20.1. Theory of Behavioral Counseling

Behavioral counseling is based on the behaviorist model of the person. Behavioral theory places particular emphasis on the strong influence of the environment on the formation and maintenance of behavior. Within behavioral counseling, a distinction is drawn between approaches based exclusively on stimulus-response connections and approaches that take cognitive mediating variables into account. The behaviorist model represents a set of principles of learning developed through experimentation⁴¹.

The behavioral approach to counseling has for a long time been fundamentally influenced by the experimental work of the outstanding Russian physiologist I.P. Pavlov. As a result of his experiments, Pavlov constructed a scheme for the development of the conditioned response. Learning a conditioned response by Pavlov's method came to be called classical, or respondent, conditioning. Pavlov and his colleagues investigated the nature of many other physiological phenomena, such as conditioned inhibition and stimulus generalization.

Watson's Behaviorism

John Broadus Watson (1878-1958) is considered the founder of behaviorism. For the behaviorist, the subject of study is human behavior. The genuine domain of psychology consists of the observation of behavior.

Psychology, from the behaviorist's point of view, being an objective and experimental branch of natural science, has practically no need for the concepts of consciousness and introspection. Since animal behavior can be studied without reference to consciousness, human behavior can be studied in the same way.

A person adapts to the environment by means of inherited predispositions and a store of habits. A stimulus, or object, that evokes a response may originate from objects located in the external environment. People are also constantly acted upon by stimuli arising from their internal environment (the occurrence of these stimuli being the result of changes taking place in the tissues of various organs). Through conditioning, the range of stimuli to which people respond becomes ever wider.

Watson considered all psychological problems and their solutions in a schematized form, using the terms stimulus and response. Stimuli can be unconditioned, and such stimuli evoke certain responses from birth, for example withdrawal or closing of the eyes at the sight of bright light. Most of the stimuli to which people respond, however, are conditioned, or acquired (for example, all printed words to which people respond), and therefore most human responses are conditioned as well.

Watson believed that the inheritance of abilities, talent, character, mental constitution, and personality traits does not actually exist, since the development of these factors depends on learning. Three systems of skills are distinguished: a) visceral, or emotional; b) manual; and c) laryngeal, or verbal. Examining the development of emotional skills makes it possible to confirm the importance of conditioning through concrete examples.

Conditioning of emotions. Watson asserts that there are three types of unlearned emotional responses: fear, rage, love. These emotional responses can be regarded as unconditioned reflexes. For example, a loud sound is a significant stimulus for the occurrence of a feeling of fear.

Watson and Rayner conducted a series of experiments aimed at forming a conditioned emotional response of fear⁴². This goal was achieved through the periodic pairing of the unconditioned and conditioned stimuli. Their experiments showed that a transfer of the conditioned fear response occurred from the object toward which the fear had been formed (a white rat) to other objects somewhat resembling the first (other furry animals: rabbits, dogs; a fur coat, cotton wool).

Watson and Rayner concluded that the development of many of the phobias dealt with by psychiatrists is probably due to emotional responses of a direct or transferred type. Emotional disorders can be traced back to conditioned and transferred responses that arose in infancy and childhood, and all of these responses can be attributed to three fundamental types of human emotion.

Mary Cover Jones, a colleague of Watson's, conducted an experiment in which a three-year-old boy named Peter was freed from the conditioning associated with fear of a rabbit⁴³. The experimenters gave Peter a breakfast consisting of crackers and a glass of milk. As soon as the child began to eat breakfast, the rabbit was placed in a wire-mesh cage far enough from the table that the animal would not disturb the boy's eating. Gradually the rabbit was brought closer and closer, and eventually Peter began taking food with one hand while playing with the rabbit with the other. A release from the conditioning associated with fear responses had taken place.

Based on such experiments, an initial understanding developed of how emotional reactions can be conditioned and released from conditioning. Watson was full of enthusiasm and optimism, yet he tried to remain objective about the role of the natural-scientific approach he had developed in treating emotional disorders.

The development of language represents the conditioning of verbal reactions to unlearned vocal sounds. Memory is regarded as the retention of verbal habits.

