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Tuesday, October 29, 2019

A Clockwork Orange (novel)

From Wikipedia, the free encyclopedia
 
Clockwork orange.jpg
Dust jacket from the first edition
AuthorAnthony Burgess
Cover artistBarry Trengove
CountryUnited Kingdom
LanguageEnglish
Nadsat
GenreScience fiction, dystopian fiction, satire, black comedy
Published1962 (William Heinemann, UK)
Media typePrint (hardback & paperback) & audio book (cassette, CD)
Pages192 pages (hardback edition)
176 pages (paperback edition)
ISBN0-434-09800-0
OCLC4205836

A Clockwork Orange is a dystopian satirical black comedy novel by English writer Anthony Burgess, published in 1962. It is set in a near-future society that has a youth subculture of extreme violence. The teenage protagonist, Alex, narrates his violent exploits and his experiences with state authorities intent on reforming him. The book is partially written in a Russian-influenced argot called "Nadsat", which takes its name from the Russian suffix that is equivalent to '-teen' in English. According to Burgess, it was a jeu d'esprit written in just three weeks.

In 2005, A Clockwork Orange was included on Time magazine's list of the 100 best English-language novels written since 1923, and it was named by Modern Library and its readers as one of the 100 best English-language novels of the 20th century. The original manuscript of the book has been located at McMaster University's William Ready Division of Archives and Research Collections in Hamilton, Ontario, Canada since the institution purchased the documents in 1971.

Plot summary

Part 1: Alex's world

Alex is a 15-year-old living in a near-future dystopian city who leads his gang on a night of opportunistic, random "ultra-violence". Alex's friends ("droogs" in the novel's Anglo-Russian slang, "Nadsat") are Dim, a slow-witted bruiser, who is the gang's muscle; Georgie, an ambitious second-in-command; and Pete, who mostly plays along as the droogs indulge their taste for ultra-violence. Characterised as a sociopath and hardened juvenile delinquent, Alex also displays intelligence, quick wit, and a predilection for classical music; he is particularly fond of Beethoven, referred to as "Lovely Ludwig Van". 

The novella begins with the droogs sitting in their favourite hangout, the Korova Milk Bar, and drinking "milk-plus" – a beverage consisting of milk laced with the customer's drug of choice – to prepare for a night of mayhem. They assault a scholar walking home from the public library; rob a store, leaving the owner and his wife bloodied and unconscious; beat up a beggar; then scuffle with a rival gang. Joyriding through the countryside in a stolen car, they break into an isolated cottage and terrorise the young couple living there, beating the husband and raping his wife. In a metafictional touch, the husband is a writer working on a manuscript called "A Clockwork Orange", and Alex contemptuously reads out a paragraph that states the novel's main theme before shredding the manuscript. Back at the Korova, Alex strikes Dim for his crude response to a woman's singing of an operatic passage, and strains within the gang become apparent. At home in his parents' futuristic flat, Alex plays classical music at top volume, which he describes as giving him orgasmic bliss before falling asleep. 

Alex coyly feigns illness to his parents to stay out of school the next day. Following an unexpected visit from P.R. Deltoid, his "post-corrective adviser", Alex visits a record store, where he meets two pre-teen girls. He invites them back to the flat, where he drugs and rapes them. That night after a nap, Alex finds his droogs in a mutinous mood, waiting downstairs in the torn-up and graffitied lobby. Georgie challenges Alex for leadership of the gang, demanding that they pull a "man-sized" job. Alex quells the rebellion by slashing Dim's hand and fighting with Georgie. Then, in a show of generosity, he takes them to a bar, where Alex insists on following through on Georgie's idea to burgle the home of a wealthy elderly woman. Alex breaks in and knocks the woman unconscious; but, when he opens the door to let the others in, Dim strikes him in payback for the earlier fight. The gang abandons Alex on the front step to be arrested by the police; while in custody, he learns that the woman has died from her injuries.

Part 2: The Ludovico Technique

Alex is convicted of murder and sentenced to 14 years in prison. (His parents visit one day to inform him that Georgie has been killed in a botched robbery). Two years into his term, he has obtained a job in one of the prison chapels, playing Christian music on the stereo to accompany the Sunday Christian services. The chaplain mistakes Alex's Bible studies for stirrings of faith; in reality, Alex is only reading Scripture for the violent passages. After his fellow cellmates blame him for beating a troublesome cellmate to death, he is chosen to undergo an experimental behaviour modification treatment called the Ludovico Technique in exchange for having the remainder of his sentence commuted. The technique is a form of aversion therapy, in which Alex is injected with nausea-inducing drugs while watching graphically violent films, eventually conditioning him to become severely ill at the mere thought of violence. As an unintended consequence, the soundtrack to one of the films, Beethoven's Ninth Symphony, renders Alex unable to enjoy his beloved classical music as before. 

The effectiveness of the technique is demonstrated to a group of VIPs, who watch as Alex collapses before a bully and abases himself before a scantily clad young woman whose presence has aroused his predatory sexual inclinations. Although the prison chaplain accuses the state of stripping Alex of free will, the government officials on the scene are pleased with the results and Alex is released from prison.

Part 3: After prison

Alex returns to his parents' flat, only to find that they are letting his room to a lodger. Now homeless, he wanders the streets and enters a public library, hoping to learn of a painless method for committing suicide. The old scholar whom Alex had assaulted in Part 1 finds him and beats him, with the help of several friends. Two policemen come to Alex's rescue, but they turn out to be Dim and Billyboy, a former rival gang leader. They take Alex outside of town, brutalise him, and abandon him there. Alex collapses at the door of an isolated cottage, realising too late that it is the one he and his droogs invaded in Part 1. The writer, F. Alexander, still lives here, but his wife has since died of injuries she sustained in the gang rape. He does not recognise Alex but gives him shelter and questions him about the conditioning he has undergone. Alexander and his colleagues, all highly critical of the government, plan to use Alex as a symbol of state brutality and thus prevent the incumbent government from being re-elected. Alex inadvertently reveals that he was the ringleader of the home invasion; he is removed from the cottage and locked in an upper-story bedroom as a relentless barrage of classical music plays over speakers. He attempts suicide by leaping from the window.

