Clinical behavior

analysis

Clinical behavior analysis (CBA; also called clinical behaviour analysis or third-generation
behavior therapy) is the clinical application of behavior analysis (ABA).[1] CBA represents a
movement in behavior therapy away from methodological behaviorism and back toward radical
behaviorism and the use of functional analytic models of verbal behavior—particularly, relational
frame theory (RFT).

Current Models
Clinical behavior analysis (CBA) therapies include acceptance and commitment therapy (ACT),
behavioral medicine (such as behavioral gerontology and pediatric feeding therapy), community
reinforcement approach and family training (CRAFT), exposure therapies/desensitization (such
as systematic desensitization), functional analytic psychotherapy (FAP, such as behavioral
activation (BA) and integrative behavioral couples therapy), and voucher-based contingency
management.
Acceptance and Commitment
Therapy
Acceptance and commitment therapy is probably the most well-researched of all the third-
generation behavior therapy models. Its development co-occurred with that of relational frame
theory, with several researchers such as Steven C Hayes being involved with both. ACT has been
argued to be based on relational frame theory.[2] Although this is a matter of some debate within
the community,[3] Originally, this approach was referred to as comprehensive distancing.[4] Every
practitioner mixes acceptance with a commitment to one's values. These ingredients become
enmeshed into the treatment in different ways which leads to ACT being either more on the
mindfulness side, or more on the behavior-changing side.[5] ACT has, as of May 2022, been
evaluated in over 900 randomized clinical trials for a variety of client problems.[6] Overall, when
compared to other active treatments designed or known to be helpful, the effect size for ACT is a
Cohen's d of around 0.6,[7][8] which is considered a medium effect size.

Behavioral Activation
Behavioral activation emerged from a component analysis of cognitive behavior therapy.
Cognitive behavior therapy focuses on trying to reverse those negative thoughts that contribute
to emotional difficulties such as depression and anxiety. This research found no additive effect
for the cognitive component.[9] Behavioral activation is based on a matching law model of
reinforcement.[10] A recent review of the research supports the notion that the use of behavioral
activation is clinically important for the treatment of depression.[11]
Community Reinforcement Approach
and Family Training
Community reinforcement approach and family training (CRAFT) is a model developed by Robert
Meyer and based on the community reinforcement approach (CRA) first developed by Nathan
Azrin and Hunt. The model focuses on the use of functional behavioral assessment to reduce
drinking behavior. CRAFT combines CRA with family therapy.

Functional Analytic Psychotherapy

Functional analytic psychotherapy is based on a functional analysis of the therapeutic
relationship.[12] It places a greater emphasis on the therapeutic context and returns to the use of
in-session reinforcement.[13] The basic FAP analysis utilizes what is called the clinically relevant
behavior (CRB1), which is the client's presenting problem as presented in-session. Client in-
session actions that improve their CRB1s are referred to as CRB2s. Client statements, or verbal
behavior, about CRBs are referred to as CRB3s. In general, 40 years of research supports the
idea that in-session reinforcement of behavior can lead to behavioral change.[14]

Integrative Behavioral Couples

Therapy
Integrative behavioral couples therapy developed from dissatisfaction with traditional behavioral
couples therapy. Integrative behavioral couples therapy looks to Skinner (1966) for the
difference between contingency shaped and rule-governed behavior.[15] It couples this analysis
with a thorough functional assessment of the couples relationship. Recent efforts have used
radical behavioral concepts to interpret a number of clinical phenomena including
forgiveness.[16]

Clinical Formulation
As with all behavior therapy, clinical behavior analysis relies on a functional analysis of problem
behavior. Depending on the clinical model this analysis draws on B.F Skinner's model of Verbal
Behavior or relational frame theory.

Professional Organizations
The Association for Behavior Analysis International has a special interest group in clinical
behavior analysis ABA:I.[17] ABA:I serves as the core intellectual home for behavior
analysts.[18][19]

The Association for Behavioral and Cognitive Therapies (ABCT) also has an interest group in
behavior analysis, which focuses on clinical behavior analysis.