+Watson defined personality as «the sum of activities that can be discovered by actual observation of behavior over a sufficiently long period of time… In other words, personality is a product of our systems of habits»⁴⁴. The method of studying personality in behaviorism consists in isolating and examining a group of habit systems within the flow of activity at a particular period of time, say, at a particular age. Among the types of activity, one can distinguish dominant habit systems within each of the three main groups of habit systems - the visceral, the physical, and the laryngeal. Personality problems are behavioral disturbances and conflicts of habits, which should be treated through deconditioning and conditioning.

Skinner's Behaviorism

Burrhus Frederic Skinner (1904-1990), like Watson, was fascinated by the study of the science whose subject matter is human behavior. In the experiments conducted by Pavlov and Watson, classical, or respondent, conditioning was studied, in which the organism is passive at the moment of conditioning. Skinner made a special contribution to the development of psychology, as he discovered that the consequences, or results, of behavior are of great importance, and he developed this position further. Skinner proposed adhering to the following fundamental principle: «Behavior is shaped and maintained by its consequences»⁴⁵. Skinner conducted a series of experiments to substantiate this principle. He believed that he had gone beyond stimulus and response to take into account the effect of the environment on the organism after a response occurs.

Operant behavior. According to Skinner's concept of operant behavior, reinforcement depends on the response the organism receives to an action performed. Skinner notes that one can predict the probability of such a reaction being repeated in the future. If a behavioral response entails some benefit, it is likely to be repeated in the future. The unit of the predictive science of behavior is the operant (repeated behavior). The use of the term «operant» emphasizes that behavior operates on the environment, producing consequences. Classical conditioning and operant conditioning are the only two possible types of conditioning.

Contingent reinforcement. Skinner emphasized that behavior both affects the environment, producing consequences, and depends on the consequences produced by the environment. Any adequate description of the interaction between an organism and its environment must include the definition of three elements: a) the situation in which the given response occurs; b) the response itself; and c) the reinforcing consequences. The relationship among these three elements underlies contingent reinforcement.

Positive and negative reinforcement. Positive reinforcement involves providing something (for example, food, water, the opportunity for sexual contact) in a certain situation. The removal of a positive reinforcing stimulus acts in the same way as the provision of negative reinforcement. The probability of a response occurring increases both after positive and after negative reinforcement.

Only a small portion of behavior is immediately reinforced by food, water, sexual contact, or other factors of obvious biological significance. Such reinforcements are called primary, or unconditioned.

Most behavior is a response to reinforcements that have become associated with primary reinforcements or are conditioned by them. For example, if a bright light is turned on every time a hungry pigeon is fed, the turning on of the light eventually becomes a conditioned reinforcing stimulus. The light, just like the food, can then be used to condition the operant. Conditioned reinforcement becomes generalized when it is paired with more than one primary reinforcement. This fact is of great significance, since generalized conditioned reinforcement, such as money, is useful because it applies not only to one specific state of deprivation (for example, a state characterized by hunger) but also to many other similar states. Other generalized conditioned reinforcing stimuli are attention, approval, and affection.

Schedules of reinforcement. Skinner noted that many essential features of the formation and maintenance of behavior can be explained only by studying schedules of reinforcement. There are continuous schedules of reinforcement and intermittent schedules of reinforcement.

Skinner identified several types of intermittent reinforcement schedules.

1. A fixed-ratio schedule, in which every response is reinforced. This schedule is common in everyday life and plays a significant role in controlling behavior. This reinforcement schedule generally entails a high operant level.

2. A fixed-interval schedule, in which the first response occurring after a set period of time has elapsed is reinforced, and a new period begins immediately after reinforcement. Examples include the payment of a salary for work performed over a month, or a fixed schedule of student assessment (an exam once every six months). This schedule produces a low rate of responding immediately after reinforcement is received.

3. A variable-ratio reinforcement schedule (a dramatic example being the behavior of a person under the sway of playing a slot machine). Extinction of behavior under this schedule occurs very slowly.

4. A variable-interval reinforcement schedule. The rate of responding under this schedule depends on the length of the interval: short intervals produce a high rate, long ones a low rate. An example would be a parent's occasional (not every time) praise of a child in the hope that the child will behave well even during unreinforced periods. Teachers administering tests on a variable-interval basis helps sustain a high level of diligence among students⁴⁶.

