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Reflections on Psychology and Behavior Modification

 By Dr. Brian Campbell

 

Students:

 

Professional psychologists receive a broad spectrum of training, which includes an array of different therapeutic modalities that are relevant to a broad spectrum of disorders and clinical populations. I treat children and adults from the “womb to the tomb.”  The techniques I have in my clinical “toolkit” can be applied to just about any type of problem I encounter in my private practice.

 

One important area of training that I have not discussed with you yet is that of behavior modification.  I am an expert in behavior modification and I utilize this treatment modality every day in counseling.  In fact, I would have to say that the theory and constructs of behavior modification lie at the heart of my treatment techniques—including my Christian counseling.

 

In my opinion, learning to conceptualize problems based on knowledge of operant and classical conditioning is critical for effective counseling.  If you have not taken a course in behavior modification—you should!  There are literally thousands of problems that I have seen over my career that were effectively addressed by utilizing my knowledge of behavior modification.  I became an expert in this modality “the hard way.”

 

I was originally trained in psychodynamic psychotherapy (during my predoctoral internship).  Then I trained in applied behavioral analysis in my postdoctoral fellowship, which involved work with developmentally disabled individuals.  I trained under a radical behaviorist, who only saw the world from this particular theoretical orientation.

 

One of my first cases in the State Hospital involved working with projectile vomiter.  I smile as I wonder how Jay Adams would handle this case.  This young man was in the back wards of the hospital.  He was mentally retarded and had lived in the hospital most of his life.  To protect himself from others, he had learned (serendipitously) a very primitive response to keep others away.  He would throw up on them.  He had become so proficient at this that he could project his vomit about ten feet.

 

This case could not be treated with scripture memory or cognitive restructuring.  Behavior modification was the only applicable treatment technique.  With the help of my supervisor and a cram course on behavior modification techniques, I started treatment with this young man.  Our treatment consisted of giving him an abundance of liquids.  We did this so that he would have enough liquid to keep throwing up on us.

 

I remember entering the behavior-training unit dressed in a yellow raincoat and galoshes.  We fed this young man drinks by putting them down next to him and letting him drink.  After he gulped down the drink, we would approach him.  He would then self-protectively try to vomit on us (I was working with two other therapists). 

 

We would then forcefully place the man on a soft mat that was near the table where we were working.  He did not like to be touched and was very defensive.  Using behavioral techniques of “shaping, “fading,” and “negative reinforcement,” we let him up when he quieted down.  The punishment he received for his vomiting worked well, and his projectile vomiting sharply decreased.  The fact that he was eventually able to around other people in the hospital setting was extremely rewarding (to me).

 

As my fellowship proceeded, I learned to work effectively with individuals who exhibited a wide range of behavioral disorders.  We did not do “talky” therapy.  We used strict behavior modification techniques.  Most of the clients improved significantly and the quality of their lives improved immeasurably.  

 

Later on, as a professor at Nova Southeastern University, I became a consultant at South Florida Hospital (it is now closed), where I started a unit for severely violent and aggressive mentally retarded/psychotic adults.  These adults exhibited a wide range of aberrant behavior—the majority of which we successfully treated with behavior modification techniques. 

 

The techniques that I learned in the hospital setting turned out to be crucial for all my subsequent work as a psychologist.  They form the core and foundation of cognitive therapy techniques as well as my Christian counseling.  Let me give you a brief glimpse of the connection…

 

Anxiety disorders, such as obsessive-compulsive disorder, can be conceptualized by understanding the autonomic nervous system and with the use of the behavior modification concept of “negative reinforcement.”  Anxiety, when experienced at high levels is uncomfortable.  Any behavior that an individual exhibits (such as hand-washing) that “switches off” or “postpones” the occurrence of painful event will be “negatively reinforced.” 

 

The concept of “negative reinforcement” has considerable explanatory power, especially with regard to the development, and treatment, of OCD behaviors.  As a behaviorist, I have treatment techniques that utilize this concept, together with other behavior modification procedures.  Typically, I utilize cue-controlled relaxation procedures together with response prevention and systematic desensitization.

 

With my Christian clients, I explain the biology underlying OCD and the treatment techniques that we can utilize.  Reducing the overall level of anxiety is extremely important, because it is the uncomfortable level of anxiety that is the “fuel” for negative reinforcement.  If you reduce the overall level of anxiety, you can reduce powerful effects of negative reinforcement. 

 

To help reduce anxiety, I utilize God’s word (scriptures) to help me, help them.  For example, I have a tape called “Overcoming Anxiety,” that includes scriptures from the Bible that are set to relaxing music.  Sometimes I hand my Christian brothers or sisters a copy of the Bible and ask them to show me a scripture that says that we, as Christians, should fret or worry.  Of course, there are none.

 

When treating anxiety, half of the cure is knowledge and “understanding.”  When I provide an explanation of anxiety disorders, utilizing my knowledge of biology and psychology, the treatment has already begun.  Utilizing a combination of behavior modification techniques, relaxation techniques, cognitive-restructuring techniques, anti-anxiety medication, and Christian counseling techniques (such as prayer and scriptures), I have been very successful in treating individuals with anxiety disorders.

 

Finally, as I think back to Adams’ text, I wonder how he would handle the wide range of problems I have encountered in my clinical practice.  I’ll start with the following example:

 

Child Behavior Problems:  I am an expert in parenting techniques and treating child behavior problems.  Most of my interventions utilize my knowledge of behavior modification techniques.  I can help parents get their children to sleep through the night; to eat their food; to go to bed at night; to behave themselves in public; to stop having tantrums; to eliminate biting or hitting, to reduce sibling fighting, and to stop whining behavior.  I wonder if Adams could possibly be effective in treating these disorders—especially if the child (and his parents) are non-Christians.  I would suggest he would not have much that he could do to help, except pray (not to minimize the power of prayer).

 

To help introduce behavior modification to you, I will refer you to a document I use with parents that I developed called:  “How to Teach Your Child to Whine—or Not!”  It is located on my internet site.  I often use it as a handout for my clients.

 

With Christian families, I also refer them to a chapter in “Godly Counsel” dealing with scriptures relating to the topic of parenting.  I am an advocate of corporal punishment (at certain ages and with certain children).  Spanking is, in essence, a behavior modification procedure (termed “punishment”), so I want to make sure that my parents are ok with using punishment.  Of course, I remind them that “God disciplines those he loves.”  Please have a look at my chapter on parenting.

 

I hope you enjoy the presentation on whining.  It is meant to be “tongue-in-cheek.”

 

Blessings,

 

Dr. Campbell