What Is Behavioral Therapy?
Behavioral therapy, also known as behavioral modification, is an approach to psychotherapy based on learning theory that aims to treat psychopathology through techniques that are designed to reinforce desired behaviors and eliminate undesired behaviors. Ancient philosophical traditions, such as Stoicism, provided the precursors of certain fundamental aspects of behavioral therapy. The first occurrence of the term “behavioral therapy” may have been used in a 1953 research project by B.F. Skinner, Ogden Lindsley, Nathan H. Azrin, and Harry C. Solomon. Other early pioneers in this type of therapy include Joseph Wolpe and Hans Eysenck.
Behavioral therapy is considered to have three distinct points of origin: South Africa (Wolpe’s group), the United States (Skinner), and the United Kingdom (Rachman and Eysenck). Eysenck, in particular, viewed behavioral problems as an interplay between environment, behavior, and personal characteristics. Skinner’s group, on the other hand, took more of an operant conditioning approach, which involved a functional approach to assessment and interventions focused on contingency management (reward and punishment for positive and negative behavior, respectively, also known as the “token system”) and behavioral activation.
Skinner became interested in individualizing programs to improve the learning of people with and without disabilities; he worked with Fred S. Keller to develop programmed instruction. Programmed instruction showed clinical success in treating aphasia rehabilitation. Skinner’s student, Ogden Lindsley, is credited with forming a movement called “precision teaching,” which developed a type of graphing program that kept track of how much progress the clients were making.
In the second half of the 20th century, many therapists began combining this therapy with the cognitive therapy of Aaron Beck and Albert Ellis, which created cognitive behavioral therapy. In some areas, the cognitive component added to the therapy (especially when it came to social phobia treatment), but in other areas, the cognitive component did not add to the therapy. This led to the pursuit of Third Generation Behavioral Therapies.
Third Generation Behavioral Therapies combines the basic principles of operant and respondent psychology with functional analysis and a Clinical formulation or case conceptualization of verbal behavior, which incorporates more of the view of the behavioral analysts. Some research shows that Third Generation Behavioral Therapies are more effective in some cases than cognitive therapy, but more research needs to be done in order for the evidence to be conclusive.
Some of the most widely used approaches in behavioral therapy today include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Analysis System of Psychotherapy (CBASP), behavioral activation (BA), and Integrative behavioral couples therapy. The behavioral therapy combines the principles of classical conditioning developed by Ivan Pavlov and the principles of operant conditioning developed by B. F. Skinner. There has been some confusion on how these two conditionings differ and how the various techniques of this have any common scientific basis. An online paper, “Reinforcing Behavioral Therapy, provides an answer to this confusion.
Operant conditioning has led to contingency management programs. These programs have been quite effective, even in adults who deal with schizophrenia. Respondent conditioning has led to systematic desensitization and exposure and response prevention. Social skills training teaches clients the skills to access reinforcers and to lessen life punishment. However, operant conditioning procedures in meta-analysis had the greatest effect in training social skills. While social skills training had shown some effectiveness for schizophrenia, applying behavioral programs to schizophrenia has generally lost favor amongst many psychologists.
Behavioral therapy’s core interventions are based on functional analysis. Amongst the many problems that behavioral therapy have functionally analyzed include intimacy in couples, forgiveness in couples, relationships, chronic pain, anorexia, depression, obesity, and anxiety. Functional analysis has even been applied to problems that therapists will often encounter with patients, including involuntary clients, partially engaged clients, and client resistance. This has led to considerable tools for therapists to use to enhance therapeutic effectiveness, including using positive reinforcement or operant conditioning.
This has led many to believe that behavioral therapy is as effective, if not more effective, to treating depression, attention-deficit hyperactivity disorder, and obsessive-compulsive disorder than drug treatment. Another successful form of therapy that has shown great success is Habit reversal training. This has proven highly effective in treating tics. The characteristics of behavioral therapy include being empirical (data-driven), contextual (focusing on environment and context), functional (interested in a behavior’s consequence or effect), probabilistic (seeing behavior as statistically predictable), monistic (treating the person as a unit and rejecting mind-body dualism), and relational (analyzing bidirectional interactions).