Behaviour therapy, or behavior therapy, can be studied scientifically by observing overt behaviour, without discussing internal mental states. Without holding inner states as causal, Skinner's radical behaviourism accepted internal states as part of a causal chain of behaviour, but continued to hold that the only way to improve the internal state was through environmental manipulation.

Contents 1 History 2 Scientific basis 2.1 Applied to problem behaviour 2.2 Third generation 2.3 Organizations 3 Characteristics 4 Methods 5 See also 6 References

[edit] History

Possibly the first occurrence of "behavior therapy" was in a 1953 research project by B.F. Skinner, Ogden Lindsley, and Harry C. Solomon.^[1] Other early pioneers in behaviour therapy include Joseph Wolpe and Hans Eysenck.^[2]

In general, behaviour therapy is seen as having three distinct points of origin: South Africa (Wolpe's group), The United States (Skinner), and the United Kingdom (Rachman and Eysenck). Each had its own distinct approach to viewing behaviour problems. Eysenck in particular viewed behaviour problems as an interplay between personality characteristics, environment, and behaviour^[3]. Skinner's group in the United States took more of an operant conditioning focus. The operant focus created a functional approach to assessment and interventions focused on contingency management such as the token economy and behavioural activation. Skinner's student Ogden Lindsley is credited with forming a movement called precision teaching, which developed a particular type of graphing program called the standard celeration chart to monitor the progress of clients. Skinner became interested in the individualizing of programs for improved learning in those with or without disabilities and worked with Fred S. Keller to develop programmed instruction. Programmed instruction had some clinical success in aphasia rehabilitation ^[4] Gerald Patterson used program instruction to develop his parenting text for children with conduct problems^[5]. With age, respondent conditioning appears to slow but operant conditioning remains relatively stable^[6]

While many behaviour therapists remain staunchly committed to the basic operant and respondent paradigm, in the second half of the 20th century, many therapists coupled behaviour therapy with the cognitive therapy of Aaron Beck and Albert Ellis, to form cognitive behavioural therapy. In some areas the cognitive component had an additive effect (for example, sex offender treatment) but in other areas it did not enhance the treatment, which led to the pursuit of Third Generation Behavior Therapies. Third generation behaviour therapy uses basic principles of operant and respondent psychology but couples them with functional analysis and a case conceptualization of verbal behaviour more inline with view of the behaviour analysts.

[edit] Scientific basis

Behaviour therapy is based upon the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B.F. Skinner. There has been up to now a good deal of confusion about how exactly these two conditionings differ and whether the various techniques of Behaviour Therapy have any common scientific base. One answer has come in the form of an online paper called Reinforcing Behaviour Therapy which more and more psychologists are now studying and appreciating.

Contingency management programs are a direct product of research from operant conditioning. These programs have been highly successful, producing results even with adults who suffer from schizophrenia^[7]

Systematic desensitization and exposure and response prevention both evolved from respondent conditioning and have also received considerable research.

Social skills training teaches clients skills to access reinforcers and lessen life punishment. Operant conditioning procedures in meta-analysis had the largest effect size for training social skills, followed by modelling, coaching, and social cognitive techniques in that order ^[8] Social skills training has some empirical support particularly for schizophrenia^{[9] [10]} However, with schizophrenia, behavioural programs have generally lost favour.^[11]

[edit] Applied to problem behaviour

Behaviour therapy based its core interventions on functional analysis. Just a few of the many problems that behaviour therapy have functionally analysed include intimacy in couples relationships^{[12] [13] [14]}, forgiveness in couples^[15], chronic pain^[16], stress related behaviour problems of being an adult child of an alcoholic^[17], anorexia^[18], chronic distress^[19], substance abuse^[20], depression^[21], anxiety ^[22], and obesity.^[23]

Functional analysis has even been applied to problems that therapists commonly encounter like client resistance, particially engaged clients and involuntary clients.^[24][25] Applications to these problems have left clinicans with considerable tools for enhancing therapeutic effectiveness. One way to enhance therapeutic effectiveness is to use positive reenforcement or operant conditioning.

Many have argued that behaviour therapy is at least as effective as drug treatment for depression, ADHD, and OCD.^[26] Considerable policy implications have been inspired by behavioural views of various forms of psychopathology.

[edit] Third generation

Of particular interest, in behaviour therapy today are the areas often referred to as Third Generation Behavior Therapy.^[27] This movement has been called clinical behaviour analysis because it represents a movement away from cognitivism and back toward radical behaviourism and other forms of behaviourism, in particular functional analysis and behavioural models of verbal behaviour. This area includes Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Analysis System of Psychotherapy (CBASP) (McCullough, 2000), behavioural activation (BA), Kohlenberg & Tsai's Functional Analytic Psychotherapy, Integrative behavioural couples therapy and dialectical behavioural therapy. These approaches are squarely within the applied behaviour analysis tradition of behaviour therapy.

Acceptance and Commitment Therapy is probably the most well-researched of all the third generation behaviour therapy models. It is based on Relational Frame Theory.^[28]

Functional Analytic Psychotherapy is based on a functional analysis of the therapeutic relationship.^[29] It places a greater emphasis on the therapeutic context and returns to the use of in session reinforcement ^[30] In general, 40 years of research supports the idea that in-session reinforcement of behaviour can lead to behavioural change.^[31]

Behavioural activation emerged from a component analysis of cognitive behaviour therapy. This research found no additive effect for the cognitive component.^[32] Behavioural activation is based on a matching model of reinforcement.^[33] A recent review of the research, supports the notion that the use of behavioural activation is clinically important for the treatment of depression.^[34][www.behavior-analyst-online.org]

Integrative behavioural couples therapy developed from dissatisfaction with traditional behavioural couples therapy. Integrative behavioural couples therapy looks to Skinner (1966) for the difference between contingency shaped and rule governed behaviour.^[35] It couples this analysis with a thorough functional assessment of the couples relationship. Recent efforts have used radical behavioural concepts to interpret a number of clinical phenomena including forgiveness.^[36]

[edit] Organizations

Many organizations exist for behaviour therapists around the world. In the United States, the American Psychological Association's Division 25 is the division for behaviour analysis. The Association for Contextual Behavior Therapy is another professional organization. ACBS is home to many clinicians with specific interest in third generation behaviour therapy. The Association for Cognitive and Behavior Therapy (formerly the Association for the Advancement of Behavior Therapy) is for those with a more cognitive orientation. Internationally, most behaviour therapists find a core intellectual home in the International Association of Behavior Analysis (ABA:I) [11].

[edit] Characteristics

By nature, behavioural therapies are empirical (data-driven), contextual (focused on the environment and context), functional (interested in the effect or consequence a behaviour ultimately has), probabilistic (viewing behaviour as statistically predictable), monistic (rejecting mind-body dualism and treating the person as a unit), and relational (analysing bidirectional interactions).^[37]

[edit] Methods

• Systematic desensitization
• Exposure and response prevention
• Behaviour modification
• Flooding
• Operant conditioning
• Covert conditioning
• Observational learning
• Contingency management
• Matching law
• Habit reversal training

[edit] See also

• Cognitive therapy
• Cognitive behavioural therapy
• Applied behaviour analysis
• Behaviour modification
• Professional practice of behaviour analysis
• Functional Analytic Psychotherapy
• Acceptance and Commitment Therapy
• Dialectical behavioural therapy
• Behavioural activation
• Creative Applied Modification
• A Clockwork Orange

[edit] References

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