counterconditioning, habituation, extinction, cognitive changes, and emotional processing.
- Integration of findings from behavioral and neuroscience research to support a connectionist model.
Main Results:
- Existing explanations for therapeutic mechanisms often face logical challenges or lack sufficient empirical support.
- A connectionist learning-memory mechanism provides a viable alternative explanation for treatment effectiveness.
- This connectionist model is supported by evidence from both behavioral and neuroscience research.
Conclusions:
- Prioritizing empirically supported principles of change (ESPs) over specific treatments is recommended for advancing psychological science.
- Connectionist learning-memory models offer a robust framework for understanding therapeutic mechanisms.
- Further research and discussion are needed to explore the implications of connectionist explanations for ESPs.
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