Alex wakes up in a hospital, where he is courted by government officials anxious to counter the bad publicity created by his suicide attempt. Placed in a mental institution, Alex is offered a well-paying job if he agrees to side with the government. A round of tests reveals that his old violent impulses have returned, indicating that the hospital doctors have undone the effects of his conditioning. As photographers snap pictures, Alex daydreams of orgiastic violence and reflects, "I was cured all right." 

In the final chapter, Alex finds himself halfheartedly preparing for yet another night of crime with a new gang (Lenn, Rick, Bully). After a chance encounter with Pete, who has reformed and married, Alex finds himself taking less and less pleasure in acts of senseless violence. He begins contemplating giving up crime himself to become a productive member of society and start a family of his own, while reflecting on the notion that his own children could possibly end up being just as destructive as he has been, if not more so.

Omission of the final chapter

The book has three parts, each with seven chapters. Burgess has stated that the total of 21 chapters was an intentional nod to the age of 21 being recognised as a milestone in human maturation. The 21st chapter was omitted from the editions published in the United States prior to 1986. In the introduction to the updated American text (these newer editions include the missing 21st chapter), Burgess explains that when he first brought the book to an American publisher, he was told that U.S. audiences would never go for the final chapter, in which Alex sees the error of his ways, decides he has lost all energy for and thrill from violence and resolves to turn his life around (a moment of metanoia). 

At the American publisher's insistence, Burgess allowed their editors to cut the redeeming final chapter from the U.S. version, so that the tale would end on a darker note, with Alex succumbing to his violent, reckless nature – an ending which the publisher insisted would be "more realistic" and appealing to a US audience. The film adaptation, directed by Stanley Kubrick, is based on the American edition of the book (which Burgess considered to be "badly flawed"). Kubrick called Chapter 21 "an extra chapter" and claimed that he had not read the original version until he had virtually finished the screenplay, and that he had never given serious consideration to using it. In Kubrick's opinion – as in the opinion of other readers, including the original American editor – the final chapter was unconvincing and inconsistent with the book.

Characters

  • Alex: The novel's protagonist and leader among his droogs. He often refers to himself as "Your Humble Narrator". Having coaxed two ten-year-old girls into his bedroom, Alex refers to himself as "Alexander the Large" while raping them; this was later the basis for Alex's claimed surname DeLarge in the 1971 film.
  • George, Georgie or Georgie Boy: Effectively Alex's greedy second-in-command. Georgie attempts to undermine Alex's status as leader of the gang and take over their gang as the new leader. He is later killed during a botched robbery while Alex is in prison.
  • Pete: The only one who does not take particular sides when the droogs fight among themselves. He later meets and marries a girl named Georgina, renouncing his violent ways and even losing his former (Nadsat) speech patterns. A chance encounter with Pete in the final chapter influences Alex to realise that he has grown bored with violence and recognise that human energy is better expended on creation than destruction.
  • Dim: An idiotic and thoroughly gormless member of the gang, persistently condescended to by Alex, but respected to some extent by his droogs for his formidable fighting abilities, his weapon of choice being a length of bike chain. He later becomes a police officer, exacting his revenge on Alex for the abuse he once suffered under his command.
  • P. R. Deltoid: A criminal rehabilitation social worker assigned the task of keeping Alex on the straight and narrow. He seemingly has no clue about dealing with young people, and is devoid of empathy or understanding for his troublesome charge. Indeed, when Alex is arrested for murdering an old woman and then ferociously beaten by several police officers, Deltoid simply spits on him.
  • Prison Chaplain: The character who first questions whether it is moral to turn a violent person into a behavioural automaton who can make no choice in such matters. This is the only character who is truly concerned about Alex's welfare; he is not taken seriously by Alex, though. He is nicknamed by Alex "prison charlie" or "chaplin", a pun on Charlie Chaplin.
  • Billyboy: A rival of Alex's. Early on in the story, Alex and his droogs battle Billyboy and his droogs, which ends abruptly when the police arrive. Later, after Alex is released from prison, Billyboy (along with Dim, who like Billyboy has become a police officer) rescues Alex from a mob, then subsequently beats him in a location out of town.
  • Prison Governor: The man who decides to let Alex "choose" to be the first reformed by the Ludovico technique.
  • The Minister of the Interior: The government high-official who determined that the Ludovico's technique will be used to cut recidivism. He is referred to as the Inferior by Alex.
  • Dr. Branom: A scientist, co-developer of the Ludovico technique. He appears friendly and almost paternal towards Alex at first, before forcing him into the theatre and what Alex calls the "chair of torture".
  • Dr. Brodsky: Branom's colleague and co-developer of the Ludovico technique. He seems much more passive than Branom and says considerably less.
  • F. Alexander: An author who was in the process of typing his magnum opus A Clockwork Orange when Alex and his droogs broke into his house, beat him, tore up his work and then brutally gang-raped his wife, which caused her subsequent death. He is left deeply scarred by these events and when he encounters Alex two years later, he uses him as a guinea pig in a sadistic experiment intended to prove the Ludovico technique unsound. He is given the name Frank Alexander in the film.
  • Cat Woman: An indirectly named woman who blocks Alex's gang's entrance scheme, and threatens to shoot Alex and set her cats on him if he does not leave. After Alex breaks into her house, she fights with him, ordering her cats to join the melee, but reprimands Alex for fighting them off. She sustains a fatal blow to the head during the scuffle. She is given the name Miss Weathers in the film.

