Clinical Behavior Analysis is one of several ABA subspecialty fact sheets produced by the BACB in partnership with subject matter experts (SMEs). Clinical behavior analysis (CBA; also called clinical behaviour analysis or third-generation behavior therapy) is the clinical application of behavior analysis (ABA). CBA represents a movement in

behavior therapy Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or ...

away from

methodological behaviorism Behaviorism is a systematic approach to understanding the behavior of humans and animals. It assumes that behavior is either a reflex evoked by the pairing of certain antecedent stimuli in the environment, or a consequence of that individual ...

and back toward

radical behaviorism Radical behaviorism is a "philosophy of the science of behavior" developed by B. F. Skinner. It refers to the philosophy behind behavior analysis, and is to be distinguished from methodological behaviorism—which has an intense emphasis on ...

and the use of functional analytic models of

verbal behavior ''Verbal Behavior'' is a 1957 book by psychologist B. F. Skinner, in which he describes what he calls verbal behavior, or what was traditionally called linguistics. Skinner's work describes the controlling elements of verbal behavior with termino ...

—particularly,

relational frame theory Relational frame theory (RFT) is a psychological theory of human language, cognition, and behaviour. It was developed originally by Steven C. Hayes of University of Nevada, Reno and has been extended in research, notably by Dermot Barnes-Holmes ...

(RFT).

Current Models

Clinical behavior analysis (CBA) therapies include

acceptance and commitment therapy Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and m ...

(ACT),

behavioral medicine Behavioral medicine is concerned with the integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness. These sciences include epidemiology, anthropology, sociology, psychology, ph ...

(such as behavioral gerontology and pediatric feeding therapy),

community reinforcement approach and family training Community reinforcement approach and family training (CRAFT) is a behavior therapy approach in psychotherapy for treating addiction developed by Robert J. Meyers in the late 1970s. Meyers worked with Nathan Azrin in the early 1970s whilst he was de ...

(CRAFT), exposure therapies/ desensitization (such as

systematic desensitization Systematic desensitization, or graduated exposure therapy, is a behavior therapy developed by the psychiatrist Joseph Wolpe. It is used when a phobia or anxiety disorder is maintained by classical conditioning. It shares the same elements of both c ...

functional analytic psychotherapy Functional analytic psychotherapy (FAP) is a psychotherapeutic approach based on clinical behavior analysis (CBA) that focuses on the therapeutic relationship as a means to maximize client change. Specifically, FAP suggests that in-session conting ...

(FAP, such as

behavioral activation Behavioral activation (BA) is a third generation behavior therapy for treating depression. It is one form of functional analytic psychotherapy, which is based on a Skinnerian psychological model of behavior change, generally referred to as app ...

(BA) and

integrative behavioral couples therapy Behavioral marital therapy, sometimes called behavioral couples therapy, has its origins in behaviorism and is a form of behavior therapy. The theory is rooted in social learning theory and behavior analysis. As a model, it is constantly being rev ...

), and voucher-based

contingency management Contingency management (CM) is the application of the three-term contingency (or operant conditioning), which uses stimulus control and consequences to change behavior. CM originally derived from the science of applied behavior analysis (ABA), bu ...

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

, with several researchers such as Steven C Hayes being involved with both. ACT has been argued to be based on relational frame theory. Although this is a matter of some debate within the community, Originally, this approach was referred to as comprehensive distancing. 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. ACT has, as of May 2022, been evaluated in over 900

randomized clinical trial A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical t ...

s for a variety of client problems. Overall, when compared to other active treatments designed or known to be helpful, the effect size for ACT is a

Cohen's d In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the ...

of around 0.6, which is considered a medium

effect size In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the ...

Behavioral Activation

Behavioral activation emerged from a component analysis of

cognitive behavior therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...

. 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. Behavioral activation is based on a

matching law In operant conditioning, the matching law is a quantitative relationship that holds between the relative rates of response and the relative rates of reinforcement in concurrent schedules of reinforcement. For example, if two response alternative ...

model of reinforcement. A recent review of the research supports the notion that the use of behavioral activation is clinically important for the treatment of depression.

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 Nathan H. Azrin (November 26, 1930 – March 29, 2013) was a behavioral modification researcher, psychologist, and university professor. He taught at Southern Illinois University and was the research director of Anna State Hospital between ...

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. It places a greater emphasis on the therapeutic context and returns to the use of in-session reinforcement. 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.

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. 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.

Clinical Formulation

As with all

, 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 ''Verbal Behavior'' is a 1957 book by psychologist B. F. Skinner, in which he describes what he calls verbal behavior, or what was traditionally called linguistics. Skinner's work describes the controlling elements of verbal behavior with termino ...

Professional Organizations

The

Association for Behavior Analysis The Association for Behavior Analysis International (ABAI) is a nonprofit organization dedicated to promoting behavior analysis. The organization has over 9,000 members. The group organizes conferences and publishes journals on the topic of appl ...

International has a special interest group in clinical behavior analysis ABA:I. ABA:I serves as the core intellectual home for behavior analysts. The

Association for Behavioral and Cognitive Therapies The Association for Behavioral and Cognitive Therapies (ABCT) was founded in 1966. Its headquarters are in New York City and its membership includes researchers, psychologists, psychiatrists, physicians, social workers, marriage and family therap ...

(ABCT) also has an interest group in

behavior analysis Behaviorism is a systematic approach to understanding the behavior of humans and animals. It assumes that behavior is either a reflex evoked by the pairing of certain antecedent stimuli in the environment, or a consequence of that individual' ...

, which focuses on clinical behavior analysis. The

Association for Contextual Behavioral Science The Association for Contextual Behavioral Science (ACBS) is a worldwide nonprofit professional membership organization associated with acceptance and commitment therapy (ACT), and relational frame theory (RFT) among other topics. The term "conte ...

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

{{Psychotherapy Behavior therapy Behaviorism