Behavioral therapies: first, second and third wave

Throughout the history of psychology, many approaches and theories have emerged to explain how the human mind works, what psychological mechanisms influence and participate in our behavior, and even how they can be altered so that patterns of inappropriate thought and action occur. in the form of mental disorders.

At the level of clinical psychology, attempts have been made to help people with maladaptive disorders and patterns and the producers of discomfort through so-called behavioral therapy and the three waves or generations of treatments it produces.

Behavioral therapy: a brief definition

We call behavioral therapy type of treatment based on experimental psychology in which behavior is considered, although predisposed by biology, to be determined and can change by learning and applying patterns of behavior and thought.

In the presence of inappropriate behaviors that generate significant discomfort in the person, it is possible to modify these patterns by teaching more useful role models.

Thus, the overall goal of this type of therapy is to generate change in the person who it can alleviate your suffering and improve your adaptation, Improve and optimize their skills and opportunities in the environment. This aims to remove, add or modify one or more behaviors in the repertoire of the individual through the process of learning.

This type of therapy focuses on the present moment, working on the current problem and being the story only one thing that informs us of how the current situation was reached. The psychotherapist will apply the treatment according to the characteristics of the subject to be treated and his circumstances, having to adapt the therapy to each situation.

The three waves or generations of therapy

While many applied techniques and therapies have remained since behavioral or behavior modification therapies first appeared, behavioral therapy hasn’t stopped evolving behind improving both his effectiveness and his understanding of the mental and behavioral processes he is working on.

So far we can talk about a total of three major waves or generations of therapies which have succeeded each other over time as one or the other stream of thought predominated, each of them overcoming many explanatory and methodological limitations of previous models.

1. First wave: behavioral therapies

Behavioral therapy originated at a time in the history of psychology when behavioralism strongly emerged in reaction to psychoanalytic cutting therapies born with Sigmund Freud. The latter focused on hypothetical constructions that were not empirically opposable, and viewed behavioral disorders as the expression of poor resolution of unconscious conflicts related to the repression of instincts and needs.

However, behavioral models opposed these considerations, preaching the need to treat disorders on the basis of verifiable and contrastable evidence from experience. Behaviorists have focused on managing the behavior present at the time of the problem, worrying about the relationships between stimuli, their reactions, and the consequences thereof.

The methodology of the first wave

The behavior was understood to intervene mainly by the association between the stimuli and the consequences of the responses given to them. The therapies that appeared at this time are therefore based on conditioning., Functional aspects such as association of stimuli, habituation or sensitization to them or extinction of reactions to stimuli. First-rate behavioral changes are brought about, working on directly observable behavior.

Some of the treatments belonging to this first generation of behavioral therapies that continue to be applied are exposure therapies, differential behavioral reinforcement, aversive techniques, casting, systematic desensitization or flea economics and behavioral contracting ( although at present they are applied accompanied by more cognitive treatments.).

The proposals from the first wave of behavioral therapies have been and continue to be used to treat phobias, create or restore patterns of behavior, and / or perform training in people with reduced abilities.

The behaviorist model has long been the dominant paradigm in the field of psychology and the treatment of certain mental disorders. However, their design and utility are limited: these treatments are successful only in specific circumstances and contexts in which they can manipulate behavioral variables, and have little regard for the effect of psychological variables such as cognition or affection.

The main problem with behaviorism is that although he recognizes the existence of an intermediate element between the stimulus and the responseDue to the lack of empirical data, this point was overlooked and considered an unexplored black box. For these reasons, over time, another trend has emerged to try to fill the gaps in this model.

2. Second wave: cognitive-behavioral therapies

The lack of answers to multiple questions about the processes involved between perception and reaction and the ineffectiveness of purely behavioral therapies on many disorders with a more specific impact on the content of thought have led to many experts consider that behaviorism was not enough to explain and produce a change in behavior derived from elements such as beliefs or beliefs.

At this point, we began to consider that the main element at the origin of the behavior it is not the association between stimuli but the reflection and the processing that is done of the information, Born the theories of cognitive processing and information. In other words, the second wave of behavioral therapy.