Analysis

Background

A Clockwork Orange was written in Hove, then a senescent seaside town. Burgess had arrived back in Britain after his stint abroad to see that much had changed. A youth culture had grown, including coffee bars, pop music and teenage gangs. England was gripped by fears over juvenile delinquency. Burgess stated that the novel's inspiration was his first wife Lynne's beating by a gang of drunk American servicemen stationed in England during World War II. She subsequently miscarried. In its investigation of free will, the book's target is ostensibly the concept of behaviourism, pioneered by such figures as B. F. Skinner.

Burgess later stated that he wrote the book in three weeks.

Title

Burgess has offered several clarifications about the meaning and origin of its title:
  • He had overheard the phrase "as queer as a clockwork orange" in a London pub in 1945 and assumed it was a Cockney expression. In Clockwork Marmalade, an essay published in the Listener in 1972, he said that he had heard the phrase several times since that occasion. He also explained the title in response to a question from William Everson on the television programme Camera Three in 1972, "Well, the title has a very different meaning but only to a particular generation of London Cockneys. It's a phrase which I heard many years ago and so fell in love with, I wanted to use it, the title of the book. But the phrase itself I did not make up. The phrase "as queer as a clockwork orange" is good old East London slang and it didn't seem to me necessary to explain it. Now, obviously, I have to give it an extra meaning. I've implied an extra dimension. I've implied the junction of the organic, the lively, the sweet – in other words, life, the orange – and the mechanical, the cold, the disciplined. I've brought them together in this kind of oxymoron, this sour-sweet word." Nonetheless, no other record of the expression being used before 1962 has ever appeared. Kingsley Amis notes in his Memoirs (1991) that no trace of it appears in Eric Partridge's Dictionary of Historical Slang.
  • His second explanation was that it was a pun on the Malay word orang, meaning "man." The novella contains no other Malay words or links.
  • In a prefatory note to A Clockwork Orange: A Play with Music, he wrote that the title was a metaphor for "an organic entity, full of juice and sweetness and agreeable odour, being turned into a mechanism."
  • In his essay Clockwork Oranges, Burgess asserts that "this title would be appropriate for a story about the application of Pavlovian or mechanical laws to an organism which, like a fruit, was capable of colour and sweetness."
  • While addressing the reader in a letter before some editions of the book, the author says that when a man ceases to have free will, they are no longer a man. "Just a clockwork orange," a shiny, appealing object, but "just a toy to be wound-up by either God or the Devil, or (what is increasingly replacing both) the State.
This title alludes to the protagonist's negative emotional responses to feelings of evil which prevent the exercise of his free will subsequent to the administration of the Ludovico Technique. To induce this conditioning, Alex is forced to watch scenes of violence on a screen that are systematically paired with negative physical stimulation. The negative physical stimulation takes the form of nausea and "feelings of terror," which are caused by an emetic medicine administered just before the presentation of the films.

Use of slang

The book, narrated by Alex, contains many words in a slang argot which Burgess invented for the book, called Nadsat. It is a mix of modified Slavic words, rhyming slang and derived Russian (like baboochka). For instance, these terms have the following meanings in Nadsat: droog = friend; moloko = milk; gulliver ("golova") = head; malchick or malchickiwick = boy; soomka = sack or bag; Bog = God; horrorshow ("khorosho") = good; prestoopnick = criminal; rooker ("rooka") = hand; cal = crap; veck ("chelloveck") = man or guy; litso = face; malenky = little; and so on. Some words Burgess invented himself or just adapted from pre-existing languages. Compare Polari.

One of Alex's doctors explains the language to a colleague as "odd bits of old rhyming slang; a bit of gypsy talk, too. But most of the roots are Slav propaganda. Subliminal penetration." Some words are not derived from anything, but merely easy to guess, e.g. "in-out, in-out" or "the old in-out" means sexual intercourse. Cutter, however, means "money", because "cutter" rhymes with "bread-and-butter"; this is rhyming slang, which is intended to be impenetrable to outsiders (especially eavesdropping policemen). Additionally, slang like appypolly loggy ("apology") seems to derive from school boy slang. This reflects Alex's age of 15. 

In the first edition of the book, no key was provided, and the reader was left to interpret the meaning from the context. In his appendix to the restored edition, Burgess explained that the slang would keep the book from seeming dated, and served to muffle "the raw response of pornography" from the acts of violence. 

The term "ultraviolence", referring to excessive or unjustified violence, was coined by Burgess in the book, which includes the phrase "do the ultra-violent". The term's association with aesthetic violence has led to its use in the media.

Banning and censorship history in the US

In 1976, A Clockwork Orange was removed from an Aurora, Colorado high school because of "objectionable language". A year later in 1977 it was removed from high school classrooms in Westport, Massachusetts over similar concerns with "objectionable" language. In 1982, it was removed from two Anniston, Alabama libraries, later to be reinstated on a restricted basis. Also, in 1973 a bookseller was arrested for selling the novel. The charges were later dropped. However, each of these instances came after the release of Stanley Kubrick's popular 1971 film adaptation of A Clockwork Orange, itself the subject of much controversy.

Reception

Initial response

The Sunday Telegraph review was positive, and described the book as "entertaining ... even profound". The Sunday Times review was negative, and described the book as "a very ordinary, brutal and psychologically shallow story". The Times also reviewed the book negatively, describing it as "a somewhat clumsy experiment with science fiction [with] clumsy cliches about juvenile delinquency". The violence was criticised as "unconvincing in detail".

Writer's appraisal

Burgess in 1986
 
Burgess dismissed A Clockwork Orange as "too didactic to be artistic". He claimed that the violent content of the novel "nauseated" him.

