Behavior modification is based on methodological behaviorism, which refers to limiting behavior-change procedures to behaviors that are observable and was employed briefly during the late 1950s but predominately from the late 1970s to early 1980s. Specifically, behavior was modified through the use of presumed consequences, including positive and negative reinforcement contingencies to increase desirable behavior or by administering extinction and/or punishment to reduce behavior.
In contrast to behavior analysis, analyzing the behavior-environment interactions (including antecedent stimuli) was not considered relevant in behavior modification; it also lacked the conceptual piece (radical behaviorism) initially purposed by B. F. Skinner. Subsequently, applied behavior analysis (ABA) has superseded the early term behavior modification since the 1990s.
The first use of the term behavior modification appears to have been by Edward Thorndike in 1911. His article Provisional Laws of Acquired Behavior or Learning makes frequent use of the term "modifying behavior". Through early research in the 1940s and the 1950s the term was used by Joseph Wolpe's research group. The experimental tradition in clinical psychology used it to refer to psycho-therapeutic techniques derived from empirical research. It has since come to refer mainly to techniques for increasing adaptive behavior through reinforcement and decreasing maladaptive behavior through extinction or punishment (with emphasis on the former). Emphasizing the empirical roots of behavior modification, some authors consider it to be broader in scope and to subsume the other two categories of behavior change methods.
In recent years, the concept of punishment has had many critics, though these criticisms tend not to apply to negative punishment (time-outs) and usually apply to the addition of some aversive event. The use of positive punishment by board certified behavior analysts is restricted to extreme circumstances when all other forms of treatment have failed and when the behavior to be modified is a danger to the person or to others (see professional practice of behavior analysis). In clinical settings positive punishment is usually restricted to using a spray bottle filled with water as an aversive event. When misused, more aversive punishment can lead to affective (emotional) disorders, as well as to the receiver of the punishment increasingly trying to avoid the punishment (i.e., "not get caught").
Behavior modification relies on the following:
- Reinforcement (Positive and Negative)
- Punishment (Positive and Negative)
Some areas of effectiveness
Functional behavior assessment forms the core of applied behavior analysis. Many techniques in this therapy are specific techniques aimed at specific issues. Interventions based on behavior analytic/modification principles have been extremely effective in developing evidence-based treatments.
In addition to the above, a growing list of research-based interventions from the behavioral paradigm exist. With children with attention deficit hyperactivity disorder (ADHD), one study showed that over a several year period, children in the behavior modification group had half the number of felony arrests as children in the medication group. These findings have yet to be replicated, but are considered encouraging for the use of behavior modification for children with ADHD. There is strong and consistent evidence that behavioral treatments are effective for treating ADHD. A recent meta-analysis found that the use of behavior modification for ADHD resulted in effect sizes in between group studies (.83), pre-post studies (.70), within group studies (2.64), and single subject studies (3.78) indicating behavioral treatments are highly effective.
Behavior modification programs form the core of many residential treatment facility programs. They have shown success in reducing recidivism for adolescents with conduct problems and adult offenders. One particular program that is of interest is teaching-family homes (see Teaching Family Model), which is based on a social learning model that emerged from radical behaviorism. These particular homes use a family style approach to residential treatment, which has been carefully replicated over 700 times. Recent efforts have seen a push for the inclusion of more behavior modification programs in residential re-entry programs in the U.S. to aid prisoners in re-adjusting after release.
One area that has repeatedly shown effectiveness has been the work of behaviorists working in the area of community reinforcement for addictions. Another area of research that has been strongly supported has been behavioral activation for depression.
One way of giving positive reinforcement in behavior modification is in providing compliments, approval, encouragement, and affirmation; a ratio of five compliments for every one complaint is generally seen as being effective in altering behavior in a desired manner and even in producing stable marriages.
Of notable interest is that the right behavioral intervention can have profound system effects. For example, Forgatch and DeGarmo (2007) found that with mothers who were recently divorced, a standard round of parent management training (programs based on social learning principles that teaches rewarding good behavior and punishing bad behavior combined with communication skills) could help elevate the divorced mother out of poverty. In addition, parent management training programs, sometimes referred to as behavioral parent training programs, have shown relative cost effectiveness for their efforts for the treatment of conduct disorder. Thus, such intervention can have profound effects on socializing the child in a relatively cost effective fashion and help get the parent out of poverty. This level of effect is often looked for and valued by those who practice behavioral engineering and results of this type have caused the Association for Behavior Analysis International to take a position that those receiving treatment have a right to effective treatment  and a right to effective education.
In job performance
The use of positive reinforcement to change behavior has many applications to organizational training. An assessment called performance audit is conducted first, to determine the problems or behaviors that can be modified for more efficient job performance. A program of positive reinforcement is then introduced to reward employees for displaying the desired behaviors, such as reducing errors or production time per unit. Punishment or reprimands are not used: although these may temporarily eliminate an undesirable behavior, they may leave in its place anxiety, hostility and anger. Providing positive reinforcement is much more effective in improving employee productivity and behavior.
Behavior modification is critiqued in person-centered psychotherapeutic approaches such as Rogerian Counseling and Re-evaluation Counseling, which involve "connecting with the human qualities of the person to promote healing", while behaviorism is "denigrating to the human spirit". B.F. Skinner argues in Beyond Freedom and Dignity that unrestricted reinforcement is what led to the "feeling of freedom", thus removal of aversive events allows people to "feel freer". Further criticism extends to the presumption that behavior increases only when it is reinforced. This premise is at odds with research conducted by Albert Bandura at Stanford University. His findings indicate that violent behavior is imitated, without being reinforced, in studies conducted with children watching films showing various individuals "beating the daylights out of Bobo". Bandura believes that human personality and learning is the result of the interaction between environment, behavior and psychological process. There is evidence, however, that imitation is a class of behavior that can be learned just like anything else. Children have been shown to imitate behavior that they have never displayed before and are never reinforced for, after being taught to imitate in general.
Several people have criticized the level of training required to perform behavior modification procedures, especially those that are restrictive or use aversives, aversion therapy, or punishment protocols. Some desire to limit such restrictive procedures only to licensed psychologists or licensed counselors. Once licensed for this group, post-licensed certification in behavior modification is sought to show scope of competence in the area through groups like the World Association for Behavior Analysis. Still others desire to create an independent practice of behavior analysis through licensure to offer consumers choices between proven techniques and unproven ones (see Professional practice of behavior analysis). Level of training and consumer protection remain of critical importance in applied behavior analysis and behavior modification.
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