Behavior has consequences, and when these consequences or reinforcement are no longer available, extinction of the behavior occurs. When people engage in behavior that no longer has useful consequences, they become progressively less inclined to behave that way. Reinforcement schedules bear on extinction. For example, resistance to extinction produced by intermittent reinforcement can be far stronger than resistance to extinction that develops under continuous reinforcement. The task of the science of behavior is to explain the probability of a response occurring given its history of reinforcement and extinction. Skinner used the term "operant strength" to denote the probability of a given response occurring. Skinner believed that a state characterized by low operant strength, resulting from extinction, often requires treatment. From this standpoint, psychotherapy can be regarded as a system of reinforcement designed to restore extinguished behavior.

Operant behavior is carried out through the establishment of essential connections with the environment. Contingencies of reinforcement are made up of several elements: stimulus, response, reinforcement. The process by which, ultimately, a response to a presented stimulus becomes most likely to occur is called discrimination. In other words, it can be formulated as follows: the response has come under the control of a discriminative stimulus, or, more briefly, under stimulus control. Once an operant discrimination has been established, the probability of a response occurring can be increased or decreased by presenting or removing the discriminative stimulus. For example, the likelihood that store visitors will make a purchase increases with effective product displays in the store.

Stimulus generalization is the reinforcing effect of one stimulus that extends to other stimuli. An example of stimulus generalization in everyday life is responding in a certain way to a person who resembles someone familiar.

Personality, according to Skinner, represents a repertoire of behaviors, the acquisition of which is conditioned by reinforcements from the environment; moreover, this repertoire is maintained or extinguished depending on the current contingencies of reinforcement.

Self-control. In self-control, people manipulate events in their environment in order to manage their own behavior. Self-control involves two interdependent responses: 1) acting on the environment and changing the probability of secondary responses occurring (for example, an adult may employ a controlling escape response in such a way that they become able to manage their anger response; or the removal of a discriminative stimulus such as food, which promotes weaning off the habit of overeating); 2) using the presence of certain discriminative stimuli that can make desirable behavior more likely (for example, a particular desk can be a stimulus for study behavior, and a knot tied in a handkerchief can reinforce a deferred action).

+Psychotherapy and counseling. Much of the behavior associated with mental illness is learned. The main task of the behaviorist counselor is to change behavior by managing the contingencies of reinforcement affecting the client. The goal of psychotherapy is to correct the undesirable effects of excessive or inconsistent external and internal control. External means of control may include the influence of parents, as well as educational and other institutions. Skinner believed that the use of punishment as a means of control leads to the development of many characteristic features of mental illness, as well as the development of emotional side effects.

Diagnosis in counseling and psychotherapy includes functional analysis aimed at discovering variables that can be used to change undesirable behavior. One important variable in psychotherapy is considered to be the therapist's ability to act as a controlling figure or a powerful reinforcing stimulus. It is important that the therapist be able to respond in ways that are incompatible with punishment. This can lead to the extinction of punishment effects and the reappearance, in the client's behavioral repertoire, of behavior that was previously suppressed. In some situations, the therapist may see the need to create new contingencies of control or to teach the client methods of self-control.

Wolpe's Reciprocal Inhibition

In the late 1940s, Joseph Wolpe conducted a laboratory experiment studying the behavior of cats, and developed a method based on reciprocal inhibition⁴⁷. This method was designed to decondition neurotic fear reactions. Wolpe then applied the results of his experiments to clinical practice with great success. In 1958, the experiments and their application to clinical work and counseling were described in the book «Psychotherapy by Reciprocal Inhibition».

Wolpe observed that old habits often extinguish if new habits are given the opportunity to develop in the same situation. The term «reciprocal inhibition» is used to describe situations in which the occurrence of a new response clearly leads to a decrease in the intensity of a previously occurring response.

When stimuli capable of eliciting incompatible responses are present simultaneously, the development of the response that is dominant in the given situation implies reciprocal inhibition of the other responses.

Learning of neurotic fears and habits in people. Any persistent habit of maladaptive behavior, the acquisition of which is due to learning in a physiologically normal organism, is understood by Wolpe as neurotic behavior. Neurotic habits include anxiety, the degree of maladaptiveness of which is considered a criterion of the severity of the neurosis. Anxiety disrupts the normal functioning of the organism, causing disturbances in the motor, emotional, and cognitive spheres.

