600 CHAPTER 15
USING REINFORCEMENT Reinforcement is the strengthening of a response by following
it with some pleasurable consequence (positive reinforcement) or the removal of an
unpleasant stimulus (negative reinforcement). Reinforcement of both types can form the
basis for treatment of people with behavioral problems.
In a token economy, objects known as tokens can be traded for food, candy, treats, or
special privileges. Clients earn tokens for behaving correctly or accomplishing behav-
ioral goals and can later exchange those tokens for things that they want. They may
also lose tokens for inappropriate behavior. This trading system is a token economy.
to Learning Objective 5.9. Token economies have also been used successfully
in modifying the behavior of relatively disturbed persons in mental institutions, such
as people with schizophrenia or depressed persons (Dickerson et al., 1994; Glynn, 1990;
McMonagle & Sultana, 2002).
Another method based on the use of reinforcement involves making a contin-
gency contract with the client (Salend, 1987). This contract is a formal agreement
between therapist and client (or teacher and student, or parent and child) in which
both parties’ responsibilities and goals are clearly stated. Such contracts are useful
in treating specific problems such as drug addiction (Talbott & Crosby, 2001), edu-
cational problems (Evans & Meyer, 1985; Evans et al., 1989), and eating disorders
(Brubaker & Leddy, 2003). Monetary contingency contracts may be useful in weight-
loss programs (Sykes-Muskett et al., 2015). Because the stated tasks, penalties, and
reinforcements are clearly stated and consistent, both parties are always aware of the
consequences of acting or failing to act within the specifications of the contract, mak-
ing this form of behavioral treatment fairly effective. Consistency is one of the most
effective tools in using both rewards and punishments to mold behavior. to
Learning Objectives 5.6, 5.7.
USING EXTINCTION Extinction involves the removal of a reinforcer to reduce the
frequency of a particular response. In modifying behavior, operant extinction often
involves removing one’s attention from the person when that person is engaging in
an inappropriate or undesirable behavior. With children, this removal of attention
may be a form of time-out, in which the child is removed from the situation that pro-
vides reinforcement (Kazdin, 1980). In adults, a simple refusal by the other persons in
the room to acknowledge the behavior is often successful in reducing the frequency
of that behavior.
BEHAVIORAL ACTIVATION Behavioral activation is an operant-based intervention that
has been used successfully with depression. Individuals with depression may limit
their involvement with others or the typical activities they would normally engage in.
This avoidant behavior limits their opportunities to be positively reinforced through
social activities or pleasant experiences. Behavioral activation involves reintroduc-
ing individuals to their regular environments and routines as one way to increase
opportunities for positive reinforcement (Dimidjian et al., 2006; Ekers et al., 2014;
Forman, n.d.). Therapists work with their clients to schedule activities through daily
activity monitoring, activity scheduling, and a variety of other ways to restore an
environment that increases the likelihood of activation behavior, decreases avoidant
and depressive behavior, and increases positive reinforcement (Manos et al., 2010;
Puspitasari et al., 2013).
EVALUATION OF BEHAVIOR THERAPIES Behavior therapies may be more effec-
tive than other forms of therapy in treating specific behavioral problems, such
as bed- wetting, overeating, drug addictions, and phobic reactions (Burgio, 1998;
We t h e re l l , 2 0 0 2 ). S o m e p ro b l e m s d o n o t re s p o n d a s w e l l o v e r a l l t o b e h a v i o r a l t re a t-
ments, although improvement of specific symptoms can be achieved (Glynn, 1990;
McMonagle & Sultana, 2002). While EX/RP is often a successful treatment for OCD,
some associated cognitive symptoms, such as deficits in executive functioning, maycontingency contract
a formal, written agreement between
the therapist and client (or teacher
and student) in which goals for behav-
ioral change, reinforcements, and pen-
alties are clearly stated.
time-out
an extinction process in which a per-
son is removed from the situation that
provides reinforcement for undesir-
able behavior, usually by being placed
in a quiet corner or room away from
possible attention and reinforcement
opportunities.
Contingency contracts are useful for
establishing a variety of desired behaviors.
When used effectively, explicit expectations
and consistency of implementation are key
factors that lead to their success.