Behavioral Therapies: first, second and third wave

The three generations of therapies show the evolution of health-focused psychology.

Throughout the history of psychology, many approaches and theories have emerged with the aim of explaining how the human mind works, what psychological mechanisms influence and participate in our behavior and even how they can be altered in such a way as to produce maladaptive patterns of thinking and acting in the form of mental disorders.

At the level of clinical psychology, attempts have been made to help those who suffer from disorders and maladaptive and distress-producing patterns through what is known as behavioral therapy and the three waves or generations of treatments that it has produced.

Behavior therapy: a brief definition

Behavior therapy is the name given to the type of treatment based on experimental psychology in which it is considered that behavior, although predisposed by biology, is determined and can be changed by learning and applying patterns of behavior and thought.

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

Thus, the general objective of this type of therapy is to generate a change in the person that can alleviate their suffering and improve their adaptation. alleviate his or her suffering and improve his or her adaptation, enhancing and optimizing his or herand optimizing their abilities and opportunities in the environment. The aim is to eliminate, add or change one or more behaviors to the individual's repertoire through learning processes.

This type of therapy focuses on the present moment, working on the current problem and the history is only something that informs us of how we have arrived at the current situation. 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 therapies

Although many of the techniques and therapies applied have remained the same since behavioral therapies or behavior modification therapies made their appearance, behavioral therapy has not ceased to be a new generation of therapies, behavioral therapy has continued to evolve in order to improve both its effectiveness to improve both its effectiveness and the understanding of the mental and behavioral processes on which it works.

So far, we can speak of a total of three major waves or generations of therapies that have succeeded each other over time. which have succeeded each other over time according to the predominance of one or another current of thought, each of them overcoming many of the explanatory and methodological limitations of the previous models.

1. First wave: Behavioral therapies

Behavioral therapy was born at a time in the history of psychology when behaviorism was emerging strongly as a reaction to the psychoanalytic therapies born with Sigmund Freud. as a reaction to the psychoanalytic therapies born with Sigmund Freud. The latter focused on hypothetical constructs that could not be empirically contrasted, and considered behavioral disorders to be the expression of the poor resolution of unconscious conflicts related to the repression of instincts and needs.

However, behaviorist models opposed these considerations, predicting the need to deal with disorders on the basis of verifiable data that could be contrasted by experience.. The behaviorists focused on treating the behavior present at the time of the problem, being concerned with the relationships between stimuli, reactions and their consequences.

The methodology of the first wave

Behavior was understood as being mediated mainly by the association between stimuli and the consequences of the responses given to them. The therapies that appeared at this time were based on conditioning, working on aspects such as stimulus association, habituation or sensitization to them or extinction.working on aspects such as the association of stimuli, habituation or sensitization to them or the extinction of reactions to stimuli. First order changes in behavior are provoked, working on directly observable behavior.

Some of the treatments belonging to this first generation of behavioral therapies that are still applied are exposure therapies, differential reinforcement of behaviors, aversive techniques, shaping, systematic desensitization or token economy and behavioral contract (although they are currently applied together with more cognitive treatments).

The proposals of the first wave of Behavioral Therapies were used and are still used for the treatment of phobias, creating or restoring behavioral patterns and/or training people with reduced capacities.

The behavioral model was for a long time the prevailing paradigm in the field of psychology and the treatment of certain mental disorders. and the treatment of certain mental disorders. However, its conception and usefulness are limited: these treatments are only successful in specific circumstances and contexts in which behavioral variables can be manipulated, and take little account of the effect of psychological variables such as cognition or affect.

The main problem with behaviorism is that although it recognizes the existence of an intermediate element between stimulus and response, due to the lack of empirical data.The main problem of behaviorism is that although it recognizes the existence of an intermediate element between stimulus and response, due to the lack of empirical data this point was ignored and considered an unexplorable black box. For these reasons, over time another current emerged that tried to make up for the shortcomings of this model.

2. Second wave: Cognitive-behavioral therapies

The lack of answers to multiple questions about the processes mediating between perception and reaction and the ineffectiveness of purely behavioral therapies on many disorders with a more content-related involvement of thought led many experts to consider that behaviorism was not sufficient for the treatment of many disorders. that behaviorism was not sufficient to explain and produce a change in to explain and produce a change in behaviors derived from elements such as convictions or beliefs.