In 1985, Burgess published Flame into Being: The Life and Work of D. H. Lawrence and while discussing Lady Chatterley's Lover in his biography, Burgess compared that novel's notoriety with A Clockwork Orange: "We all suffer from the popular desire to make the known notorious. The book I am best known for, or only known for, is a novel I am prepared to repudiate: written a quarter of a century ago, a jeu d'esprit knocked off for money in three weeks, it became known as the raw material for a film which seemed to glorify sex and violence. The film made it easy for readers of the book to misunderstand what it was about, and the misunderstanding will pursue me until I die. I should not have written the book because of this danger of misinterpretation, and the same may be said of Lawrence and Lady Chatterley's Lover."

Awards and nominations and rankings

  • 1983 – Prometheus Award (Preliminary Nominee)
  • 1999 – Prometheus Award (Nomination)
  • 2002 – Prometheus Award (Nomination)
  • 2003 – Prometheus Award (Nomination)
  • 2006 – Prometheus Award (Nomination)
  • 2008 – Prometheus Award (Hall of Fame Award)
A Clockwork Orange was chosen by Time magazine as one of the 100 best English-language books from 1923 to 2005.

Adaptations

A 1965 film by Andy Warhol entitled Vinyl was an adaptation of Burgess's novel.

The best known adaptation of the novella to other forms is the 1971 film A Clockwork Orange by Stanley Kubrick, starring Malcolm McDowell as Alex. In 1987 Burgess published a stage play titled A Clockwork Orange: A Play with Music. The play includes songs, written by Burgess, which are inspired by Beethoven and Nadsat slang.

In 1988, a German adaptation of A Clockwork Orange at the intimate theatre of Bad Godesberg featured a musical score by the German punk rock band Die Toten Hosen which, combined with orchestral clips of Beethoven's Ninth Symphony and "other dirty melodies" (so stated by the subtitle), was released on the album Ein kleines bisschen Horrorschau. The track Hier kommt Alex became one of the band's signature songs. 

Vanessa Claire Smith, Sterling Wolfe, Michael Holmes, and Ricky Coates in Brad Mays' multi-media stage production of A Clockwork Orange, 2003, Los Angeles. (photo: Peter Zuehlke)
 
Vanessa Claire Smith in Brad Mays' multi-media stage production of A Clockwork Orange, 2003, Los Angeles. (photo: Peter Zuehlke)
 
In February 1990, another musical version was produced at the Barbican Theatre in London by the Royal Shakespeare Company. Titled A Clockwork Orange: 2004, it received mostly negative reviews, with John Peter of The Sunday Times of London calling it "only an intellectual Rocky Horror Show", and John Gross of The Sunday Telegraph calling it "a clockwork lemon". Even Burgess himself, who wrote the script based on his novel, was disappointed. According to The Evening Standard, he called the score, written by Bono and The Edge of the rock group U2, "neo-wallpaper." Burgess had originally worked alongside the director of the production, Ron Daniels, and envisioned a musical score that was entirely classical. Unhappy with the decision to abandon that score, he heavily criticised the band's experimental mix of hip hop, liturgical and gothic music. Lise Hand of The Irish Independent reported The Edge as saying that Burgess's original conception was "a score written by a novelist rather than a songwriter". Calling it "meaningless glitz", Jane Edwardes of 20/20 Magazine said that watching this production was "like being invited to an expensive French Restaurant – and being served with a Big Mac." 

In 1994, Chicago's Steppenwolf Theater put on a production of A Clockwork Orange directed by Terry Kinney. The American premiere of novelist Anthony Burgess's own adaptation of his A Clockwork Orange starred K. Todd Freeman as Alex. In 2001, UNI Theatre (Mississauga, Ontario) presented the Canadian premiere of the play under the direction of Terry Costa.

In 2002, Godlight Theatre Company presented the New York Premiere adaptation of A Clockwork Orange at Manhattan Theatre Source. The production went on to play at the SoHo Playhouse (2002), Ensemble Studio Theatre (2004), 59E59 Theaters (2005) and the Edinburgh Festival Fringe (2005). While at Edinburgh, the production received rave reviews from the press while playing to sold-out audiences. The production was directed by Godlight's Artistic Director, Joe Tantalo. 

In 2003, Los Angeles director Brad Mays and the ARK Theatre Company staged a multi-media adaptation of A Clockwork Orange, which was named "Pick Of The Week" by the LA Weekly and nominated for three of the 2004 LA Weekly Theater Awards: Direction, Revival Production (of a 20th-century work), and Leading Female Performance. Vanessa Claire Smith won Best Actress for her gender-bending portrayal of Alex, the music-loving teenage sociopath. This production utilised three separate video streams outputted to seven onstage video monitors – six 19-inch and one 40-inch. In order to preserve the first-person narrative of the book, a pre-recorded video stream of Alex, "your humble narrator", was projected onto the 40-inch monitor, thereby freeing the onstage character during passages which would have been awkward or impossible to sustain in the breaking of the fourth wall.

An adaptation of the work, based on the original novel, the film and Burgess's own stage version, was performed by The SiLo Theatre in Auckland, New Zealand in early 2007.

Behaviour therapy

From Wikipedia, the free encyclopedia
 
Behaviour therapy
ICD-9-CM94.33
MeSHD001521

Behavior therapy or behavioral psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviorism. Those who practice behavior therapy tend to look at specific, learned behaviors and how the environment influences those behaviors. Those who practice behavior therapy are called behaviourists, or behavior analysts. They tend to look for treatment outcomes that are objectively measurable. Behavior therapy does not involve one specific method but it has a wide range of techniques that can be used to treat a person's psychological problems. Traditional behavior therapy draws from respondent conditioning and operant conditioning to solve patients problems.

Behavioral psychotherapy is sometimes juxtaposed with cognitive psychotherapy, while cognitive behavioral therapy integrates aspects of both approaches.

