Which therapeutic technique involves directing clients' fantasies related to masturbation to modify stimuli associated with arousal?

The technique that directs clients' fantasies related to masturbation to modify stimuli associated with arousal is orgasmic reconditioning. This approach is designed to help individuals connect their sexual arousal with more appropriate or desired fantasies, rather than maladaptive or unwanted stimuli. By doing this, clients can reshape their sexual arousal patterns over time, reinforcing more positive associations with sexual feelings and behaviors.

This technique is especially relevant in addressing issues such as paraphilic disorders or unwanted sexual behaviors, where the goal is to redirect arousal toward healthier stimuli. It is a behaviorally oriented strategy that integrates awareness of sexual fantasies and the practice of redirecting those thoughts during masturbation to enhance overall sexual health and functioning.

In contrast to the other options, systematic desensitization primarily focuses on reducing anxiety responses via a gradual exposure to feared stimuli; behavioral modification involves altering behavior through reinforcement techniques without specific focus on sexual arousal; and imaginal exposure typically addresses anxiety or trauma through mental imagery rather than modifying arousal stimuli in the context of sexual fantasies. These distinctions clarify why orgasmic reconditioning stands out as the correct answer.