Clinical Psychology

Stress Inoculation Training

BOX14-5:Focus on Clinical Applications:

Common“Irrational”Ideas

Beck’s Cognitive Therapy

BOX14-6:Focus on Clinical Applications:

Features of Cognitive Therapy

for Depression

Dialectical Behavior Therapy

An Evaluation of Behavior Therapy
Strengths

BOX14-7:Focus on Clinical Applications:

Excerpts from Sessions of Dialectical Behavior

Therapy (DBT)

BOX14-8:Psychologist Perspective: Rhonda

Oswalt Reitz, Ph.D.

Limitations

The Future

CHAPTER SUMMARY

KEY TERMS

WEB SITES OF INTEREST

B

ehavioral and cognitive-behavioral therapies,

often together referred to as CBT, have

become a major force in clinical psychology. A

constant flow of books provides wide-ranging dis-

cussions of the theory, technique, and application

of an extensive variety of these methods. Lists of

evidence-based treatments (seeChapter 11) include

many treatments that fall under the broad rubric of

CBT. CBT has truly come of age and is now a

force with which to be reckoned.

Origins of the Behavioral Approach

We begin our discussion of behavior therapy with
the question of definitions and then move into a
brief presentation of this treatment’s historical
roots. We then discuss CBT more specifically.

Definition

The diversity of behavioral approaches to therapy
makes a satisfactory definition almost impossible.
Some definitions are couched largely in the termi-
nology of operant conditioning (Skinner, 1971).
Others rely on concepts of classical conditioning
(Wolpe, 1958). For still others, the emphasis is on
general principles of learning (Ullman & Krasner,
1969) or may even have strikingly cognitive over-
tones (Meichenbaum, 1977). In light of this

diversity, Goldfried and Davison (1994) were

moved to comment:

We believe that behavior therapy is more

appropriately construed as reflecting a gen-

eral orientation to clinical work that aligns

itself philosophically with an experimental

approach to the study of human behavior.

The assumption basic to this particular ori-

entation is that the problematic behaviors

seen within the clinical setting can best be

understood in light of those principles

derived from a wide variety of psychologi-

cal experimentation, and that these princi-

ples have implications for behavior change

within the clinical setting. (pp. 3–4)

Traditionally, the behavioral approach allies itself

with (a) a scientific emphasis and (b) a de-emphasis of

the role of inferred variables. The behaviorists are

likely to trace their origins to the“science”of Skinner

or Pavlov rather than the“mentalism”of Freud. The

focus is on stimuli and responses rather than variables

that are presumed to mediate them. However, as we

shall see later in this chapter, CBT over the years has

broadened its scope to include techniques that address

cognitive and other mediational processes (Goldfried

& Davison, 1994). Nevertheless, it is instructive to

review behavior therapy’s historical roots.

A Brief History

We begin by presenting the groundbreaking work

of Watson and Rayner (1920), who conducted the

widely cited laboratory study of Albert and a

398 CHAPTER 14