Current Medical Diagnosis & Treatment in Psychiatry

Conclusion

Modern behavioral and cognitive-behavioral interventions emphasize the role of learning and adaptation to the environment both in shaping and maintaining normal life functions and in the emergence of maladaptive symptomatology. In essence, these approaches focus on behavior as important in its own right and often seek to change instances of disordered behavior via the application of clearly articulated basic principles of learning. Three basic, interrelated perspectives exist: classical conditioning, which emphasizes the learning of associations between classes of stimuli; operant conditioning, which emphasizes the learning of relations between behaviors and their consequences; and the cognitive perspective, which emphasizes the role of idiosyncratic beliefs and misconceptions in coloring each of the two earlier perspectives. There can be little doubt that the learning-based approaches have sparked a major revolution in the treatment of psychiatric disorders and that each perspective can point to a series of notable gains. These approaches can often be combined with medications for beneficial effect and should be part of the armamentarium of any well-trained clinician.

References

Roots of Behavioral & Cognitive-Behavioral Interventions

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Hollon SD, Beck AT: Cognitive and cognitive-behavioral therapies. Pages 428–466 in: Bergin AE, Garfield SL (editors): Handbook of Psychotherapy and Behavior Change, 4th ed. John Wiley & Sons, 1994.

Marks IM: Fears, Phobias and Rituals. Oxford University Press, 1987.

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Fundamental Assumptions of Learning Theory–Based Therapies

Bandura A: Principles of Behavior Modification. Holt, Rinehart & Winston, 1969.

Craighead WE, Craighead LW, Ilardi SS: Behavior therapies in historical perspective. In: Bonger BM et al (editors): Comprehensive Textbook of Psychotherapy: Theory and Practice. Oxford University Press, 1995.

Kazdin AE: History of Behavior Modification: Experimental Foundations of Contemporary Research. University Park, 1978.

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Combinations with Medications

Klerman GL et al: Medication and psychotherapy. Pages 734–782 in: Bergin AE, Garfield SL (editors): Handbook of Psychotherapy and Behavior Change, 4th ed. John Wiley & Sons, 1994.

Combined Interventions in Developmental Disabilities

Lutzker JR: Behavior analysis for developmental disabilities: the stages of efficacy and comparative treatments. Pages 89–106 in: Giles TR (editor): Handbook of Effective Psychotherapy. Plenum Publishing Corp, 1993.

Symons FJ, Fox ND, Thompson T: Functional communication training and naltrexone treatment of self-injurious behavior. JARID 1997;10:1.

Thompson T, Grabowski JG: Behavior Modification of the Mentally Retarded, 2nd ed. Oxford University Press, 1977.

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