Created by Wolpe in the 1950s, systematic desensitization (along with aversive counter-conditioning and assertiveness training) is founded on the idea of counter-conditioning. Systematic desensitization uses reciprocal inhibition to decrease anxiety by substituting it with a relaxation reaction because it is impossible physiologically for relaxation and anxiety to exist at the same time. It previously was used for treating phobias, however, it is now found to be equally effective for treating chronic alcoholism, nightmares, and insomnia.

In the actual therapy, the client will be relaxed, form an anxiety hierarchy, and couple relaxation reactions with imagined anxiety-provoking hierarchy scenes (such as going to a bar after work to hang out with friends). The individual will also engage in real life desensitizations where he/or she will face the stimulus that causes fear, such as having an opened bottle of alcohol readily available.