The Association for Contextual Behavioral Science is devoted to third-generation therapies and
basic research on derived relational responding and relational frame theory.[20]

The Behavior Analyst Certification Board (in partnership with subject matter experts) has
produced a "Clinical Behavior Analysis" fact sheet.[21]

See also

Behavioral psychotherapy
References

1. Kohlenberg, R. J.; Bolling, M. Y.; Kanter, J.

W.; Parker, C. R. (2002). "Clinical behavior
analysis: Where it went wrong, how it was
made good again, and why its future is so
bright" (https://web.archive.org/web/20111
008194237/https://pantherfile.uwm.edu/jk
anter/www/pdf/publication/behavioranalys
is.pdf) (PDF). The Behavior Analyst Today.
3 (3): 248–53. doi:10.1037/h0099988 (http
s://doi.org/10.1037%2Fh0099988) .
ISSN 1539-4352 (https://www.worldcat.or
g/issn/1539-4352) . Archived from the
original (https://pantherfile.uwm.edu/jkante
r/www/pdf/publication/behavioranalysis.p
 df) (PDF) on October 8, 2011. Retrieved
May 23, 2010.
2. Blackledge, J.T. (2003). "An Introduction to
Relational Frame Theory: Basics and
Applications" (https://web.archive.org/web/
20160413165349/http://facts4u.com/free/
rft_blackledge.pdf) (PDF). The Behavior
Analyst Today. 3 (4): 421–42.
doi:10.1037/h0099997 (https://doi.org/10.
1037%2Fh0099997) . Archived from the
original (http://facts4u.com/free/rft_blackle
dge.pdf) (PDF) on April 13, 2016. Retrieved
August 19, 2016.
3. Zettle, Robert D; Hayes, Steven C; Barnes-
Holmes, Dermot; Biglan, Anthony, eds.
(2015). The Wiley Handbook of Contextual
Behavioral Science - Wiley Online Library.
doi:10.1002/9781118489857 (https://doi.or
g/10.1002%2F9781118489857) .
ISBN 9781118489857. S2CID 147707892
(https://api.semanticscholar.org/CorpusID:
147707892) .
4. Zettle, R.D. (2005). "The Evolution of a
Contextual Approach to Therapy: From
Comprehensive Distancing to ACT".
International Journal of Behavioral
Consultation and Therapy. 1 (2): 77–89.
doi:10.1037/h0100736 (https://doi.org/10.
1037%2Fh0100736) . S2CID 4835864 (http
s://api.semanticscholar.org/CorpusID:4835
864) .
5. Hayes, Steven. "Acceptance & Commitment
Therapy (ACT)" (http://www.contextualpsyc
hology.org/act) .
ContextualPsychology.org.
6. "State of the ACT Evidence | Association for
Contextual Behavioral Science" (https://con
textualscience.org/state_of_the_act_eviden
ce) . contextualscience.org. Retrieved
December 5, 2016.
7. Lappalainen, R.; Lehtonen, T.; Skarp, E.;
Taubert, E.; Ojanen, M. & Hayes, S.C. (2007).
"The impact of CBT and ACT models using
psychology trainee therapists: A preliminary
controlled effectiveness trial" (https://www.
researchgate.net/publication/6287169) .
Behavior Modification. 31 (4): 488–511.
doi:10.1177/0145445506298436 (https://d
oi.org/10.1177%2F0145445506298436) .
PMID 17548542 (https://pubmed.ncbi.nlm.
nih.gov/17548542) . S2CID 21133628 (http
s://api.semanticscholar.org/CorpusID:2113
3628) .
8. Zettle, R.D. & Rains, J.C. (1989). "Group
cognitive and contextual therapies in
treatment of depression" (https://www.rese
archgate.net/publication/20409969) .
Journal of Clinical Psychology. 45 (3): 438–
45. doi:10.1002/1097-
4679(198905)45:3<436::aid-
jclp2270450314>3.0.co;2-l (https://doi.org/
10.1002%2F1097-4679%28198905%2945%
3A3%3C436%3A%3Aaid-jclp2270450314%3
