Behavioral Therapy (College Board AP® Psychology): Revision Note

Focus of behavioral therapy

• Behavioral therapy is based on the principle that all behavior is learned

  • Therefore maladaptive behavior can be unlearned and replaced with adaptive responses

• Behavioral therapists apply the following learning principles to treat psychological disorders

  • classical conditioning

  • operant conditioning

  • observational learning

Applied behavior analysis (ABA)

• Applied behavior analysis (ABA) is the systematic application of conditioning principles to address mental disorders and developmental disabilities

  • ABA therapists use reinforcement systems to teach clients adaptive behaviors

  • ABA has been shown to be especially effective in treating autism spectrum disorder (ASD) and anxiety disorders

• The focus is always on observable behavior

  • Behavioral therapists measure outcomes in terms of changes in behavior, not insight or self-understanding

Counterconditioning

• Counterconditioning is a technique in which a maladaptive response to a stimulus is replaced by a more adaptive one

  • Based on classical conditioning, the therapist works to pair the previously feared or problematic stimulus with a new, more positive response

    • E.g. a client who has learned to associate going to the doctor with fear might be helped to associate the same situation with calm and positive feelings through repeated pairings with calming stimuli

Techniques used in behavioral therapy

Systematic desensitization

• Systematic desensitization is a counterconditioning technique used primarily to treat phobias and anxiety disorders

• The core aim is to replace the learned fear response to a stimulus with a learned relaxation response through repeated classical conditioning pairings

  • Because relaxation and anxiety are incompatible states, once relaxation becomes the conditioned response, anxiety cannot easily co-exist with it

• Systematic desensitization involves three stages:

  • Stage 1: Learning relaxation

    • The client is taught relaxation techniques such as deep breathing or progressive muscle relaxation

  • Stage 2: Constructing a fear hierarchy

    • The therapist and client together create an anxiety or fear hierarchy of feared stimuli from least to most frightening

  • Stage 3: Working through the hierarchy

    • The client progressively confronts each feared stimulus (in imagination or in reality) while using relaxation techniques, moving up the hierarchy only when calm at each step

• Systematic desensitization can be conducted:

  • in vivo, where the client confronts the actual feared stimulus

  • covertly, where the client imagines the feared stimulus

• In vivo desensitization tends to produce stronger and more durable results, as the fear response is extinguished in the real-world context

Flooding

• Flooding is an exposure technique that uses classical conditioning principles

• It differs from systematic desensitization in the following ways:

  • Instead of working gradually up a fear hierarchy, flooding exposes the client to the most frightening stimulus immediately and maintains that exposure

  • The client cannot escape or avoid the stimulus, so the fear response eventually extinguishes as the client learns nothing harmful actually occurs

    • E.g. a client with a spider phobia might be placed in a room with large spiders crawling on the walls

• Flooding produces rapid results but is highly distressing, and clients may be unwilling to complete the procedure

Aversion therapy

• Aversion therapy is a counterconditioning technique that pairs an unpleasant stimulus (an aversive stimulus) with a behavior the client wants to stop

  • The goal is to build a classically conditioned negative response to the previously desired behavior

    • E.g. a client wishing to stop drinking alcohol might receive a mild electric shock or nausea-inducing drug each time they consume alcohol

  • Over repeated pairings, the client associates the behavior with the unpleasant stimulus rather than with pleasure

• Aversion therapy has shown effectiveness for addictive behaviors such as alcohol dependence and smoking

Token economy

• A token economy is a behavioral intervention that uses operant conditioning principles to modify behavior

  • Individuals earn tokens when they perform target behaviors identified by the therapist

  • Tokens can later be exchanged for desired objects or privileges, functioning as a conditioned reinforcer

  • Token economies are widely used in institutional settings such as psychiatric wards, schools, and residential programs

• Token economies are effective because they provide immediate, consistent reinforcement

Modeling

• Modeling is a therapeutic approach based on social learning theory, in which the client learns by observing and then imitating the behavior of another person

  • E.g. a therapist treating a client with a spider phobia might have them watch someone else calmly and confidently handle a spider, then attempt the same behavior themselves

• Modeling can be used alongside systematic desensitization and flooding for treating phobias, as well as a wide range of other difficulties

Biofeedback

• Biofeedback uses principles of conditioning to help clients learn to regulate physiological body systems that contribute to anxiety, stress, or depression

  • Clients are connected to monitoring equipment that provides real-time feedback about physiological responses such as:

    • heart rate

    • muscle tension

    • breathing rate

    • brainwave activity

  • Using this feedback, clients learn to recognize when their body is becoming stressed and practice techniques to bring these responses under voluntary control

    • Techniques include breathing and guided visualization

• Over time, clients can regulate the sympathetic and parasympathetic nervous systems without the monitoring equipment

• Biofeedback has shown effectiveness in treating anxiety disorders, hypertension, chronic pain, and ADHD