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| − | '''Behaviour therapy''', or '''behavior therapy''' (behavior modification) is an approach to psychotherapy based on [[Behaviorism|learning theory]] which aims to treat [[psychopathology]] through techniques designed to [[Reinforcement|reinforce]] desired and [[Extinction (psychology)|eliminate]] undesired behaviors.<ref>behavior therapy. (n.d.). ''Memidex/WordNet''. Retrieved July 15, 2010, from http://www.memidex.com/behaviour-therapy</ref>
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| − | == History ==
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| − | Precursors of certain fundamental aspects of behavior therapy have been identified in various ancient philosophical traditions, particularly [[Stoicism]].<ref name="RobertsonUS952010">{{Cite book | author=Robertson, D | title=The Philosophy of Cognitive-Behavioural Therapy: Stoicism as Rational and Cognitive Psychotherapy| year=2010| publisher=Karnac| location=London| isbn=978-1855757561|url=http://books.google.co.uk/books?id=XsOFyJaR5vEC&lpg}}</ref> For example, Wolpe and Lazarus wrote,
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| − | <blockquote>While the modern behavior therapist deliberately applies principles of learning to this therapeutic operations, empirical behavior therapy is probably as old as civilisation – if we consider civilisation as having begun when man first did things to further the well-being of other men. From the time that this became a feature of human life there must have been occasions when a man complained of his ills to another who advised or persuaded him of a course of action. In a broad sense, this could be called behavior therapy whenever the behavior itself was conceived as the therapeutic agent. Ancient writings contain innumerable behavioral prescriptions that accord with this broad conception of behavior therapy.<ref>Wolpe,J. & Lazarus,A. (1966) Behavior Therapy Techniques: A Guide to the Treatment of Neuroses, pp. 1-2.</ref></blockquote>
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| − | Possibly the first occurrence of the term "behavior therapy" was in a 1953 research project by [[B.F. Skinner]], [[Ogden Lindsley]], [[Nathan H. Azrin]] and [[Harry C. Solomon]].<ref name="lindsleyUS95etalUS951953">{{cite journal
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| − | | author = Lindsley, O., Skinner, B.F., Solomon, H.C.
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| − | | title = Studies in behavior therapy (Status Report I)
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| − | | publisher = Walthama, MA.: Metropolitan State Hospital
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| − | | year = 1953}}</ref> Other early pioneers in behaviour therapy include [[Joseph Wolpe]] and [[Hans Eysenck]].<ref name="clarkUS95fairburn">{{cite book
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| − | | last = Clark
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| − | | first = David M.
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| − | | coauthors = Christopher G. Fairburn
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| − | | authorlink = David Clark (psychiatrist)
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| − | | title = Science and Practice of Cognitive Behaviour Therapy
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| − | | publisher = [[Oxford University Press]]
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| − | | year = 1997
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| − | | isbn = 0192627260 }}</ref>
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| − | 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<ref>Yates,, A.J.(1970). Behavior Therapy. New York Wiley</ref>. 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 [[behavioral activation|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 <ref>Goldfarb, R. (2006): Operant Conditioning and Programmed Instruction in Aphasia Rehabilitation - ''SLP-ABA, 1.(1),'' 56-65 [http://www.baojournal.com BAO]</ref> Gerald Patterson used program instruction to develop his parenting text for children with conduct problems<ref>Patterson, G.R. (1969).''Families: A social learning approach to family life.''</ref>. (see [[Parent Management Training]]). With age, [[respondent conditioning]] appears to slow but [[operant conditioning]] remains relatively stable<ref>Perlmutter, M. and Hall, E. (1985). ''Adult development and aging.'' New York: John Wiley.</ref>
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| − | 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 (psychologist)|Albert Ellis]], to form [[cognitive behavioral therapy|cognitive behavioural therapy]]. In some areas the cognitive component had an additive effect (for example, evidence suggests that cognitive interventions improve the result of social phobia treatment.<ref>{{Cite journal | doi = 10.1037/0022-006X.74.3.568 | volume = 74 | issue = 3 | pages = 568–578 | last = Clark | first = David M | title = Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial | journal = Journal of Consulting and Clinical Psychology | accessdate = 2008-11-09 | date = 2006-06 | pmid = 16822113 | last2 = Ehlers | first2 = A | last3 = Hackmann | first3 = A | last4 = McManus | first4 = F | last5 = Fennell | first5 = M | last6 = Grey | first6 = N | last7 = Waddington | first7 = L | last8 = Wild | first8 = J}}</ref>) 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 [[Clinical formulation]] / case conceptualization of verbal behaviour more inline with view of the behaviour analysts. Some research supports these therapies as being more effective in some cases than cogntive therapy <ref>Block, J.A. & Wulfert, E. (2000) Acceptance or Change: Treating Socially Anxious College Students with ACT or CBGT. The Behavior Analyst Today, 1(2), 3-10. [http://www.baojournal.com BAO]</ref> overall the question is still in need of answers<ref>Öst, L. G. (2008). "Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis". ''Behaviour research and therapy 46 (3):'' 296–321</ref>.
