Behaviorism was founded by John B. Watson in 1913 with efforts to describe, predict, explain, and manipulate observable human behavior (Sommers-Flannigan & Sommers-Flannigan, 2012). This theory focuses specifically on observable phenomena or materialist concepts in human behavior to ensure that it is based on verifiable, measurable scientific data (Seligman, 2006). While Behaviorism is backed scientifically, it has not been proven efficacious yet when used in the different sectors of the multicultural domain, especially if the individual’s culture strongly values collectivist views (Sommers-Flannigan et al., 2012). Behaviorism systematically excludes introspection and consciousness, and favors determinism rather than in free will (Sommers-Flannigan et al., 2012). Watson first sought to demonstrate that individual fears and phobias were a result of classical conditioning, and therefore not caused by psychoanalytical constructs as commonly believed. He examined this relationship through an experiment commonly referred to as the ‘Little Albert’ study. Watson’s application and the theory itself was well supported with works by Mary Cover Jones, Ivan Pavlov, Edward Thorndike, and B. F. Skinner (Sommers-Flannigan, 2012). After Thorndike established the law of effect, B. F. Skinner demonstrated how powerful negative and positive reinforcement can be, and also introduced the concept of systematic desensitization (Seligman, 2006). Behaviorism contains important concepts like social learning theory and cognitive appraisal theory, which aims for higher self-efficacy (Kimble, 2000). Many of the basic concepts of Behaviorism have since become integrated with Cognitive-Behavioral theory (CBT), and one would not be able to demonstrate the effects of Behaviorism without touching on CBT because of how similar they are in their approaches, and how often the two intersect while in session (Wampbold, 2010). CBT operates on the notion that by fixing faulty, irrational beliefs, the client can learn to behave differently; ideally more effectively and happier overall (Cully & Teten, 2008). It is based on the cognitive model from Aaron Beck (1964) and hypothesizes that an individual’s emotions and behaviors are influenced by their perception of events (Beck, 1995). Dysfunction is represented by irrational thought patterns (Cully et al., 2008). This approach is time-limited and problem focused, directive, structured (Sommers-Flannigan, 2012). Additionally, it has been shown effective for treatment of anxiety and phobias, depression, mood dysregulation issues, PTSD, Obsessive-Compulsive disorder, anger management troubles, and substance abuse and dependency (Cochran & Cochran, 2015).
In CBT, clients learn to change by learning how to think differently about their problems, and act on that learning in ways that alter their lives (Sommers-Flannigan et al., 2012). Essentially, CBT therapy assumes that behaviors are linked together, such as in a chain, consisting of multiple elements of subjective experience. The activing event triggers a belief about the event, which causes the individual to react emotionally. The individual’s emotional reaction causes the individual to think and respond behaviorally (Seligman, 2006). In other words, there is a specific and precipitating event that is mentally interpreted by the individual, thought about, and acted upon that leads to positive or negative consequence. More specifically, this demonstrated that our thoughts are merely the result of our behaviors and emotions interacting, and this assumes that behavior is internally and intrinsically driven (Sommers-Flannigan, 2012). Therefore, thoughts are not only involved in the behavioral process, but necessary to it; and these thoughts can be measured, monitored or altered with appropriate intervention (Seligman, 2006).Behaviorism employs techniques that are based on modern learning theory, as well as techniques supported from scientific research (Sommers-Flannigan, 2012). Because it is so easy to measure compared to other theories, Behaviorism has a long history of scientific backing. Applied Behavioral Analysis is a behavioral approach that is based on operant conditioning principles and argues that behavior is a function of its consequences (Sommers-Flannigan, 2012). Operant Conditioning is a stimulus-response theory and includes concepts such as reinforcement, punishment, extinction, and stimulus control (Seligman, 2006). It argues that maladaptive behavior is always learned and can be replaced unlearned or by new learning (Kimble, 2000). Albert Ellis’ Rational Emotive Behavioral Therapy model can be conceptualized similarly, by demonstrating that a stimulus provokes a thought, which causes an emotion, leads to a behavior, and ultimately results in a consequence of that behavior (Sommers-Flannigan, 2012). While this concept is typically thought of as a CBT model, it’s roots are grounded in basic Behaviorism, and demonstrates how the two theories often coincide.
