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Behavior Therapy From a Multicultural Perspective Strengths from a Diversity
Perspective
● Working with diverse client populations includes specificity, task orientation, focus on
objectivity, focus on cognition and behavior, action orientation, dealing with the present more
than the past, emphasis on brief interventions, teaching coping strategies, and problem-solving
orientation
● Clients who are looking for action plans and specific behavioral change are likely to
cooperate with this approach because
they can see that it offers them concrete methods for dealing with their problems of living
Focuses on environmental conditions th at contribute to a client’s problems
○ Takes into consideration social, and cultural dimensions of the client’s life
○ Special attention to specific conditions: the client’s cultural conception of problem
behaviors, establishing specific therapeutic goals, arranging conditions to increase the client’s
expectation of successful therapeutic outcomes, and employing appropriate social influence
agents
● Foundation of ethical practice involves a therapist’s familiarity with the client’s
culture, as well as the competent application of this knowledge in formulating assessment,
diagnostic, and treatment strategies
● It stresses a thorough assessment of the person’s life circumstances to ascertain not only
what conditions give rise to the client’s problems but also whether the target behavior is
amenable to change and whether such a change is likely to lead to a significant improvement in
the client’s total life situation
● Functional analysis of the problem situation is conducted with assessments that
take into consideration the cultural context, consequences, sociocultural environment, resources
within the environment, and impact on the client’s social surrounding
Shortcomings from a Diversity Perspective
behavior therapists need to become more responsive to specific issues about all forms of
diversity
● race, gender, ethnicity, and sexual orientation are critical variables that influence the
process and outcome of therapy, behavior therapists must pay careful attention to these factors
and address social justice issues as they arise in a client’s therapy
Some behavioral counselors may focus on using a variety of techniques in narrowly treating
specific behavioral problems
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● practitioners concentrate too much on problems within the individual. In doing so they
may overlook significant issues in the lives of clients
Before deciding too quickly on goals for therapy, the counselor and client need to discuss the
complexity inherent in change
● It is essential for therapists to conduct a thorough assessment of the interpersonal and
cultural dimensions of the problem
● Clients should be helped in assessing the possible consequences of some of their newly
acquired social skills.
○ Once goals are determined and therapy is underway, clients should have opportunities to
talk about the problems they encounter as they bring new skills and behaviors into their home
and work settings
Summary and Evaluation Summary:
Behavior therapy is diverse with respect not only to basic concepts but also to techniques that
can be applied in coping with specific problems with a wide range of clients
● behavioral movement includes four major areas of development: classical conditioning,
operant conditioning, social-cognitive theory, and increasing attention to the cognitive factors
influencing behavior
● Third-generation behavior therapies are recent developments in the field, and they
include mindfulness and acceptance-based behavior therapies
● unique characteristic of all forms of behavior therapy is its strict reliance on the principles
of the scientific method
○ Concepts and procedures are stated explicitly, tested empirically, and revised continually.
■ Treatment and assessment are interrelated and occur simultaneously.
■ Research is considered to be a basic aspect of the approach, and therapeutic techniques
are continually refined.
● cornerstone of behavior therapy is identifying specific goals at the outset of the
therapeutic process.
● In helping clients achieve their goals, behavior therapists typically assume an active and
directive role.
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○ client generally determines what behavior will be changed, and the therapist typically
determines how this behavior can best be modified.
■ In designing a treatment plan, behavior therapists employ techniques and procedures
from a wide variety of therapeutic systems and apply them to the unique needs of each client
● Contemporary behavior therapy emphasizes the interplay between the individual and the
environment.
● Behavioral strategies can be used to attain both individual goals and societal goals.
Because cognitive factors have a place in the practice of behavior therapy, techniques from this
approach can be used to attain humanistic ends.
● Mindfulness practices rely on experiential learning and client discovery rather than on
didactic instruction
○ Mindfulness is a way of being that takes ongoing effort to develop and refine
● Self-compassion is a foundational part of the new wave of behavior therapies and is
linked to an increased sense of well-being
Contributions of Behavior Therapy
Behavior therapy challenges us to reconsider our global approach to counseling
Some may assume they know what a client means by the statement, “I feel unloved; life has no
meaning.”