There are two main sources of neurotic fears and habits: classical conditioning and cognitive misinformation. To overcome clients' neurotic reactions, a complete analysis of behavior must be carried out, making it possible to determine which stimuli trigger the neurotic reactions.

The method developed by Wolpe involves finding responses that are best suited to producing reciprocal inhibition of neurotic anxiety reactions. Wolpe identified eight responses incompatible with anxiety, the deliberate use of which leads to changes in clients' behavior. These are the following responses:

1) assertive responses;

2) sexual responses;

3) relaxation responses;

4) respiratory responses;

5) «anxiety-relief» responses;

6) competitively conditioned motor responses;

7) «pleasurable» responses arising in various life situations (with pharmacological enhancement);

8 a) emotional responses evoked by the interview;

8 b) abreaction - release of tension caused by repressed emotions, by means of verbal or role-play enactment of the conflict situation⁴⁸.

+Relaxation, as part of systematic desensitization, is the main incompatible response used by Wolpe in counseling practice. Desensitization involves reducing clients' sensitivity to what causes them fear. Relaxation, achieved through the tensing and relaxing of various muscles, makes it possible to induce a state of emotional calm. In systematic desensitization, scenes that provoke anxiety - for example, scenes related to fear of exams - are gradually presented by the counselor to the imagination of the relaxed client in a specific order. The idea is that the relaxation response gradually reciprocally inhibits the anxiety response. There is a close link between the reduction of clients' anxiety in imagination and in the real-life situation.

Assertiveness training involves both the mobilization of emotions (for example, anger) that compete with and inhibit social anxiety, and teaching appropriate ways of verbal and motor expression.

20.2. Methods and Techniques of Behavioral Counseling

The main goals of behavioral counseling can be formulated within the framework of the basic theories of behaviorism:

• eliminating deficits in behavioral repertoires;

• strengthening adaptive behavior;

• weakening or eliminating maladaptive behavior;

• eliminating exhausting anxiety reactions;

• developing the ability to relax;

• developing effective social skills;

• developing the ability to self-regulate.

Analysis and Assessment of Behavior

Behavioral counseling begins with a functional analysis of the client's problem areas⁴⁹. Behavioral assessment at the initial stages of counseling has two focuses: first, clarifying the client's problem areas, and second, determining the most appropriate methods the counselor can use. Adequate behavioral assessments allow counselors to identify the stimuli that preceded the reactions they need to address.

Behavioral counselors attempt an analysis based on the ABC assessment (A - antecedent stimulus from the past situation, B - response variables (behavior), C - consequences, or outcome variables). The goal of ABC analysis is to find the key variables that govern the client's behavior. These variables may be disguised: for example, aggression displayed at work may reflect poor marital relations. Behavioral analysis should strive for a high degree of specificity. It is necessary to find out the duration, intensity, and frequency of occurrence of the troubling reaction. The client's self-assessment is also important and can be regarded as a supplement to the counselor's assessment.

Behavioral assessment within an interview presupposes empathy on the part of the counselor. This is because empathy helps build the relationship between counselor and client and facilitates client self-disclosure; moreover, the presence of empathy guarantees that the counselor listens attentively to the client. At the initial stage, the counselor should gather basic information, learning the client's age, gender, marital, and professional status. The counselor should allow clients to describe their troubling problems in their own words and briefly explain what the goals of the initial behavioral assessment are, noting that most behaviors are learned.

Behavioral counselors rarely ask questions beginning with the word «why», for example: «Why do you get angry when she snaps at you?». Questions beginning with "how", "when", "where", and "what" are more effective in identifying the personal and situational variables relevant to the client's problems and in helping to recreate these problems in the present⁵⁰.

For the purpose of initial assessment, counselors observe the verbal and nonverbal behavior of clients. Socially awkward people may display some of their problems during the interview. Counselors pay attention to clients' personal qualities and to the ways they resolve problems or avoid them. In addition, counselors assess the motivational factors that drive clients toward change or hinder them from changing.

Additional sources of data needed for assessment may include medical information, reports on previous psychotherapy, self-report questionnaires, etc.

A medical examination is necessary if there is suspicion that the problem has physiological roots. Counselors may, at various stages of counseling, refer clients to psychotherapists or psychiatrists.

