Under what conditions systematic desensitization is not recommended?

Answer:
Well, systematic desensitization is actually an old technique developed by Wolpe. His students have since come up with a technique that is just as effective but more convenient.

Since imagery has since been indicated to be as effective as circumstance (note "Imagery and the Brain" by Kosslyn) it's entirely possible to increase the patient's levels of stress with imagery. When the stress levels are maintained at a high state without negative consequence, the contingency between the phobia and the patient's avoidance behavior is extinguished.

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http://www.guidetopsychology.com/sysden.

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Systematic desensitization in the treatment of fear of flying. In this work we present the preliminary results for the validation of a systematic desensitization programme applied to fear of flying. The programme is made up of three phases: the first consists of four sessions in relaxation and imagination training, the second phase has three sessions focusing on the elaboration of the phobic stimulus hierarchy (travelling by plane); the third, with a minimum of five and maximum of eight sessions, deals with the application of the systematic desensitization, together with stop thinking. The programme was applied to 20 patients (treatment group), while 21 patients made up the waiting-control group. Therapeutic success was assessed by means of self-report scales, clinical interview and the recording of psychophysiological variables in a simulation situation. The results obtained appear to support the validity of the programme.

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