Behavioral Therapy

Behaviorism see psychological disorders as the result of maladaptive learning, as people are born tabula rasa (a blank slate). They do not assume that sets of symptoms reflect single underlying causes.

Behaviorism assumes that all behavior is learnt from the environment and symptoms are acquired through classical conditioning and operant conditioning.

Classical conditioning involves learning by association and is usually the cause of most phobias. Operant conditioning involves learning by reinforcement (e.g. rewards) and punishment, and can explain abnormal behavior should as eating disorders.

Consequently, if a behavior is learnt, it can also be unlearned.


Therapies

Behavioral therapies are based on the theory of classical conditioning.  The premise is that all behavior is learned; faulty learning (i.e. conditioning) is the cause of abnormal behavior. Therefore the individual has to learn the correct or acceptable behavior. 

An important feature of behavioral therapy is its focus on current problems and behavior, and on attempts to remove behavior the patient finds troublesome.

This contrasts greatly with psychodynamic therapy (re: Freud), where the focus is much more on trying to uncover unresolved conflicts from childhood (i.e. the cause of abnormal behavior).  Examples of behavior therapy include:

  • Systematic Desensitization
  • Aversion Therapy
  • Flooding
  • The theory of classical conditioning suggests a response is learned and repeated through immediate association.  behavioral therapies based on classical conditioning aim to break the association between stimulus and undesired response (e.g. phobia, additional etc.).


    Aversion Therapy

    Aversion therapy is used when there are stimulus situations and associated behavior patterns that are attractive to the client, but which the therapist and the client both regard as undesirable. For example, alcoholics enjoy going to pubs and consuming large amounts of alcohol

    Aversion therapy involves associating such stimuli and behavior with a very unpleasant unconditioned stimulus, such as an electric shock.

    The client thus learns to associate the undesirable behavior with the electric shock, and a link is formed between the undesirable behavior and the reflex response to an electric shock.

    In the case of alcoholism, what is often done is to require the client to take a sip of alcohol while under the effect of a nausea-inducing drug.  Sipping the drink is followed almost at once by vomiting. In future the smell of alcohol produces a memory of vomiting and should stop the patient wanting a drink.

    More controversially, aversion therapy has been used to "cure" homosexuals by electrocuting them if they become aroused to specific stimuli.

    Critical Evaluation

    Apart from ethical considerations, there are two other issues relating to the use of aversion therapy.

    First, it is not very clear how the shocks or drugs have their effects.  It may be that they make the previously attractive stimulus (e.g. sight/smell/taste of alcohol) aversive, or it may be that they inhibit (i.e. reduce) the behavior of drinking.

    Second, there are doubts about the long-term effectiveness of aversion therapy.  It can have dramatic effects in the therapist’s office.  However, it is often much less effective in the outside world, where no nausea-inducing drug has been taken and it is obvious that no shocks will be given.

    Also, relapse rates are very high – the success of the therapy depends of whether the patient can avoid the stimulus they have been conditioned against.


    Flooding

    Flooding (also known as implosion therapy) works by exposing the patient directly to their worst fears. (S)he is thrown in at the deep end. For example a claustrophobic will be locked in a closet for 4 hours or an individual with a fear of flying will be sent up in a light aircraft.

    What flooding aims to do is expose the sufferer to the phobic object or situation for an extended period of time in a safe and controlled environment. Unlike systematic desensitisation which might use in vitro or virtual exposure, flooding generally involves vivo exposure.

    Fear is a time limited response. At first the person is in a state of extreme anxiety, perhaps even panic, but eventually exhaustion sets in and the anxiety level begins to go down.

    Of course normally the person would do everything they can to avoid such a situation. Now they have no choice but confront their fears and when the panic subsides and they find they have come to no harm. The fear (which to a large degree was anticipatory) is extinguished.

    Prolonged intense exposure eventually creates a new association between the feared object and something positive (e.g. a sense of calm and lack of anxiety). It also prevents reinforcement of phobia through escape or avoidance behaviours.

    Critical Evaluation

    Flooding is rarely used and if you are not careful it can be dangerous. It is not an appropriate treatment for every phobia. It should be used with caution as some people can actually increase their fear after therapy, and it is not possible to predict when this will occur.

    Wolpe (1969) reported the case of a client whose anxiety intensified to such as degree that flooding therapy resulted in her being hospitalized.

    Also, some people will not be able to tolerate the high levels of anxiety induced by the therapy, and are therefore at risk of exiting the therapy before they are calm and relaxed. This is a problem, as existing treatment before completion is likely to strengthen rather than weaken the phobia.

    However one application is with people who have a fear of water (they are forced to swim out of their depth). It is also sometimes used with agoraphobia. In general flooding produces results as effective (sometimes even more so) as systematic desensitisation.

    The success of the method confirms the hypothesis that phobias are so persistent because the object is avoided in real life and is therefore not extinguished by the discovery that it is harmless.

    For example, Wolpe (1960) forced an adolescent girl with a fear of cars into the back of a car and drove her around continuously for four hours: her fear reached hysterical heights but then receded and, by the end of the journey, had completely disappeared.


    References

    Wolpe, J. (1969). Basic principles and practices of behavior therapy of neuroses. American Journal of Psychiatry, 125(9), 1242-1247.


    How to cite this article:

    McLeod, S. A. (2010). Behavioral Therapy. Retrieved from www.simplypsychology.org/behavioral-therapy.html