10
Reeducative Therapy
The relationship between patient and thera-
pist in reeducative therapy has as its object
the achievement of more extensive goals
than in supportive therapy, namely, an ac-
tual remodeling of the patient's attitudes
and behavior in line with more adaptive life
ei-
integration. The therapist here attempts
ther (1) to influence the processes directly
between the patient and his or her neurotic
behavior, rewarding healthy responses, or
(2) to release in the patient self-actualizing
as a
tendencies by utilizing the relationship
There is
corrective emotional experience.
than
less emphasis on searching for causes
on promoting new and better forms of be-
havior. It is posited that individuals with
help from a therapist have within them-
selves the ability to reorganize their values
and behavioral patterns. Such approaches
nature and,
are more or less reeducative in
therefore, may be designated as "reeduca
tive therapy."
The objective in reeducative therapy,
behavior di-
thus, is the modification of
and negative rein-
rectly through positive
forcers, and/or interpersonal relationships,
with deliberate efforts at environmental re
liberation of
adjustment, goal modification,
it is
existing creative potentialities, and,
hoped, promotion of greater self-growth.
for
No deliberate attempt is made to probe
circum-
unconscious conflict. Under these
144
stances individuals may achieve sufficien
command of their problems to enable
them
(1) to check acting-out tendencies, to rec
tify remediable environmental distortions.
or to adjust to irremediable ones; (2) to or.
ganize life goals more rationally and to exe.
cute them in a facile manner; and (3) to con
solidate some adaptive defenses and to
alter others that are less adaptive. These
are eminently worthwhile objectives, and,
for reasons that will be considered later, are
often as far as many patients can progress,
even with the most intensive reconstructive
approaches. Indeed, in many instances, re.
educative therapy is the treatment of
choice.
A fundamental assumption in reeduca
tive therapy is that if one succeeds in alter
ing a significant pattern in one's life, the
restored sense of mastery will generalize
behavior. If sub-
over a broad spectrum of
stantial improvement is scored in one di-
mension of functioning, this may impor
of
tantly infiuence other parameters
personality operation.
Reeducative therapy is conducted
of a variety
through (1) the implementation be-
reconditioning
of techniques aimed at
the patient
havior or(2) an examination by
that the patient
and the therapist of ways
relates to people and to
herself.
himself or
manifestations of tension
and
In the latter,
Reeducative Therapy
anxiety are explored, and the patient is
helped to recognize certain aspects of his or
her behavior that are destructive to adjust-
ment. The patient is then encouraged to ex-
periment with new interpersonal attitudes
and additionally stimulated to utilize his or
her assets to best advantage so as to expand
positive qualities within. While interview
procedures are employed, little or no use is
made of dream material, transference mani-
festations, and free association. Sometimes
reconstructive changes occur as a conse-
quence of reeducative therapy, although
these are not specifically the objectives to
ward which treatment is directed.
The application of reeducative therapy
requires specialized training that sensitizes
the therapist both to aspects of behavior
that require and will be amenable to altera-
tion and to the recognition of gross interfer-
ences to the therapeutic process of transfer-
ence and resistance. . While personal
psychoanalysis or personal reconstructive
therapy for the therapist is helpful, it is not
absolutely essential in executing this ap-
proach, provided the therapist does not
have severe neurotic difficulties and can
control countertransference if this begins to
project itself harmfully into relationships
with patients. Among reeducative thera-
peutic measures are "behavior therapy,*"
therapeutic counseling, directive psycho-
therapy, casework therapy, "relationship
therapy,'" "attitude therapy," distributive
analysis and synthesis, interview psycho-
reeducative
therapy, semantic therapy,
group therapy, and certain philosophical
approaches.
BEHAVIOR THERAPYY
Behavior therapy continues to spread
of human
its influence over the entire field
This is no fortui-
afflictions and disabilities.
methods have proven
tous event since its
skilled practition-
valuable in the hands of
and
ers. Books and articles on the subject
145
membership in behavior therapy organiza-
tions have increased in the past decade. To
the traditional zone of behavioral distor-
tions have been added internal mental pro-
cesses and psychophysiological ailments
and habits. Maintaining the original dedica-
tion to the principles and findings of experi-
mental psychology, behavior therapy has
elaborated a plethora of techniques and a
diversity of views that go far beyond learn-
ing theory and that are dedicated to the alle-
viation of all aspects of human suffering
and the general enhancement of function-
ing. More specifically, behavior therapy is
said to address "clinical problems using-(a)
a testable conceptual framework, (b) treat
ment methods that can be objectively mea-
sured and replicated, (c) outcome criteria
that can be validated, and (d) evaluative
procedures for determining the effective
ness of specific methods applied to particu-
lar problems" (Lazarus & Fay, 1984).
Lazarus (1984) has stated that "there is
scarcely a clinical entity for which a behav-
ioral intervention strategy cannot be pro-
posed and implemented." The literature in-
cludes discussion of behavior therapy in the
treatment of these and other problems: af-
fective disorders (De Rubeis & Hollon,
1981), alcoholism (Chaney et al, 1978),
asthma (Creer & Kotses, 1983; Dekker et
al, 1957; King, 1980, Philander, 1979; Rich-
ter & Dahme, 1982), back pain (Cairns et al,
1980; Gottlieb et al, 1977; Newman, et al
1978), cardiac arrythmia (Benson et al,
1975), cardiac problems (Matarazzo et al,
1982), dental problems (Ingersoll et al,
1977), depression (Lewinsohn & Hober
man, 1982; McLean & Hakstian, 1979), ger-
iatrics (Patterson & Jackson, 1980; Patter-
son, 1982), headache (Blanchard et al,
1979), insomnia (Ascher & Efran, 1978; As-
cher & Turner, 1980; Bootzen, 1972, 1977;
Borkovec & Boundewyns, 1976; Jason,
1975; NaHauri, 1979; Turner & Ascher,
1982), obesity (Stunkard, 1982), obsessions
(Emmelkamp & Kwee, 1977; Foa et al,
1980; Marks et al, 1975, 1980; Marks, 1981;