428 Chapter 12 Approaches to Treatment and Therapy
Skills-training programs have been designed for all
kinds of behavioral problems: to teach parents how
to discipline their children, impulsive adults how to
manage anger, shy people how to converse in social
situations, autistic children how to behave ap-
propriately, and people with schizophrenia how to
hold a job. These skills are also being taught in vir-
tual worlds, such as Second Life. After face-to-face
sessions with a therapist, the client creates an avatar
to explore a virtual environment and experiment
with new behaviors; at the same time, the therapist
can be monitoring the client’s psychological and
even physiological reactions.
A behaviorist would treat Murray’s procras-
tination in several ways. Monitoring his own be-
havior with a diary would let Murray know exactly
how he spends his time, and how much time he
should realistically allot to a project. Instead of
having a vague, impossibly huge goal, such as “I’m
going to reorganize my life,” Murray would estab-
lish specific small goals, such as reading the two
books necessary for an English paper and writing
one page of an assignment. If Murray does not
know how to write clearly, however, even writing
one page might feel overwhelming; he might also
need some skills training, such as a basic composi-
tion class. Most of all, the therapist would change
the reinforcers that are maintaining Murray’s “pro-
crastination behavior”—perhaps the immediate
gratification of partying with friends—and replace
them with reinforcers for getting the work done.Cognitive Techniques. Gloomy thoughts can
generate an array of negative emotions and self-
defeating behavior. The underlying premise of cog-
nitive therapy is that constructive thinking can do the
opposite, reducing or dispelling anger, fear, and de-
pression. Cognitive therapists help clients identify
the beliefs and expectations that might be unneces-
sarily prolonging their unhappiness, conflicts, and
other problems (Persons, Davidson, & Tompkins,skills training In behav-
ior therapy, an effort to
teach the client skills
that he or she may lack,
as well as new construc-
tive behaviors to replace
self-defeating ones.
cognitive therapy A
form of therapy designed
to identify and change
irrational, unproductive
ways of thinking and,
hence, to reduce negative
emotions and their self-
defeating consequences.
Would you like to cut back on eating sweets? You
may not be aware of how much you are eating
throughout the day to relieve tension, boost your
energy, or just to be sociable when you are hanging
out; a behavioral record will show how much and
when you eat. A mother might complain that her
child “always” has temper tantrums; a behavioral
record will show when, where, and with whom
those tantrums occur. Once the unwanted behavior
is identified, along with the reinforcers that have
been maintaining it, a treatment program can be
designed to change it. For instance, you might find
other ways to reduce stress besides eating, and make
sure that you are nowhere near junk food in the late
afternoon, when your energy is low. The mother
can learn to respond to her child’s tantrum not with
her attention (or a cookie to buy silence) but with
a time out: banishing the child to a corner or other
place where no positive reinforcers are available.4
Skills training. It is not enough to tell someone
“Don’t be shy” if the person does not know
how to make small talk with others, or “Don’t yell!”
if the person does not know how to express feelings
calmly. Therefore, some behavior therapists use
operant-conditioning techniques, modeling, and
role-playing to teach the skills a client might lack.This man is using a virtual reality form of systematic
desensitization to overcome his fear of heights.Get Involved! Cure Your Fears
In Chapter 11, a Get Involved exercise asked you to identify your greatest fear. Now see whether system-
atic desensitization procedures will help you conquer it. Write down a list of situations that evoke your fear,
starting with one that produces little anxiety (e.g., seeing a photo of a tiny spider) and ending with the most
frightening one possible (e.g., looking at live tarantulas at a pet store). Then find a quiet room where you
will have no distractions or interruptions, sit in a comfortable reclining chair, and relax all the muscles of
your body. Breathe slowly and deeply. Imagine the first, easiest scene, remaining as relaxed as possible.
Do this until you can confront the image without becoming the least bit anxious. When that happens, go
on to the next scene in your hierarchy. Do not try this all at once; space out your sessions over time. Does
it work?