A Behavioral Approach to the Case of Ms.S.

Abstract

This article provides a behavioral formulation and treatment plan for the case of Ms. S. Given the complexity of Ms. S and the status of current research, interventions proposed emphasize empirically supported principles of change over any specific protocol. This particular behavioral approach incorporates aspects of dialectical behavior therapy and functional analytic psychotherapy in addition to more traditional behavior therapy. The utility of the therapeutic relationship in this approach is described. My approach to psychotherapy is behavioral, such that I conceptualize the development and maintenance of behaviors according to learning theory (operant conditioning, classical conditioning, etc.). I view the context in which behavior occurs as critical to accurate conceptualizations and change. I focus on the function of behavior over the form of behavior (i.e., what the behavior does for the person as opposed to what it looks like), and I place high value on accurate assessments of (the function of) behavior, adhering to the adage, “Assess; do not assume.” I have a broad perspective on behavior and view most things that humans do as behavior (including feeling, thinking, behaving, and even some glandular squirting), all influenced by the same principles of learning, and all worthy of consideration in the development, maintenance, and change of problems. My interventions pull from empirically supported treatments and principles that are targeted to my behavioral formulations. I have been influenced by functional analytic psychotherapy (Kohlenberg & Tsai, 1991), a radical behavioral approach to psychotherapy that places high importance on attending to and addressing clinically relevant in-session behavior and views the therapeutic relationship as critical to change. I also have a strong background in dialectical behavior therapy (DBT; Correspondence concerning this article should be addressed to Amy W. Wagner, De