International Research Journal of Advanced Engineering and Science

ISSN (Online): 2455-9024

Effectiveness of Systematic Desensitization for

Decreasing of Anxiety in Individual with
Specific Phobia
Agus Prayetno, Raras Sutatminingsih, Josetta M. R. Tuapattinaja
Faculty of Psychology, University of Sumatera Utara, Indonesia

Abstract— This study aims to examine the effectiveness of systematic

desensitization to reduce anxiety in individuals with specific phobia.
daily activities. Moreover, individuals with specific phobias
The research design used a quasi-experimental one group pre-test will usually experience physical symptoms such as fatigue,
post-test design. The sampling method used a purposive sample. The weakness, cold sweat, palpitations, dizziness, nausea, tremors
subject of this study consisted of six people with specific phobia or want to faint when meeting directly with the object or
according to DSM-5. The systematic desensitization module used situation they anxiety.5,10 Besides, specific phobias are
includes the relaxation exercises, develop a hierarchy of anxiety- important risk factors in the development of other mental
producing stimuli, the process of imagining a hierarchy of anxiety disorders. Specific phobias are predictors of increasing
while maintaining relaxation. Therapy sessions were given six times suicidal tendencies, and risk factors for developing major
in three weeks. Quantitative data is taken from the Subjective Units of
depression or anxiety disorder. Specific phobias are also
Discomfort Scale (SUDS). The quantitative data obtained were
analyzed using the Wilcoxon nonparametric statistical test. The associated with physical illnesses such as respiratory illness,
results showed a decrease in anxiety scores in individuals with heart disease, vascular disease, migraines, and others. 14 For
specific phobias after being given systematic desensitization (p = this reason psychological treatment is needed, so that specific
0.014; p <0.05; Z = -2.201). Based on the results of the statistical phobias do not develop into other disorders.
analysis shows that systematic desensitization is effective in reducing Several factors influence the development of specific
anxiety in individuals with specific phobias. phobias namely genetic, educational and economic, learning
behavioral, and cognition.5 Learning behavior can affect
Keywords— Anxiety, Systematic Desensitization, Specific Phobia. specific phobias due to classical conditioning, modeling, and
I. INTRODUCTION information transmission. Classical conditioning explains that
a person can be conditioned to show an anxiety response to a
One of the most common disorders in populations in the world harmless situation by repeatedly linking a harmless
is Specific Phobia. In Europe, the estimated number of conditioned stimulus to a dangerous stimulus.4 The
specific phobia sufferers is 7.7% - 15.3% of the general transmission of negative information has the effect of forming
population. In East Asia, the population experiencing specific beliefs related to anxieties or fears about certain situations or
phobias is 2% -4% with details of 2.6% in China, 3.4% in objects. Information transition is done by studying information
Japan, and 3.8% in Korea. Whereas in America around 6%. conveyed by others that an object or situation is dangerous. 15
2,5,12
Hamm revealed someone called experiencing a specific Modeling is a process that can also develop phobias. Modeling
phobia characterized by constant anxiety and fear caused by a refers to the phenomenon that anxiety can be learned by
particular object or situation accompanied by a strong desire to observing other people's responses to certain stimuli or
escape or avoid meeting with an object or event that is the situations.9
main feature of a specific phobia.6 In DSM-5, specific phobias Several psychological therapies can be performed to treat
are classified into five types: animal (for example dog, snake, specific phobias, one of which is systematic desensitization.
insect), natural environment (for example dark, altitude, Systematic desensitization is an intervention developed by
storm), situational (For example closed space, elevator, fly), Wolpe based on the classical conditioning principle. The goal
blood-injection-injury (For example: see blood, receive of this therapy is to reduce the response of negative emotions
injections) and other subtypes (For example: choking, noise, in people with phobias by connecting the dreaded stimulus
character costumes).2 with something soothing.8,5,13 The implementation of systemic
Individuals with specific phobias usually tend to ignore the desensitization has three stages: participants learn to use one
disorder they experience compared to individuals with other of the relaxation skills, therapists and participants develop a
phobias. Only one-tenth to a quarter of individuals with hierarchy of anxiety-producing stimulus, participants
specific phobias receive treatment, the rest are many gradually imagine the hierarchy of anxiety-producing stimulus
individuals with specific phobias not seeking treatment. This while applying relaxation.
possibility is caused by avoidance behavior can reduce the
pressure and disturbances experienced. Even though the II. OBJECTIVE AND METHOD
perceived impact can prevent them from carrying out their The main objective of this study is to examine the
effectiveness of systematic desensitization to reduce anxiety in
124