Applied behavior analysis (ABA) is the application of behavior analysis that focuses on assessing how environmental variables influence learning principles, particularly respondent and operant conditioning, to identify potential behavior-change procedures, which are frequently used throughout clinical therapy. Cognitive-behavior therapy views cognition and emotions as preceding overt behavior with treatment plans in psychotherapy to lessen the issue. Hallmark techniques of behaviour therapies are overlapping components of cognitive psychology, in addition to behaviour analytic principles of counterconditioning, punishment, habituation, and functional analysis (FA).

History

Precursors of certain fundamental aspects of behaviour therapy have been identified in various ancient philosophical traditions, particularly Stoicism. For example, Wolpe and Lazarus wrote,
While the modern behavior therapist deliberately applies principles of learning to this therapeutic operations, empirical behavior therapy is probably as old as civilization – if we consider civilization as having started when man first did things to further the well-being of other men. From the time that this became a feature of human life there must have been occasions when a man complained of his ills to another who advised or persuaded him of a course of action. In a broad sense, this could be called behavior therapy whenever the behavior itself was conceived as the therapeutic agent. Ancient writings contain innumerable behavioral prescriptions that accord with this broad conception of behavior therapy.
The first use of the term behaviour modification appears to have been by Edward Thorndike in 1911. His article Provisional Laws of Acquired Behavior or Learning makes frequent use of the term "modifying behavior". Through early research in the 1940s and the 1950s the term was used by Joseph Wolpe's research group. The experimental tradition in clinical psychology used it to refer to psycho-therapeutic techniques derived from empirical research. It has since come to refer mainly to techniques for increasing adaptive behaviour through reinforcement and decreasing maladaptive behaviour through extinction or punishment (with emphasis on the former). Two related terms are behaviour therapy and applied behaviour analysis. Since techniques derived from behavioural psychology tend to be the most effective in altering behaviour, most practitioners consider behaviour modification along with behaviour therapy and applied behaviour analysis to be founded in behaviourism. While behaviour modification and applied behaviour analysis typically uses interventions based on the same behavioural principles, many behaviour modifiers who are not applied behaviour analysts tend to use packages of interventions and do not conduct functional assessments before intervening.

Possibly the first occurrence of the term "behavior therapy" was in a 1953 research project by B.F. Skinner, Ogden Lindsley, Nathan H. Azrin and Harry C. Solomon. The paper talked about operant conditioning and how it could be used to help improve the functioning of people who were diagnosed with chronic schizophrenia. Early pioneers in behaviour therapy include Joseph Wolpe and Hans Eysenck.

In general, behaviour therapy is seen as having three distinct points of origin: South Africa (Wolpe's group), The United States (Skinner), and the United Kingdom (Rachman and Eysenck). Each had its own distinct approach to viewing behaviour problems. Eysenck in particular viewed behaviour problems as an interplay between personality characteristics, environment, and behaviour. Skinner's group in the United States took more of an operant conditioning focus. The operant focus created a functional approach to assessment and interventions focused on contingency management such as the token economy and behavioural activation. Skinner's student Ogden Lindsley is credited with forming a movement called precision teaching, which developed a particular type of graphing program called the standard celeration chart to monitor the progress of clients. Skinner became interested in the individualising of programs for improved learning in those with or without disabilities and worked with Fred S. Keller to develop programmed instruction. Programmed instruction had some clinical success in aphasia rehabilitation. Gerald Patterson used programme instruction to develop his parenting text for children with conduct problems. With age, respondent conditioning appears to slow but operant conditioning remains relatively stable. While the concept had its share of advocates and critics in the west, its introduction in the Asian setting, particularly in India in the early 1970s and its grand success were testament to the famous Indian psychologist H. Narayan Murthy's enduring commitment to the principles of behavioural therapy and biofeedback. 

While many behaviour therapists remain staunchly committed to the basic operant and respondent paradigm, in the second half of the 20th century, many therapists coupled behaviour therapy with the cognitive therapy, of Aaron Beck, Albert Ellis, and [Donald Meichenbaum (psychologist)]]to form cognitive behaviour therapy. In some areas the cognitive component had an additive effect (for example, evidence suggests that cognitive interventions improve the result of social phobia treatment.) but in other areas it did not enhance the treatment, which led to the pursuit of third generation behaviour therapies. Third generation behaviour therapy uses basic principles of operant and respondent psychology but couples them with functional analysis and a clinical formulation/case conceptualisation of verbal behaviour more inline with view of the behaviour analysts. Some research supports these therapies as being more effective in some cases than cognitive therapy, but overall the question is still in need of answers.

Theoretical basis

The behavioural approach to therapy assumes that behaviour that is associated with psychological problems develops through the same processes of learning that affects the development of other behaviours. Therefore, behaviourists see personality problems in the way that personality was developed. They do not look at behaviour disorders as something a person has but that it reflects how learning has influenced certain people to behave in a certain way in certain situations.

Behaviour therapy is based upon the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B.F. Skinner. Classical conditioning happens when a neutral stimulus comes right before another stimulus that triggers a reflexive response. The idea is that if the neutral stimulus and whatever other stimulus that triggers a response is paired together often enough that the neutral stimulus will produce the reflexive response. Operant conditioning has to do with rewards and punishments and how they can either strengthen or weaken certain behaviours.

Contingency management programs are a direct product of research from operant conditioning. These programs have been highly successful with those suffering from panic disorders, anxiety disorders, and phobias.

Systematic desensitisation and exposure and response prevention both evolved from respondent conditioning and have also received considerable research.

Behavior avoidance test (BAT) is a behavioural procedure in which the therapist measures how long the client can tolerate an anxiety-inducing stimulus. The BAT falls under the exposure-based methods of behaviour therapy. Exposure-based methods of behavioural therapy are well suited to the treatment of phobias, which include intense and unreasonable fears (e.g., of spiders, blood, public speaking). The therapist needs some type of behavioural assessment to record the continuing progress of a client undergoing an exposure-based treatment for phobia. One simple assessment approach for this is the BAT. The BAT approach is predicted on the assumption that the client's fear is the main determinant of behaviour in the testing situation. BAT can be conducted visual, virtually, or physically, depending on the clients' maladaptive behaviour. Its application is not limited to phobias, it is applied to various disorders such as post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD).

