ICD treatment psych imaginal desensitisation

Question 1

imaginal desensitisation

Answer 1

ICD environmental cues trigger urges to enact behaviour
ID uses relaxation based imagery to reduce strength of these urges
reducing excitement and physical arousal to triggering stimulus

Question 2

how imaginal desensitisation works

Answer 2

empowers client by developing coping skills
building self efficiacy

mcconaghy’s 1980 behaviour completion mechanism

compulsive behaviour repeated bc person doesnt complete full behaviour sequence

imagine full behavioural sequence nd feelings that go w it to reduce urges and behaviour
and the tension that reinforces it

Question 3

progressive muscle relaxation

Answer 3

sessions in a quiet room
4-5 mins of progressive muscle relaxation (PMR)
tensing diff muscle groups while breathing in and relaxing them when breathe out

relaxation so anxiety cant interfere during guided imagery session

can be applied in situations that trigger arousal and urges
neutralising and calm

Question 4

guided imagery

Answer 4

open qs to identify typical behavioural sequences linked to onset of urges

environmental cues easy like radio adverts
personal cues like feeling lonely harder

may be asked to monitor urges before initial discussion using handouts

break sequence into 4-6 scenes leading up to behaviour

then write guided imagery script for 20 mins w the 6 stages
script used in f2f sessions w client
made into audio recording for between sessions

Question 5

homework

Answer 5

2-3 times a day for 5-7 days

record progress on handouts

blaszczynski and nower 2003 advise 15 sessions in 7 days
20 min sesions at same time daily

handouts designed to track sessions and monitor strength of urges and incidents of target behaviour

may only have 2/3 f2f sessions
1) inform design of script
2) practice relaxation and run thru script and details of how to practice @ home
3) check progress and see if need modify script

Question 6

strength - research evidence

Answer 6

80% w gambling disorder fiund long term relief after 6 sessions grant et al 2011

after 6 months gambling urges and behaviour much improved compared to pre treatment

despite reduction in hours therapy can have long term success

BUT small increase in symptoms at the 6 month follow up compared to immediate post treatment
so relapse IS possible without maintenance sessions or regular practice

Question 7

strength - practicality

Answer 7

hgih level of client satisfaction
quicker and cheaper than other CBT
sessions can be recorded to time is mostly for interviewing to make scripts rather than f2f therapy
more cost effective for client and provider so increases access to therapy for those who can’t otherwise afford it

Question 8

weakness - undermotivation/org

Answer 8

won’t work if forget guided imagery sessions
less effective w attention deficit disorder or comorbid disorders including depression

BUT grant et al 2012 treated a 17 yo korean american client w ASD OCD and klepto
therapists should make treatment based on individual client
personal strengths etc
depending on support they have

Question 9

weakness - TAKES EFFORT and relies on relaxation and immersion

Answer 9

some clients find difficult
need meds to relax
takes effort to carry out 3 times a day if only for a week

may prefer to either augment it w anti anxiety meds or use drugs bc minimal effort other than j taking the drugs