Agus Prayetno, Raras Sutatminingsih, and Josetta M. R. Tuapattinaja, “Effect of Systematic Desensitization for Decreasing of Anxiety in
Individual with Specific Phobia,” International Research Journal of Advanced Engineering and Science, Volume 5, Issue 3, pp. 124-126,
2020.
 International Research Journal of Advanced Engineering and Science
ISSN (Online): 2455-9024

individuals with specific phobias. The design of this study

and diaphragmatic breathing). After they managed to learn it.
uses a quasi-experimental one group pre-test post-test design.
The therapist then invites participants to identify some of the
The sampling method used was purposive sampling.
triggers for anxiety and then compile them from stimuli that
Participants in this study were six people with specific phobias
are less anxiety to the most anxiety when faced with the object
according to DSM-5 criteria. All participants aged 19-30
phobic. After the participants managed to arrange it in the
years. Each participant was given systematic desensitization
form of a hierarchy of anxiety, the therapist asked participants
therapy individually. Therapeutic sessions were given six
to imagine the hierarchy of anxiety gradually and asked
times in three weeks. Quantitative data were taken from the
participants to relax while imagining it. The process of
Subjective Units of Discomfort Scale (SUDS) and analyzed by
imagining is repeated until participants feel able to fight their
Wilcoxon nonparametric statistical tests.
anxiety and feel more comfortable.
III. RESULT AND DISCUSSION The success of participants in dealing with anxiety stimuli
imaginary creates confidence to challenge themselves to face
This study hypothesizes that systematic desensitization is
more extreme anxiety stimuli. Even participants felt ready to
effective in reducing anxiety in individuals with specific
face directly their anxiety stimulus. This is evidenced by
phobias. The Wilcoxon analysis test results of pre-test and
participants accepted the challenge from the therapist to face
post-test scores obtained Z = -2,201 and obtained a
directly some of the situation the hierarchy of anxiety that
significance value of 0.014 less than p <0.05, it can be
successfully they passed through imaginal processes. It seems
concluded that there are significant differences between
that participants began to prepare themselves by doing
pretest and posttest in participants after systematic
relaxation and still seeing the anxiety object and continuing to
desensitization. This shows a decrease in the anxiety of the
relax. After several times the participants felt bolder and were
phobic objects in participants with specific phobias after the
not afraid to see the object they were afraid of. Following
administration of systematic desensitization.
research conducted by Rajiah and Saravanan, it was revealed
In DSM-5 specific phobias are characterized by excessive
that psychoeducation and systematic desensitization had a
fear and anxiety towards certain objects or situations. The
significant effect in reducing anxiety, psychological pressure,
object or situation of phobia is always avoided by intense
and amotivation on first-year pharmacy students in Malaysia.
anxiety.2 Participants who received systematic desensitization
Students who receive psychoeducation and systematic
in this study experienced a decrease in the anxiety of phobia
desensitization can reduce anxiety and psychological stress
objects or situations. Ifeany revealed systematic
before the exam, which in turn increases their confidence and
desensitization is a therapy that has been developed by experts
motivates them to obtain a higher GPA. 11 This study confirms
to eliminate maladaptive behaviors such as fear, anxiety,
that systematic desensitization plays a role in influencing the
insecurity, and depression.7 Research conducted by Abood and
emergence of self- confidence in participants to facing more
Abu-Melhim also revealed that systematic desensitization
challenging situations that cause anxiety.
contributed to reducing the anxiety and fear associated with
The results of this study indicate a change in behavior in
learning foreign languages.1 This statement adds to the
the participants. If previously the participants did not dare and
evidence that systematic desensitization can indeed reduce
avoid their phobic object. After undergoing systematic
anxiety. The difference in this study is systematic
desensitization the participants do relaxation and stay faced
desensitization is effective in reducing anxiety in individuals
with the objects or phobic situations.
with specific phobias.
The decrease in anxiety was also evident from the reduced IV. CONCLUSION
physical response experienced by participants after getting
Based on the results of this study it can be concluded that
systematic desensitization. Physical responses such as
systematic desensitization is effective in reducing anxiety in
palpitations, cold hands, trembling, rapid breathing, and tense
individuals with specific phobias. This can be seen from the
when faced with phobia objects or situations have been
Wilcoxon test results, pretest scores and posttest scores
reduced and successfully overcome by doing the relaxation
obtained Z scores = -2.01 and scores p = 0.014 so that p <0.05.
taught. The body's response such as palpitations, cold hands,
based on the results of Wilcoxon analysis it was found that
trembling, rapid breathing is the autonomic arousal
there were significant differences between the pretest and
experienced as components of the fear and anxiety problem
posttest of study participants after systematic desensitization
experienced. Relaxation procedures are used to reduce
was given. This means that after systematic desensitization,
autonomic arousal.8 Carter, et al. stated that relaxation is a
the participant experiences a decline in the anxiety of the
series of practices that are performed to obtain a relaxed
object or situation of phobic.
(comfortable) response, and reduce overall physical arousal
symptoms. Individuals with phobias applying relaxation REFERENCES
techniques aim to reduce the stress of the dreaded stimulus. [1] Abood, M. H dan Abu-Melhim, A-R. H. "Investigating the Effectiveness
Decrease physical symptoms in participants, making them of Systematic Desensitization in Reducing Anxiety among Jordanian
confident and bolder against anxiety when dealing with EFL Learners," Arab World English Journal, Conference Proceedings,
objects or situations of phobic.3 pp.54-70, 2015.
[2] American Psychiatric Association (APA). Diagnostic and Statistical
In systematic desensitization, participants are trained to Manual of Mental Disorders, Fifth Edition, DSM 5. Washington D.C.:
use two relaxation techniques (progressive muscle relaxation American Psychiatric Association, pp.197-199, 2013.