From this point of view, abnormal behavior patterns were considered to be due to the existence of a series of distorted and dysfunctional patterns, structures and thought processes, which cause great suffering to those who experience them.

Proponents of the second wave of therapies do not exclude the importance of association and conditioning, but believe that the therapies should be targeted. changing dysfunctional or deficient beliefs and thoughts. Thus, this current has in fact incorporated many behavioral techniques into its repertoire, although these have a new perspective and add cognitive components. From this combination were born cognitive-behavioral therapies.

Focus on mental processes

In this paradigm, much attention is paid to how effective the treatment is, maximizing it as much as possible, but at the expense of putting less effort into finding out why it works.

This second wave has a much higher success rate than the rest in a large number of disorders, Being in fact one of the most predominant cognitive-behavioral paradigm in clinical psychology today. The goal is to change the cognitions or emotions that cause maladaptive behaviors, either by restricting or modifying them. Some of the more well-known behavioral therapies in general are typical of this period, such as Aaron Beck’s Cognitive Therapy for Depression, Self-Learning Therapy, or Albert Ellis’ Rational Emotional Therapy, among others.

However, despite its clinical success, this type of therapy also presents some problems. Among them stands out the fact that we tend to try to eradicate anything that generates discomfortRegardless of the fact that removing all negative elements can result in rigid patterns of behavior which in turn may be unsuitable. In fact, the attempt at control may end up causing effects contrary to what it claims to be.

The second wave of therapies also has the added difficulty of focusing so much on the effectiveness of the therapies while neglecting the study of their causes. notor it is well known which parts of the process are producing exactly positive change. Finally, to generalize the results of this therapy to the usual context of the patient’s life and to maintain them is complicated, and problems such as relapses appear with a certain frequency.

These problems have led to the relatively recent birth of new therapies that they try to report in a renewed perspective; this is the third wave of behavioral therapy.

Third wave: third generation therapies

This is the latest wave of behavior modification therapy. They are considered to belong to these third generation therapies those developed from the point of view of the need to establish a more contextualized and holistic approach of the person, taking into account not only the symptoms and problems of the subject but the improvement of the vital situation and the connection with the environment, as well as the generation of a real and permanent change of the individual which allows the final overcoming of discomfort.

This type of behavioral therapy takes into account psychological problems they are largely due to the socio-cultural and communicative context of the individual, And whether a given behavior is considered normal or aberrant. More than in the fight against symptomatology, therapy should focus on reorienting and refocusing the individual’s attention towards goals and values ​​important to him, improving the person’s psychosocial adjustment.

A context-focused therapeutic perspective

From the third generation therapies, a change at a deep level is sought, Deepen the heart of the person and less in the specific situation of the problem, which helps to make the changes produced more permanent and meaningful. The third wave also focuses on better understanding and legitimizing symptoms. Likewise, the goal ceases to be to avoid the discomfort or negative thoughts of each of them to move forward to help the subject vary the type of relationship and vision he has of himself and of the problem.

Another element to note is the importance given to the therapist-patient relationship, considered capable of producing on its own changes in the subject’s situation. Through communication between the two, he seeks to change the functionality of the patient’s or client’s behavior, producing changes at a deep level.

In this third wave we find therapies such as Analytical-Functional Psychotherapy, Dialectical Behavior Therapy, or Acceptance and Commitment Therapy. Mindfulness is also very relevant in this wave of therapy, but not as a type of therapy per se, but as a tool.

Bibliographical references:

  • D’Zurilla, TJ and Goldfried, MR (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107-126.
  • Hayes, SC (2004). Acceptance and Commitment Therapy, Relational Framework Theory and Third Wave of Behavioral and Cognitive Therapies. Behavioral therapy, 35, 639-665.
  • Mañas, I. (sf). New Psychological Therapies: The Third Wave of Behavioral Therapies or Third Generation Therapies. Psychology Gazette, 40; 26-34. University of Almeria.
  • Oblitas, LA (2004). “How to succeed in psychotherapy?” The 22 most important approaches to contemporary and avant-garde psychotherapeutic practice. PSICOM editors. Bogota DC Colombia. Pg. 146.
  • Vila, J. and Fernández, MC (2004). Psychological treatments. The experimental perspective. Madrid: Pyramid.

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