is there a difference between systematic desensitisation and gratuated exposure? Saw a question on a practice exam of it.
In the research literature, the terms "systematic desensitisation" and "graduated exposure" are often confused, often because systematic desensitisation approaches involve a degree of graduated exposure to a fear/anxiety-inducing stimulus. As youshine mentioned however, there is a difference.
Both SD and GE are types of
Exposure-Based Interventions in CBT for fear/anxiety, phobias and related disorders such as PTSD.
Graduated exposure aims to gradually expose patients to stimulus reminders (or the stimulus itself) that are more salient or intense as treatment progresses. Starting with relatively non-confronting exposures, up to more intense exposures.
Often at the beginning of therapy, the clinician will use psychological interviewing techniques establish a hierarchy of stimulus reminders that the patient has rated from "least to most fearful". The graduated exposure therapy will then progress along this hierarchy at a pace that depends on the patients degree of responsiveness. It is important that the exposure is to realistically non-dangerous cues as it progresses or else the fear may be reinforced, rather than diminished. Also, it is important at each stage that the patient clearly recognises that their fearful expectations have not come true - in other words, by gradually exposing them to symbolic and imaginary representations and then eventually real instances of the feared stimulus, their 'worst nightmares' haven't come true.
For example in a patient that has arachnophobia, the psychologist establishes the following hierarchy of what the patient fears least to most: looking at the word 'spider', thinking about a spider moving, looking at a photo of a spider, looking at a video of a spider, talking about an incident where they were exposed to a spider, being in a room with a spider behind glass etc etc. Then the psychologist may start the session by getting the patient to write the word spider and then discuss maybe one thing they fear about spiders while looking at the word. They patient may start to recognise that exposure to spider-related stimuli doesn't result in harm and thus their fearful anticipation is somewhat alleviated. This approach allows the psychologist to change the pace according to progress - if something is too stressful, it can be toned down to avoid reinforcing the fear - which is why this graduated approach is often used in children and adolescents who can be more easily overwhelmed than many adults.
Systematic desensitisation, which is based on Wolpe's principle of "reciprocal inhibition", is similar to GE in that it too gradually exposed patients along a fear hierarchy, but it is different in that it adds procedures/techniques to produce physiological and psychological reactions that are incompatible with fear and anxiety. It's essentially a de-conditioning process.
In the arachnophobia example, the psychologist and patient may have graduated up to looking at a photo of a spider. To counter the patients fear response (ie fight or flight response - e.g. muscle tension, heavy breathing, jitters), the psychologist may subtly play relaxing or 'happy' music in the background and get the patient to perform muscle relaxation and breathing exercises. Maybe humour could be brought in (e.g. make a joke about a celebrity who looks like a spider). Some researchers have argued that relaxing physiological reactions "compete" with fearful reactions in this scenario.
Some in summary:
Graduated exposure: gradually expose patients to a hierarchy of reminders/fearful stimuli are more salient or intense as treatment progresses.
Systematic desensitation: gradually expose patients to a hierarchy, while adding procedures/techniques that produce physiological (or psychological) reactions that are 'incompatible' with fear and anxiety.
Note: I am unfamilar with the exact requirements of VCE psychology, so you may or may not be required to make this distinction.