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Deviant Behavior
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Application of behavioral
principles within family
systems therapy: A
conceptual framework for the
treatment of alcoholism
a b
Jeffrey L. Bessey & Charles M. Borduin
a
University of Missouri‐Columbia , Columbia
b
Department of Psychology , University of
Missouri , 210 McAlester Hall, Columbia, Missouri,
65211
Published online: 18 May 2010.

To cite this article: Jeffrey L. Bessey & Charles M. Borduin (1986) Application
of behavioral principles within family systems therapy: A conceptual framework
for the treatment of alcoholism, Deviant Behavior, 7:4, 357-369, DOI:
10.1080/01639625.1986.9967722

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 APPLICATION OF BEHAVIORAL PRINCIPLES
WITHIN FAMILY SYSTEMS THERAPY: A CONCEPTUAL FRAMEWORK
FOR THE TREATMENT OF ALCOHOLISM

JEFFREYL.BESSEY and CHARLES M. BORDUIN

University of Missouri-Columbia
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Although family systems therapy has been successfully used

in the treatment of various clinical problems, there has
been little research regarding the process variables that
contribute to successful outcomes in family therapy. We
propose that the integration of behavioral (learning theory)
principles with the family systems framework would allow
researchers to establish clear operational definitions and
reliable measures of family therapy processes. This paper
presents a description of several core concepts in family
therapy from the perspective of learning theory. We also
present alcoholism within the family as an example of how
behavioral principles can help to define and measure family
process concepts. Finally, we discuss several of the
proposed mechanisms of change in family therapy of the
alcoholic through an integration of behavioral principles.

Family therapy has been shown to be effective in the treatment of

a broad range of "individual" problems as well as more obvious
family conflicts (Gurman and Kniskern, 1978, 1981). However, the
process variables that contribute to family treatment outcomes
have not been clearly identified. While certain aspects of
systemic change may always defy observation and description, it is
essential that we attempt to identify some of the more salient
factors that govern family interaction and that are frequently
considered when planning family therapy interventions.
One major reason that there is so little research on family
therapy process is related to the nature of the concepts used by
family systems theorists. Theorists that emphasize the systemic
nature of family functioning have often used explanatory concepts
developed from areas such as cybernetics (Wiener, 1948),
communications analysis (Ruesch and Bateson, 1951), sociology
(Jackson, 1957), and General Systems Theory (von Bertalanffy,
1968). The concepts that have been developed "make sense," but
Deviant Behavior, 7:357-369, 1986 357
Copyright ©1986 by Hemisphere Publishing Corporation
 358 /. L BESSEY AND C M. BORDUIN

they are highly abstract and difficult to operationalize (Coyne,

1982). Before process research can proceed, researchers must
first have clear definitions of theoretical constructs from which
to develop testable hypotheses (Kiesler, 1973). In this paper, we
suggest that it is possible to overtly integrate various
behavioral principles derived from learning theory within the
family systems framework in order to improve our ability to
operationally define and measure the process of family therapy.
Recent efforts to integrate behavioral and systems perspectives
(Barton and Alexander, 1981; Birchler and Spinks, 1980) have
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emphasized the unique contributions of each view for therapy.

However, it would also seem useful to identify some of the
behavioral mechanisms that are operative in the family systems
approach. In this paper, we will first describe how behavioral
principles can provide an operational framework for some core
family therapy concepts. Second, we will discuss alcoholism as
an example of how behavioral principles can be applied to help
identify and explain maladaptive processes within the family
system. Finally, several issues concerning the treatment of the
alcoholic family system will also be addressed using an
integration of behavioral concepts.

Behavioral Principles Within Family Therapy Models

Although family systems models differ substantially in their
descriptions of family relations and therapeutic techniques (e.g.,
Haley, 1963; Jackson, 1965; Minuchin, 1974), they each assume that
change in one member of a system will create compensatory change
in other members of that system. Ablon (1976) notes that "...if
the family is considered as a social system with interdependent
parts consisting of interacting personalities with each having
his own expected role functions, it follows that the behavior of
each part sensitively affects the functioning of others" (p. 209).
This assumption is based upon the concept of homeostasis.
According to Jackson (1957), homeostasis represents a type of
regulating mechanism that restores a sense of balance or
equilibrium within the family whenever there are behaviors that
effect disruption on that balance. The homeostatic balance
maintained by the family can be affected by any of its individual
members. The primary means of maintaining the equilibrium of
behavior is the feedback loop, whereby interrelated behaviors of
family members supply positive or negative information back to the
system, necessitating a systemic reaction to that feedback
(Jackson, 1957). If two interrelated behaviors conflict, their
joint presence disrupts systemic norms and results in the
inhibition of the behavior that is least congruent with the
homeostatic balance at that point in time.

