Therapies 521-Behavior Therapy Discussion

Therapies 521-Behavior Therapy Discussion

Therapies 521-Behavior Therapy Discussion

Any therapy designed to actively change behavior.

Behavior modification

The application of learning principles to change human behavior, especially maladaptive behavior. Aversion therapy Suppressing an undesirable response by associating it with aversive (painful or uncomfortable) stimuli.

Client didn’t need to probe into his past or his emotions and conflicts; he simply wanted to break his shoplifting habit. This and the next section describe some innovative—and very successful—behavioral therapies.

Behavior therapists assume that people have learned to be the way they are. If they have learned responses that cause problems, then they can change them by relearning more appropriate behaviors. Broadly speaking, behavior modification refers to any use of classical or operant conditioning to directly alter human behavior (Miltenberger, 2011; Spiegler & Guevremont, 2010). (Some therapists prefer to call this approach applied behavior analysis.) Behavioral approaches include aversion therapy, desensitization, token economies, and other techniques (Forsyth & Savsevitz, 2002).

How does classical conditioning work? I’m not sure I remember. Perhaps a brief review would be helpful. Classical conditioning is a form of learning in which simple responses (especially reflexes) are associated with new stimuli. In classical conditioning, a neutral stimulus is followed by an unconditioned stimulus (US) that consistently produces an unlearned reaction, called the unconditioned response (UR). Eventually, the previously neutral stimulus begins to produce this response directly. The response is then called a conditioned response (CR), and the stimulus becomes a conditioned stimulus (CS). Thus, for a child the sight of a hypodermic needle (CS) is followed by an injection (US), which causes anxiety or fear (UR). Eventually, the sight of a hypodermic (the conditioned stimulus) may produce anxiety or fear (a conditioned response) before the child gets an injection.

For a more thorough review of classical conditioning, return to Chapter 6, pages 207–212.

BRIDGES

What does classical conditioning have to do with behavior modification? Classical conditioning can be used to associate discomfort with a bad habit, as Jay did to deal with his kleptomania. More powerful versions of this approach are called aversion therapy.

Aversion Therapy Imagine that you are eating an apple. Suddenly, you discover that you just bit a large green worm in half. You vomit. Months later, you cannot eat an apple again without feeling ill. It’s apparent that you have developed a conditioned aversion to apples. (A conditioned aversion is a learned dislike or negative emotional response to some stimulus.)

How are conditioned aversions used in therapy? In aversion therapy, an individual learns to associate a strong aversion to an undesirable habit such as smoking, drinking, or gambling. Aversion therapy has been used to cure hiccups, sneezing, stuttering, vomiting, nail-biting, bed-wetting, compulsive hair-pulling, alcoholism, and the smoking of tobacco, marijuana, or crack cocaine. Actually, aversive conditioning happens every day. For example, not many physicians who treat lung cancer patients are smokers, nor do many emergency room doctors drive without using their seat belts (Eifert & Lejuez, 2000).

Puffing Up an Aversion The fact that nicotine is toxic makes it easy to create an aversion that helps people give up smoking. Behavior therapists have found that electric shock, nauseating drugs, and similar aversive stimuli are not required to make smokers uncomfortable. All that is needed is for the smoker to smoke—rapidly, for a long time, at a forced pace. During rapid smoking, clients are told to smoke continuously, taking a puff every 6 to 8 seconds. Rapid smoking continues until the smoker is miserable and can stand it no more. By then, most people are thinking, “I never want to see another cigarette for the rest of my life.”

Rapid smoking has long been known as an effective behavior therapy for smoking (McRobbie & Hajek, 2007). Nevertheless, anyone tempted to try rapid smoking should realize that it is very unpleasant. Without the help of a therapist, most people quit too soon for the procedure to succeed. In addition, rapid smoking can be dangerous. It should be done only with professional supervision. (An alternative method that is more practical is described in the Psychology in Action section of this chapter.)