Treatment of Abnormal Behavior for AP Psychology (page 3)

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By — McGraw-Hill Professional
Updated on Mar 4, 2011

Operant Conditioning Therapies

Operant conditioning therapies include contingency management techniques of behavior modification and token economies designed to change behavior by modifying its consequences. In both, rewards are used to reinforce target behaviors.

  • In behavior modification, the client selects a goal and, with each step toward it, receives a small reward until the intended goal is finally achieved. Weight Watchers and other weight-reducing programs use this method to keep clients motivated.
  • In token economies, positive behaviors are rewarded with secondary reinforcers (tokens, points, etc.), which can eventually be exchanged for extrinsic rewards, such as food. Token economies are often used in institutions to encourage socially acceptable behaviors and to discourage socially unacceptable ones.

Other Behavior Therapies

Social skills training is a behavior therapy, based on operant conditioning and Albert Bandura's social learning theory, to improve interpersonal skills by using modeling, behavioral rehearsal, and shaping. With modeling, the client is encouraged to observe socially skilled people in order to learn appropriate behaviors. In behavioral rehearsal, the client practices the appropriate social behaviors through role-playing in structured situations. The therapist helps the client by providing positive reinforcement and corrective feedback. Shaping involves reinforcement of more and more complex social situations. Through social skills training, people with social phobias learn to make friends or date, and former mental patients learn to deal normally with people outside of the hospital. Biofeedback training is a widely used behavioral therapy that involves giving the individual immediate information about the degree to which he/she is able to change anxiety-related responses such as heart rate, muscle tension, and skin temperature to facilitate improved control of the physiological process and, therefore, lessen physiological arousal.

Behavior therapies have been found effective for treating anxiety disorders (generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder), alcohol and drug addictions, bed-wetting, sexual dysfunctions, and autism.

Psychoanalysts discount the quick cure offered by behaviorists. Since behaviorists are unconcerned with the cause of anxiety, analysts believe that it will resurface in a new form. Until the unconscious conflict is made conscious, the behaviorist is only "curing" the symptom of the problem; so through symptom substitution, a new problem will occur. The so-called cured smoker suddenly begins another compulsive habit, like eating or drinking.

Cognitive-Behavioral Approaches

Cognitive therapists, sometimes called cognitive-behavioral therapists, think that abnormal behavior is the result of faulty thought patterns. Many psychologists consider cognitive therapy to be an insight therapy. Cognitive-behavior therapy helps clients change both the way they think and the way they behave. Through cognitive restructuring, or turning the faulty, disordered thoughts into more realistic thoughts, the client may change abnormal behavior.

Rational Emotive Behavior Therapy

Albert Ellis developed Rational Emotive Therapy (RET), which is also called rational emotive behavior therapy (REBT), based on the idea that anxiety, guilt, depression, and other psychological problems result from self-defeating thoughts. The therapist has the client confront irrational thoughts by discussing his/her actions, his/her beliefs about those actions, and finally the consequences of those beliefs. The actions, beliefs, and consequences he called the ABCs of treatment. For instance, a young man is feeling guilty about not having helped his mother more before she died. Ellis might have confronted this guilty belief with a statement like "And you were the only person in the entire universe who could have helped her, right?" While defending these beliefs, the client may see how absurd they truly are. Ellis believed that much of this thinking involves the tyranny of the "shoulds," what we believe we must do, rather than what is actually realistic or necessary.

Cognitive Triad Therapy

Aaron Beck also developed a cognitive therapy to alleviate faulty and negative thoughts. His cognitive triad looks at what a person thinks about his/her Self, his/her World, and his/her Future. Depressed individuals tend to have negative perceptions in all three areas. As noted by Martin Seligman, depressed individuals tend to think they caused the negative events, the negative events will affect everything they do, and the negative events will last forever. Such thoughts and beliefs lead to low self-esteem, depression, and anxiety. The goal of therapy is to help them change these irrationally negative beliefs into more positive and realistic views. Failures are attributed to things outside their control and successes are seen as personal accomplishments. Beck suggests specific tactics, including evaluating the evidence the client has for and against automatic thoughts, reattributing the blame to situational factors rather than the client's incompetence, and discussing alternative solutions to the problem. For example, instead of blaming yourself for being stupid when the entire class does poorly on a math exam, you might substitute the thought that you didn't have an adequate opportunity to study, and the test may not have been valid.

