Behavioural approach to normal and abnormal psychology - Essay Example

ORDER 120872 Describe the assumptions of the behavioural approach to normal and abnormal psychology. Evaluate the model in terms of its practical implications and therapeutic approaches. The behavioural approach to psychology focuses on observable behaviour rather than unobservable, mental phenomena such as feelings and thoughts. It assumes that both normal and abnormal psychology can be explained in terms of environmental factors and is therefore on the nurture side of the nature-nurture debate. Specifically, the behavioural approach assumes that all behaviour is learned or conditioned, and can be explained in terms of principles of reinforcement. " The gap between normal and abnormal behaviour is reduced, since both are viewed within the same general framework" (Davison & Neale, 1990), and conceptions of normality and abnormality are relative to the social or cultural contexts in which they are considered. The behavioural approach encompasses two distinct theories: classical or respondent conditioning and operant or instrumental conditioning. Classical conditioning (Pavlov, 1927) refers to a type of learning in which a stimulus that wouldn't normally elicit a particular response eventually comes to do so by being repeatedly paired with a stimulus that would normally elicit the response. For example, if the sound of a bell is repeatedly paired with the presentation of food, the sound of the bell alone will eventually elicit the response of salivation. Food is an unconditioned stimulus that elicits the unconditioned response of salivation; by being repeatedly paired with food, the sound of the bell becomes a conditioned stimulus that elicits the conditoned response of salivation. Whereas classical or respondent conditioning is essentially passive, Skinner (1938) viewed the learner as much more active when he proposed his theory of operant or instrumental conditioning. According to Skinner's law of effect,' behaviour is shaped and maintained by its consequences'. Humans and animals operate on their environment and the consequences of this behaviour determine the likelihood of it being repeated. The consequences of behaviour can be positive reinforcement, negative reinforcement, or punishment. Positive reinforcement refers to the presentation of a pleasurable stimulus (eg, food), negative reinforcement refers to the removal of an aversive stimulus (eg, electric shock), and punishment refers to the presentation of an aversive stimulus. Both positive and negative reinforcement strengthen behaviour, increasing the likelihood that it will be repeated, while punishment weakens behaviour, decreasing its likelihood. The assumptions of the behavioural approach to normal and abnormal psychology carry some very important implications: If all behaviour is learned by the principles of classical and operant conditioning, then (i) behaviour can be manipulated and predicted, and (ii) maladaptive behaviour can be extinguished and replaced with more adaptive responses. Accordingly, classical and operant conditioning form the basis of a number of therapeutic approaches that attempt to modify abnormal behaviour, cognition, and affect. Approaches based on classical conditioning principles include implosion and flooding, systematic desensitisation, aversion therapy, and covert sensitisation. Therapeutic approaches based on operant conditioning principles include extinction-based and reinforcement-based therapies. Each of these will be considered in turn. Implosion and flooding have both been used extensively with phobic patients. Implosion requires the patient to vividly imagine their most frightening form of exposure to the phobic object or situation, while flooding exposes the patient to this in vivo (ie, in reality). Both implosion and flooding are intented to maintain anxiety at such a level that it must eventually subside; at the same time, the patient is prevented from making an escape or avoidance response. In this way, the maladaptive bahaviour is extinguished. Both implosion and flooding have been found effective in treating phobias (Emmelkamp, 1994). For example, Emmelkamp & Wessels (1975) and Marks (1981b) found flooding very effective in treating agoraphobia. In fact, Marks (1981a) reviewed the literature and found flooding to be the most effective treatment for phobias. Nevertheless, whether this type of 'forced reality testing' is ethically acceptable is questionable. In systematic desensitisation (Wolpe, 1958), a phobic patient would first be helped to relax then gradually exposed to the phobic object or situation (initially in imagination then later in vivo) based on a hierarchy of the least to most frightening forms of exposure. Systematic desensitisation is based on the principle of reciprocal inhibition, which essentially states that two opposite emotions cannot be experienced simultaneously. Relaxation, then, inhibits anxiety during exposure to the phobic object or situation; in this way, the maladaptive anxiety response is extinguished by weakening its association with the phobic object. Systematic sensitisation has been used to treat a wide variety of anxiety-related conditions. It has been found very effective in the treatment of simple phobias, even in controlled laboratory conditions (eg, Lazovik and Lang, 1960; Lang and Lazovik, 1963). According to Richards (2002), graded exposure in vivo is the 'singularly most effective psychotherapeutic technique of modern times'. The outcome of systematic desensitisation is undoubtedly effective, but the process by which this is achieved is less certain. For example, Marks (1973) questions the role of reciprocal inhibition and claims that systematic desensitisation works because of the exposure to the feared stimulus. Indeed, exposure to fear-inducing stimuli is what most behavioural