The derailment of behavior therapy: a tale of conceptual misdirection

Forty years ago it was shown that neuroses are persistent unadaptive anxiety response habits that can be systematically overcome by deconditioning procedures collectively known as behavior therapy. Indispensable to behavior therapy is behavior analysis--detailed and accurate specification of the antecedents of the individual's neurotic patterns. In recent years, the behavior therapy movement has been infiltrated by two alien orientations--"exposure therapy" and cognitivism--which repudiate conditioning theory and dispense with the characteristic behavior analysis. By claiming to be more effective, the alien approaches have induced widespread abandonment of the conditioning model. In fact, outcomes have not been improved by the alien methodologies, and in many cases have become worse. Also, no viable theory of change has been proposed in place of conditioning. The result is an amorphous eclecticism to which psychoanalysis and primal scream could readily be added. Some first steps are suggested towards restoring conditioning principles to their central role in the behavior therapy field.