Nevertheless, the principles of classical conditioning are used successfully to treat many phobias. In fact, behavioural therapy is one of the few ways to treat phobias. Systematic desensitisation is a form of classical conditioning where a patient learns to associate the feared thing with a new response, that is, relaxation. First, the patient learns how to relax. Next, the patient constructs a hierarchy of fearful things from least to most fearful. Then the patient is asked to imagine the least fearful thing while relaxing at the same time. It is not possible to experience 2 conflicting emotions simultaneously, so eventually the fear is replaced by relaxation & this conditioned response is paired with the feared stimulus. Then the patient imagines the next most fearful thing in the hierarchy and so on, until the fear is gone. If at any time the patient feels anxious. He/she is reminded to stop & regain composure & relax.
It is possible that SD works for reasons other than unlearning. For example, it can be explained in terms of cognitive restructuring, i.e. patients do not form new associations but change the way they think about the feared object. Any reference to thinking is beyond behaviourism. However, cognitive-behavioural therapy is a more recent development of behaviour therapy which combines elements of both.
There are other behavioural therapies based in classical conditioning as well as those based on operant conditioning. A successful example of the latter is token economy. If behaviours are learned because of rewards & reinforcers then the new, more desirable behaviours can be learned in this way. The principle of operant conditioning is that any behaviour that results in a pleasant state of affairs is more likely to be repeated. In the case of a person with maladaptive behaviours, these can be identified & only desirable behaviours are rewarded with tokens, which can then be exchanged for other things (e.g. sweets). This can be used in an institutional setting to teach patients to learn to make their beds & look after themselves, for example. It has also been used in the treatment of eating disorders.
The main problem appears to be that the new learned behaviours do not always transfer to life outside the institutions. This may be understood in terms of context-dependent learning, which suggests that we learn to do certain things in certain situations because of rewards specific to that situation, but the same S-R links do not transfer elsewhere.
It is possible to explain the success of token economies in ways other than through conditioning theory. It could be that the system allows for more careful structuring of the therapeutic situation & this leads to improvements. Recovery may also be due to a general increase in attention or even more emotional care from nursing staff. The therapy raises ethical concerns because behaviour manipulation is involved. Someone has to decide what constitutes a desirable behaviour (the one to be acquired) & what is undesirable.
There are general issues relating to evaluating a therapy, such as what constitutes a cure. Just removing certain symptoms, which is the goal of behaviour therapies, does not mean that a problem is solved. It may well be that an underlying problem remains & will soon be expressed through other symptoms. Behaviourists assume that there are no underlying behaviours that need concern us; there are only symptoms. If they are removed, the patient is cured.
