Contemporary Views of Behavioral Learning Theory
There remains quite a bit of controversy, among researchers and clinicians alike, regarding the role of classical conditioning in the development of anxiety disorders. First, it is not always possible to identify the initial classical conditioning life event which led to the development of an anxiety disorder. Second, there is a great deal of evidence in the literature to suggest a multitude of factors combine to produce an anxiety disorder, including genetics and disposition, psychological vulnerabilities, and social learning. We discussed these influences in the section on the biopsychosocial model. While the precise role of classical conditioning is still uncertain, it does appear there is sufficient evidence to support the reinforcing nature of avoidance learning, according to the principles of operant conditioning.
Not withstanding these limitations, these two theoretical models directly gave rise to numerous effective behavioral therapies that are applied in clinical practice today, and continue to be refined. Behavioral techniques are widely used for a plethora of problems, including drug/alcohol addiction, smoking cessation, improving social skills, and helping children with Autism and Attention Deficit Hyperactivity Disorder. In the next section, we discuss the application of behavioral theory as it relates to the treatment of anxiety disorders.
Behavioral therapies for anxiety disorders
Since it was demonstrated that phobias could be learned through paired association, and reinforced through avoidance and escape, scientists hypothesized that what could be learned, could potentially be un-learned. A common type of behavioral therapy, called exposure and response prevention therapy, was developed as a direct result of the classical and operant conditioning research. For some disorders, such as Obsessive-Compulsive Disorder (OCD) the two components (exposure and response prevention) are most effective when used together. For other disorders they may be applied separately, or together.
Exposure simply means facing or confronting one's fears repeatedly until the fear subsides (called habituation, see below), and response prevention mean refraining from engaging in typical avoidance or escape behaviors when faced with a feared situation, so that these maladaptive behaviors are no longer reinforced. For example, if a person has germ contamination OCD, a typical exposure exercise consists of shaking hands with someone (exposure), and not washing afterwards (response prevention).