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| − | == Scientific basis ==
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| − | 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 a good deal of confusion on how these two conditionings differ and whether the various techniques of Behaviour Therapy have any common scientific base. One answer has come from an online paper called Reinforcing Behaviour Therapy, which more and more psychologists are now studying and appreciating.
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| − | [[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<ref>Paul, G.L. & Lentz, R.J.(1977). Psychosocial treatment of chronic mental patients: Milieu versus social learning programs. Cambridge, MA: Harvard University Press.</ref>
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| − | [[Systematic desensitization]] and [[exposure and response prevention]] both evolved from [[respondent conditioning]] and have also received considerable research.
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| − | [[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 (psychology)|modelling]], coaching, and social cognitive techniques in that order <ref>Schnieder, B.H. & Bryne, B.M. (1985). Children's social skills training: A meta-analysis. In B.H. Schneider, K. Rubin, & J.E. Ledingham (Eds.) Children's Peer relations: Issues in assessment and intervention (pp. 175-190). New York: Springer-Verlag.</ref> Social skills training has some empirical support particularly for schizophrenia<ref>Corrigan, P.W. (1997). Behavior therapy empowers persons with severe mental illness. Behavior Modification, 21, 45-61</ref><ref>Corrigan, P.W. Holmes, E.P.(1994). Patient identification of "street skills" for a psychosocial training module. Hospital and Community Psychiatry, 45, 273-276.</ref> However, with schizophrenia, behavioural programs have generally lost favour.<ref>Wong, S.E. (2006). Behavior Analysis of Psychotic Disorders: Scientific Dead End or Casualty of the Mental Health Political Economy? ''Behavior and Social Issues,15 (2),''152-177 [http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/bsi/article/view/365]</ref>
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| − | ===Applied to problem behaviour===
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| − | 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<ref>Cordova, J. (2003). Behavior Analysis and the Scientific Study of Couples. ''The Behavior Analyst Today, 3 (4),'' 412-419 [http://www.baojournal.com]</ref><ref>Stuart, R.B. (1998). Updating Behavior Therapy with Couples. ''The Family Journal,'' 6(1), 6-12</ref><ref>Christensen, A., Jacobson, N.S. & Babcock, J.C. (1995). Integrative behavioral couples therapy. In N.S. Jacobson & A.S. Gurman (Eds.) Clinical Handbook for Couples Therapy (pp. 31-64). New York: Guildford.</ref>, forgiveness in couples<ref>Cordova, J., Cautilli,J.D., Simon, C. & Axelrod-sabag, R. (2006). Behavior Analysis of Forgiveness in Couples Therapy - '' IJBCT, 2.(2),'' 192-208 [http://www.baojournal.com]</ref>, chronic pain<ref>Sanders, S.H. (2006). Behavioral Conceptualization and Treatment for Chronic Pain (2006). ''The Behavior Analyst Today, 7(2),'' 253-261. [http://www.baojournal.com]</ref>, stress related behaviour problems of being an adult child of an alcoholic<ref>Ruben, D. H. (2001). Treating Adult Children of Alcoholics: A behavioral approach. San Diego, CA: Academic Press.</ref>, anorexia<ref>Lappalainen and Tuomisto (2005): Functional Analysis of Anorexia Nervosa: Applications to Clinical Practice.''The Behavior Analyst Today, 6.