Invitation to Psychology

Chapter 12 Approaches to Treatment and Therapy 427

the degree of confrontation with the source of the

fear: Someone who is trying to avoid thinking of

a traumatic event might be asked to imagine the

event over and over, until it no longer evokes the

same degree of panic. A more dramatic form of

exposure is flooding, in which the therapist takes

the client directly into the feared situation and

remains there until the client’s panic and anxiety

decline. Thus, a person suffering from agorapho-

bia might be taken into a department store or a

subway, an action that would normally be terrify-

ing even to contemplate.

2

Systematic desensitization. Systematic desen-

sitization is an older behavioral method, a

step-by-step process of breaking down a client’s

conditioned associations to a feared object or ex-

perience (Wolpe, 1958). It is based on the classical-

conditioning procedure of counterconditioning, in

which a stimulus (such as a dog) for an unwanted

response (such as fear) is paired with some other

stimulus or situation that elicits a response in-

compatible with the undesirable one (see Chapter

9). In this case, the incompatible response is usu-

ally relaxation. The client learns to relax deeply

while imagining or looking at a sequence of feared

stimuli, arranged in a hierarchy from the least

frightening to the most frightening. The hierarchy

itself is provided by the client. The sequence for a

person who is terrified of spiders might be to read

the classic children’s story Charlotte’s Web, then

look at pictures of small, cute spiders, then look at

pictures of tarantulas, then move on to observing

a real spider, and so on. At each step, the person

must become relaxed before going on. Eventually,

the fear responses are extinguished.

Taking advantage of computer technology,

some behavior therapists have developed virtual re-

ality (VR) programs to desensitize clients to anxiety

and to various phobias, notably of flying, heights,

spiders, and public speaking (Gregg & Tarrier,

2007; Weiderhold & Weiderhold, 2000). Others are

experimenting with VR to treat combat veterans

who are suffering from intractable posttraumatic

stress symptoms. In a program called Virtual Iraq,

vets get a combination of exposure and desensitiza-

tion. They wear a helmet with video goggles and

earphones to hear the sounds of war, and then play

a version of the VR game Full Spectrum Warrior

adapted to the Iraq experience (S. Halpern, 2008).

3

Behavioral self-monitoring. Before you can change

your behavior, it helps to identify the reinforc-

ers that are supporting your unwanted habits: atten-

tion from others, temporary relief from tension or

unhappiness, or tangible rewards such as money or

a good meal. One way to do this is to keep a record

of the behavior that you would like to change.

flooding In behavior ther-

apy, a form of exposure

treatment in which the cli-

ent is taken directly into a

feared situation until his

or her panic subsides.

systematic desen-

sitization In behavior

therapy, a step-by-step

process of desensitiz-

ing a client to a feared

object or experience; it

is based on the classical-

conditioning procedure of

counterconditioning.

behavioral self-

monitoring In behavior

therapy, a method of

keeping careful data on

the frequency and conse-

quences of the behavior

to be changed.

Behavior and Cognitive Therapy

LO 12.5, LO 12.6

Clinical psychologists who practice behavior ther-

apy would get right to the problem: What are

the reinforcers in Murray’s environment that are

maintaining his behavior? “Mur,” they would say,

“forget about insight. You have lousy study hab-

its.” Clinicians who practice cognitive therapy

would focus on helping Murray understand how

his beliefs about studying, writing papers, and

success are woefully unrealistic. Often these two

approaches are combined.

Behavioral Techniques. Behavior therapy is

based on principles of classical and operant condi-

tioning that are discussed in Chapter 9. (You may

want to review those principles before going on.)

Here are some of the main methods that behavior

therapists use (Martin & Pear, 2011):

1

Exposure. The most widely used behavioral ap-

proach for treating fears and panic is graduated

exposure. When people are afraid of some situ-

ation, object, or upsetting memory, they usually

do everything they can to avoid confronting or

thinking of it. Unfortunately, this seemingly logi-

cal response only makes the fear worse. Exposure

treatments, either in the client’s imagination or in

actual situations, are aimed at reversing this ten-

dency. In graduated exposure, the client controls

behavior therapy A

form of therapy that ap-

plies principles of clas-

sical and operant con-

ditioning to help people

change self-defeating or

problematic behaviors.

graduated exposure

In behavior therapy, a

method in which a person

suffering from a phobia

or panic attacks is gradu-

ally taken into the feared

situation or exposed to a

traumatic memory until

the anxiety subsides.

IN THE BLEACHERS © Steve Moore. Reprinted with permission of UNIVERSAL PRESS SYNDICATE. All Rights Reserved.