Chapter Seven: Behavioral Theory and Therapy

							Chapter Seven: Behavioral
Theory and Therapy
Historical Context
 The Third Force
  – Behaviorism as science
  – Little Hans and Little Albert
  – Little Peter
 Behavior Therapy
  – Skinner
  – Wolpe/Lazarus/Rachman
Theoretical Principles of Behavioral
Theory and Therapy
 Based on Learning Theory


 Strong allegiance to efficacy research
Theoretical Models of Applied
Learning Theory

 Applied Behavioral Analysis
 Neobehavioristic, Mediational Stimulus-
  Response Model
 Social Learning Theory
 Cognitive Behavioral
Theory of Psychopathology

 All behavior, both adaptive and
  maladaptive, is learned.
 ―Pathology‖ is inadequate learning or skills
  deficit
The Practice of Behavior
Therapy
 Preparing yourself


 Preparing your client


 Assessment Issues and Procedures
Specific Therapy Techniques

 Operant Conditioning
 Relaxation Training
 Systematic Desensitization
 Other Exposure-Based Treatments
Specific Therapy Techniques
(continued)
 Skills Training
   – Assertiveness and other social behavior
   – Problem solving
Extended Case Examples

 Assessment
 Medical consult
 Specific behavioral interpretations and
  instructions
Therapy Outcomes Research

 Historical comments
 Specific treatment for specific disorders
 Conceptual commentary
Multicultural Perspectives

 Some cultures prefer active, directive
  qualities of behavioral treatments
Concluding Comments
 Behavior therapy has evolved
 Less deterministic
 Admirable allegiance to research
Student Review Assignments
 Critical corner
 Reviewing key terms
 Review questions
Critical Corner
 Some critics might claim that behavior therapy is
  fundamentally flawed because it involves one
  person (a designated expert) teaching another
  person (a vulnerable client) about what’s normal
  and acceptable behavior. Although behaviorists
  may hide behind ―symptom reduction‖ as their
  lofty goal, in reality, they are simply teaching
  clients to ignore symptoms and the symptom’s
  important underlying messages to the client.
Critical Corner (continued)
 Despite the emphasis in this chapter on the
  flexible, clinically astute behavior therapist,
  most behavior therapists are just
  technicians. For the most part, they aren’t
  attuned to or very interested in client’s
  feelings, the dynamics of the therapy
  relationship or life’s meaning and so they
  ignore these bigger issues, focusing instead
  on trivial and less important matters.
Critical Corner (continued)
 Although there is ample scientific evidence
  attesting to the efficacy of behavior therapy,
  behavior therapists have generated most of this
  evidence. There is no doubt that behavior therapy
  researcher bias exists and that behavior therapist
  researchers construct outcome measures that rig
  the outcomes in their favor. Overall, the
  promotion of behavior therapies as ―Empirically
  Validated Therapies‖ smacks of a business-related
  scam designed to improve insurance
  reimbursement rates for behaviorally oriented
  therapy providers.
Critical Corner (continued)
 The length to which behavior therapists will
  go to dehumanize individuals is scary.
  Examples include aversive conditioning
  using electric shock, token economies that
  curtail the freedom and dignity of patients,
  and the excessive punishment of children in
  our schools. The biggest problem with
  behavior therapy is that humans are treated
  more like rats or pigeons than humans.
Critical Corner (continued)
Critical Corner (continued)
 Behavior therapy is currently governed by so
  many divergent learning theories that the entire
  field is not much more than a hodge-podge of
  different techniques. If you look hard, you’ll find
  it’s difficult to find an underlying theory that
  guides the entire field. This lack of backbone will
  only get worse until behavior therapy begins to
  base itself on a coherent theory—rather than
  simply basing itself on scientific methodology.
Review Key Terms
 Behavior therapy
 Behaviorism
 Classical conditioning
 Operant conditioning
 Counter-conditioning
 Applied behavior analysis
 Stimulus-Response (S-R) theory
 Neobehavioristic mediational S-R model
Key Terms (continued)
 Stimulus generalization
 Stimulus discrimination
 Extinction
 Spontaneous recovery
 Social learning theory
 Observational learning
 Positive reinforcement
 Punishment
Key Terms (continued)
 Negative reinforcement
 Systematic desensitization
 Self-efficacy
 Cognitive-behavioral therapy
 Behavioral ABCs
 Operational definition
 Self-monitoring
 Token economy
Key Terms (continued)
 Fading
 Aversive conditioning
 Progressive muscle relaxation
 Exposure treatment
 Imaginal and in-vivo exposure
 Massed vs. spaced exposure
 Virtual reality exposure
 Interoceptive exposure
Key Terms (continued)
   Response prevention
   Participant modeling
   Skills training
   Assertiveness training
   Problem-solving
   Generating behavioral alternatives
   Breathing retraining
   Overbreathing
   Empirically validated treatments
Review Questions
 Discuss the relative importance of John Watson
  and Mary Cover Jones in the development of
  applied behavior therapy techniques. Which of
  these researchers amassed a large amount of
  practical information about counter-conditioning?
 Who is the historical figure to which applied
  behavior analysis can be traced? Do applied
  behavior analysts believe in using cognitive
  constructs to understand human behavior?
Review Questions
 What is the difference between S-R theory
  and neobehavioristic S-R theory?
 Explain how self-efficacy can be viewed as
  a cognitive variable in a therapy situation.
 What is the difference between counter-
  conditioning and extinction? Which of these
  experimental procedures is most directly
  linked to response prevention? Which one is
  linked to systematic desensitization?
Review Questions
 List and describe the behavioral ABCs.
 What are the main methods that behavior
  therapists use to teach clients assertiveness skills?
 What are the five steps of problem-solving that
  behavior therapists teach clients as a part of skills
  training? Which of these steps was illustrated in
  the therapy excerpt with the aggressive
  adolescent?
Review Questions
 In the case example involving Richard, it’s clear
  that Richard does not initially believe all of the
  educational information that his therapist is
  providing him. Is the therapist concerned about
  Richard’s disbelief? If so, what strategies does the
  therapist use to work on Richard’s adherence to
  therapy?
 Explain how overbreathing can be used in an
  interoceptive exposure model? Why is this
  approach especially appropriate for clients with
  Panic Disorder?