One of the key elements of is collaborative empiricism. Collaborative empiricism is the establishment of a strong therapeutic relationships between the client and counselor, in which they work together to identify maladaptive or ineffective cognitions and behavior, as well as test its validity, and make revisions these plans (Sommers-Flannigan, 2012). The principle goal of this collaborative process is to help clients effectively define and manage their own problems (Wampbold, 2010). In doing so, the counselor relies on building a strong rapport with the client, as well as expressing genuineness, understanding, and empathy toward the client (Cochran et al., 2015). Fundamentally, the way thoughts are conceptualized can be broken down into three levels: core beliefs, dysfunctional assumptions, and automatic negative thoughts. Core beliefs are learned early in life and are influenced by childhood memories that are seen as absolute to the individual (Sommers-Flannigan et al., 2012). They consist of ideologies about the self (‘I’m useless’), the world or others (‘the world is unfair’), and the future (‘things will never work out for me’) (Sommers-Flannigan et al., 2012). Dysfunctional assumptions are rigid conditional rules for living that people adopt as their own based on their experiences (Wampold, 2012). It is possible that they may be unrealistic and maladaptive. Negative automatic thoughts are cognitions that are involuntarily activated in certain situations (Sommers-Flannigan et al., 2012). They center around negativity, uselessness, and low self-esteem. While the past may be referenced at times to gain a better understanding, the aim of this approach is to maintain a problem-orientated emphasis on “the here and now” (Cully et al., 2008). Because CBT is time limited, the counselor will often assign homework for the client to complete outside of session (Sommers-Flannigan). This is to increase efficiency of the sessions, as well as allow the client to begin to work towards their goals on their own while still maintaining the support of the counselor (Sommers-Flannigan, 2012). The goal of Behaviorism is to simply unlearn old maladaptive behaviors and replace them with new, positive behaviors (Kimble, 2000). Because of the thought-emotion-behavior model, the goals of Behaviorism often align with the goals of CBT, hence why they are often blended together. The goals of CBT can be summarized in three steps: 1) identify the client’s irrational or maladaptive thought patterns, assumptions, or beliefs; 2) explore how they are inaccurate, dysfunctional; 3) help the client replace these thoughts with more realistic, self-assisting alternatives (Beck, 1995).
The counselor aims to establish what is commonly referred to as “SMART” goals with the client early in their time spent together (Sommers-Flannigan et al., 2012). SMART stands for specific, measurable, achievable, realistic, and time-limited (Sommers-Flannigan et al., 2012). By meeting these goal criteria, it prioritizes the client’s goals by breaking them down into smaller, more seemingly achievable goals (Sommers-Flannigan, 2012). Other general goals of the approach aim to elicit complaints that can be addressed with CBT and ensuring the client understands the basic concepts of the model, as well as discussing treatment expectations (Wampold, 2010). Additionally, following up with the client on the completion of homework and encouraging the client to keep a record of thoughts or concepts is important (Seligman, 2006)
Therapeutic Alliance
1) What are the possible Counselor roles in the counseling process?
The counselor is expected to listen, educate, learn, and encourage the client to express concerns and implement their own learning (Sommers-Flannigan et al., 2012). Counselors do not tell their clients what to do or give advice, rather, they search for client strengths and use them to teach their clients how to find their own strengths (Cochran et al., 2015). They motivate them to change their behavior (Cochran et al., 2015). It is also the counselor’s job to work to build a strong therapeutic relationship with the client and empathically challenge their irrational or maladaptive beliefs (Sommers-Flannigan et al., 2012). Additionally, it is up to the counselor to help guide the client through setting and reaching their short term realistic goals, as well as reinforcing them (Sommers-Flannigan et al., 2012). Finally, the counselor should observe the client during a behavioral interview and attempt to identify functions of the client’s behavior to better support them in working toward their goals (Sommers-Flannigan et al., 2012). “Behavior therapy is a research-based and highly effective form of therapy based on modern learning theories. Humans are constantly learning new skills and behaviors, and everyone has a tremendous capacity for learning. I’ll help you unlearn old troubling habits and learn new, more positive habits. Research has proven that behavioral therapy is helpful with many problems. In therapy, we will talk about some of the hardest things you’re facing in your life. Then we’ll develop a plan for helping you overcome the problems that distress you. Some new learning will happen inside of our sessions, and some will happen outside of out sessions. That means I will give you homework that I would like you to complete outside of our time together so that the new learning will happen even faster and you will be able to begin to practice on your own. Behavior therapy is a brief therapy; you won’t come see me forever. Depending on your problem, it may take only a few sessions, or it may take a few months. We’ll check in regularly about your progress. My job is to work collaboratively with you to improve your life and relieve your uncomfortable symptoms. Therefore, I’ll explain exactly what we’re doing it and why we’re doing it.”
Behaviorism can be described as a therapy dog. A therapy dog is born just like any other dog, but through training and conditioning, the correct behaviors such as sensing emotion in humans or obeying their master’s unique commands can be acquired with time and appropriate behavioral intervention. Functional Behavioral Analysis, otherwise known as ‘the behavioral ABCs’ described above, serves as a positive intervention for Behavioral therapy (Sommers-Flannigan et al., 2012). This intervention aims to answer what reinforcements are maintaining the client’s current behavior (Seligman, 2006). In other words, why do they keep doing it, and what do they get out of it? Behavioral interviews are often used to unravel this. In a behavioral interview, the counselor observes the client’s behavior, identifies antecedents to troublesome behavior as well as the target behavior itself, and the consequences that result from their behavior (Seligman, 2006). Reinforcements can come from a structured token economy, as well as focus on contingency management (Sommers-Flannigan et al., 2012). Other interventions commonly used are scheduling activities, or graded task assignment.