Current forms

Behavioral therapy based on operant and respondent principles has considerable evidence base to support its usage. This approach remains a vital area of clinical psychology and is often termed clinical behavior analysis. Behavioral psychotherapy has become increasingly contextual in recent years. Behavioral psychotherapy has developed greater interest in recent years in personality disorders as well as a greater focus on acceptance and complex case conceptualizations.

Functional analytic psychotherapy

One current form of behavioral psychotherapy is functional analytic psychotherapy. Functional analytic psychotherapy is a longer duration behavior therapy. Functional analytic therapy focuses on in-session use of reinforcement and is primarily a relationally-based therapy. As with most of the behavioral psychotherapies, functional analytic psychotherapy is contextual in its origins and nature. and draws heavily on radical behaviorism and functional contextualism

Functional analytic psychotherapy holds to a process model of research, which makes it unique compared to traditional behavior therapy and cognitive behavioral therapy.

Functional analytic psychotherapy has a strong research support. Recent functional analytic psychotherapy research efforts are focusing on management of aggressive inpatients.

Assessment

Behaviour therapists complete a functional analysis or a functional assessment that looks at four important areas: stimulus, organism, response and consequences. The stimulus is the condition or environmental trigger that causes behaviour. An organism involves the internal responses of a person, like physiological responses, emotions and cognition. A response is the behaviour that a person exhibits and the consequences are the result of the behaviour. These four things are incorporated into an assessment done by the behaviour therapist.

Most behaviour therapists use objective assessment methods like structured interviews, objective psychological tests or different behavioural rating forms. These types of assessments are used so that the behaviour therapist can determine exactly what a client's problem may be and establish a baseline for any maladaptive responses that the client may have. By having this baseline, as therapy continues this same measure can be used to check a client's progress, which can help determine if the therapy is working. Behaviour therapists do not typically ask the why questions but tend to be more focused on the how, when, where and what questions. Tests such as the Rorschach inkblot test or personality tests like the MMPI (Minnesota Multiphasic Personality Inventory) are not commonly used for behavioural assessment because they are based on personality trait theory assuming that a person's answer to these methods can predict behaviour. Behaviour assessment is more focused on the observations of a persons behaviour in their natural environment.

Behavioural assessment specifically attempts to find out what the environmental and self-imposed variables are. These variables are the things that are allowing a person to maintain their maladaptive feelings, thoughts and behaviours. In a behavioural assessment "person variables" are also considered. These "person variables" come from a person's social learning history and they effect the way in which the environment affects that person's behaviour. An example of a person variable would be behavioural competence. Behavioural competence looks at whether a person has the appropriate skills and behaviours that are necessary when performing a specific response to a certain situation or stimuli.

When making a behavioural assessment the behaviour therapist wants to answer two questions: (1) what are the different factors (environmental or psychological) that are maintaining the maladaptive behaviour and (2) what type of behaviour therapy or technique that can help the individual improve most effectively. The first question involves looking at all aspects of a person, which can be summed up by the acronym BASIC ID. This acronym stands for behaviour, affective responses, sensory reactions, imagery, cognitive processes, interpersonal relationships and drug use.

Clinical applications

Behaviour therapy based its core interventions on functional analysis. Just a few of the many problems that behaviour therapy have functionally analysed include intimacy in couples relationships, forgiveness in couples, chronic pain, stress-related behaviour problems of being an adult child of an alcoholic, anorexia, chronic distress, substance abuse, depression, anxiety, insomnia, and obesity.

Functional analysis has even been applied to problems that therapists commonly encounter like client resistance, partially engaged clients and involuntary clients. Applications to these problems have left clinicians with considerable tools for enhancing therapeutic effectiveness. One way to enhance therapeutic effectiveness is to use positive reinforcement or operant conditioning. Although behaviour therapy is based on the general learning model, it can be applied in a lot of different treatment packages that can be specifically developed to deal with problematic behaviours. Some of the more well known types of treatments are: Relaxation training, systematic desensitization, virtual reality exposure, exposure and response prevention techniques, social skills training, modeling, behavioural rehearsal and homework, and aversion therapy and punishment.

Relaxation training involves clients learning to lower arousal to reduce their stress by tensing and releasing certain muscle groups throughout their body. Systematic desensitization is a treatment in which the client slowly substitutes a new learned response for a maladaptive response by moving up a hierarchy of situations involving fear. Systematic desensitization is based in part on counter conditioning. Counter conditioning is learning new ways to change one response for another and in the case of desensitization it is substituting that maladaptive behaviour for a more relaxing behaviour. Exposure and response prevention techniques (also known as flooding and response prevention) is the general technique in which a therapist exposes an individual to anxiety-provoking stimuli while keeping them from having any avoidance responses.

Virtual reality therapy provides realistic, computer-based simulations of troublesome situations. The modeling process involves a person being subjected to watching other individuals who demonstrate behaviour that is considered adaptive and that should be adopted by the client. This exposure involves not only the cues of the "model person" as well as the situations of a certain behaviour that way the relationship can be seen between the appropriateness of a certain behaviour and situation in which that behaviour occurs is demonstrated. With the behavioural rehearsal and homework treatment a client gets a desired behaviour during a therapy session and then they practice and record that behaviour between their sessions. Aversion therapy and punishment is a technique in which an aversive (painful or unpleasant) stimulus is used to decrease unwanted behaviours from occurring. It is concerned with two procedures: 1) the procedures are used to decrease the likelihood of the frequency of a certain behaviour and 2) procedures that will reduce the attractiveness of certain behaviours and the stimuli that elicit them. The punishment side of aversion therapy is when an aversive stimulus is presented at the same time that a negative stimulus and then they are stopped at the same time when a positive stimulus or response is presented. Examples of the type of negative stimulus or punishment that can be used is shock therapy treatments, aversive drug treatments as well as response cost contingent punishment which involves taking away a reward. 

