OVERVIEW OF BEHAVIOR THERAPY

Key Figures and Major Focus

Key figures: Arnold Lazarus, Albert Bandura, and Joseph Wolpe. Historically, the
behavioral trend developed in the 1950s and early 1960s as a radical departure
from the psychoanalytic perspective. Four major phases in the development of
behavior therapy are (1) the classical conditioning trend, (2) the operant
conditioning model, (3) the social learning approach, and (4) cognitive behavior
therapy.
Philosophy and Basic Assumptions
Behavior is the product of learning. We are both the product and the producer of
our environment. No set of unifying assumptions about behavior can incorporate
all the existing procedures in the behavioral field. Due to the diversity of
views and strategies it is more accurate to think of behavioral therapies rather
than a unified approach. Contemporary behavior therapy encompasses a variety of
conceptualizations, research methods, and treatment procedures to explain and
change behavior.
Key Concepts
The approach emphasizes current behavior as opposed to historical antecedents,
precise treatment goals, diverse therapeutic strategies tailored to these goals,
and objective evaluation of therapeutic outcomes. Therapy focuses on behavior
change in the present and on action programs.
Therapeutic Goals
The general goal is eliminating maladaptive behaviors and learning more
effective behavior patterns. Therapy aims at changing problematic behavior
through learning experiences. Generally, client and therapist collaboratively
specify treatment goals in concrete and objective terms.
Therapeutic Relationship
Although the approach does not assign an all-important role to the
client/therapist relation- ship, a good working relationship is an essential
precondition for effective therapy. The skilled therapist can conceptualize
problems behaviorally and make use of the therapeutic relation- ship in bringing
about change. The therapist's role is primarily exploring alternative courses of
action and their possible consequences. Clients must be actively involved in the
therapeutic process from beginning to end, and they must be willing to
experiment with new behaviors both in the sessions and outside of therapy.
Techniques and Procedures
Behavioral procedures are tailored to fit the unique needs of each client. Any
technique that can be demonstrated to change behavior may be incorporated in a
treatment plan. A strength of the approach lies in the many and varied
techniques aimed at producing behavior change, a few of which are relaxation
methods, systematic desensitization, in vivo desensitization, flooding, eye
movement desensitization reprocessing, assertion training, self-management
programs, and multimodal therapy.
Applications

The approach has wide applicability to a range of clients desiring specific

behavioral changes. A few problem areas for which behavior therapy appears to be
effective include phobic disorders, depression, sexual disorders, children'sdisorders, and the prevention and treatment of cardiovascular disease. Going
beyond the usual areas of clinical practice, behavioral approaches are deeply
enmeshed in geriatrics, pediatrics, stress management, behavioral medicine,
business and management, and education, to mention only a few.
Contributions
Behavior therapy is a short-term approach that has wide applicability. It
emphasizes research into and assessment of the techniques used, thus providing
accountability. Specific problems are identified and attacked, and clients are
kept informed about the therapeutic process and about what gains are being made.
The approach has demonstrated effectiveness in many areas of human functioning.
The concepts and procedures are easily grasped. The therapist is an explicit
reinforcer, consultant, model, teacher, and expert in behavioral change. The approach has undergone tremendous development and expansion over the past two
decades, and the literature continues to expand at a phenomenal rate. Behavioral
approaches can be appropriately integrated into counseling with culturally
diverse client populations, particularly because of their emphasis on teaching
clients about the therapeutic process and the structure that is provided by the
model.
Limitations
The success of the approach is in proportion to the ability to control
environmental variables. In institutional settings (schools, psychiatric
hospitals, mental health outpatient clinics) the danger exists of imposing
conforming behavior. Therapists can manipulate clients toward ends they have not
chosen. A basic criticism leveled at this approach is that it does not ad- dress
broader human problems -such as meaning, the search for values, and identity issues-but focuses instead on very specific and narrow behavioral problems.
GLOSSARY of KEY TERMS
Assertion training - A set of techniques that involves behavioral rehearsal,
coaching, and learning more effective social skills; specific skills training
procedures used to teach people ways to express both positive and negative
feelings openly and directly.
BASIC J.D. - The conceptual framework of multimodal therapy, based on the
premise that human personality can be understood by assessing seven major areas
of functioning: be- havior, affective responses, sensations, images, cognitions,
interpersonal relationships, and drugs/biological functions.
Behavior rehearsal - A technique consisting of trying out in therapy new
behaviors (per- forming target behaviors) that are to be used in everyday
situations.
Cognitive behavioral coping skills therapy - Procedures aimed at teaching
clients spe- cific skills to deal effectively with problematic situations.

Contingency contracting - Written agreement between a client and another person

that specifies the relationship between performing target behaviors and their
consequences.
Exposure therapy - Treatment for anxiety and fear responses that exposes clients
to situations or events that create the unwanted emotional responses.
Eye movement desensitization reprocessing (EMDR) - An exposure-based therapy
that involves imaginal flooding, cognitive restructuring, and the use of
rhythmic eye movements and other bilateral stimulation to treat traumatic stress
disorders and fearful memories of clients.
Flooding - Prolonged and intensive in vivo or imaginal exposure to highly
anxiety-evoking stimuli without the opportunity to avoid or escape from them.
In vivo desensitization Brief and graduated exposure to an actual fear situation
or event.
Modeling - Learning through observation and imitation.
Multimodal therapy - A model endorsing technical eclecticism; uses procedures
drawn from various sources without necessarily subscribing to the theories
behind these techniques; developed by Arnold Lazarus.
Negative reinforcement - The termination or withdrawal of an unpleasant stimulus
as a result of performing some desired behavior.
Positive reinforcement - A form of conditioning whereby the individual receives
something desirable as a consequence of his or her behavior; a reward that
increases the probability of its recurrence.
Reinforcement - A specified event that strengthens the tendency for a response
to be repeated.
Self-management - A collection of cognitive behavioral strategies based on the
idea that change can be brought about by teaching people to use coping skills in
problematic situations such as anxiety, depression, and pain.
Self-monitoring - The process of observing one's own behavior patterns as well
as one's interactions in various social situations.
Skills training - A treatment package used to teach clients skills that include
modeling, behavior rehearsal, and reinforcement.
Social learning theory - A perspective holding that behavior is best understood
by taking into consideration the social conditions under which learning occurs;
developed primarily by Albert Bandura.
Systematic desensitization - A procedure based on the principles of classical
conditioning in which the client is taught to relax while imagining a graded
series of progressively anxiety-arousing situations. Eventually, the client
reaches a point at which the anxiety- producing stimulus no longer brings about
the anxious response.