● A humanist might nod in acceptance to such a statement,
● Behaviorists may respond with: “Who specifically do you feel is not loving you?” “What
is going on in your life to make you think it has no meaning?” “What are some specific things
you might be doing that contribute to the state you are in?” “What would you most like to
change?”
A key strength of behavior therapy is its precision in specifying goals, target behaviors, and
procedures
● specificity of the behavioral approaches helps clients translate unclear goals into concrete
plans of action, and it helps both the counselor and the client to keep these plans clearly in focus
○ therapists can help clients learn about the contingencies that maintain their problematic
thoughts and behaviors and then teach them ways to make the changes they want
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○ Techniques such as role-playing, relaxation procedures, behavioral rehearsal, coaching,
guided practice, modeling, feedback, learning by successive approximations, mindfulness skills,
and homework assignments can be included in any therapist’s repertoire, regardless of
theoretical orientation.
The advantage behavior therapists have is the wide variety of specific behavioral techniques at
their disposal.
● Because behavior therapy stresses doing, as opposed to merely talking about problems
and gathering insights, practitioners use many behavioral strategies to assist clients in
formulating a plan of action for changing behavior.
● The basic therapeutic conditions stressed by person-centered therapists— active listening,
accurate empathy, positive regard, genuineness, respect, acceptance, and immediacy need to be —
integrated into a behavioral framework.
A major contribution of behavior therapy is its emphasis on research into and assessment of
treatment outcomes.
● It is up to practitioners to demonstrate that therapy is working. If progress is not being
made, therapists look carefully at the original analysis and treatment plan
● Of all the therapies presented in this book, this approach and its techniques have been
subjected to the most empirical research.
○ Behavioral practitioners are put to the test by identifying specific interventions that have
been demonstrated to be effective.
Evidence-based therapies (EBT) are a hallmark of both behavior therapy and cognitive behavior
therapy
● behavior therapists are willing to examine the effectiveness of their procedures in terms
of the generalizability, meaningfulness, and durability of change
○ Most studies show that behavior therapy methods are more effective than no treatment.
○ Several behavioral and cognitive behavioral procedures are currently the best treatment
strategies available for depression, obsessive-compulsive disorder, panic disorder, social phobia,
hypochondriasis, generalized anxiety disorder, posttraumatic stress disorder, eating disorders,
borderline personality disorder, bipolar disorder, childhood disorders
A new generation of mindfulness and acceptance-based therapies has shifted behavior therapy
from treating simple and discrete problems to more complex and complete psychotherapy that is
based on behavioral principles
strength of the behavioral approaches is the emphasis on ethical accountability
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● Behavior therapy is ethically neutral in that it does not dictate whose behavior or what
behavior should be changed
● in cases of voluntary counseling, the behavioral practitioner only specifies how to
change those behaviors the client targets for change
○ Clients have a good deal of control and freedom in deciding what the goals of therapy
will be
○ Collaborative therapist-client relationship is an essential
○ Clients are active in selecting goals and procedures in the therapy process and are
applying what they are learning in therapy to daily life, the chance that they will become the
target of unethical behavior is decreased
Limitations and Criticisms of Behavior Therapy Four common criticisms and misconceptions
1. Behavior therapy may change behaviors, but it does not change feelings.
a. Some critics argue that feelings must change before behavior can change. Behavioral
practitioners hold that empirical evidence has not shown that feelings must be changed first, and
behavioral clinicians do in actual practice deal with feelings as an overall part of the treatment
process. A general criticism of both the behavioral and cognitive approaches is that clients are
not encouraged to experience their emotions. In concentrating on how clients are behaving or
thinking, some behavior therapists tend to play down the working through of emotional issues
2. Behavior therapy does not provide insight.
a. If this assertion is indeed true, behavior therapists would probably respond that insight is
not a necessary requisite for behavior change.
b. Follette and Callaghan (2011) state that contemporary behavior therapists tend to
be leery of the role of insight in favor of alterable, controllable, causal variables.
c. Therapy can proceed without a client knowing how change is taking place.