The most commonly used questionnaires ask clients to describe situations that generate anxiety in them. One such questionnaire is the «Fear Inventory», proposed by Wolpe⁵¹. Clients are asked to rate how anxious they would feel in each of the 87 situations listed in the questionnaire (for example, «Interacting with people in positions of authority», «Talking with angry people», «Darkness», etc.).

To organize self-observation, clients can be asked to keep a daily journal and then analyze the entries made from the standpoint of ABC assessment (A - antecedent stimulus from the past situation, B - response variables (behavior), C - consequences, or outcome variables).

Behavioral counselors may accompany clients to some public place in order to see how the clients behave in real life. However, in the presence of counselors, clients may not behave as they normally would.

Counselors can gather information from people significant to the clients who interact with the clients in their everyday lives. Counselors should try to determine to what extent the reported behavior reflects the clients' behavior in specific situations.

Direct observation in a simulated setting can be carried out using role play in a simulated setting. Clients can be asked to act out specific fragments of behavior that they usually display. Clients can also be asked to play the roles of other people in a given situation. This can help, for example, schoolchildren and students who have difficulty talking with teachers and parents, as well as marital partners who are struggling to improve their relationship.

+Defining counseling goals. After conducting a behavioral analysis, the counselor and client together determine the nature of the problems, how they arise, and what contributes to their persistence. These conclusions are formulated as hypotheses, which should be tested during the course of counseling. The ultimate outcome of behavioral analysis is a precise definition of goals, which makes it easier for counselors to select the most suitable methods for achieving them. Clients usually have several problem areas. In such cases, it is necessary to act according to a specific order of priorities. Behavioral assessment and monitoring are necessary throughout the entire course of counseling.

Relaxation procedures

Relaxation procedures can be used on their own or as part of a comprehensive set of training exercises. The foundations of relaxation training were developed by Edmund Jacobson. The first edition of his major book, "Progressive Relaxation," appeared in 1929⁵². Jacobson noted that the state he called "neuromuscular hypertension" is found not only in people with serious disorders. The application of progressive relaxation makes it possible for the neuromuscular system, including the brain, to rest (whether completely or partially). Thanks to Wolpe, the relaxation methods proposed by Jacobson became very popular; these methods are core elements of the systematic desensitization technique developed by Wolpe. Relaxation procedures are appropriately used in the presence of such problems as tension headaches, insomnia, and a general feeling of tension.

1. Progressive muscle relaxation has many variants. The setting in counselors' offices should promote relaxation; irritating noises should be eliminated, a calm style should be used in decorating the room, and excessively bright lighting should be avoided. Clients can be taught to relax in reclining chairs, on mats, or on comfortable upright chairs with headrests. Relaxation training may be necessary for achieving one of the client's behavioral goals, for example, reducing feelings of tension and irritability. It is important that clients clearly understand the significance of relaxation procedures for solving their problems. Clients must understand that success in mastering the skill of relaxation, just like success in mastering any other skill, is achieved only through constant practice, and therefore special exercises must be performed regularly at home. Before the first session begins, counselors may recommend that clients wear loose, comfortable clothing and remove their shoes and glasses while performing the exercises.

Bernstein and Borkovec note that in the process of teaching muscle relaxation, a number of sequential stages can be identified, through which one should proceed when working with each muscle group⁵³. Five elements are distinguished in the "tension - relaxation" cycle: a) focusing attention on a particular muscle group; b) tensing that muscle group; c) holding, maintaining the tension for 5-7 seconds; d) releasing the tension in that muscle group; e) relaxation, focusing attention on the reduction of tension and further relaxation of that muscle group. The counselor can demonstrate this cycle using their own right hand and forearm as an example, beginning with the following words: "I am focusing all my attention on my right hand and right forearm, and I want you to do the same." Then he says: "I am clenching my right fist and tensing the muscles of the lower arm..."; after that the counselor says: "I am keeping my right fist clenched and maintaining the tension in the muscles of the lower arm...". Then follow the words: "Now I am releasing the tension in my right hand and lower arm as quickly as possible...". The counselor's concluding words might be: "I am relaxing my right hand and forearm, allowing the tension to drain away further and further and allowing the muscles to become more and more relaxed." The final stage of relaxation can last from 30 to 60 seconds. At this stage, the counselor can help the client relax by talking about how the tension is disappearing and a feeling of ever deeper relaxation is emerging. After the client has gone through the "tension - relaxation" cycle once, the counselor may suggest that the client go through it again.