E3.0.co%3B2-l) . PMID 2745733 (https://pu
bmed.ncbi.nlm.nih.gov/2745733) .
9. Jacobson, N.S.; Martell, C.R. & Dimidjian, S.
(2001). "Behavioral activation treatment for
depression: Returning to contextual roots"
(http://www.personal.kent.edu/~dfresco/C
BT_Readings/CPSP_Jacobson_et_al_BA.pd
f) (PDF). Clinical Psychology: Science and
Practice. 8 (3): 255–70.
doi:10.1093/clipsy.8.3.255 (https://doi.org/
10.1093%2Fclipsy.8.3.255) .
10. Cullen, J.M.; Spates, C.R.; Pagoto, S. &
Doran, N. (2006). "Behavioral Activation
Treatment for Major Depressive Disorder: A
Pilot Investigation" (https://escholarship.u
massmed.edu/cgi/viewcontent.cgi?article=
1107&context=prevbeh_pp) . The Behavior
Analyst Today. 7 (1): 151–64.
doi:10.1037/h0100150 (https://doi.org/10.
1037%2Fh0100150) . S2CID 41079284 (htt
ps://api.semanticscholar.org/CorpusID:410
79284) .
11. Spates, C.R.; Pagoto, S. & Kalata, A. (2006).
"A Qualitative And Quantitative Review of
Behavioral Activation Treatment of Major
Depressive Disorder" (https://escholarship.
umassmed.edu/prevbeh_pp/113) . The
Behavior Analyst Today. 7 (4): 508–12.
doi:10.1037/h0100089 (https://doi.org/10.
1037%2Fh0100089) . S2CID 3337916 (http
s://api.semanticscholar.org/CorpusID:3337
916) .
12. Kohlenberg, R.J.; Tsai, M. (1991). Functional
Analytic Psychotherapy. New York: Plenum.
13. Wulfert (2002). "Can Contextual Therapies
Save Clinical Behavior Analysis?". The
Behavior Analyst Today. 3 (3): 254.
doi:10.1037/h0099984 (https://doi.org/10.
1037%2Fh0099984) .
14. Cautilli, J.T.; Riley-Tillman, C.; Axelrod, S. &
Hineline, P. (2005). "The Role of Verbal
Conditioning in Third Generation Behavior
Therapy". The Behavior Analyst Today. 6
(2): 138–57. doi:10.1037/h0100152 (http
s://doi.org/10.1037%2Fh0100152) .
15. Skinner, B.F. (1969). Contingencies of
Reinforcement: A Theoretical Analysis. New
York: Meredith Corporation.
16. Cordova, J.; Cautilli, J.D.; Simon, C. &
Axelrod-Sabtig, R. (2006). "Behavior
Analysis of Forgiveness in Couples
Therapy" (http://files.eric.ed.gov/fulltext/EJ
804016.pdf) (PDF). International Journal of
Behavioral Consultation and Therapy. 2 (2):
192–213. CiteSeerX 10.1.1.507.7911 (http
s://citeseerx.ist.psu.edu/viewdoc/summar
y?doi=10.1.1.507.7911) .
doi:10.1037/h0100776 (https://doi.org/10.
1037%2Fh0100776) .
17. ABA:I (http://www.abainternational.org/)
18. Twyman, J.S. (2007). "A new era of science
and practice in behavior analysis".
Association for Behavior Analysis
International: Newsletter. 30 (3): 1–4.
19. Hassert, D.L.; Kelly, A.N.; Pritchard, J.K. &
Cautilli, J.D. (2008). "The Licensing of
Behavior Analysts: Protecting the
profession and the public". Journal of Early
and Intensive Behavior Intervention. 5 (2):
8–19. doi:10.1037/h0100415 (https://doi.or
g/10.1037%2Fh0100415) .
S2CID 145406830 (https://api.semanticsch
olar.org/CorpusID:145406830) .
20. Association for Contextual Behavioral
Science (http://www.contextualpsychology.
org)
21. "Clinical Behavior Analysis" (https://www.ba
cb.com/about-behavior-analysis/clinical-b
a/) . Behavior Analyst Certification Board.
Retrieved September 14, 2022.
Retrieved from
"https://en.wikipedia.org/w/index.php?
title=Clinical_behavior_analysis&oldid=1207758814
"

This page was last edited on 15 February 2024, at

17:07 (UTC). •
Content is available under CC BY-SA 4.0 unless
otherwise noted.