The current status and future direction of clinical behavior analysis: Introduction to the special section.

Abstract

During the 1960s and early 1970s, when Skinnerian behaviorism had reached its apogee, many behavior therapists in clinical practice employed operant principles in their work with the range of clinical disorders. Behavior therapists prided themselves in the utilization of principles that were derived from well-controlled laboratory experiments. Their empirically based approach commanded a far greater scientific respectability than the rather vaguely defined interventions of psychodynamic and humanistic therapists. However, starting in the early 1970s, cognitive psychology began to develop momentum and many behavior therapists gradually began to shift from a behavioral to a cognitive stance. This movement eventually resulted in a split between two types of behaviorally oriented practitioners. On the one hand, there were the applied behavior analysts who faithfully carried on the operant tradition. They worked mainly with developmentally disabled children and adults or employed behavior modification principles in relatively closed systems such as educational, correctional, and organizational settings. On the other hand, there were the behavior therapists who worked with the range of problems presented by adult outpatients. In their majority, these therapists began to embrace the new cognitive-behavioral perspective, whereas psychotherapists employing Skinnerian principles in the treatment of adult outpatients all but disappeared. This situation changed when in the late 1980s two approaches to adult outpatient psychotherapy were introduced which were both based on Skinner's radical behaviorism: Acceptance and Commitment Therapy (ACT; Hayes, 1987) and Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1987). With the advent of these therapies, a novel form of operant based behavior therapy was born, which during the early 1990s eventually established itself as 'clinical behavior analysis' (CBA). CBA has its philosophical roots in a modernized version of radical behaviorism termed 'functional contextualism' (Biglan & Hayes, 1996) and is geared toward the amelioration of emotional problems that more typically have been the purview of traditional adult psychotherapy. A number of writers have shown how CBA based approaches can be extended to the treatment of a wide spectrum of psychological disorders, including problems as complex as personality, mood, sexual, or substance use disorders (Dougher, 1999; Hayes, Jacobson, Follette, & Dougher, 1994). The beauty of CBA is that it deals effectively with the fundamental theoretical problem of how talking within the therapy session helps ameliorate clients' problems that occur in their everyday lives. By carefully examining the verbal interactions between therapists and clients within a conceptual framework that brings to bear the principles of verbal behavior (Skinner, 1957), rule-governed behavior (Skinner, 1969), and stimulus equivalence (Sidman, 1994), clinical behavior analysts have developed a theoretical basis for adult psychotherapy that is consistent with contemporary radical behaviorism. Thus, for the first time in a long time there is evidence of a renewed rapprochement between basic behavioral science and its application. Over the past several decades, behavior therapy has gradually separated itself from its theoretical and philosophical foundation in behaviorism, which during its beginnings had been its greatest strength. With the advent of CBA, the gap between the basic and the applied branch of the behavioral approach is closing. Thus, CBA holds the clear promise of reestablishing the conceptual integrity of the behavioral approach to psychotherapy. …