(3),'' 166-175 [http://www.baojournal.com]</ref>, chronic distress<ref>Holmes, Dykstra Williamns, Diwan, & River, (2003) Functional Analytic Rehabilitation: A Contextual Behavioral Approach to Chronic Distress. ''The Behavior Analyst Today, 4 (1)'', 34-45 [http://www.baojournal.com BAO]</ref>, substance abuse<ref>Smith, J.E., Milford, J.L and Meyers, R.J. (2004). CRA and CRAFT: Behavioral Approaches to Treating Substance-Abusing Individuals. ''The Behavior Analyst Today, 5.(4),'' 391-402 [http://www.baojournal.com BAO]</ref>, depression<ref>Kanter, J.W., Cautilli, J.D., Busch, A.M. & Baruch, D.E. (2005). Toward a Comprehensive Functional Analysis of Depressive Behavior: Five Environmental Factors and a Possible Sixth and Seventh. ''The Behavior Analyst Today, 6.(1),'' Page 65-78. [http://www.baojournal.com BAO]</ref>, anxiety <ref>Hopko , D.R., Robertson, S. and Lejuez, C.W.(2006). Behavioral Activation for Anxiety Disorders. ''The Behavior Analyst Today, 7(2),'' 212-233 [http://www.baojournal.com]</ref>, and obesity.<ref>Stuart, R.B.(1967). Behavioral Control of overeating. Behavior research and therapy, 5, 357-365 [http://www.garfield.library.upenn.edu/classics1983/A1983QN93200001.pdf]</ref>
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| − | Functional analysis has even been applied to problems that therapists commonly encounter like client resistance, particially engaged clients and involuntary clients.<ref>Cautilli,J., Tillman, T.C., Axelrod, S., Dziewolska, H. & Hineline, P. (2006): Resistance Is Not Futile: An experimental analogue of the effects of consultee “resistance” on the consultant’s therapeutic behavior in the consultation process: A replication and extension. ''IJBCT, 2.(3),'' 362 -376. [http://www.baojournal.com BAO]</ref><ref>Cautilli,J.D. Riley-Tillman, T.C., Axelrod, S. & Hineline, P. (2005). Current Behavioral Models of Client and Consultee Resistance: A Critical Review. ''IJBCT, 1(2),'' 147-164 [http://wwww.baojournal.com BAO]</ref> 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.
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| − | Many have argued that behaviour therapy is at least as effective as drug treatment for depression, ADHD, and OCD.<ref>Flora, S.R. (2007).'' Taking America off Drugs: why behavioral therapy is more effective for treating ADHD, OCD, Depression, and other psychological problems''. SUNY</ref> Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behavior therapy [[Habit reversal training]] has been found to be highly effective for treating tics.
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| − | ===Third generation===
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| − | Of particular interest, in behaviour therapy today are the areas often referred to as Third Generation Behavior Therapy.<ref>{{Cite journal | volume = 3 | pages = 248–253 | last = Kohlenberg | first = R. J. | coauthors = M. Y. Bolling, J. W. Kanter, C. R. Parker | title = Clinical behavior analysis: Where it went wrong, how it was made good again, and why its future is so bright | journal = The Behavior Analyst Today | year = 2002 | issn = 15394352 | url = https://pantherfile.uwm.edu/jkanter/www/pdf/publication/behavioranalysis.pdf | format = PDF}}</ref> This movement has been called [[clinical behavior analysis]] because it represents a movement away from cognitivism and back toward [[radical behaviorism|radical behaviourism]] and other forms of [[behaviorism|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), [[behavioral activation|behavioural activation]] (BA), Kohlenberg & Tsai's [[Functional Analytic Psychotherapy]], [[Integrative behavioral couples therapy]] and [[Dialectical behavioral therapy|dialectical behavioural therapy]]. These approaches are squarely within the [[applied behavior analysis|applied behaviour analysis]] tradition of behaviour therapy.