The mechanisms underlying the concept of homeostasis can be

delineated using experimentally established learning theory
principles. Certain behaviors of family members are positively
reinforced, thus promoting the likelihood of the repetition of
 BEHAVIORAL PRINCIPLES WITHIN FAMILY SYSTEMS THERAPY 359

those behaviors, while others are systematically inhibited via

negative reinforcement, punishment, and extinction. Thus, the
patterns of interaction that occur in the family system are
developed and maintained in a manner that is consistent with
learning theory principles that explain the acquisition,
maintenance, and modification of operant behavior (Honig and
Staddon, 1976; Skinner, 1969). From this perspective, there is a
gradual change in the performance of overt behaviors as the
behaviors are practiced. If the behaviors are satisfying for the
individual in a given situation, the strength of association
between the behavior and the situation will grow, increasing the
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likelihood that the individual will subsequently manifest the

behavior in that context. Conversely, if the behavior is not
reinforced or is punished, there is a lower probability that the
same response will be repeated in the stimulus context; rather,
the individual will probably attempt another behavior to evoke
reinforcement.
It would follow that the homeostatic balance in the family system
could be operationally defined in terms of a behavioral exchange
model whereby individual members manifest communication and
behavioral patterns that are perceived to maximize rewards and
minimize costs for themselves (Gibb, 1961; Thibaut and Kelley,
1959). Accordingly, the family members will attempt to utilize
reinforcement techniques which meet their individual needs yet
also promote a balance of rewards for the entire family
(regardless of the actual quality of that balance). This
assumes that the actual pattern of communication and behavioral
interactions is perceived by members as the most rewarding of the
available alternatives at any one point in time (Stuart, 1969).
Reliable measurement and quantitative analysis of these complex
behavioral processes could be achieved through the use of
observational research methods that assess the specific behaviors
of the family members sequentially over time.
Another principle that has long been emphasized by family systems
theorists is the reciprocal nature of behavior within families.
Jackson (1965) described reciprocity as a process whereby family
members define and modify the behavior of one another whenever
they exchange communication. Similarly, Minuchin (1974) has
suggested that mutual accommodation is a central process in the
interactions of well-adjusted families.
From a learning theory perspective, reciprocity can be described
as the systematic and mutual provision of positively or negatively
reinforcing behaviors. Using this as an operational definition,
one might predict, for example, that the presentation of positive
or negative reinforcement by one family member to another would
increase the probability of receiving the same type of
reinforcement in return. Consistent with this perspective,
research (Alexander, 1973; Brewer and Brewer, 1968; Byrne and
Nelson, 1965) has demonstrated that supportive, positively
reinforcing behaviors (e.g., information giving, empathic
understanding) are reciprocated often in normal families, but
 360 j. L BESSEYAND C M. BORDUIN

seldom in maladaptive families. Disturbed families tend to

reciprocate defensive, nonreinforcing behaviors at a high rate
(e.g., judgmental-dogmatism, indifference).
How might we explain these differences between healthy and
disturbed families? It has been suggested that members of
dysfunctional families tend to use coercion, or negative
reinforcement, in an attempt to obtain positive reinforcement from
each other (Lorber et al., 1984; Patterson, 1982) However, there
are two major problems with using coercion as a means to obtain
reinforcement. First, negative reinforcement is itself unpleasant
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and, as such, decreases the likelihood that the other party will
give the positive reinforcement desired—even when the negative
reinforcement of coercion is subsequently reduced (Stuart, 1969).
Second, even if the coerced party were to comply with the demand
in order to avoid the negative reinforcement, the behavior might
not be viewed by the receiving party as genuine, thereby negating
the reinforcing properties of the behavior (Haley, 1963). The
ultimate effect of such coercive behavior will be to effectively
extinguish those rewarding behaviors normally given by the target
of coercion. The target individual is likely to withdraw all
efforts to give satisfaction to the coercive party, thus greatly
increasing the incidence of the nonreinforcing and defensive
behaviors found in maladaptive families (Borduin et al.,
forthcoming; Burbach and Borduin, 1986).
Many of the clinical techniques that are practiced by family
systems therapists might also be viewed from the framework of
learning theory. For example, a common element of the variegated
systems orientations is the implementation of a change in the
family's interactions such that the reinforcing potential of those
interactions is maximized. A number of techniques, such as
paradox, reframing, and boundary marking, to mention but a few,
might be defined as being aimed toward disrupting and replacing
maladaptive interaction patterns. With the overt acceptance of
those behavioral principles that apply, it is possible to
operationally define and thereby more effectively delineate those
clinical interventions (e.g., paradoxical directives) that
contribute to changes in specific categories of family
transactions (e.g., supportive behaviors).
Next, we discuss how behavioral principles can be used to help
identify and explain the underlying mechanisms of dysfunctional
behavior within alcohol-involved systems. Our extensive work with
alcoholics and their families has indicated that behavioral
principles can contribute substantially to established family
systems concepts. It should be noted, however, that there are
several additional reasons for selecting alcohol-involved systems
as our example. Epidemiological data indicate that alcohol abuse
and/or dependence is the most common psychiatric disorder among
men in the United States and affects between 11% and 16% of all
adults at some time in their lives (Robins et al., 1984). In
addition, abuse of alcohol has been estimated to cost the American
society over 49 billion dollars annually in expenditures for
 BEHAVIORAL PRINCIPLES WITHIN FAMILY SYSTEMS THERAPY 361

