Behavior Therapy

A goal-oriented, therapeutic approach that treats emotional and behavioral disorders as maladaptive learned responses that can be replaced by healthier ones with appropriate training.

In contrast to the psychoanalytic method of Sigmund Freud (1856-1939), which focuses on unconscious mental processes and their roots in the past, behavior therapy focuses on observable behavior and its modification in the present. Behavior therapy was developed during the 1950s by researchers and therapists critical of the psychodynamic treatment methods that prevailed at the time. It drew on a variety of theoretical work, including the classical conditioning principles of the Russian physiologist Ivan Pavlov (1849-1936), who became famous for experiments in which dogs were trained to salivate at the sound of a bell, and the work of American B.F. Skinner (1904-1990), who pioneered the concept of operant conditioning, in which behavior is modified by changing the response it elicits. By the 1970s, behavior therapy enjoyed widespread popularity as a treatment approach. Over the past two decades, the attention of behavior therapists has focused increasingly on their clients' cognitive processes, and many therapists have begun to use cognitive behavior therapy to change clients' unhealthy behavior by replacing negative or self-defeating thought patterns with more positive ones.

As an initial step in many types of behavioral therapy, the client monitors his or her own behavior carefully, often keeping a written record. The client and therapist establish a set of specific goals that will result in gradual behavior change. The therapist's role is often similar to that of a coach or teacher who gives the client "homework assignments" and provides advice and encouragement. Therapists continuously monitor and evaluate the course of the treatment itself, making any necessary adjustments to increase its effectiveness.

A number of specific techniques are commonly used in behavioral therapy. Human behavior is routinely motivated and rewarded by positive reinforcement. A more specialized version of this phenomenon, called systematic positive reinforcement, is used by behavior-oriented therapists. Rules are established that specify particular behaviors that are to be reinforced, and a reward system is set up. With children, this sometimes takes the form of tokens that may be accumulated and later exchanged for certain privileges. Just as providing reinforcement strengthens behaviors, withholding it weakens them. Eradicating undesirable behavior by deliberately withholding reinforcement is another popular treatment method called extinction. For example, a child who habitually shouts to attract attention may be ignored unless he or she speaks in a conversational tone.

Aversive conditioning employs the principles of classical conditioning to lessen the appeal of a behavior that is difficult to change because it is either very habitual or temporarily rewarding. The client is exposed to an unpleasant stimulus while engaged in or thinking about the behavior in question. Eventually the behavior itself becomes associated with unpleasant rather than pleasant feelings. One treatment method used with alcoholics is the administration of a nausea-inducing drug together with an alcoholic beverage to produce an aversion to the taste and smell of alcohol by having it become associated with nausea. In counter conditioning, a maladaptive response is weakened by the strengthening of a response that is incompatible with it. A well-known type of counterconditioning is systematic desensitization, which counteracts the anxiety connected with a particular behavior or situation by inducing a relaxed response to it instead. This method is often used in the treatment of people who are afraid of flying. Modeling, another treatment method, is based on the human tendency to learn through observation and imitation. A desired behavior is performed by another person while the client watches. In some cases, the client practices the behavior together with a model, who is often the therapist.