Covert sensitization is a behavior therapy procedure, developed by Joseph Cautela and his colleagues in the 1960s, in which an unwanted target behavior is paired with an aversive stimulus with the use of imagery. For example, a clinician may instruct clients to visualize themselves beginning to engage in a maladaptive behavior targeted for change (e.g., overeating) and to then add aversive imagery, such as the experience of nausea and vomiting, to their visualization. The primary goal of this procedure is to eliminate the targeted maladaptive behavior through this visual pairing process. Covert sensitization is typically useful with cooperative clients who wish to change the behavioral target.

This procedure’s mechanism of action is the subject of some debate, with at least three behavioral formulations being hypothesized. The ...

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