Applied behaviour analysis is using behavioural methods to modify certain behaviours that are seen as being important socially or personally. There are four main characteristics of applied behaviour analysis. First behaviour analysis is focused mainly on overt behaviours in an applied setting. Treatments are developed as a way to alter the relationship between those overt behaviours and their consequences.

Another characteristic of applied behaviour analysis is how it(behaviour analysis) goes about evaluating treatment effects. The individual subject is where the focus of study is on, the investigation is centered on the one individual being treated. A third characteristic is that it focuses on what the environment does to cause significant behaviour changes. Finally the last characteristic of applied behaviour analysis is the use of those techniques that stem from operant and classical conditioning such as providing reinforcement, punishment, stimulus control and any other learning principles that may apply.

Social skills training teaches clients skills to access reinforcers and lessen life punishment. Operant conditioning procedures in meta-analysis had the largest effect size for training social skills, followed by modelling, coaching, and social cognitive techniques in that order. Social skills training has some empirical support particularly for schizophrenia. However, with schizophrenia, behavioural programs have generally lost favor.

Some other techniques that have been used in behaviour therapy are contingency contracting, response costs, token economies, biofeedback, and using shaping and grading task assignments.

Shaping and graded task assignments are used when behaviour that needs to be learned is complex. The complex behaviours that need to be learned are broken down into simpler steps where the person can achieve small things gradually building up to the more complex behaviour. Each step approximates the eventual goal and helps the person to expand their activities in a gradual way. This behaviour is used when a person feels that something in their lives can not be changed and life's tasks appear to be overwhelming.

Another technique of behaviour therapy involves holding a client or patient accountable of their behaviours in an effort to change them. This is called a contingency contract, which is a formal written contract between two or more people that defines the specific expected behaviours that you wish to change and the rewards and punishments that go along with that behaviour. In order for a contingency contract to be official it needs to have five elements. First it must state what each person will get if they successfully complete the desired behaviour. Secondly those people involved have to monitor the behaviours. Third, if the desired behaviour is not being performed in the way that was agreed upon in the contract the punishments that were defined in the contract must be done. Fourth if the persons involved are complying with the contract they must receive bonuses. The last element involves documenting the compliance and noncompliance while using this treatment in order to give the persons involved consistent feedback about the target behaviour and the provision of reinforcers.

Token economies is a behaviour therapy technique where clients are reinforced with tokens that are considered a type of currency that can be used to purchase desired rewards, like being able to watch television or getting a snack that they want when they perform designated behaviours. Token economies are mainly used in institutional and therapeutic settings. In order for a token economy to be effective their must be consistency in administering the program by the entire staff. Procedures must be clearly defined so that there is no confusion among the clients. Instead of looking for ways to punish the patients or to deny them of rewards, the staff has to reinforce the positive behaviours so that the clients will increase the occurrence of the desired behaviour. Over time the tokens need to be replaced with less tangible rewards such as compliments so that the client will be prepared when they leave the institution and won't expect to get something every time they perform a desired behaviour.

Closely related to token economies is a technique called response costs. This technique can either be used with or without token economies. Response costs is the punishment side of token economies where there is a loss of a reward or privilege after someone performs an undesirable behaviour. Like token economies this technique is used mainly in institutional and therapeutic settings.

Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy, habit reversal training, has been found to be highly effective for treating tics.

In rehabilitation

Currently, there is a greater call for behavioral psychologists to be involved in rehabilitation efforts.

Treatment of mental disorders

Two large studies done by the Faculty of Health Sciences at Simon Fraser University indicates that both behaviour therapy and cognitive-behavioural therapy (CBT) are equally effective for OCD. CBT has been shown to perform slightly better at treating co-occurring depression.

Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy (habit reversal training) has been found to be highly effective for treating tics. 

There has been a development towards combining techniques to treat psychiatric disorders. Cognitive interventions are used to enhance the effects of more established behavioural interventions based on operant and classical conditioning. An increased effort has also been placed to address the interpersonal context of behaviour.

Behaviour therapy can be applied to a number of mental disorders and in many cases is more effective for specific disorders as compared to others. Behaviour therapy techniques can be used to deal with any phobias that a person may have. Desensitization has also been applied to other issues such as dealing with anger, if a person has trouble sleeping and certain speech disorders. Desensitization does not occur over night, there is a process of treatment. Desensitization is done on a hierarchy and happens over a number of sessions. The hierarchy goes from situations that make a person less anxious or nervous up to things that are considered to be extreme for the patient.

Modeling has been used in dealing with fears and phobias. Modeling has been used in the treatment of fear of snakes as well as a fear of water.

Aversive therapy techniques have been used to treat sexual deviations as well as alcoholism.

Exposure and prevention procedure techniques can be used to treat people who have anxiety problems as well as any fears or phobias. These procedures have also been used to help people dealing with any anger issues as well as pathological grievers (people who have distressing thoughts about a deceased person).

Virtual reality therapy deals with fear of heights, fear of flying, and a variety of other anxiety disorders. VRT has also been applied to help people with substance abuse problems reduce their responsiveness to certain cues that trigger their need to use drugs.

Shaping and graded task assignments has been used in dealing with suicide and depressed or inhibited individuals. This is used when a patient feel hopeless and they have no way of changing their lives. This hopelessness involves how the person reacts and responds to someone else and certain situations and their perceived powerlessness to change that situation that adds to the hopelessness. For a person with suicidal ideation, it is important to start with small steps. Because that person may perceive everything as being a big step, the smaller you start the easier it will be for the person to master each step. This technique has also been applied to people dealing with agoraphobia, or fear of being in public places or doing something embarrassing.

