Treatment Interventions 351(Abramson, Seligman, & Teasdale, 1978): Persons who are
likely to become depressed attribute their failures to their
own personality characteristics, while those who are not at
risk for depression attribute failures to external, transitory,
specific circumstances. Accordingly, the cognitive therapist
might help a person to be less depressed by coming to see
how failures occur in certain situations and dealing with
those events more effectively.
Cognitive behavior therapy for treating panic disorders in-
volves teaching the patient to interpret symptoms of acute
anxiety as relatively harmless rather than as indications of a
pending heart attack or psychotic episode (Craske, Brown, &
Barlow, 1991). This was found to be more beneficial than
treatment with the anti-anxiety drug Xanax (alprazolam).
More recently, Marsha Linehan (1993) developed a proce-
dure, called dialectical behavior therapy, that shows promise
in the treatment of borderline personality disorder.
Social learning is yet another major approach in behavior
therapy, which owes much to the work of Albert Bandura
(1977). The emphasis here is on learning that occurs without
obvious rewards, as when we learn what to do by observing
the consequences of behaviors performed by others (vicarious
learning); or when we imitate the behaviors of those we like,
respect, or admire (modeling); or when we have internalized
values and standards and reward or punish ourselves for our
successes or failures in living up to them, a self-regulating
process.
Susan Mineka and her colleagues (Mineka, Davidson,
Cook, & Keir, 1984) demonstrated the acquisition of fears in
rhesus monkeys through vicarious or observational learning.
When adolescent monkeys were allowed to watch their par-
ents, who had an intense fear of snakes, interact with toy
snakes and real ones, they soon exhibited the same fear, even
though they did not do so originally. Even at a 3-month
follow-up, the fear was strongly evident. Similarly, much
research was devoted to the consequences of watching
violence in movies and television, particularly for produc-
ing antisocial, aggressive behaviors in children, which are
apt to lead to such behaviors in adulthood (Huesmann,
Eron, Lefkowitz, & Walder, 1984). A final example, Peter
Lewinsohn’s research (Lewinsohn, 1975, 1988; Teri &
Lewinsohn, 1986), demonstrated a correlation between de-
pression and a reduced number of rewards: Losses of any and
every kind are risk factors for depression and frequently
involve losses of rewards, and a depressed person is less
affected by and is less apt to engage in behaviors that elicit
social rewards. By helping the person to perform behaviors
that generate social rewards, the depression can be alleviated.
Behavioral approaches in treatment have obviously in-
creased rapidly in number and applications. It was not until
1955 that the first course in behavior modification was
offered by Arthur Staats, and by the early 1970s about two-
thirds of the psychology departments in the United States of-
fered behavior therapy courses. It would be rare today for
instruction in this topic to be neglected. Equally significant
has been its acceptance in medical, psychiatric, and psycho-
dynamic settings. This acceptance has come about because
for almost any purpose—reducing stress (Lazarus, 1966),
overcoming shyness, modeling appropriate behaviors in the
hospital, or applying for a job—training procedures can be
helpful. In some circumstances, such as teaching people with
retardation or autism, behavioral techniques are among the
few means available to provide assistance.
Considerable interest was generated in the study of Smith
and Glass (1977), who through a relatively new statistical
procedure, meta-analysis, sought to determine if psychother-
apy was effective. By reexamining the data from 375 con-
trolled studies of psychotherapy and counseling, they found
that typical patients receiving therapy were rated higher than
75% of those in the control groups. They concluded this was
evidence for the effectiveness of psychotherapy, though they
did not find any support for the superiority of one type of psy-
chotherapy over another.
An alternative or supplement to psychotherapy and behav-
ior therapy is drug treatment. The first neuroleptic medications
for the treatment of psychosis were introduced in France in
1952, and by the 1960s they had revolutionized psychiatric
treatment. Psychiatry went from shock therapies and custodial
care to a “revolving door” policy in mental hospitals that sent
patients into halfway houses, where they could be maintained
on drugs. This drug revolution—this change in emphasis from
“warehousing” patients to avoiding the effects of institutional-
ization, from isolating them to returning them to society—
stimulated the field of community psychology, which was also
invigorated by the Community Mental Health Centers Act of- The drugs, particularly chlorpromazine (Thorazine) and
other phenothiazines, became widely used all over the world
and led to great reductions in the numbers of patients requiring
hospitalization. Such medications did not necessarily elimi-
nate the psychosis, but they did reduce the severity of symp-
toms and so helped patients to be more acceptable to others.
Some clinicians have been involved in the study of the long-
term effects of taking neuroleptics, for example, tardive dysk-
inesia, a neurological syndrome that involves involuntary
movements of the lips and tongue (Sprague, Kalachnik, &
Shaw, 1989). Other clinical psychologists have conducted re-
search on the use of both traditional neuroleptics and the newer
drugs of this type, for example, risperidone, in the treatment of
self-injurious behaviors and aggression in individuals with
mental retardation (Schroeder, Rojahn, & Reese, 1997).