125

Agus Prayetno, Raras Sutatminingsih, and Josetta M. R. Tuapattinaja, “Effect of Systematic Desensitization for Decreasing of Anxiety in
Individual with Specific Phobia,” International Research Journal of Advanced Engineering and Science, Volume 5, Issue 3, pp. 124-126,
2020.
 International Research Journal of Advanced Engineering and Science
ISSN (Online): 2455-9024

[3] Carter, A.E., Carter, G., Boschen, M., Alshwaimi, E., & George, G.
"Pathway of anxiety and anxiety in dentistry: A review," World Jornal Psychology, Universitas Gadjah Mada., Yogyakarta, Indonesia, 2017.
Clinical Cases, vol 2, issue 11, pp 642-653, 2014. [11] Rajiah, K., & Saravanan, C. “The effectiveness of psychoeducation and
[4] Coelho, C.M dan Purkis, H. "The Origins of Specific Phobias: Systematic Desensitization to Reduce Test Anxiety Among First-year
Influential Theories and Current Perspectives," Review of General Pharmacy students," American Journal of Pharmaceutical Education,
Psychology, vol 13, issue 4, pp 333-348, 2009. vol 78, issue 9, pp 163-169, 2014.
[5] Eaton, W.W., Bienvenu, O.J dan Miloyan, B. "Specific Phobia," Lancet [12] Rudaz, M., Ledermann, T., Margraf, J., Becker, E.S., Craske, M.G. “The
Psychiatry, Vol 5, issue 8, pp 678-686, 2018. moderating role of avoidance behavior on anxiety over time: Is there a
[6] Hamm, A.O. "Phobias Across the Lifespan," International Encyclopedia difference between social anxiety disorder and specific phobia?” Plos
of the Social & Behavioral Sciences, 2nd edition, vol 18, pp37-44, 2015. One, vol 12, issue 7, pp 1-14, 2017.
[7] Ifeany, A. "Effect of systematic desensitization technique on test anxiety [13] Singh, J., Singh, J. “Treatment Options for The Specific Phobias,”
among secondary school students," International Journal of Humanities International Journal of Basic and Clinical Pharmacology, 5(3): 593-
Social Sciences and Education, vol 2, issue 2, pp 167-178, 2015. 598, 2016.
[8] Miltenberger R.G. Behavior Modification Principles & Procedures. [14] Witthauer, C., Ajdacic-Gross, V., Meyer, A.H., Vollenweider, P.,
USA: Wadsworth Cengage Learning, 2012. Waeber, G., Preisig, M., Leib. R. “Associations of specific phobia and
[9] Muris, P & Merckelbach, H. Specific Phobia: Phenomenology, its subtypes with physical diseases: an adult community study,” BMC
Epidemiology, and Etiology. Netherlands: Springer Science+Business Psychiatry, vol 16, issue 155, pp 1-10, 2016.
Media, pp 3-18, 2012. [15] Koerner. N, Rogojanski, J. dan Antony, M.M. Specific Phobia.
[10] Mutiara, V. “Empathic Love Therapy untuk mengurangi Kecemasan Cambridge University Press, pp 61-67, 2010.
pada Individu dengan Fobia Spesifik,” M.S. thesis, Department of

126

Agus Prayetno, Raras Sutatminingsih, and Josetta M. R. Tuapattinaja, “Effect of Systematic Desensitization for Decreasing of Anxiety in
Individual with Specific Phobia,” International Research Journal of Advanced Engineering and Science, Volume 5, Issue 3, pp. 124-126,
2020.