adaptive behavior. Therapies are based on the learning principles of classical conditioning,
operant conditioning, and observational or social learning theory.
Classical Conditioning Therapies
Classical conditioning therapies involving reconditioning include the counterconditioning
techniques of systematic desensitization, flooding, and aversive conditioning.
- Originally called reciprocal inhibition,systematic desensitizationis a behavior therapy
founded on the idea that an anxiety response is inhibited by an incompatible relaxation
response. Joseph Wolpe explains systematic desensitization as reconditioning so that the
crucial conditioned stimulus elicits a new conditioned response. The procedure has three
steps. First, the client is taught how to relax. Next, the therapist and client create an
anxiety hierarchyof all associated fears from the least-feared to the most-feared stimulus.
For example, for school phobia, they may list the following situations: thinking about
going to school, seeing a picture of the school, getting on the school bus, walking
towards the school, opening the school door, and finally sitting in the classroom. Third,
the therapist has the student imagine each of the fearful associations beginning with the
least feared stimulus, the mere thought about going to school. After the student can relax
with this fear, the process is repeated, finally ascending to the most fear-provoking stim-
ulus of actually sitting in the classroom. When the student can sit in the classroom and
be completely relaxed, the relaxation response is effective for inhibiting the fear response.
Systematic desensitization is typically accomplished within 10 sessions. - Floodingis an exposure technique,another classical conditioning treatment for phobias
and other anxiety disorders, that extinguishes the conditioned response. As a result of the
client directly confronting the anxiety-provoking stimulus, extinction is achieved; the
feared stimulus (the conditioned stimulus) is repeatedly presented without the reason for
being afraid (the unconditioned stimulus). For example, if someone afraid of dogs is
repeatedly exposed to friendly dogs that do not bite, the fear associated with the dogs will
eventually be extinguished. - Yet another form of behavior therapy based on the principles of classical conditioning,
aversive conditioning, trains the client to associate physical or psychological discomfort
with behaviors, thoughts, or situations he/she wants to stop or avoid. One example of
aversive conditioning uses a drug called Antabuse (US) to discourage the use of alcohol.
By itself, the drug has no chemical effect, but when paired with alcohol (CS), the com-
bination causes extreme nausea (CR). Similar to taste aversions discussed in Chapter 10,
after very few pairings of Antabuse and alcohol, the client learns to avoid alcohol.
Without an occasional pairing of the Antabuse with the alcohol again, this new response
can easily be extinguished.
Operant Conditioning Therapies
Operant conditioning therapies include contingency managementtechniques of behavior
modification and token economies designed to change behavior by modifying its conse-
quences. In both, rewards are used for target behaviors.
•In behavior modification, the client selects a goal and, with each step toward it, receives
a small reward until the intended goal is finally achieved. Weight Watchers and other
weight-reducing programs use this method to keep clients motivated.
•In token economies, positive behaviors are rewarded with secondary reinforcers
(tokens, points, etc.), which can eventually be exchanged for primary reinforcers, such
as food or other rewards. Token economies are often used in institutions to encourage
socially acceptable behaviors and to discourage socially unacceptable ones.
232 ❯ STEP 4. Review the Knowledge You Need to Score High