BEHAVIOURAL APPROACH

INTRODUCTION

Behavior therapy practitioners focus on directly observable behavior,

current determinants of behavior, learning experiences that promote
change, tailoring treatment strategies to individual clients, and rigorous
assessment and evaluation. Behavior therapy has been used to treat a
wide range of psychological disorders with different client populations.
Anxiety disorders, depression, posttraumatic stress disorder, substance
abuse, eating and weight disorders, sexual problems, pain management,
and hypertension have all been successfully treated using this approach
(Wilson, 2011). Behavioral procedures are used in the fi elds of
developmental disabilities, mental illness, education and special
education, community psychology, clinical psychology, rehabilitation,
business, self-management, sports psychology, health-related behaviors,
medicine, and gerontology (Miltenberger, 2012; Wilson, 2011).

Behavior therapy is based on the principles and procedures of the

scientifi c method. Experimentally derived principles of learning are
systematically applied to help people change their maladaptive behaviors.

Behavior is not limited to overt actions a person engages in that we

can observe; behavior also includes internal processes such as cognitions,
images, beliefs, and emotions. The key characteristic of a behavior is that
it is something that can be operationally defi ned.

Behavior therapy deals with the client’s current problems and the
factors infl uencing them, as opposed to an analysis of possible historical
determinants.

Clients involved in behavior therapy are expected to assume an

active role by engaging in specifi c actions to deal with their problems.
Rather than simply talking about their condition, clients are required to
do something to bring about change

This approach assumes that change can take place without insight
into underlying dynamics and without understanding the origins of a
psychological problem.
 Behavioral treatment interventions are individually tailored to
specifi c problems experienced by the client

GOALS OF THIS THERPAY

The general goals of behavior therapy are to increase personal choice and
to create new conditions for learning.

The client, with the help of the therapist, defi nes specific treatment goals at
the outset of the therapeutic process. Although assessment and treatment
occur together, a formal assessment takes place prior to treatment to
determine behaviors that are targets of change. Continual assessment
throughout therapy determines the degree to which identifi ed goals are
being met.

It is important to devise a way to measure progress toward goals based on

empirical validation.

The therapist assists clients in formulating specific measurable goals.

Goals must be clear, concrete, understood, and agreed on by the client

and the counselor.

The counselor and client discuss the behaviors associated with the goals,
the circumstances required for change, the nature of sub-goals, and a
plan of action to work toward these goals.

This process of determining therapeutic goals entails a negotiation

between client and counselor that results in a contract that guides the
course of therapy.

Behavior therapists and clients alter goals throughout the therapeutic

process as needed.

THERAPIST’S ROLE

# The therapist strives to understand the function of client behaviors,

including how certain behaviors originated and how they are sustained.
With this understanding, the therapist formulates initial treatment goals
and designs and implements a treatment plan to accomplish these goals.

• The behavioral clinician uses strategies that have research support for
use with a particular kind of problem. These evidence-based strategies
promote generalization and maintenance of behavior change. A number
of these strategies are described later in this chapter.

• The clinician evaluates the success of the change plan by measuring

progress toward the goals throughout the duration of treatment. Outcome
measures are given to the client at the beginning of treatment (called a
baseline) and collected again periodically during and after treatment to
determine whether the strategy and treatment plan are working. If not,
adjustments are made in the strategies being used.

• A key task of the therapist is to conduct follow-up assessments to see

whether the changes are durable over time. Clients learn how to identify
and cope with potential setbacks. The emphasis is on helping clients
maintain changes over time and acquire behavioral and cognitive
coping skills to prevent relapses.

TECHNIQUES MAJORLY USED

Techniques Based On Classical And Operant

Here are two key principles that form the foundations of behavioural
therapy - classical conditioning and operant conditioning.

Classical conditioning
Behavioural therapy that is based on classical conditioning uses a
number of techniques to bring about behaviour change. Originally this
type of therapy was known as behaviour modification, but these days it is
usually referred to as applied behaviour analysis. The various methods of
changing behaviour include:

Flooding
Flooding is a process generally used for those with phobias and anxiety
and involves exposing the individual to objects/situations they are afraid
of in an intense and fast manner. An example of this would be exposing a
person who is afraid of dogs to a dog for an extended period of time. The
longer this continues with nothing bad happening, the less fearful the
person becomes.

The idea is that the person cannot escape the object/situation during the
process and therefore must confront their fear head on. Obviously this
method can be disconcerting and may only be suitable for certain
situations.

Systematic desensitisation
This technique works on a similar premise to flooding, however it is more
gradual. The therapist would begin by asking the individual to write a list
of fears they have. Once this list is written, the therapist will teach
relaxation techniques for the individual to use while thinking about the
list of fears. Working their way up from the least fear-inducing item to the
most fear-inducing item - the therapist will help the individual confront
their fears in a relaxed state.

An example of this would be a person who is afraid of small spaces. They

may start by thinking about a small space or looking at an image of a
small space while utilising relaxation techniques, and work their way up
to being in a small space. This pairing of the fear-inducing item and
newly learned relaxation behaviour aims to eliminate the phobia or
anxiety.

Aversion therapy
This process pairs undesirable behaviour with some form of aversive
stimulus with the aim of reducing unwanted behaviour. An example of
how this is commonly used is when an alcoholic is prescribed a certain
drug that induces nausea, anxiety and headaches when combined with
alcohol. This means every time the person drinks, they get negative side
effects. This hopes to put off that person from drinking to help them
overcome their addiction.

Operant conditioning
Operant conditioning uses techniques such as positive reinforcement,
punishment and modelling to help alter behaviour. The following
strategies may be used within this type of therapy:

Token economies
This strategy relies on positive reinforcement - offering individuals 'tokens'
that can be exchanged for privileges or desired items when positive
behaviour is exhibited. This is a common tactic used by parents and
teachers to help improve the behaviour of children.

Contingency management
A more formal approach, contingency management involves a written
contract between the therapist and individual that outlines goals,
rewards and penalties. For some, having this kind of clear agreement
helps to change behaviour and add a sense of accountability.

Modelling
Modelling involves learning through observation and imitation of others.
Having a positive role model can give individuals something to aim for,
allowing them to change their behaviour to match their role model's. This
role model may be the therapist or someone the individual already knows.

Extinction
Extinction works by removing any type of reinforcement to behaviour. An
example of this would be a disruptive child who is given a time-out or told
to sit on the 'naughty step'. By removing them from the situation (and
associated attention) the behaviour should stop. This premise can be
carried across to adults too - however the 'naughty step' will probably be
given a different name.

LIMITATIONS AND CRITICISMS

WEAKNESSES ƒ

Overdependence on animal research (Weiten, 2007). ƒ

Denies the existence of free will and the importance of cognitive processes
(Weiten, 2007). ƒ

Treats symptoms rather than underlying issues (Corey, 2005). ƒ

Does not provide insight (Corey, 2005).

Personality structure only focuses on stimulus-response associations. There

is no emphasis on underlying concepts (Weiten, 1998).

STRENGTHS

When using in therapy, it accomplishes what the theory predicts will

happen (Guilliard, James & Bowman, 1994). ƒ

Treatment outcomes have been scientifically and empirically validated

(Corey, 2005). ƒ

Emphasizes ethical accountability (Corey, 2005). ƒ ƒ

Wide variety of techniques that may be utilised in therapy (Corey, 2005). ƒ