Behavioral therapy is based on the works of I.P. Pavlov and B. Skinner, its essence is the modification of behavior through weaning from unwanted habits and reactions and learning the desired behavior. In behavioral therapy, the psychologist does not set the task of explaining to the client what is the cause of his problems, he simply influences the undesirable behavior so that it changes in the right direction.
In the United States, behavioral therapy is quite common, used in specific situations: for the treatment of phobias, bad habits (alcoholism, smoking, overeating), to combat enuresis and stuttering, and is widely used in psychiatric institutions.
As a method of influence, operant learning and the classical method of conditioned reflexes are most often used — methods that use positive and negative reinforcement. The patient is not treated — he is taught the correct behavior with the help of a training program. For a psychotherapist working on this principle, the main thing is to choose reinforcements that are effective for this particular patient. Sometimes this is done by simply asking: “What will be positive and what will be negative reinforcement for you? What will you like and what will you not?
And then for some, a positive reinforcement will be permission to watch TV, for some — sweets, for some in psychiatric institutions — to live in a separate room, visit the dining room one more time.
Behavioral therapy uses classical conditioning techniques.
You know the classic conditioning: when the light comes on, you have to pull your paw back, because if you don’t, you’ll get an electric shock. After a while, everyone learns this: both people and dogs, regardless of the level of intelligence and outlook on life.
The most commonly used technique is counterconditioning, or desensitization (desensitization): as a rule, for the treatment of phobias in dogs and humans.
For example, dogs have a fear of loud noises, and humans have a fear of dogs.
Methodology: first we find out what would be a reinforcement for the client, we teach him to relax. After that, we ask what situations cause anxiety in the client, rank these situations from those that are slightly disturbing to those that he cannot cope with. After a stressful situation, we associate it with muscle relaxation. In a situation of relaxation, we recall the situation that causes minimal anxiety, then we also discuss other situations that are more and more disturbing. Total: being in a stressful situation, a person will experience much less stress, will feel quite calm.
Simple, but it works.
The same with the dog. You practice a command that she knows well, such as «Sit!», «Play ball!» (this command should be associated with positive emotions), and then enter into a desensitization situation. You are directing her attention to behaviors that she can use to cope with the situation. Through the desensitization situation, you guide the dog through a series of more and more disturbing situations. For example, if a dog is frightened in a clinic and refuses to walk there, they start working from the farthest distance. As soon as she feels anxiety (looks around, spins around her tail, etc.), switch her to a different type of activity (usually play) or to execute a practiced command, and then gradually reduce the distance.
At a more general level, you give the subject a way to cope with the situation, and then lead her into situations that cause anxiety, and switch him to the behavior with which he could cope with himself in other situations. This is counterconditioning through desensitization.
Another technique is aversive conditioning. For example, in the fight against overeating, a simple device with a battery is attached to the Big Mac, a person bites the Big Mac and receives a weak discharge. A trifle, but unpleasant. Similarly — if the hand reaches for a cigarette, we get a discharge for a cigarette. Coding for alcoholism is the same principle, although the gag reflex is more often used here. A glass to your mouth — and an attack of nausea or a feeling that you are dying.
It is unpleasant, but in a situation of choice — a future normal life or the loss of a family, or even more so a prison, people readily go for it and get the desired result.
It is interesting that enuresis is also treated: the child lies on the bed, moisture sensors are placed under the sheet. The child has described himself — the light is turned on, the diaper is changed for the child. The child does not want to wake up. but this always happens, and usually enough to stop the enuresis. A few repetitions — the problem is solved.
Once upon a time, at the dawn of research, they tried to use weak shocks of an electric current as a negative reinforcement. Life has shown that there is no need for this: the usual diaper change is on time! — this function is fully performed.
Operant learning methods are used in psychiatric institutions — for example, the method of accumulating tokens.
Brushes teeth — a token, cleans the bed — a token, tokens are exchanged for privileges: cigarettes, living in a separate room, an additional visit to the dining room. The technique is not ideal, but among all possible it is recognized as the most effective.
Behavioral therapy is a rapid therapy that allows you to control the consequences.
Total
Behavioral therapy is not magic, it has its drawbacks and limitations.
Not everything is determined only by the techniques applied to the patient: if the patient is interested in a cure, the effectiveness of the cure is higher. However, this is typical for any approach, not only the behavioral approach, and we note that it is in the behavioral approach that the moment of client’s interest plays a lesser role than in other approaches.
The behavioral approach shows high efficiency for simple cases of psychotherapy: getting rid of standard phobias (fears), unwanted habits, the formation of desirable behavior. In more complex, confusing, «personal» cases, not just about behavior, but about values and lifestyle (which is typical for many problems with drug addicts and alcoholics), the use of behavioral methods is unsustainable and has a short-term effect.
Behavioral Model Therapy is used to treat anxiety and fear. An anxious person is shown how confident people behave in a problem situation, and they are offered to reproduce, repeat this behavior. In addition, the psychologist can explain ways to get out of an alarming situation, adequate speech responses, and, if necessary, develop the skill of using these means.
If what is being removed by behavioral therapy turns out to be a symptom of something more serious and deeper, there may be backlashes and repetitions. However, the so-called in-depth approach also does not guarantee sustainable results, and well-conducted behavioral therapy often leads not only to the removal of a symptom that disturbs a person, but also to an overall improvement in his condition.
S. Ginger writes about this in the book «Gestalt — Contact Therapy»:
In traditional psychoanalysis, the symptom is often relegated to the background and regarded as a guide on the path of self-discovery. Consistent awareness of the repressed material is carried out through a global approach to the deep personality, through the analysis of transfer and interpretations. It is believed that «recovery» will come by itself, as if in addition to the above; Freud himself recommended to beware of excessive «zeal for a cure.» In this case, a subjective and rather pessimistic view of a person appears (the oppressive determinism of early childhood, natural «polymorphic perverse» inclinations, etc.).
In the behavioral approach, on the contrary, the symptom itself is treated; this is explained by concern for the effectiveness of therapy and “respect for the most explicit request of the client”, who came to the consultation with her and, as a rule, does not ask for anything more. After all, a client who comes to buy only a tie is not offered an expensive three-piece suit! Precise deconditioning and desensitization techniques (Wolp) often lead to a rapid disappearance of a symptom, for example in the case of phobias or sexual disorders, which, however, is not accompanied by a global restructuring of the entire personality. Let’s add along the way that symptomatic shifts (the appearance of new, replacement symptoms), according to statistics, occur much less frequently than psychoanalysts think. And even vice versa, positive “chain reactions” are often noted (For example, with the cure of sexual impotence, car accidents (integration of the body schema) and outbursts of anger (the illusion of omnipotence) stop. Proponents of this approach believe that their view of a person is objective and realistic.↑
When evaluating the effectiveness of behavioral therapy, one must also take into account historical preferences: America prefers behavioral approaches to all others, in Russia behaviorism is not honored.