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Improvement resulting from real-life exposure usually does not disappear shortly after treatment - once people have fully desensitised themselves, they can remain free of fear. Real-life desensitisation does however involve the uncomfortable prospect of having to tolerate the unpleasantness of facing phobic situations, and of having to persist with the practising of real-life desensitisation on a regular basis.

The procedure of real-life desensitisation involves the use of a basic hierarchy of phobic scenes that have been constructed to bring about desensitisation (see examples). Goals must be clearly defined, with careful consideration given to what constitutes full recovery. A timeframe should be decided on by which goals should be realised. Broad goals, such as shopping in a mall for example, are fragmented into smaller, more manageable goals, such as travelling to the mall, walking around outside the mall and then eventually shopping in the mall.

The hierarchy presented below can be used as guidelines for attaining desensitisation to one of the most common social phobias:

Fear Of Speaking In Public

• In any group situation, while sitting down, make a one-sentence comment.
• Make a 3 to 5 minute comment while sitting with a group.
• Standing up in a small group, make a 30 second comment.
• Announce to a small group that you will be giving a short comment at every break.
• Join Toastmasters.
• In a familiar group, stand up and make a comment.
• In a familiar group, stand up and make a short statement.
• Present a short talk on any subject.
• Make a comment at any meeting you may attend.
• Return to the group some time later and comment on your progress.

Information supplied by the Depression and Anxiety Support Group

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