Behavior Therapy

carrot with stick

Behavior therapy (or behavior modification) is an approach to psychotherapy based on behaviorism which aims to treat psychopathology through techniques designed to reinforce desired and eliminate undesired behaviors. Precursors of certain fundamental aspects of behavior therapy have been identified in various ancient philosophical traditions, particularly Stoicism.

While the modern behavior therapist deliberately applies principles of learning to this therapeutic operations, empirical behavior therapy is probably as old as civilization – if we consider civilization as having begun when man first did things to further the well-being of other men. From the time that this became a feature of human life there must have been occasions when a man complained of his ills to another who advised or persuaded him of a course of action. In a broad sense, this could be called behavior therapy whenever the behavior itself was conceived as the therapeutic agent.

While many behavior therapists remain staunchly committed to the basic operant and respondent paradigm first developed by B.F. Skinner in the second half of the 20th century, many therapists coupled behavior therapy with the cognitive therapy of Aaron Beck and Albert Ellis, to form cognitive behavioral therapy. In some areas the cognitive component had an additive effect (for example, evidence suggests that cognitive interventions improve the result of social phobia treatment) but in other areas it did not enhance the treatment, which led to the pursuit of ‘Third Generation Behavior Therapies,’ which uses basic principles of operant and respondent psychology but couples them with functional analysis.

Problems that behavior therapy has functionally analyzed include intimacy in couples relationships, forgiveness in couples, chronic pain, stress related behavior problems of being an adult child of an alcoholic, anorexia, chronic distress, substance abuse, depression, anxiety, and obesity. Functional analysis has even been applied to problems that therapists commonly encounter like client resistance, particially engaged clients and involuntary clients. Applications to these problems have left clinicans with considerable tools for enhancing therapeutic effectiveness. One way to enhance therapeutic effectiveness is to use positive reinforcement or operant conditioning. Many have argued that behavior therapy is at least as effective as drug treatment for depression, ADHD, and OCD. Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behavior therapy, Habit reversal training, has been found to be highly effective for treating tics.

Behavior therapy is based upon the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B.F. Skinner. There has been a good deal of confusion on how these two conditioning differ and whether the various techniques of Behavior Therapy have any common scientific base. Contingency management programs are a direct product of research from operant conditioning. These programs have been highly successful with those suffering from panic disorders, anxiety disorders, and phobias. Systematic desensitization and exposure and response prevention both evolved from respondent conditioning and have also received considerable research.

Third Generation Behavior Therapy has been called clinical behavior analysis because it represents a movement away from cognitivism and back toward radical behaviourism and other forms of behaviorism, in particular functional analysis and behavioral models of verbal behavior. This area includes Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Analysis System of Psychotherapy (CBASP), behavioral activation (BA), Functional Analytic Psychotherapy, Integrative behavioral couples therapy, and dialectical behavioural therapy.

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