The counselor then usually helps clients work with other muscle groups. For most clients, the most noticeable effect (for example, the suppression of feelings of anxiety) is usually achieved after relaxing the facial muscles.

The table lists 16 muscle groups and gives instructions for creating tension in these muscles⁵⁴.

Table. Instructions for teaching muscle relaxation

After clients have learned to tense various muscle groups, the counselor should suggest that they keep their eyes closed while performing the exercises. At the end of the exercises, counselors ask clients whether they have fully relaxed. Counselors should monitor clients' body position and breathing in order to accurately determine the degree of relaxation. Complete relaxation should not be expected immediately.

If clients fail to relax a particular muscle group, the counselor may change the strategy for grouping muscles. For example, the neck and throat muscles can be tensed by shrugging the shoulders, or by sharply pulling the chin down toward the chest without letting them touch. Counselors should pay particular attention to clients' individual difficulties with tensing and relaxing various muscle groups.

At the end of the entire procedure, the counselor may begin counting from 5 to 1, and on the count of «one» ask the clients to open their eyes and awaken in a pleasant, relaxed state. Bernstein and Borkovec recommend that at the end of a session clients be invited to focus for 1-2 minutes on the most pleasant moment of relaxation before beginning the count from 5 to 1.

To monitor completion of homework assignments, it is useful to have clients keep diaries

2. Brief muscle relaxation procedures allow less time and effort to be spent achieving deep relaxation. Clients can be introduced to brief muscle relaxation procedures once they have learned to correctly perform the full muscle relaxation procedures. Bernstein and Borkovec recommend that for brief procedures, 7 muscle groups be tensed (and then relaxed) as follows: the muscles of the right arm, the muscles of the left arm, and the facial muscles should be tensed as separate groups; the neck and throat muscles should be tensed as indicated above; and the muscles of the chest, shoulder girdle and abdomen, the muscles of the right leg and foot, and the muscles of the left leg and foot should be tensed as separate groups. It is also possible to tense and relax not 7 but 4 muscle groups: the arm muscles; the facial, neck, and throat muscles; the chest, shoulder girdle, and abdominal muscles; and the leg and foot muscles. Simultaneous muscle relaxation involves tensing all the muscles at once⁵⁵.

3. Verbal relaxation procedures may involve either the counselor instructing the clients, or the clients instructing themselves⁵⁶. The latter option can be especially useful in situations where clients find themselves in complex social settings, where tensing various muscle groups may be inappropriate.

The verbal relaxation procedure may be carried out as follows. The counselor asks the client to focus attention on a tensed muscle group, and then, bypassing the tension stage, proceed directly to the relaxation procedure while observing how the tension departs and gives way to relaxation. This can be done with all or only some of the muscle groups. It should be remembered that for many people, relaxing the facial muscles is especially important.

Another version of the verbal relaxation procedure: the counselor counts from 1 to 10 and asks the clients to pay attention to how the tension «flows out of their bodies». As they gain experience, clients can incorporate verbal relaxation procedures into the set of exercises performed at home.

4. Mental relaxation usually involves imagining some calm, pleasant scene. For example, a client might imagine lying in a meadow on a beautiful summer day watching the clouds. Counselors can find out which images are most conducive to relaxation for their clients. Mental relaxation is recommended for use after muscle relaxation.

+5. Conditioned relaxation involves conditioning clients so that they begin to associate a key word, such as «calm» or «rest», with the state of deep relaxation that can be achieved through progressive muscle relaxation. Subsequently, clients can use the key word to suppress feelings of anxiety that arise under stress.

