Treatment of excessive urinary frequency and urgency by desensitization and progressive retention training.

A 20-yr-old male presenting a 2-yr history of excessive urinary urgency and frequency was treated with a three-phase behavioral intervention. Progressive urinary retention training was first suggested to decrease urinary frequency and increase functional bladder capacity (phase one). The patient was not able to comply with the instructions, showing a phobic fear of accidents and an over-valued consideration of the social consequences of incontinence. Systematic desensitization, in vivo desensitization and cognitive restructuring were implemented in phase two. The patient was then able to comply with the progressive urinary retention training (phase three) and completely overcame his problem. Gains were maintained at 6 and 12-month follow-ups. The results suggest that progressive urinary retention training alone is effective both at the behavioral and physiological levels, but its application is facilitated by a consideration and modification of the patient's subjective attitude towards excessive micturition frequency and its feared consequences.

In vivo desensitization of a severe driving phobia through radio contact with telemonitoring of neurophysiological reactions.

A 34 year-old man with a severe driving phobia was treated by in vivo desensitization. A radio transceiver was used to provide the anxiety inhibiting effects of voice contact during exposure to phobic driving experiences. Transceivers were linked to a Telemonitor apparatus programmed to broadcast heartbeat and GSR readings automatically every 15 minutes or on demand, each of 10 seconds duration. The therapist was therefore in touch with the subjective and physiological arousal of the patient from distances up to 7 miles. This allowed him to conduct more efficiently a program of in vivo graduated exposure. Treatment effects were maintained at a 9-month follow-up.