Cognitive therapies have been demonstrated to be effective in treating depression, eating disorders, chronic pain, marital discord, and anxiety disorders (generalized anxiety disorder, panic disorder, agoraphobia, and social phobia).

Biological/Biomedical Treatments

Biological psychologists believe that abnormal behavior results from neurochemical imbalances, abnormalities in brain structures, or possibly some genetic predisposition. Treatments, therefore, include psychopharmacotherapy (the use of psychotropic drugs to treat mental disorders), electroconvulsive therapy, and psychosurgery. Medical doctors, psychiatric nurse practitioners, and a limited number of clinical psychologists can prescribe psychoactive drugs. Four major classifications of psychotropic drugs are anxiolytics (antianxiety medications), antidepressants, stimulants, and neuroleptics (antipsychotics).


Anxiolytics, also called tranquilizers and antianxiety drugs, include quick-acting benzodiazepines such as the widely prescribed drugs Valium (diazepam), Librium (chlordiazepoxide), and Xanax (alprazolam); and slow-acting BuSpar (buspirone). Benzodiazepines increase availability of the inhibitory neurotransmitter GABA to the limbic system and reticular activating system where arousal is too high, reducing the anxiety felt by the patient. Other therapies such as visualization, relaxation, and time management can be used in conjunction with drugs so that the drugs may be tapered off over time, because patients can develop unpleasant side effects and build up a tolerance to these compounds. Anxiolytics are helpful in the treatment of post-traumatic stress disorder, panic disorder, agoraphobia, and generalized anxiety disorder.


Antidepressant medications elevate mood by making monoamine neurotransmitters including serotonin, norepinephrine, and/or dopamine more available at the synapse to stimulate postsynaptic neurons. Types of antidepressants include monoamine oxidase inhibitors (MAOIs), which inhibit the effects of chemicals that break down norepinephrine and serotonin; tricyclics, which inhibit reuptake of serotonin; selective serotonin reuptake inhibitors (SSRIs), which inhibit reuptake only of serotonin; and atypical antidepressants (sometimes called non-SSRIs), some of which may inhibit reuptake of serotonin, norepinephrine, and dopamine, or a combination of two of them. Commonly advertised SSRls include paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa, Lexapro), and fluvoxamine (Luvox). Non-SRRIs include bupropion (Wellbutrin) and velafaxine HCL (Effexor XR). They have all been found effective for treating depression, and some have also been found effective for treating anxiety disorders, such as obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder (PTSD). For treatment of bipolar disorder, lithium has been widely used to stabilize mood, alone or with antidepressants. Anti-seizure medicines used to treat epilepsy, such as valproic acid (Depakene), divalproex (Depakote), and Topiramate (Topamax) have also been used.


Stimulants are psychoactive drugs, such as Ritalin (methylphenidate) and Dexedrine (dextroamphetamine), that activate motivational centers and reduce activity in inhibitory centers of the central nervous system by increasing activity of serotonin, dopamine, and norepinephrine neurotransmitter systems. They are used to treat people with narcolepsy and people with attention-deficit hyperactivity disorder.


The last class of drugs, neuroleptics, are powerful medicines that lessen agitated behavior, reduce tension, decrease hallucinations and delusions, improve social behavior, and produce better sleep behavior, especially in schizophrenic patients. An excess of dopamine is thought to be the cause of the schizophrenic symptoms; neuroleptics block dopamine receptors. Neuroleptics include Thorazine (chlorpromazine), Haldol, and Clozaril. Unfortunately, these drugs can have serious side effects, including tardive dyskinesia, or problems with walking, drooling, and involuntary muscle spasms, which result from the blocking of dopamine at other sites. These problems cause some patients to abandon the medication after hospitalization, which results in a return of psychotic symptoms.

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