hospitalization, rehabilitation, lost work productivity, criminal

justice, fire damage and protection, and motor vehicle crashes
(National Institute on Alcohol Abuse and Alcoholism, 1983).
Finally, alcohol abuse is a life-threatening form of deviant
behavior, with mortality rates of alcoholics being several times
that of the general population (NIAAA, 1983; Pell and D'Alonzo,
1973). Although the behavioral-systems formulation presented
below could also be applied to other forms of deviant behavior
that have been shown to respond to family therapy interventions
(e.g., anorexia, juvenile delinquency), we believe that improved
understanding of alcoholism is of unsurpassed importance to mental
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health professionals.

A Behavioral-Systems Perspective of Alcoholism

From a systems perspective of alcoholism, one must consider
drinking behavior within the contexts in which it occurs
(Steinglass, 1977). In fact, it has been suggested that
alcoholism can be best understood by examining how it influences
the functioning of the active, ongoing system of the family
(Steinglass et al., 1971b). Systems theorists who have examined
the role of alcoholism in the family have cogently argued that the
alcoholic maintains an integral position within the functioning of
the family (McCrady, 1982). Moreover, each of the other family
members learns to adapt to the role of the alcoholic member
(Jackson, 1954), and the family develops characteristic patterns
of interaction that serve to maintain the alcoholic behavior
(Ewing and Fox, 1968; Steinglass, 1977; Steinglass et al., 1971b).
Indeed, if the alcoholic stops drinking, it is not uncommon for
the other family members to subtly encourage the alcoholic to
start drinking again, or failing at that, to transfer the deviant
role to another member of the family.
An integration of systems theory with operant learning principles
(cf. Brady, 1979; Skinner, 1969) leads us to postulate that
problem drinking behavior is maintained by positive reinforcement
in conjunction with the tendency to avoid aversive consequences.
In their classic study with alcoholic couples, Davis et al.
(1974) indicated that alcohol abuse has certain adaptive
consequences for the family system which are highly reinforcing.
There is also evidence that the family members may unconsciously
view alcoholism as a stabilizing influence within the family
(Steinglass et al., 1977; Steinglass et al., 1971a, 1971b; Wolin
et al., 1975). These findings suggest that alcoholism itself may
acquire a function that is adaptive and, ironically, highly
reinforcing. Specifically, an inebriated state promulgates
"patterned, predictable, and rigid sets of interactions"
(Steinglass, 1977:280). While these interactions may have
long-term negative effects on the personal adjustment of the
individual family members, in the short term they provide the
family members with a predictable and "safe" environment
(Steinglass, 1976, 1977). Indeed, by maintaining alcoholic
behavior and the corresponding family patterns, the family system
 362 J. L BESSEY AND C M. BORDUIN

is able to avoid potential aversive threats to a predictable,

albeit rigid, lifestyle.
Ward and Faillace (1970) have observed that the spouse of the male
problem drinker may play a critical role in maintaining the
abusive drinking behavior. If the spouse denies that her partner
has a problem, the alcoholic's own denial of the problem may be
reinforced. Alternatively, if the spouse reacts with sympathy
and/or forgiveness, the alcoholic quickly learns that he will
elicit attention and kindness as long as he acts remorseful and
sick. Such behavior by the spouse can also serve to protect the
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alcoholic from the negative consequences of drinking. A third

