Are procedures like systematic desensitization that use imaginal exposure as effective as procedures ...

Research indicates that procedures like systematic desensitization that use imaginal exposure are not quite as effective as procedures that use in vivo (i.e., live) exposure. For example, the practice of giving a speech to a live audience more successfully desensitizes anxiety than imagining giving the speech. However, because fear can paralyze and prevent action, for some people it is more motivating to first take the transitional step through systematic desensitization on the way to confronting the real life phobic scenario than to try to confront the feared scenario without this preparation.