Psychology of Learning

Module 13: Behavioral Therapy

Summary

Classical Conditioning in Therapy

• Foundations: Pavlov’s principles applied to clinical problems; fears can be learned and unlearned.
• Little Albert: Demonstrated conditioned fear and stimulus generalization; raised ethical and methodological concerns.
• Mary Cover Jones: Developed counterconditioning and direct conditioning; paired feared stimuli with positive experiences.
• Systematic desensitization (Wolpe): Combines relaxation, anxiety hierarchy, and gradual exposure; based on reciprocal inhibition.
• Exposure therapies: In vivo exposure more effective than imaginal; flooding and implosive therapy use intense exposure.
• Inhibitory learning model: Exposure creates new safety memories rather than erasing fear.
• ERP for OCD: Combines exposure with prevention of compulsions; gold standard treatment.
• Virtual reality exposure therapy (VRET): Simulates feared situations; effective for phobias and PTSD.
• Aversion therapy: Creates negative associations with problematic behaviors; ethical concerns limit use.
• Efficacy: Meta-analyses confirm exposure-based therapies as highly effective for anxiety and PTSD.

Operant Conditioning in Therapy

• Core principle: Behavior changes through consequences—reinforcement increases behavior; punishment or extinction decreases it.
• Token economies: Use tokens as conditioned reinforcers; historically effective in psychiatric settings; ethical and generalization issues led to decline.
• Contingency management (CM): Provides tangible rewards for abstinence; strongest evidence for stimulant use disorders; includes voucher-based and prize-based models.
• Behavioral activation (BA): Treats depression by increasing response-contingent reinforcement; strong empirical support and scalability.
• Functional behavior assessment (FBA): Identifies behavior function using A-B-C analysis; guides individualized interventions.
• Differential reinforcement: Reinforces alternative or incompatible behaviors (DRA, DRI, DRO, DRL); widely used in education and clinical settings.
• Biofeedback and neurofeedback: Apply operant principles to physiological and neural regulation; evidence for ADHD, anxiety, and stress management.
• Habit reversal training (HRT): Combines awareness and competing response strategies; highly effective for tics and repetitive behaviors.
• Integration: Operant approaches remain central for addiction, depression, and behavioral disorders; emphasize empirical evaluation and contingency control.

Observational Learning in Therapy

• Bandura’s social learning theory: Learning through observation expands therapeutic scope beyond direct experience.
• Modeling-based fear reduction: Participant modeling most effective; enhances self-efficacy through guided mastery.
• Social skills training (SST): Structured instruction, modeling, role-play, feedback, and reinforcement; strong evidence for psychosis and social anxiety.
• Video modeling: Effective for teaching social and functional skills, especially in autism; includes self-modeling and point-of-view variations.
• Parent training programs: PCIT uses live coaching; Triple P and Incredible Years employ video and group modeling; improve child behavior and parenting skills.
• Cognitive modeling and self-instructional training: Teach internal strategies for self-regulation; applied in ADHD and anxiety treatments.
• Virtual reality applications: VRET for phobias and PTSD; avatar-based modeling for social skills; telehealth expands access.
• Group therapy: Peer modeling and imitative behavior enhance learning; DBT skills groups integrate modeling and practice.
• Evidence base: Modeling interventions effective across diverse populations; technology continues to expand reach and impact.

Conclusion

Module 13 demonstrates how classical conditioning, operant conditioning, and observational learning principles form the foundation of behavioral therapy. These approaches provide empirically supported treatments for anxiety, depression, addiction, and social deficits, with growing integration of technology to enhance accessibility and effectiveness.