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| − | [[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]].<ref>Blackledge, J.T. (2003). An Introduction to Relational Frame Theory: Basics and Applications. ''The Behavior Analyst Today, 3 (4),'' 421-442 [http://www.baojournal.com]</ref>
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| − | [[Functional Analytic Psychotherapy]] is based on a functional analysis of the therapeutic relationship.<ref>Kohlenberg, R. J. & Tsai, M. (1991) Functional Analytic Psychotherapy. New York: Plenum</ref> It places a greater emphasis on the therapeutic context and returns to the use of in session reinforcement <ref>Wulfert (2002) Can Contextual Therapies Save Clinical Behavior Analysis? ''The Behavior Analyst Today, 3 (3),'' 254 [http://www.baojournal.com]</ref> In general, 40 years of research supports the idea that in-session reinforcement of behaviour can lead to behavioural change.<ref>Cautilli,J. T. Chris Riley-Tillman, Saul Axelrod and Hineline, P. (2005). The Role of Verbal Conditioning in Third Generation Behavior Therapy. ''The Behavior Analyst Today, 6.(2),'' 138- 157 [http://www.baojournal.com BAO]</ref>
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| − | [[Behavioral activation|Behavioural activation]] emerged from a component analysis of cognitive behaviour therapy. This research found no additive effect for the cognitive component.<ref>Jacobson, N.S., Martell, C.R., & Dimidjian, S.(2001). Behavioral activation treatment for depression: Returning to contextual roots. ''Clinical Psychology: Science and Practice, 8,'' 255-270.</ref> Behavioural activation is based on a matching model of reinforcement.<ref>Cullen, J.M. Spates, C.R, Pagoto, S. & Doran, N. (2006). Behavioral Activation Treatment for Major Depressive Disorder: A Pilot Investigation - ''The Behavior Analyst Today, 7.(1), '' 151-164.</ref> A recent review of the research, supports the notion that the use of behavioural activation is clinically important for the treatment of depression.<ref>Spates,C.R., Pagoto, S. and Kalata, A. (2006). A Qualitative And Quantitative Review of Behavioral Activation Treatment of Major Depressive Disorder.''' The Behavior Analyst Today, 7.(4), ''' 508-512 [http://www.baojournal.com]</ref>
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| − | [[Integrative behavioral 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.<ref>Skinner, B.F. (1969). Contingencies of Reinforcement: A Theoretical Analysis. New York: Meredith Corporation.</ref> 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.<ref>Cordova,J., Cautilli, J.D., Simon, C. & Axelrod-sabag, R. (2006). Behavior Analysis of Forgiveness in Couples Therapy. IJBCT, 2.(2), 192-213 [http://www.baojournal.com]</ref>
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| − | ===Organizations===
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| − | Many organizations exist for behaviour therapists around the world. The World Assocaition for Behavior Analysis offers a certification in behavior therapy [http://worldcenterba.com/index.html] In the United States, the American Psychological Association's Division 25 is the division for [[behavior analysis|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 Behavioral and Cognitive Therapies]] (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 for Behavior Analysis]] (ABA:I) [http://www.abainternational.org/].
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| − | ==Characteristics==
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| − | 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).<ref>{{cite book | last = Sundberg | first = Norman | title = Clinical Psychology: Evolving Theory, Practice, and Research | publisher = Prentice Hall | location = Englewood Cliffs | year = 2001 | isbn = 0130871192 }}</ref>
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| − | == Methods ==
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| − | * [[Systematic desensitization]]
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| − | * [[Exposure and response prevention]]
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| − | * [[Behavior modification|Behaviour modification]]
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| − | * [[Flooding (psychology)|Flooding]]
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| − | * [[Operant conditioning]]
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| − | * [[Covert conditioning]]
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| − | * [[Observational learning]]
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| − | * [[Contingency management]]
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| − | * [[Matching law]]
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| − | * [[Habit reversal training]]
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| − | == See also ==
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| − | * [[Aversion therapy]]
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| − | * [[Cognitive therapy]]
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| − | * [[Cognitive behavioral therapy|Cognitive behavioural therapy]]
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| − | * [[Applied behavior analysis|Applied behaviour analysis]]
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| − | * [[Behavior modification|Behaviour modification]]
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| − | * [[Professional practice of behavior analysis|Professional practice of behaviour analysis]]
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| − | * [[Functional Analytic Psychotherapy]]
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| − | * [[Acceptance and Commitment Therapy]]
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| − | * [[Dialectical behavioral therapy|Dialectical behavioural therapy]]
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| − | * [[Behavioral activation|Behavioural activation]]
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| − | * [[Creative Applied Modification]]
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| − | * [[A Clockwork Orange]]
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| − | == References==
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| − | <references/>
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| − | {{Psychotherapy}}
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| − | [[Category:Behavior therapy]]
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| − | [[Category:Psychotherapy]]
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