Behavior Therapy I: Traditional Behavior Therapy

Abstract

What do each of the following case vignettes have in common? ◾ To enhance the self-image of a man whose body was deformed by abirth defect, his counselor instructed him to substitute positive, selfenhancing thoughts (e.g., “I look just fine”) for his habitual negative, self-effacing thoughts (e.g., “I look like a freak”). (cognitive restructuring)◾ A second-generation Japanese-American woman was unable to discuss problems she was having at work with her boss. Despite her primary identification with her American culture, her parents had always taught her to show deference toward people in authority. However, she wanted to be able to talk openly with her boss. She learned to express herdesires appropriately by observing her counselor demonstrate effective ways of politely yet forcefully expressing feelings to superiors. (modeling) She practiced these behaviors-initially with the therapist, later with people less threatening than her boss, and finally with her boss. (behavior rehearsal)◾ A 7-year-old boy frequently bullied smaller children. The frequency of the boy’s bullying decreased when he had to miss recess or gym (his favorite activities at school) each time he was caught bullying. (response cost)◾ A woman worked hard for wages that were substantially lower than the wages her male co-workers earned. To relieve her frustration, she drank excessively and verbally vented her irritation toward her family. The counselor taught the woman coping skills, including muscle relaxation and self-instructions, to remind her that her family was not the source of her frustration. In counseling, she role-played being in various frustrating situations and practiced applying the coping skills. Then she used the skills in her everyday life whenever she felt frustrated and had the urge to drink or act abusively. (stress inoculation training)◾ An 82-year-old man experienced anxiety about interacting with residents in the nursing home he had recently entered. He was taught muscle relaxation, and then, while relaxed, he imagined increasingly more anxiety-evoking situations (beginning with nodding hello to another resident and ending with spending time conversing with a small group of residents). (systematic desensitization)◾ A young single mother had beaten her 3-year-old son on several occasions when he had had a temper tantrum. The more she tried to get her son to stop crying, the angrier she got. First, the counselor taught the mother anger management skills. Then, to directly reduce the boy’s temper tantrums and indirectly decrease the mother’s anger and physical abuse, the counselor taught the mother to ignore her son during a temper tantrum (extinction) and to reinforce him with attention when he was behaving appropriately. (differential reinforcement)◾ A gay couple who had been together for 11 years sought help because they “fought all the time” and they believed that they no longer loved each other. Their counselor taught them communication skills and problem solving for dealing with their conflicts. (social skills training and problem-solving therapy)◾ In a predominantly Latino-American junior high school, students were required to speak only English in class. However, a number of firstgeneration immigrant students often reverted to Spanish because they could express themselves better in their native tongue. They were taught to subvocally say, “Speak only English,” to remind themselves each time they raised their hands to speak in class. (self-instructional training)The vignettes you’ve just read provide a small sample of the therapeutic procedures (named in parentheses) that comprise behavior therapy. In contrast to most other counseling approaches that have a basic unitary methodof treatment, behavior therapy incorporates many different specific behavior therapies (although, as you will learn, they all have the same fundamental purpose). Behavior therapists also refer to specific behavior therapies as behavior therapy techniques (the terms are synonymous, and I will use them interchangeably). However, a behavior therapy technique is a self-contained, stand-alone therapy rather than a specific therapeutic tactic (such as free association in psychoanalytic therapy [Chapter 3] and experiments in Gestalt therapy [Chapter 7]).