Contingency contracting has been used to deal with behaviour problems in delinquents and when dealing with on task behaviours in students.

Token economies are used in controlled environments and are found mostly in psychiatric hospitals. They can be used to help patients with different mental illnesses but it doesn't focus on the treatment of the mental illness but instead on the behavioural aspects of a patient. The response cost technique has been used to address a variety of behaviours such as smoking, overeating, stuttering, and psychotic talk.

Treatment outcomes

Systematic desensitization has been shown to successfully treat phobias about heights, driving, insects as well as any anxiety that a person may have. Anxiety can include social anxiety, anxiety about public speaking as well as test anxiety. It has been shown that the use of systematic desensitization is an effective technique that can be applied to a number of problems that a person may have.

When using modeling procedures this technique is often compared to another behavioural therapy technique. When compared to desensitization, the modeling technique does appear to be less effective. However it is clear that the greater the interaction between the patient and the subject he is modeling the greater the effectiveness of the treatment.

While undergoing exposure therapy a person usually needs five sessions to see if the treatment is working. After five sessions exposure treatment is seen to benefit the patient and help with their problems. However even after five sessions it is recommended that the patient or client should still continue treatment.

Virtual Reality treatment has shown to be effective for a fear of heights. It has also been shown to help with the treatment of a variety of anxiety disorders. Virtual reality therapy can be very costly so therapists are still awaiting results of controlled trials for VR treatment to see which applications show the best results.

For those with suicidal ideation treatment depends on how severe the person's depression and feeling of hopelessness is. If these things are severe the person's response to completing small steps will not be of importance to them because they don't consider it to be a big deal. Generally those who aren't severely depressed or fearful, this technique has been successful because the completion of simpler activities build up their confidences and allows them to continue on to more complex situations.

Contingency contracts have been seen to be effective in changing any undesired behaviours of individuals. It has been seen to be effective in treating behaviour problems in delinquents regardless of the specific characteristics of the contract.

Token economies have been shown to be effective when treating patients in psychiatric wards who had chronic schizophrenia. The results showed that the contingent tokens were controlling the behaviour of the patients.

Response costs has been shown to work in suppressing a variety of behaviours such as smoking, overeating or stuttering with a diverse group of clinical populations ranging from sociopaths to school children. These behaviours that have been suppressed using this technique often do not recover when the punishment contingency is withdrawn. Also undesirable side effects that are usually seen with punishment are not typically found when using the response cost technique.

Third generation

The third-generation behaviour therapy movement has been called clinical behavior analysis because it represents a movement away from cognitivism and back toward radical behaviourism and other forms of behaviourism, in particular functional analysis and behavioural models of verbal behaviour. This area includes acceptance and commitment therapy (ACT), cognitive behavioral analysis system of psychotherapy (CBASP) (McCullough, 2000), behavioural activation (BA), functional analytic psychotherapy (FAP), integrative behavioural couples therapy and dialectical behavioural therapy. These approaches are squarely within the applied behaviour analysis tradition of behaviour therapy.

ACT may be the most well-researched of all the third-generation behaviour therapy models. It is based on relational frame theory. Other authors object to the term "third generation" or "third wave" and incorporate many of the "third wave" therapeutic techniques under the general umbrella term of modern cognitive behavioral therapies.

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. In general, 40 years of research supports the idea that in-session reinforcement of behaviour can lead to behavioural change.

Behavioural activation emerged from a component analysis of cognitive behaviour therapy. This research found no additive effect for the cognitive component. Behavioural activation is based on a matching model of reinforcement. A recent review of the research, supports the notion that the use of behavioural activation is clinically important for the treatment of depression.

Integrative behavioural couples therapy developed from dissatisfaction with traditional behavioural couples therapy. Integrative behavioural couples therapy looks to Skinner (1966) for the difference between contingency-shaped and rule-governed behaviour. It couples this analysis with a thorough functional assessment of the couple's relationship. Recent efforts have used radical behavioural concepts to interpret a number of clinical phenomena including forgiveness.

Organizations

Many organisations exist for behaviour therapists around the world. The Association for Behavior Analysis International (ABAI) provides accreditation for training programs in behaviour therapy. The ABAI has a special interest group for practitioner issues, behavioral counseling, and clinical behavior analysis ABA:I. ABAI has larger special interest groups for autism and its peculiar and narrow interpretation of behavioral medicine. ABAI serves as the core intellectual home for behavior analysts. ABAI sponsors two conferences/year – one in the U.S. and one international. 

In the United States, the American Psychological Association's Division 25 is the division for behaviour analysis. The Association for Contextual Behavior Therapy is another professional organisation. ACBS is home to many clinicians with specific interest in third generation behaviour therapy. Doctoral-level behavior analysts who are psychologists belong to American Psychological Association's division 25 – Behavior analysis. APA offers a diplomate in behavioral psychology. 

The Association for Behavioral and Cognitive Therapies (formerly the Association for the Advancement of Behavior Therapy) is for those with a more cognitive orientation. The ABCT also has an interest group in behavior analysis, which focuses on clinical behavior analysis. In addition, the Association for Behavioral an Cognitive Therapies has a special interest group on addictions. 

The World Association for Behavior Analysis offers a certification in behavior therapy.

Characteristics

By nature, behavioural therapies are empirical (data-driven), contextual (focused on the environment and context), functional (interested in the effect or consequence a behaviour ultimately has), probabilistic (viewing behaviour as statistically predictable), monistic (rejecting mind–body dualism and treating the person as a unit), and relational (analysing bidirectional interactions).

Behavioural therapy develops, adds and provides behavioural intervention strategies and programs for clients, and training to people who care to facilitate successful lives in the communities.

Training

Recent efforts in behavioral psychotherapy have focused on the supervision process. A key point of behavioral models of supervision is that the supervisory process parallels the behavioral psychotherapy.

Methods

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