Sexual fantasy alternation: procedural considerations

Abstract

Leonard and Hayes (1983) reported several clinical trials of the sexual fantasy alternation procedure, a form of orgasmic reconditioning. Due apparently to unfamiliarity with several essential components of the procedure, their results were equivocal and they questioned the clinical utility of the technique. In this report the Leonard and Hayes study is evaluated on the issues of subject selection, evaluation of pre-treatment baseline data, prediction for direction and magnitude of effect, mechanisms of effect and ethical concerns. It is concluded that, if clinicians respect certain basic conventions, the sexual fantasy alternation procedure is considerably more orderly than the authors believe.