Another intervention used primarily by CBT counselors is to practice behavioral experiments to test catastrophic predictions in order to teach the client to learn how to tolerate their anxiety (Sommers-Flannigan et al., 2012). For example, the client makes a prediction that something will happen before doing something, then the client records if this turns out to be true or not. Over time, this exercise can cause the client to re-evaluate their thoughts and allow the counselor to work with them through the hierarchy of anxiety. These experiments are also used to help the clients gather evidence against the use of their safety or avoidance behaviors to prevent them from relying on them (Cully et al., 2008). Various exposure techniques such as virtual reality exposure or introspective exposure slowly expose the client to their feared stimulus with the support of the counselor (Sommers-Flannigan et al., 2012). Teaching the client how to relax when emotionally heightened is important for the client’s long term maintenance (Sommers-Flannigan et al., 2012). Techniques such as progressive muscle relaxation or deep breathing exercises can be used to reduce anxiety levels (Cully et al., 2008).
Problem solving therapy is a behavioral treatment with cognitive dimensions. This approach is based on the notion that effective problem solving is a buffer that helps clients manage stressful life events more effectively, and achieve a better sense of well-being (Seligman, 2006). The aim is to teach clients to have a more positive attitude toward problem solving; more specifically, to solve their own problems (Cochran et al., 2015). Another effective technique is self-monitoring. Self-monitoring can be accomplished by encouraging journaling, teaching mindfulness, utilizing relaxation tactics, and an increase in social, thinking, and physical exercises that may help the client become more aware of their emotional and behavioral patterns (Sommers-Flannigan et al., 2012).
Homework may be used to encourage the client to apply the skills they’ve learned in session to their outside worlds (Sommers-Flannigan et al., 2012). Due to time limitations, homework can be a critical aspect to many treatment plans, as it challenges clients to continue working toward their goals independently, but are still supported and held accountable by the counselor (Sommers-Flannigan et al., 2012). Homework is specifically tailored to the client and their problems, but when used with CBT, thought records are a common assignment. Thought records are used to help the client consider alternative thoughts as the resulting change in emotions; they can also be used to challenge these thoughts, as the client is asked to provide evidence that supports or negates their assumptions (Sommers-Flannigan et al., 2012). Guided discovery is commonly used as an exploratory mechanism. Guided discovery is trying to understand the client’s perspective and helping them expand their thinking to become more aware of their underlying assumptions of their world (Seligman, 2006). Finally, counselors use questions to probe a client’s assumptions through Socratic questioning as it can encourage discovering alternative views and solutions to their problems (Seligman, 2006). Upon completion of the final session, the client will have unlearned old maladaptive behaviors and replaced them with new, more adaptive and positive behaviors (Sommers-Flannigan et al., 2012). These goals can be measured by means of standardized assessment depending on the client’s presenting problem, or else by checking in with the client periodically to determine their level of satisfaction (Cully et al., 2008). The client will also be able to see that their irrational beliefs are in fact irrational, and with encouragement from their counselor they will be able to feel as though they have some aspect of control over their own life (Sommers-Flannigan et al., 2012). The client will begin to understand that their perspective is everything. Upon conclusion of the counseling relationship, the client should be able to relax and avoid anxiety attacks by utilizing the relaxation techniques they have learned or slowly exposing themselves to the phobia they are afraid of (Sommers-Flannigan et al., 2012). Therapeutic relationships help build a strong rapport so the client feels comfortable disclosing to the counselor. By trying to understand the client’s perspective and help them expand their thinking so that they are more aware of their underlying assumptions, the counselor can help the client discover alternative views and find solutions to their problems for themselves (Cully et al., 2008). Behaviorism is important to understand and know how to enact in session, as human behavior is something all counselors will deal with in some capacity, regardless of their therapeutic approach. As mentioned previously, Behaviorism interlaces with CBT quite often, and the therapeutic approaches can typically be explored together. Both theories are supported scientifically, especially CBT. CBT is one of the most widely used and empirically supported therapy approaches today, so gaining a better understanding of the approach’s inner principles is important to develop as a counselor. CBT will most definitely come into play in my professional life, as it is the theory I feel I understand and implement the best. I already tend to incorporate many facets of Behaviorism and Cognitive Behavior Therapy into my daily work through use of functional behavioral assessments and authorship of positive behavior support plans. This allows me to clearly identify the function of my clients’ behavior and find what would motivate them to change their behavior, if needed. Because I work with individuals with disabilities each day, I can’t help but wonder how this approach may need to be adjusted at times to work with this population. Behaviorism is all about learned behavior and how it has been reinforced for the individual. I would be curious to see how this would work with individuals with learning disabilities or complex mental health problems that may complicate treatment.