treatments have in common, and exposure in vivo is usually more effective than exposure in imagination (Emmelkamp, 1994) which lends support to Marks's argument. Aversion therapy and covert sensitisation have both been used to treat alcoholism. Here, alcohol is repeatedly paired with an aversive stimulus (eg, an emetic/nausea-inducing drug). With aversion therapy this happens in vivo, while with covert sensitisation it happens in imagination. In this way, the maladative response (alcohol consumption) is extinguished through its association with nausea. Well-controlled studies of aversion therapy and covert sensitisation are limited. Cannon and Baker (1981) found that alcoholics given emetic aversion therapy plus group therapy showed evidence of a conditioned aversion to alcohol flavours, while a one-year follow-up study conducted by Canon, Baker, and Wehl (1981) suggested that emetic aversion therapy can enhance post-treatment abstinence rates through its effect on heart-rate response to alcohol. However, the patients in the original study received standard in-patient alcoholism treatment in addition to aversion therapy and this prevents any firm conclusions being drawn. A study by Elkins (1980) provided some evidence that nausea could be conditioned in alcoholics receiving covert sensitisation treatment, and that abstinence could be extended. However, there was no control group in this study and the subjects were also in-patients in a traditional alcohol rehabilitation programme. Like flooding, aversion therapy is questionable on ethical/humanitarian grounds and in this respect covert sensitisation is preferable (Gross, 2005). Furthermore, aversion therapy is highly controversial in some of the uses to which it has been applied; these include homosexuality and other forms of 'sexual deviance'. Finally, aversion therapy is rarely used alone; therapists who favour the technique tend to use positive techniques to teach new responses to replace those being extinguished, and these act as confounding variables when attempting to evaluate the effectiveness of aversion therapy. The principles of operant conditioning have been used both to extinguish maladaptive behaviour and reinforce more adaptive responses. An example of behaviour modification based on these principles was demonstrated in a study by Matson, Ollendick, and Adkins (1980). They attempted to modify eating behaviour in profoundly-impaired adults using techniques that included peer and therapist modelling of appropriate behaviour and verbal prompts to shape behaviour. Reinforcers took the form of being allowed to go to meals early and having one's own table-mat. Matson et al found a sustained significant improvement in eating behaviour 4 months after treatment compared with an untreated control group. Operant conditioning techniques have been used to treat a variety of problems including: bed-wetting, aggression, poor school performance, language deficiency, and asthmatic attacks. Another example of behaviour modification based on operant conditioning principles is the token economy. Here, tokens are used as secondary or conditioned reinforcers and given for desirable behaviours as they occur; these can later be exchanged for primary reinforcers such as recreation time or luxuries. Paul and Lentz (1977) compared a token economy/social learning, milieu therapy, and custodial care with 84 carefully-matched, chronic psychiatric patients over a 6-year period. They found that patients in the token economy/social learning condition showed the greatest reduction in symptoms such as bizarre motor behaviours, and the greatest increase in interpersonal, vocational, housekeeping, and self-care skills. Also, the token economy/social learning group had the greatest number of patients who were subsequently able to leave the hospital and live independently. In Paul and Lentz's (1977) study, patients in the token economy condition were also exposed to social-learning therapy which contained elements that went beyond operant conditioning (Davison & Neale, 1990), so it is not possible to draw any definite conclusions about the effectiveness of token economies from this study alone. However, since the 1960s, hundreds of carefully-controlled experiments have shown the effectiveness of token economies with a range of psychiatric patient behaviours (Gross, 2005). Token economies are not without their limitations, however. Maintaining desired behaviour following cessation of a token economy can be problematic (Gross, 2005), while some research suggests that like systematic desensitisation, token economies are effective for reasons unrelated to learning theory principles (eg, Fonagy & Higgitt, 1984). Finally, ethical questions arise from the necessity of depriving individuals of certain amenities in order for these to be earned. Therapeutic approaches based on classical and operant conditioning principles have clearly made a significant contribution to the treatment of abnormal behaviour. However, as indicated, these have both practical and ethical limitations. Furthermore, the process by which these treatments achieve their outcomes is not necessarily related to the principles of learning theory; conversely, the effectiveness of a treatment does not necesarily imply that the maladaptive behaviour treated was actually acquired through learning theory principles. That said, therapeutic approaches based on classical and operant conditioning principles are 'one of the main tools in the clinical psychologists's kit bag' (Gross, 2005) and are therefore clearly of great value in the alleviation of personal suffering. References Cannon & Baker (1981). In Bergin, A.E. & Garfield, S.L. (eds) Handbook of Psychotherapy and Behavior Change (4th ed). Chichester: John Wiley & Sons, Inc. Cannon, Baker, & Wehl (1981). 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