DR. C.: Great. How could you tell her that? ANNE: Well, I could say, "Mom, you know, you give me a lot of suggestions. Some are OK, now and then, but, to be {182} honest, I'd really like to hear some praise sometimes. Do you think you could find some things to compliment me on? I don't want any false praise, but I need to hear some encouraging things from people I love." DR. C.: Anne, you're doing very well: ... Humor, reinterpreting so you don't feel criticized, and talking about criticism from a more detached point of view. You're definitely learning how to cope with criticism much better. APPLICATIONS OF BEHAVIORAL PSYCHOTHERAPY Desensitization is normally used in the context of individual therapy. Behavior modification and cognitive approaches to behavior change are frequently used in groups. People with problems in common--smoking, obesity, phobias, etc.--are sometimes grouped together. Often, however, a mixture in groups is desirable. For example, it is frequently helpful for shy people to be part of a group in which they may watch others who can model more assertive ways of acting. (For more about group therapy, see Chapter 13.) Behavioral approaches to therapy must be tailored to the individuality of each client; whatever goals are established have to be in accord with the client's own desires. Behavioral psychotherapy presupposes that clients will practice instructions and new behaviors between sessions and that they can maintain an adequate level of motivation, both while in treatment and after treatment ends, so that new habits of behaving or thinking can become effective and reliable parts of their own personalities. In general, behavioral approaches to therapy have been less effective in treating panic attacks, chronic depression, substance abuse (smoking, for example, is one of the habits most resistant to formal therapy), and psychosis. COUNTER-CONDITIONING This approach, which includes desensitization, assertiveness training, and sex therapy, has been used effectively in treating these problems: * phobias * psychosomatic complaints {183} * sex, marriage, and family problems * passivity and shyness * personality trait problems: lonely, anxious, hostile, or overbearing individuals BEHAVIOR MODIFICATION This approach has been used successfully in connection with these problems: * sexually deviant behavior * children's problems, school discipline, academic performance, and juvenile delinquency * problems of the mentally retarded and of psychotically regressed individuals * some instances of obesity, alcoholism, and smoking * schizophrenia * stuttering COGNITIVE APPROACHES TO BEHAVIOR CHANGE These approaches have, for example, been used to treat such problems as: * anxiety and depression * adjustment problems * marital and sexual difficulties * psychosomatic problems