Behavior Therapies

Radical behaviourism does not deny inner life; it declines to treat it as a cause. Thoughts and feelings are themselves behaviours, subject to the same contingencies as any other, and explaining an action by reference to a mental state is — on this account — a description dressed as an explanation. Saying someone drinks because they are depressed does not tell you what to change.

The three-term contingency

Antecedent → Behaviour → Consequence. Everything else in the system elaborates on this.

The four contingencies — and the one that matters most

Positive reinforcement

Something added; behaviour increases. Praise, money, attention, relief that is actively pleasant.

Negative reinforcement

Something aversive removed; behaviour increases. The engine of virtually all clinical avoidance, and the most misunderstood term in the field.

Positive punishment

Something aversive added; behaviour decreases. Effective in the short term, poor in the long, with substantial side effects.

Negative punishment

Something desirable removed; behaviour decreases. Response cost, time out.

Schedules of reinforcement

Intermittent, variable schedules produce behaviour that is far more resistant to extinction than continuous reinforcement. Clinically this explains why a partner who gives in occasionally produces more persistent demanding than one who always gives in, and why gambling is uniquely difficult to extinguish.

Self-efficacy

Bandura’s addition, and among the most useful constructs in applied psychology: the belief in one’s capacity to execute the behaviour needed for a particular outcome. It is domain-specific, it predicts persistence better than outcome expectancy, and it is built primarily by mastery experience — which is an argument for graded, achievable assignments over encouragement.

There are no disorders in this framework, only behavioural excesses, deficits, and problems of stimulus control. The diagnostic question is replaced by a functional one: what is this behaviour doing, for this person, in this context, right now?

1. 1Behavioural excess — too much, too often, too intense: compulsions, aggression, drinking, checking.
2. 2Behavioural deficit — too little or absent: withdrawal, unassertiveness, missing social skills, inactivity.
3. 3Inappropriate stimulus control — the right behaviour under the wrong conditions, or triggered by cues that no longer signal anything.

Depression, behaviourally

Ferster and Lewinsohn: depression follows a reduction in response-contingent positive reinforcement. The person does less, gets less back, feels worse, and does less still. Avoidance — of effort, of people, of anything that might fail — accelerates the spiral. On this account the treatment is not to change how the person thinks about their life but to change what is in it.

Change follows from altering the contingencies, teaching what is missing, and rearranging the environment. Insight is neither necessary nor sufficient, and is treated as a possible by-product rather than a goal.

1. 1Define the target behaviour so precisely that it can be counted.
2. 2Measure a baseline. Without one you cannot know whether anything happened.
3. 3Conduct a functional analysis: what maintains it?
4. 4Change the antecedents (stimulus control), the consequences (contingency management), or the repertoire (skills training).
5. 5Shape by successive approximation; reinforce what is available now rather than waiting for the finished behaviour.
6. 6Programme generalisation and maintenance deliberately — behaviour change confined to the clinic is a well-documented failure mode.