Behavior Rehearsal Method and Assertiveness Training

Behavior rehearsal is one of the counseling methods used in cases of low client assertiveness and insufficiently developed interpersonal interaction skills. When conducting behavior rehearsal, the counselor encourages clients to act out new, adequate responses rather than reinforced inadequate responses. Behavior rehearsal is divided into stages: a) identifying and analyzing the areas in which clients experience difficulties; b) ensuring clients' motivation regarding the behavior rehearsal method; c) determining the types of behavior that would be most appropriate in given situations; d) giving clients the opportunity to practice responding adequately to specific situations through role-play (counselors, as a rule, participate in the interactions, playing the role of the «opponent»); e) encouraging clients to apply the rehearsed behavior in real-life situations, offering approval in case of success and providing reinforcing tokens. The counselor's tasks include providing assistance with behavior modeling.

Assertiveness training. Wolpe defines assertive behavior as "the proper expression of any emotion other than anxiety toward another person"⁵⁷. Most clients are "inhibited" to some degree because of the neurotic fears that trouble them. Assertiveness training removes the conditioning underlying maladaptive habits of responding to other people's behavior with anxiety. As a rule, this deconditioning occurs in two ways: by weakening clients' fears and by changing their manner of speech and course of action. Counselors provide clients with the support they need to express the emotions that arise in problem situations.

Assertiveness training can be aimed at helping a person stand up for their rights, at developing oppositional behavior. In recent times, assertive behavior training increasingly includes the expression of both negative and positive feelings.

Counselors and clients together determine what kind of behavior might be appropriate in particular situations, for example when it is necessary to ask a boss for a raise. Clients can be advised to observe people who act effectively. When conducting assertiveness training, the counselor should help clients develop assertive behavior that will be as "natural" as possible for them.

Rehearsing assertive behavior involves focusing clients' attention on the verbal component of behavior, on the characteristics of eye contact, on the features of posture and gestures, on facial expression, tone and volume of voice, intonation, and fluency of speech.

To apply the skills acquired in sessions to real life, clients should be given homework of an appropriate level of difficulty. Assertiveness training can be used both in individual and in group work with clients.

Reinforcement Methods

This group of methods is applied for the purpose of changing behavior by changing its consequences. Reinforcement methods are based on the operant principle of conditioning. Both positive and negative reinforcement increase the probability of a response occurring. Positive reinforcing stimuli involve presenting something, while negative reinforcing stimuli involve removing something from the given situation.

Counseling itself can act as reinforcement. In this case, the role of counselors is seen as managing the interview by distributing deliberately created, and sometimes accidental, reinforcing stimuli. Counselors are presented as a kind of social reinforcement mechanism that shapes the client's behavior or manipulates it⁵⁸. Counselors can reinforce clients' behavior using such variables as praise, attention, eye contact, empathy, warmth, and sincerity. Counselors who sincerely empathize with their clients have a more powerful positive reinforcing effect on them.

Identifying reinforcing stimuli. To introduce and strengthen adaptive types of behavior and to weaken and eliminate inadequate types of behavior, reinforcing stimuli such as praise and the display of affection and interest can be systematically used. First, it is necessary to find out exactly what is reinforcing for individual clients. To do this, surveys of the clients themselves are used, along with discussion of clients' behavior with other people, observation of clients' speech and behavior during the interview, and encouraging clients to observe and monitor themselves between sessions.

Cautela (Cautela, 1967) developed the "Reinforcement Survey Schedule" questionnaire to identify possible reinforcement stimuli together with their corresponding reinforcement values⁵⁹. When working with children, pictures can be used instead of words to determine reinforcing stimuli. For example, Daley (Daley, 1969) developed a "reinforcement menu" to determine effective reinforcing stimuli for mentally retarded children aged 8-11⁶⁰. An artist depicted in color and collected in a separate book, or "menu," twenty-two types of activities, such as talking, writing, and coloring. Children are asked to choose the activities they would like to do.

Reinforcement programs and the token system. Positive reinforcement programs can be used to strengthen desirable behavior and to weaken undesirable behavior. Positive reinforcement programs can be created by counselors, while it is more appropriate for the reward program to be applied by significant others rather than by the counselors themselves.

Reinforcement should be powerful enough to encourage clients to continue engaging in the desired behavior. At the same time, it should be applied systematically. The connection between the demonstration of the desired behavior and the application of reinforcement should be quite clear. Counselors must be able to identify the behavior they plan to support. It is important that reinforcement of behavior occur immediately, otherwise its effect may be weakened. Counselors can use continuous reinforcement to initially establish the given behavior. Subsequently, they can use intermittent reinforcement, since resistance to extinction is greater the smaller the number of responses that are reinforced.

