Behavior Therapy

Maxie C. Maultsby, Jr. Mariusz Wirga

Howard University, College of Medicine Howard University, College of Medicine

I. Early Historical Roots of Behavior Therapy

II. Important Behaviorists and Their Contributions

III. Behavior Therapy at the Threshold of Ideal Unification

IV. Behavioral Assessment and the Therapeutic Process

V. Behavioral Medicine

Behavior The things organisms do. There are two types: (1) overt behavior— observable by other people; (2) covert behavior— observable only by the behaving people themselves, for example, thoughts, emotional feelings, and so on.

Cognitive-Emotive Dissonance The most important stage in new learning, characterized by these two features: (1) it occurs when people first begin thinking and acting in their new, correct ways for their behavioral goal but (2) they are having the uncomfortable emotional feelings that they have when they believe they are behaving incorrectly: People usually describe this experience with "This doesn't feel right,'' or "This feels wrong to me.'' A common example of this event is: an American driver "feeling wrong'' while driving correctly on the left side of the street in England. This is an unavoidable experience in psychotherapeutic or any type of change in a personal habit. In psychotherapy it is the stage of maximal therapeutic resistance. If cognitive-emotive dissonance is poorly handled in psychotherapy, patient/clients are likely to drop out or become noncompliant. Conditioning The process of learning in which an innate behavioral response to a learned or innate stimulus becomes a new behavioral response to a formerly neutral stimulus, after that neutral stimulus has been paired a sufficient number of times with the original, learned or innate stimulus. There are two major types of conditioning: (1) Classical (Pavlovian or respondent) conditioning wherein the behavioral response being learned is an innate response for a neutral stimulus such as salivating to the sound of a bell. (2) Operant (Skinnerian or instrumental) conditioning wherein the behavior being learned is new for the subject.

Discrimination The process wherein a subject reacts appropriately to only one, of two or more similar, but different stimuli.

Drive A force that activates or impels people or animals to make a behavioral response. In behavioristic terms, drives are the results of physiologic deprivations, such as of food and water, or the result of pain or some other unpleasant stimulus. Emotive Imagery The mental process of visualizing real or imaged events so vividly that the person reacts with the most logical emotional and/or physical response for the meaning that those mental pictures have for that person. In behavior therapy, emotive imagery is called mental practice.

Extinction The process wherein the frequency of a learned response to a conditioned stimulus decreases and ultimately disappears, due to lack of reinforcement.

Magic An imaginary but empirically nonexistent power that can exempt real events from the rule of nature that an event occurs only after its essentials for existing have been met.

Magical Thinking Thinking that describes only nonempirical illusions of realities or reality.

Behavior Therapy

Punishment Any undesirable consequence of the subject's behavioral response in a specific situation that decreases (ideally to zero) the probability of that response occurring in similar future situations. Reinforcement A process of increasing the probability (ideally to 100%) that a specific behavior will be repeated in similar future situations. The two classes are: positive and negative. (1) Positive reinforcement occurs when a subject receives or experiences a personally pleasant event, that is, a reward as the consequence of its specific, immediately preceding behavior. The object or experience received is a positive rein-forcer for the behavior that preceded it. (2) Negative reinforcement occurs when a subject receives an unpleasant stimulus that results in a behavioral response that terminates or removes that stimulus. The unpleasant stimulus for the behavior that terminated it is a negative reinforcer. The unpleasant simulus is called an aversive stimulus. The event of termination or removal of an aversive stimulus is a positive rein-forcer—also called a secondary reinforcer— for the behavior that immediately preceded that terminating event.

Response and Stimulus Generalization The process wherein a neutral stimulus that is similar to, but different from, a conditioned stimulus elicits the same responses that the original or conditioned stimulus elicits, without having been previously paired with either. Generalization of response is the process wherein the same response is learned to different stimuli. Stimulus A sensory event that elicits a response from a subject. The two types of stimuli are: (1) Innate or unconditioned stimuli, which elicit only natural or innate responses from a subject such as salivation when exposed to food, and (2) learned or conditioned stimuli, which elicit the responses that innate or learned stimuli elicit, but only after having been paired several times with the real or conditioned stimulus when they elicit their normal target responses.

There are varying opinions about the best way to define BEHAVIOR THERAPY. However, most health professionals accept Eysenck's definition: Behavior therapy is the attempt to alter human behavior and emotions in a beneficial way according to the laws of modern learning theory. There is only one problem with that definition: There is no generally recognized comprehensive learning theory of human behavior.

Consequently, from a phenomenological view point, behavior therapy has the following three objective appearances. First, behavior therapy is a general field of health improvement that deals with learned, undesirable emotional and physical behavioral responses. But these undesirable responses have been practiced so much that they have become personal habits. However, the people who have these undesirable habits believe that they have little or no satisfactory control over them. That is why these habits are often the main behavioral barriers to personally satisfying lives for their owners. Second, as a field of health improvement, behavior therapy consists of a diverse collection of many different behavioral (as opposed to medicinal) regimens. Each regimen has a name and is proclaimed to be based on laws of the yet-to-be-identified modern learning theory. Without a comprehensive unifying learning theory however, behavior therapy will not soon become the genuine health science discipline that it is incorrectly assumed to already be.

Third, the behavior therapy field has a generally unrecognized or generally ignored crisis of disunity. It is quite similar to (if not the same as) the crisis of disunity that Staats recently (1990) described in psychology, the "surrogate mother'' of behavior therapy. But unlike the rigidly divided field of psychology, behavior therapy has reached the threshold of identifying one unifying learning theory of human behavior that will enable it to immediately become a genuine health science discipline.

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