A girl with a phobia of flying is treated with systematic desensitization. Which finding indicates that the therapy has been successful?

Appeared in: NORCET-11 Mains

Explanation

Systematic desensitization is a behavioral therapy aimed at reducing phobic anxiety through gradual exposure paired with relaxation techniques.
The primary objective of behavioral therapy is to achieve a measurable, observable change in the patient's actual behavior.
The definitive proof of successful desensitization is the patient's ability to confront and endure the feared stimulus in real life (in vivo mastery).
Completing a flight journey demonstrates actual behavioral performance, which is the strongest objective evidence that the phobia has been successfully treated.

Why Other Options Were Wrong

Option B: Insight into the irrationality of a phobia is a defining diagnostic feature of specific phobias and is typically present before treatment even begins.
Option C: Planning a flight shows intention and a reduction in anticipatory anxiety, but it does not confirm that the patient will actually be able to board and complete the flight.
Option D: A subjective report of lessened fear is a positive sign of progress, but subjective reports are less reliable than actual behavioral mastery to declare the therapy fully successful.

Related Visual

Steps of systematic desensitization, showing the progression from relaxation training to hierarchy creation, and culminating in in vivo exposure actual behavioral performance.

Clinical Relevance

Nursing practice connection: Knowing Evaluation of Behavioral Therapy (Systematic Desensitization) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
In psychiatric nursing, evaluating the effectiveness of behavioral interventions relies heavily on objective, observable behavioral changes rather than solely on subjective reports.
Nurses should encourage patients to practice exposure exercises in real-world settings to solidify treatment gains.
What if? If the patient experiences a severe panic attack while planning the flight, the nurse should recognize that the patient needs further progression through their exposure hierarchy before attempting the actual flight.

How to Approach the Question

Identify the type of therapy mentioned in the stem: Systematic desensitization is a behavioral therapy.
Recall the primary goal of behavioral therapy: To produce a measurable change in actual behavior.
Evaluate the options based on this goal: Options B, C, and D represent cognitive, intentional, and subjective emotional changes.
Select the option that demonstrates the patient successfully performing the previously avoided behavior (Option A).

Concept Tested & Keywords

Concept Tested: Evaluation of Behavioral Therapy (Systematic Desensitization)
Stem keywords: phobia of flying, systematic desensitization, therapy has been successful
Lead-in keywords: Which finding indicates

Question ID

QI6H-_U5LSR7hy_iwr_VGt

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 5859-5861

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2424-2426

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