There are direct and indirect forms of reinforcement. Direct reinforcement can be carried out using actual reinforcing stimuli. Indirect reinforcement can be carried out using tokens, which can later be exchanged for reinforcing stimuli. In addition, reinforcement can be vicarious, when clients observe models - people who receive a reward for desirable behavior. An example of direct reinforcement is the use of candy to reinforce the desirable behavior of underperforming students attending supplementary classes.

Tokens are tangible conditioned reinforcing stimuli. They can be exchanged for backup reinforcing stimuli: the right to participate in some specific type of activity, valuable prizes, treats, and so on. Token reinforcement programs include clear exchange rules that determine how many tokens are required to obtain backup reinforcing stimuli.

Token reinforcement programs have been used in work with schoolchildren. For example, token systems used in teaching children in elementary and middle school grades led to an improvement in students' academic performance in mastering reading, writing, and arithmetic skills. Token reinforcement programs have been used in work with offenders and hospitalized patients⁶¹.

However, once symbolic reinforcement is withdrawn, extinction of the desirable behavior usually follows. Therefore, one should teach behavior that will continue to be reinforced even after training is complete. One can also proceed differently: gradually phase out token reinforcement while offering some substitute for reinforcement, such as praise. Maintenance of behavioral gains can also be achieved by encouraging clients to use self-reinforcement (clients give themselves reinforcing stimuli depending on the degree to which the desirable behavior has been carried out).

Reinforcement programs may involve cooperation with significant others. For example, counselors may find it necessary to work with teachers or parents to create reinforcement procedures for individual children or for groups of children. In addition, both teachers and parents should be aware that they may inadvertently reinforce certain behaviors that, according to them, they are trying to eliminate. Counselors should guide teachers and parents in the right direction as they attempt to apply the skills learned in sessions to real-life settings.

Helping clients obtain reinforcement. An important aspect of behavioral counseling is helping clients increase the number and expand the range of reinforcing stimuli available to them. Clients must learn to independently identify and actively seek out people, activities, and situations that could provide desirable reinforcement. And counselors should help clients with this. A low degree of positive reinforcement is a precondition for the formation of depressive behavior. A client's condition improves as positive reinforcement is increased.

Teaching clients to use self-reinforcement is based on the assertion that clients are active participants in the process of their own change. Teaching clients to use self-reinforcement is often called forming a strategy of self-control, or self-regulation. Such training may include helping clients observe their own behavior, set personal goals, identify suitable reinforcing stimuli, plan gradual steps toward a goal, and determine the moment when consequences should be applied.

Stimulus control. There are two main self-control strategies: changing the environment in order to manage target actions before they are carried out; and awarding oneself a reward after carrying out an action or series of actions that lead to the achievement of a goal. For example, behavioral counselors suggest that people following weight-loss programs modify their environment in order to regulate food intake as follows: make sure that food is out of sight and not easy to reach; equip refrigerators with locks that can only be opened at certain times; keep in the house only the amount of food that can be consumed over a short period of time; and, where possible, avoid contacts that promote overeating.

Counselors can help clients create a self-reinforcement program in the process of achieving a goal. External reinforcing stimuli can be used in two ways: 1) applying to oneself new reinforcing stimuli that go beyond everyday life (for example, a new item of clothing or some special event); 2) initially giving up some pleasant everyday experience and later applying it to oneself in connection with carrying out some desirable action⁶². Internal reinforcing stimuli are statements made by the individual (for example, «This is amazing», «I'm glad I did this») that indicate his satisfaction in connection with carrying out target actions.

It is necessary to determine suitable types of rewards in advance. For example, people striving to lose weight can buy clothing suited to a slimmer figure. One can reward oneself step by step for consistently achieving increasingly important goals.

+When designing self-reinforcement programs, behavioral counselors pay close attention to the external resources that clients can use. For example, participation in social, educational, or recreational activities can provide favorable opportunities for developing a sense of confidence and acquiring communication skills. The program may include reading relevant self-improvement books.

Self-punishment. Sometimes behavioral counselors encourage clients to impose aversive consequences on themselves. For example, clients following a weight-loss program may donate a certain amount of money to charity for every 100 calories over their daily allowance⁶³