Counterconditioning

Description of the Strategy

Counterconditioning, as a behavioral intervention for emotional or behavioral problems in children, involves the reduction of a target behavior (CR1) through the introduction competing response (CR2). This may be accomplished by presenting a conditioned stimulus (CS2) for the competing response at the same time as the previously conditioned stimulus (CS1) for the target behavior. Alternatively, the target behavior may be ignored while the competing response is reinforced. In other words, an undesired emotional response or behavior is reduced over time by the repeated practice of an incompatible emotion or behavior. For example, it has been demonstrated that anger can be eliminated with the use of humor, presumably because humor induces an incompatible emotion state to that of anger. Unwanted behaviors can also be extinguished through the use of counter-conditioning principles. For instance, an undesired habit such as nail biting can be eliminated with the induction of an incompatible response (e.g., sitting on one's hands).

Historically, the term counterconditioning is derived from Pavlovian or higher-order classical conditioning principles. In 1912, one of Ivan Pavlov's students, M. N. Erofeeva, discovered that if a mild electric shock (CS1) was applied to one part of a dog's body in temporal contiguity with food delivery (CS2), defensive behaviors (CR1) were eliminated and replaced by a conditioned salivary response (CR2). This effect was termed counterconditioning and it appeared that conditioning methods could neutralize the effects of aversive stimulation when paired with an appetitive response. In 1942, Edwin R. Guthrie described two methods for producing associative inhibition or counterconditioning. He first suggested that stimuli (CS1) could be presented in a weakened form so that they did not evoke the undesired established response (CR1), but rather elicited some alternative or antagonistic behavior (CR2). He argued that gradually increasing the strength of the stimuli would lead to the associative inhibition of the former response to these stimuli. Similar to other theorists, Guthrie's second proposed method for producing counterconditioning was to deliberately elicit an antagonistic response (CR2) for the subject in the presence of the stimulus (CS1) so that the old response (CR1) could not be called forth.

In 1958, Joseph Wolpe used the concept of counterconditioning to rationalize the positive effects observed from systematic desensitization. He described systematic desensitization as the reduction of anxious responding through reciprocal inhibition whereby a response incompatible with anxiety (e.g., deep muscle relaxation) can be made to occur in the presence of anxiety-eliciting stimuli. As a result of this incompatible response, the bond between the anxiety response and its eliciting stimuli is weakened or eliminated. Hence, extinction of the fear response occurs as associative inhibition or the learning of an incompatible response proceeds. Wolpe argued that exposure to the feared stimuli alone (i.e., without replacing the anxious response with an incompatible response) is sometimes not an effective therapeutic method of its own accord. Although counterconditioning techniques in behavior therapy have been used for a variety of disorders, they are most commonly discussed in the treatment of anxiety.

In the treatment of anxiety, counterconditioning procedures are used to extinguish anxious-over responding to a particular stimulus. For example, in the treatment of a dog phobia, the goal is to decrease anxious responses (CR1) in the presence of dogs (CS1). To recondition or countercondition the fear response, an incompatible response (CR2) is elicited by a new stimulus (CS2). A relaxed state is incompatible [Page 794]with anxiety because it is impossible to be both relaxed (i.e., muscles relaxed, slow heart rate) and anxious (i.e., muscles tense, fast heart rate) at the same time. Thus, with the aim of decreasing fear to dogs, the child would first be taught how to achieve deep relaxation. Then when in a relaxed state, the child would be exposed to dog-related stimuli. Typically, initial exposure consists of less anxiety-provoking stimuli (e.g., pictures of dogs) with later exposure consisting of intensely anxiety-provoking stimuli (e.g., petting a large dog). As a result of repeated exposure to the previously feared stimuli (dogs; CS1) when in a relaxed state (CR2), the original fear response (CR1) is replaced.

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