At this point, it began to be considered that the main element that originates behavior is not the association between stimuli but rather the is not the association between stimuli but the thought and the processing of information, giving birth to cognitive theories.This led to the birth of cognitive and information processing theories. That is, the second wave of Behavioral Therapies.

From this perspective, it was considered that abnormal behavioral patterns are due to the existence of a series of distorted and dysfunctional schemas, structures and thought processes, which cause a great deal of suffering to those who experience them.

The promoters of the second wave of therapies do not discard the importance of association and conditioning, but consider that therapies have to be directed at modify dysfunctional or deficit beliefs and thoughts.. Thus, this current has in fact incorporated many of the behavioral techniques to its repertoire, although providing them with a new perspective and adding cognitive components. Cognitive-behavioral therapies emerged from this combination.

Emphasizing mental processes

Within this paradigm, great attention is paid to the degree of efficacy of the treatment, maximizing it as much as possible, although at the cost of devoting less effort to finding out why it works.

This second wave has a much higher success rate than the others in a large number of disorders.In fact, the cognitive-behavioral paradigm is one of the most predominant in clinical psychology today. The objective is to change the cognitions or emotions that provoke the maladaptive behavior, either by restricting or modifying them. Some of the best-known behavioral therapies at a general level are typical of this period, such as Aaron Beck's Cognitive Therapy for depression, self-instructional therapy or Albert Ellis' Rational Emotive Therapy, among others.

However, despite their clinical success, this type of therapy also has some problems. Among them is the fact that there is a tendency to try to eradicate everything that generates discomfortThis is not taking into account that eliminating everything negative can cause rigid patterns of behavior that can be maladaptive. In fact, the attempt to control may end up inciting effects contrary to what is intended.

The second wave of therapies also has the added difficulty that the fact of having focused so much on making therapies effective while neglecting the study of why causes nt is not well understood exactly which parts of the process produce positive change.. Finally, generalizing the results of this therapy to the usual context of the patient's life and sustaining them is complicated, and problems such as relapses occur with some frequency.

These problems have led to the relatively recent emergence of new therapies. that try to give an account from a renewed perspective; this is the third wave of Behavioral Therapies.

Third Wave: Third Generation Therapies

This is the most recent wave of behavior modification therapies. The following are considered to belong to these third-generation therapies are those elaborated under the perspective 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 also the improvement of the vital situation and the link with the environment, as well as the generation of a real and permanent change in the individual that allows the definitive overcoming of the discomfort.

This type of Behavioral Therapies considers that psychological problems are largely due to the context are due in large part to the sociocultural and communicational context of the individualand the fact that a given behavior is considered normal or aberrant. Therapy should focus on reorienting and refocusing the individual's attention on goals and values that are important to him or her, rather than on combating symptomatology, thus improving the person's psychosocial adjustment.

A context-centered therapeutic perspective

Third-generation therapies seek change at a deep levelThis helps the changes produced to be more permanent and significant. The third wave also focuses on providing a better understanding and legitimization of the symptoms. Likewise, the aim is no longer to avoid discomfort or negative thoughts at all costs, but to help the subject to be able to change the type of relationship and view he/she has of him/herself and of the problem.

Another element to highlight is the importance given to the therapist-patient relationship, which is considered to be able to produce changes in the subject's situation by itself. Through communication between the two, the aim is to make the functionality of the patient's or client's behavior change, producing changes at a deep level.

Within this third wave we find therapies such as analytical-functional psychotherapy, dialectical behavioral therapy or Acceptance and Commitment Therapy. Mindfulness is also very relevant within this wave of therapies, although not as a type of therapy in itself but as a tool.

Bibliographical references:

• D'Zurilla, T.J. and Goldfried, M.R. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107-126.

• Hayes, S.C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35, 639-665.

• Mañas, I. (n.d.). New psychological therapies: The third wave of behavioral therapies or third generation therapies. Gaceta de psicología, 40; 26-34. University of Almería.

• Oblitas, L.A. (2004). "How to do successful psychotherapy?" The 22 most important approaches in contemporary and cutting-edge psychotherapeutic practice. PSICOM Editores. Bogotá D.C. Colombia. P. 146.

• Vila,J. and Fernández, M.C (2004). Psychological treatments. The experimental perspective. Madrid: Pirámide.