Although most of the evidence to support the theory of classical conditioning was gathered from experiments using animals, in 1920 two psychologists, Watson and Rayner, conducted an experiment on 11 month old baby to test whether or not the theory was applicable to humans (Gross 1992). At first the baby was shown a white rat and was completely fearless towards it, however after Watson repeatedly hit a metal bar behind the child’s head simultaneously to showing the rat, the child started to become fearful towards the rat when it was presented without the metal bar being struck (Hayes 1984). More shockingly, the child also began to have fear responses, such as crying, towards other objects that were white and furry including cotton wool and a Santa Claus mask (Gross 1992). Watson and Rayner (1920) demonstrated that not only can these associations be unpleasant it can lead to phobias being developed, they also discovered a concept called stimulus generalisation. This is where an individual will not only be scared of the exact stimulus but also of other objects with similar properties, in the above case the child came to fear other furry, white objects rather than just the rabbit (Rungapadiachy 1999).
Classical conditioning only relates to behaviour and responses which are reflexive and therefore are not under an individual’s conscious control, for example “emotions, tears and sexual arousal” (Rungapadiachy 1999 page 135), However, a great deal of an individual’s behaviour is voluntary and classical conditioning offers no explanation as to the causes for this type of behaviour. Behavioural psychologists such as Thorndike and later Skinner proposed that individuals learn voluntary behaviour through consequences that occur after behaviour has been performed (Cave 1999). This theory of learning is called operant conditioning and is built on the idea that all voluntary behaviour has consequences and it is the consequences that either reinforce the behaviour or help to terminate the behaviour (Rungapadiachy 1999). Skinner (1953) provided evidence for his theory through various experiments to show that animals, such as rats and pigeons, could learn to behave in ways that produced good consequences (Malim 1992). In one of Skinner’s experiments a hungry rat was placed in box with a lever which when pressed released food into the box (Rungapadiachy 1999). The rats did not automatically press the lever but when eventually the rat did press the lever the food was dropped into the box, hence the rat’s behaviour was rewarded and therefore reinforced. With every reward the rats received the reinforced behaviour increased in frequency whereas behaviour that was not reinforced i.e. didn’t result in food being dropped into the box decreased in frequency. Thus Skinner concluded that the frequency of desired behaviour could be increased through reinforcement (Cave 1999).
Every healthcare professional should be aware that they can help to change their client’s behaviour through the way they respond towards their behaviour and so tailor their responses to reward and therefore promote positive health behaviour and disregard negative health behaviour. This is especially true in children because behavioural psychologists argue that from a very young age children learn all their voluntary behaviour through operant conditioning and healthcare professionals can use this to mould their behaviour by reinforcing and rewarding the good health behaviour whilst ignoring the bad health behaviour.
Behaviour therapies are based on the principles of classical conditioning and include systematic desensitization, implosion therapy and aversion therapy.
Systematic desensitization attempts to reduce anxiety towards a feared object by first training the client to relax and then slowly exposing them to situations involving the feared object that increase with intensity over time (Hayes 1988). The hope is that the client will learn to relax in situations where the feared object is present and therefore their levels of anxiety will decrease to a point where the object no longer produces a fear response (Malim 1992). Systematic desensitization was first demonstrated in 1924 when a behavioural psychologist named Jones successfully used the process of classical conditioning to remove a 2 year olds fear of rabbits (Gross 1993). Jones (1924 cited in Gross 1993) began by placing a cage with a rabbit inside in front of the little boy while he ate his lunch. Gradually Jones was able to move the cage closer to the little boy and eventually after about 40 sessions the rabbit sat on the little boy’s lap while he ate his lunch (Gross 1993).
A benefit of this therapy is that it recognises that the phobia, and resulting fear response, will differ between clients and so allows for individual differences resulting in a more humanistic approach as opposed to the reductionist approach often seen in behaviourism. Hopefully this will allow each and every client to benefit form the therapy since it is tailored to their individual needs.
Despite the benefits and the fact that more recent studies, such as McGrath (1990 cited in Cave 1999), also support systematic desensitization as successful treatment for phobias, it is not as widely used as one might think. This is because it is a lengthy treatment process which means it is time consuming and expensive (Hayes 1988) which often proves a problem for healthcare professionals as often their time and resources are already stretched. There is however an alternative behaviourist therapy that can be used to help overcome phobias which is much shorter in duration and this is called Implosion therapy (Hayes 1988).
