This is the 2007 version. Click here for the 2017 chapter 13 table of contents.

The Medical Model versus Behavior Therapy

Behavior therapies are therapies that use conditioning procedures such as we discussed in Chapter 5. In the late 1960s, behavior therapies suddenly gained influence. They presented an alternative set of assumptions about the nature of a client's problems, as well as a new set of techniques for dealing with those problems.

What is the "medical model" and what does it imply?

Perhaps because Freud, Jung, and most other early therapists were MD's, they tended to regard psychological problems as if they were medical problems. In medicine, visible symptoms indicate a hidden problem such as infection. Rather than simply treating symptoms (for example, a sore throat) a doctor is better off treating the underlying cause (for example, an infection). If the symptoms are treated but the underlying cause remains untreated, new symptoms might appear and the patient might not get well. This set of assumptions is known as the medical model.

The medical model implies that a good therapist should always look for underlying causes of a behavior problem. If the therapist tries to change behaviors directly, without getting at the underlying cause, other symptoms will emerge. This is called symptom substitution.

What argument did behavior therapists make against the medical model?

Behavior therapists of the 1960s made a powerful argument against the medical model. First, they pointed out there was little or no evidence for symptom substitution. As a rule (behavior therapists argued) if problem behaviors are treated and eliminated, new problems do not emerge. Therefore it made sense to treat problem behaviors directly. That could be done by treating them as responses to be extinguished and replaced by more adaptive responses.

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