spousal reaction of extreme anger and hostility tends to downplay
the consequences of drinking by diverting attention to the wife's
reaction. Continued drinking in this case may be reinforced as an
escape mechanism. Finally, if the nonalcoholic spouse emotionally
distances herself from the alcoholic partner, such behavior may
remove the guilt or shame otherwise felt by the alcoholic, thereby
reducing the likelihood of a reduction in abusive drinking (Ward
and Faillace, 1970). In each instance above, the spouse's
behavior serves a regulating or homeostatic function by actually
reinforcing the alcoholic's maladaptive behavior within the
system.
Reinforcing events can also be understood in terms of a change in
stimulus context following a response. Stimulus sampling theory
asserts that an essential ingredient for learning is the
simultaneous conjunction of a stimulus and a response. The
mechanisms of conditioning and the determination of performance
from this theoretical viewpoint have been further outlined by
Estes in his stimulus sampling theory (Estes, 1970; Luce et al.,
1963, 1965). From this perspective, a contiguity association
would be established when the alcoholic's behavior (i.e.,
drunkenness) initially removes the family from other repetitive
and chronic problems (e.g., sexual inadequacy, inconsistent
parental discipline). Alcoholic behavior offers the family an
immediate way of excusing itself from the chronic problem
situation, thus resulting in stimulus change that reinforces the
behavior. This, in turn, results in the reinforcement of those
antecedent behaviors (e.g., stopping off for an extended happy
hour) which led to the response. Such behaviors are associated
with the intoxicated state, and this association tends to
reinforce the chronic drinking behavior. In addition, the
reinforcers (e.g., removing the guilt associated with sexual
inadequacy) that strengthen the contiguity association are, by and
large, intermittent in nature. According to Ferster and Skinner
(1957), this form of reinforcement is extremely powerful in
maintaining any learned behavioral pattern.

The above conceptualizations of the behavioral mechanisms of an

alcoholic system offer important ramifications for family systems
theory and therapy. The formulations offered could facilitate
identification of factors within the family system that contribute
to alcoholic behavior, as well as factors in the family which
 BEHAVIORAL PRINCIPLES WITHIN FAMILY SYSTEMS THERAPY 363

Influence therapeutic outcome with alcoholics. Indeed, learning

theory offers a way to operationalize abstract family therapy
concepts, which can then be measured using well-established
experimental methods. For example, researchers have developed a
number of observational methods that could be used to assess
reinforcement patterns in families of alcoholics (see e.g.,
Borduin et al., 1985; Gilbert and Christensen, 1985; Henggeler et
al., 1986). To the extent that learning theory helps to define
and measure systems concepts (e.g., homeostasis, reciprocity) in
terms of observable behaviors, it is invaluable in providing
direction to family researchers of alcoholism and other forms of
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deviant behavior.

Defining and Measuring Family Therapy Effects on Alcoholism

Family therapy has been successfully employed in the treatment of
alcoholism (Ablon, 1976; Berenson, 1978; Bowen, 1978; Corder et
al., 1972; Ewing and Fox, 1968; Hedberg and Campbell, 1974; Meeks
and Kelly, 1970; Nace et al., 1982; Steinglass, 1976; Ward and
Faillace, 1970). Moreover, it has been estimated that there is a
30-50% increase in rehabilitation rates if the family of the
alcoholic is included in the treatment process (Royce, 1981).
Family therapists suggest that in order to institute positive
change, the clinician must identify the pertinent aspects of the
family's homeostatic balance that maintain the alcohol abuse.
This change in the family's homeostatic balance is seen as a
necessary step to obtain results which include not only the
mitigation of abusive drinking, but also the development of
healthy family relations. Unfortunately, this interactional model
fails to clearly define those mechanisms that are operative In
promoting the necessary behavioral change. Again, behavioral
principles can be readily integrated with the systems theory
explanation of change, and thereby facilitate operationalIzation
of therapist procedures and family interactions that are related
to various treatment outcomes. The eventual empirical
identification of salient change mechanisms would represent an
important step forward in training family therapists to
effectively intervene with alcoholics.
From a structural family therapy perspective (e.g., Minuchin,
1974), it is usually necessary to reorganize the family rules and
boundaries to modify deviant behavior. We propose that what
actually may occur in this reorganization is that the family
members are taught new rules for increasing the frequency and
intensity of mutually positive interactions. Although the
therapist may not choose to explicitly teach the family techniques
of positive reinforcement, the therapist does indeed construct a
situation In which positive reinforcement is more likely. In
fact, the very strength of a systemic approach lies in the attempt
to dictate where, when, and with whom relevant reinforcements
should be made. The previously defeating interactions that
maintained the abusive drinking are replaced by behaviors that do
not promote drinking but, instead, encourage positive reciprocity.
 364 ]. L BESSEYAND C M. BORDUIN

