In systematic desensitization, which step comes immediately after constructing the anxiety hierarchy?

• A. Desensitization in imagination
• B. Relaxation training
• C. In vivo desensitization
• D. Flooding

Answer: (A)

After constructing the anxiety hierarchy, the next step is desensitization in imagination. This stage uses vivid mental imagery to expose the person to each feared cue in the order of the hierarchy while they actively apply relaxation skills to stay calm. The idea is to pair the feared stimuli with a relaxed physiological state, reducing arousal gradually as they move through the items from least to most anxiety-provoking. Only after mastering imagined exposure do you typically progress to more real-life exposure (in vivo desensitization). Relaxation training itself is usually established before this step and is used during exposure, which is why it isn’t the immediate next move after building the hierarchy. Flooding, being a rapid, intense exposure, isn’t the next step in this gradual, stepwise approach.