The golden combination to prevent and reduce fear: systematic desensitization / counterconditioning (SD/CC)

In previous posts, I have described systematic desensitization (SD – introducing scary things gradually), and counterconditioning (CC), learning to associate potentially aversive stimuli with something nice.

The combination procedure is called SD/CC, DS/CC or CC/D depending on who you’re talking to; some people skip the first word of SD and only talk about desensitization. The procedure looks the same, though: after each exposure to the stimulus, the animal gets something it really likes. SD/CC to teach a cat to accept an injection may look like this: stroking a cat, then giving it some tuna. Stroking more firmly – more tuna. Lifting the skin – tuna again. Pinching – tuna. Needle prick – tuna. Injection – tuna… Voilà, cat looking for more tuna..! Rather than becoming more fearful on every subsequent visit, animals may become progressively easier to handle.


Some trainers will let the animal have access to the food preceding and during all handling, rather than just after each handling bout is initiated. That works too and may be a good choice when there’s little time and the process needs to be performed quickly. Beware that the presence of food before handling starts may be a distraction so the animal could potentially be unaware of the handling and may react violently if surprised. In the procedure I’ve described above, the animal actually learns that the initiation of handling happens before and therefore predicts treats. 

The combination procedure SD/CC is a very powerful tool in both preventing and reducing fear and is more efficient than either procedure carried out alone. Sensitization is a huge risk when exposing animals to a frightening stimulus, and the combined procedure reduces the risk of sensitization better than either SD or CC alone. Also, without SD it would be difficult to countercondition an animal to intensely frightening stimuli – when they’re over threshold (too aroused) they’re not that receptive to treats.

Gradually building up the exposure, and all the while repeating the association with treats – even in animals who are not fearful to begin with, builds up a conditioned emotional response (sometimes referred to as a CER): the animal starts looking forward to the procedure. More importantly, establishing such a routine will to some extent protect the animal from becoming afraid on future exposures, through the process of Latent Inhibition (learning something isn’t frightening inhibits fear learning regarding that particular something, later on).

So, will this work every time, with every animal? Unfortunately, no. Only about half the cats actually accept food at the vet’s. In such cases, other techniques can be used to reduce the risk of the animal becoming more fearful. Preventing fear is a lot easier than curing it – and the SD/CC procedure should be ideally be used before the animal develops any fear-related behaviour in the vet clinic.

In the video below, Monique Feyrechilde ( starts by explaining SD/CC, and at 2.31 minutes into the video she explains the steps she will take to teach the 14-year old cat Ziggy to accept injections of Adequan for his arthritis, to be given twice a week initially. Monique takes advantage of the observation that cats easily associate noises to future events, so she uses the sound of the syringe wrapper to countercondition Ziggy as the first step before even touching him (low level systematic desensitization). Also, note how she verifies that the food she’s intending to use to countercondition the handling actually has value to the cat. Notice how she starts each handling bout by initiating handling first and then presenting the food: handling precedes food (with overlap, so feeding continues as long as handling does).

… What’s your experience? Have you successfully used SD/CC – or what types of problems have you had? Let us know in the comment section below!

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Poppen, R., 1970. Counterconditioning of conditioned suppression in rats.


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