Implosion therapy is based on Pavlov’s findings that if the bell was rung multiple times without the food being presented the dogs would eventually stop salivating (Rungapadiachy 1999). Implosion therapy assumes that the individual fears the object because they have built an association between the object and an unpleasant consequence (Hayes 1988). Therefore if the feared object if presented multiple times without the unpleasant consequence the person will no longer fear the object and the fear response will become extinct. If a child was scared of schools, for example, implosion therapy would be to make the child stay at school until their fear response is extinguished and they no longer fear school (Davenport 1994). Whilst this theory has the benefit of needing far less time and therefore expense than systematic desensitization, healthcare professionals need to exercise extreme caution when using this technique because there is a chance this method can intensify the phobia and also cause the individual to develop a fear of healthcare professionals.
Aversion therapy works very much as the reverse of implosion therapy and seeks to create an unpleasant association and is often used by healthcare professionals when trying to help a client to stop damaging behaviour (Cave 1999). An example of this is a drug called Antabuse which is an emetic drug used to help alcoholics learn an association between alcohol and nausea in the hope that they will avoid alcohol to prevent unpleasant nausea and vomiting that follow (Hayes 1988). Aversion therapy is not very popular because of the many ethical complaints but also Wallerstein (1957 cited in Cave 1999) found that the effectiveness of aversion therapy is rather low, therefore healthcare professionals should consider the low rate of success and ethical objections when deciding whether of not to use aversion therapy and possible consider alternative treatments first.
There are also methods to modify behaviour and these are based on the principles of operant conditioning, two of these behaviour modification techniques are behaviour shaping and token economy.
Behaviour shaping is based on the theory that behaviour which is positively reinforced will be repeated whereas behaviour that is ignored is less likely to be repeated (Malim 1992). Behaviour shaping is heavily used within healthcare settings with mentally handicapped children and adults but it is also widely used in schools and at home with a great deal of success. If a child does something favourable, for example helping with the chores or handing their homework in, they are rewarded with praise or a prize, this reinforces their behaviour and increases the likelihood that they will repeat the behaviour (Davenport 1994). The opposite is also true and if a child performs an undesired behaviour, by ignoring the behaviour the behaviour is not reinforced and the chances of the child repeating the behaviour decrease (Malim 1992). Healthcare professionals can use this theory to understand that problematic behaviour can arise in children when positive behaviour is being ignored and naughty behaviour is being rewarded with the parent’s attention. This is a benefit since not only can healthcare professional understand their clients better but they are also able to offer a solution as to how to solve this problem. Another benefit with this theory is that although the treatment is long in duration it is very simple to teach, requires no equipment and can be used in the home. Unfortunately the behaviourist theory does not take into account any other factors that may affect behaviour and so over looks biological problems that may affect behaviour, for example a child with attention deficit hyperactivity disorder (ADHD) may be seen as a problem child and behaviour shaping might not work with that child.
Finally there is the token economy method of behaviour modification. Again this method is based on the principles of operant conditioning but uses secondary rewards (as opposed to primary rewards like behaviour shaping) which can be saved up and exchanged for a primary reward (Cardwell 2000). One example of this method is Mestel and Concar’s 1994 study (cited in Banyard 2002) where they used the token economy method to reward cocaine addicts for not taking the drug. The participants had their urine tested weekly and were given vouchers that increased in value the longer their urine showed a negative result. The participants were advised to spend the vouchers on health promoting behaviour such as sports equipment or on rebuilding relationships with their families. Mestel and Concar (1994) found the programme was very successful however they also found that there was really negative feedback from the public because many saw it as paying drug users not to use drugs. Token economy has also been used with schizophrenics and autistic children with good success but it proves to be expensive and often the encouraged behaviour will cease once the treatment stops.
To conclude, behaviourism not only provides answers to why certain behaviours are formed but also gives healthcare professionals methods to help their clients modify and adapt their behaviour. It is a scientific approach that comes with all the benefits and indeed all the problems of a scientific perspective. To overcome the weaknesses in behaviourism healthcare professionals should seek to use an eclectic approach when treating their clients, for example using the humanistic approach of individuality and free will to overcome the reductionist and deterministic approach of behaviourism.
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Reference list
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