Although change may be taking place, clients often cannot explain precisely why. Furthermore,
insights may result after clients make a behavior change. Behavioral shifts often lead to a change
in understanding or insight, which may lead to emotional changes as well.
3. Behavior therapy treats symptoms rather than causes.
a. The psychoanalytic assumption is that early traumatic events are at the root of present
dysfunction.
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b. Behavior therapists may acknowledge that deviant responses have historical origins, but
they contend that history is less important in the maintenance of current problems than
environmental events such as antecedents and consequences.
i. However, behavior therapists emphasize changing current environmental circumstances
to change behavior.
ii. Related to this criticism is the notion that unless historical causes of present behavior are
therapeutically explored new symptoms will soon take the place of those that were “cured.”
1. Behaviorists rebut this assertion on both theoretical and empirical grounds. They contend
that behavior therapy directly changes the maintaining conditions of problem behaviors
(symptoms), thereby indirectly changing the problem behaviors.
2. Furthermore, they assert that there is no empirical evidence that symptom substitution
occurs after behavior therapy has successfully eliminated unwanted behavior because they have
changed the conditions that give rise to those behaviors
4. Behavior therapy involves control and social influence by the therapist.
a. All therapists have a power relationship with the client and thus therapy involves social
influence; the ethical issue relates to the therapist’s degree of awareness of this influence and
how it is addressed in therapy
b. Behavior therapy recognizes the importance of making the social influence
process explicit, and it emphasizes client-oriented behavioral goals.
i. Therapy progress is continually assessed and treatment is modified to ensure that the
client’s goals are being met.
ii. Behavior therapists address ethical issues by stating that therapy is a psychoeducational
process.
iii. At the outset of behavior therapy, clients learn about the nature of counseling, the
procedures that may be employed, and the benefits and risks.
1. Clients are given information about the specific therapy procedures appropriate for their
particular problems.
a. To some extent, they also participate in the choice of techniques that will be used in
dealing with their problems → clients become informed, genuine partners in the therapeutic
venture.
Chapter 10: Cognitive Behavior Therapy
1st half (pages 270- 284) → Frida
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Albert Ellis’s Rational Emotive Behavior Therapy
Rational emotive behavior therapy (REBT):
● REBT is based on the assumption that cognitions, emotions, and behaviors interact
significantly and have a reciprocal cause-and-effect relationship.
● Highly cognitive and directive
● Teaches that our emotions are mainly created from our beliefs, which influence the
evaluations and interpretations we make and fuel the reactions we have to life situations.
View of Emotional Disturbance
REBT is based on the premise that we learn irrational beliefs from significant others during
childhood and then re-create these irrational beliefs throughout our lifetime.
Here are three basics musts (or irrational beliefs) we internalize that inevitably lead to self-
defeat: 1. “I MUST do well and be loved and approved by others.”
“Other people MUST treat me fairly, kindly, and well.”
“The world and my living conditions MUST be comfortable, gratifying, and just, providing me
with all that I want in life.”
ABCA-BC Framework
A is the existence of an activating event or adversity. C is the emotional and behavioral
consequence or reaction of the individual. B is the person’s belief about A, which largely creates
C, the emotional reaction. D (disputing), encompasses methods that help clients challenge their
irrational beliefs. Then, clients are encouraged to develop E, a new effective philosophy,
replacing unhealthy irrational thoughts with healthy rational ones.
● There are three components of this disputing process: detecting, debating, and
discriminating. Clients learn to discriminate irrational (self-defeating) beliefs from rational (self-
helping) beliefs. Once they can detect irrational beliefs, particularly “shoulds” and “musts,”
clients debate dysfunctional beliefs by logically, empirically, and pragmatically questioning
them.
