The theoretical bases of behavior therapy have traditionally been concerned with the acquisition and extinction of fear and avoidance responses, and have drawn extensively on animal learning experiments carried out under carefully controlled conditions. The intriguing parallels with human experience to be found in animal experiments should not, however, be allowed to detract from an appreciation of the differences between the laboratory and the situation of a patient in a health care delivery system. In the latter, for instance, patients have already selected themselves as being unable to solve their problems on their own, and have defined these problems as requiring the sort of help provided by professionals. Patients also vary considerably in their perceptions of themselves and their abilities, and many complain of chronically low self-esteem. These factors are likely to interact with response to treatment, and for these reasons such individuals may not provide typical examples of fear acquisition and extinction processes of the kind that would be common in the laboratory.
Unable to display preview. Download preview PDF.
Department of Psychology, Stanford University, Stanford, California 94305-2131; e-mail: [email protected]
Annual Review of Psychology