This process leads to new contiguity associations that involve

recognition and competent mitigation of potential problem
situations. Thus, changing the rules governing the family's
reality leads to new patterns of behavior which are maintained by
mutual reinforcement.
From a strategic family therapy perspective (e.g., Haley, 1976),
the eventuation of a proper power hierarchy within the family is
integral to the development of positive behavior patterns. Not
only must the previously ineffectual alcoholic reassume more
responsible parental functions within the family structure, but
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the other members of the family must also modify their roles.
Defined via behavioral/Iearning principles, the new family
patterns must be developed not only to reinforce sobriety and
competence in the alcoholic, but also to promote more constructive
roles for the nonalcoholic members of the family. This role
modification includes the essential alignment of the marital dyad
in dealing with the children. Moreover, one or more of the
children must often be freed from a parental role that was
previously necessary because of the problem-drinking parent. The
establishment of a proper parent-child power hierarchy also allows
the nonalcoholic spouse to pursue aspects of life that transcend
worrying about the previously inebriated spouse. From a learning
theory perspective, it seems that family therapy succeeds because
an appropriate power hierarchy among family members is reinforced,
while inappropriate alignments and/or coalitions are progressively
extinguished.

A number of family systems theorists have adapted aspects of

communication theory to account for systemic maintenance of
deviant behavior (e.g., Watzlawick et al., 1967). Denial,
rejection, and disqualification of communication are all viewed as
factors that maintain dysfunctional behavior in the family system.
To effect change in behavior such as that manifested by the
alcoholic, clarity and continuity in the content and relationship
aspects of communication must be achieved. An explanation using
behavioral principles would agree with the importance of clear and
congruous communication, but would define and measure the
achievement of such communication patterns through the gradual
accrual of knowledge and skill. In fact, in order to establish
the positive contingencies necessary to change alcoholic behavior,
the family must first be taught the simplest procedures of
positive communication. Through therapist modeling and
reinforcement of appropriate communication, the family members can
gradually acquire the knowledge and skills necessary to increase
the ratio of supportive communication to defensive communication.
This increased supportiveness continues outside of therapy due to
the principle of reciprocity described above: the utilization of
supportive communication will increase the likelihood of receiving
supportive communication.
At the present time, there have been few attempts to define and
measure those aspects of treatment which contribute most to change
among alcoholics and their family members. In addition, the
 BEHAVIORAL PRINCIPLES WITHIN FAMILY SYSTEMS THERAPY 365

nature of the changes that occur in alcoholic families as a result

of treatment have received little attention. Although there are a
number of studies which suggest that systems techniques may indeed
be effective (e.g, Berenson, 1978; Bowen, 1978; Nace et al.,
1982), most of these studies were not comparative in nature and/or
included only the spouse in treatment. Moreover, researchers have
rarely taken a comprehensive picture of therapeutic change and,
instead, have relied on either reduced drinking or an improved
family situation as the criterion of success. Undoubtedly,
further comparative research must be undertaken to ascertain the
relative effectiveness of family therapy approaches toward
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alcoholism; in addition, process research is crucially needed to

ascertain the prepotent mechanisms of therapeutic change.
It seems likely that the lack of research evaluating the process
and effectiveness of family therapy with problems such as
alcoholism is due, in part, to the perceived difficulties
associated with operationally defining systemic change.
Specifically, the nonlinearity of systems concepts makes them
difficult to measure by traditional research methodology. To the
extent that change can be defined and measured in terms of
behavioral constructs derived from learning theory, family therapy
effects on alcoholism will be more clearly delineated.

SUMMARY
Despite the apparent utility of family therapy in the treatment of
a wide range of human problems, there has been little research
regarding the process factors that contribute to successful
outcomes in family therapy. The integration of established
behavioral principles with the family systems framework can
facilitate researchers' efforts to operationally define and
measure the therapeutic processes that are related to family and
individual change. For example, behavioral principles can
facilitate the identification of factors within the family system
that maintain alcoholic behavior, as well as aspects of treatment
that contribute most to changes among alcoholics and their
families. By establishing clear operational definitions and
reliable measures of family therapy processes, researchers can
also begin to delineate the changes that occur in families during
the course of treatment. The empirical identification of systemic
changes and of salient change mechanisms would represent an
important step forward in the training of family therapists.

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Received January 31, 1985

Accepted May 5, 1986

Request reprints from Dr. Charles M. Borduin, Depart-

ment of Psychology, 210 McAlester Hall, University of
Missouri, Columbia, Missouri 65211