334 Chapter 39
Saturdays) pays big dividends. However, this requires parents to stop
and listen to their children and find a compromise that achieves the
goal. In return, children and adolescents get to realise their views have
been taken into account.
Addressing beliefs and mood states of family members. Early behavioural
programmes were successful, but only in that proportion of cases where
the parents carried out the instructions, which was often only half or less
of those enrolled. Most practitioners now would spend a considerable
amount of time addressing parents’ fears and worries (‘If I leave him to
scream I feel a bad mother’, ‘I can’t bear to ignore crying out at night
since it reminds me of being left as a child’).
Adapting the programme according to progress. This is central to be-
havioural approaches, where success is carefully measured, and if it is
not occurring then this is examined in detail and the plan revised, or a
new strategy tried, or a course of action more acceptable to the parent
found. Rather like a game of chess, particular moves do not produce
victory in themselves, but have to be repeatedly adapted as part of an
overall strategy to succeed.Evaluation of behaviourally-based therapies
Criticisms
Behaviour therapy is soulless and ignores the world of the mind, treating
people like dogs or pigeons. Motivation, dreams, fears and beliefs about
ways of doing things are ignored. By concentrating on the presented
symptom, a behaviour therapist may entirely miss the broader meaning
of the difficulty for the individual and the worries and stresses that led
to the difficulty arising in the first place. By thinking in a ‘scientific,
logical, linear’ manner, the behaviour therapist may miss the network
of relationships and systems in the background that are maintaining the
symptom behaviour. A child’s tantrums may be the result of a disturbed
attachment relationship with the mother and require far more than a few
star charts to put right. No place is given for the intangible but essential
parts of the therapeutic relationship. Some problems, such as a disability or
a bereavement, cannot be taken away. Yet families and children often gain
a great deal from being helped to come to terms with these predicaments
and can move forward with sympathetic counselling. It is chiefly effective
only for circumscribed complaints, and cannot tackle general relationship
difficulties as may occur following sexual abuse or neglectful parenting.
Rejoinders
While early behaviourism in the 1950s and 1960s may have been
somewhat mechanical, nowadays it is an approach that is flexible, and
practitioners take the individual’s meanings, beliefs and relationships
into consideration. Parents. adolescents and children like having the
opportunity to do something practical to alleviate a problem, rather than