Clinical behavior analysis (CBA; also called clinical behaviour analysis or third-generation behavior therapy) is the clinical application of behavior analysis (ABA). CBA represents a movement in behavior therapy away from methodological behaviorism and back toward radical behaviorism and the use of functional analytic models of verbal behavior—particularly, relational frame theory (RFT).
Clinical behavior analysis (CBA) therapies include acceptance and commitment therapy (ACT), behavioral medicine (such as behavioral gerontology and pediatric feeding therapy), community reinforcement approach and family training (CRAFT), exposure therapies/desensitization (such as systematic desensitization), functional analytic psychotherapy (FAP, such as behavioral activation (BA) and integrative behavioral couples therapy), and voucher-based contingency management.
Acceptance and commitment therapy
Acceptance and commitment therapy is probably the most well-researched of all the third-generation behavior therapy models. Its development co-occurred with that of relational frame theory, with several researchers such as Steven C Hayes being involved with both. ACT has been argued to be based on relational frame theory. Although this is a matter of some debate within the community, Originally, this approach was referred to as comprehensive distancing. Every practitioner mixes acceptance with a commitment to one's values. These ingredients become enmeshed into the treatment in different ways which leads to ACT being either more on the mindfulness side, or more on the behavior-changing side. ACT has, as of May 2022, been evaluated in over 900 randomized clinical trials for a variety of client problems. Overall, when compared to other active treatments designed or known to be helpful, the effect size for ACT is a Cohen's d of around 0.6, which is considered a medium effect size.
Behavioral activation
Behavioral activation emerged from a component analysis of cognitive behavior therapy.
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Functional analytic psychotherapy (FAP) is a psychotherapeutic approach based on clinical behavior analysis (CBA) that focuses on the therapeutic relationship as a means to maximize client change. Specifically, FAP suggests that in-session contingent responding to client target behaviors leads to significant therapeutic improvements. FAP was first conceptualized in the 1980s by psychologists Robert Kohlenberg and Mavis Tsai who, after noticing a clinically significant association between client outcomes and the quality of the therapeutic relationship, set out to develop a theoretical and psychodynamic model of behavioral psychotherapy based on these concepts.
Behavioral activation (BA) is a third generation behavior therapy for treating depression. Behavioral activation primarily emphasizes engaging in positive and enjoyable activities to enhance one's mood. It is one form of functional analytic psychotherapy, which is based on a Skinnerian psychological model of behavior change, generally referred to as applied behavior analysis. This area is also a part of what is called clinical behavior analysis (CBA) and makes up one of the most effective practices in the professional practice of behavior analysis.
Functional analysis in behavioral psychology is the application of the laws of operant and respondent conditioning to establish the relationships between stimuli and responses. To establish the function of operant behavior, one typically examines the "four-term contingency": first by identifying the motivating operations (EO or AO), then identifying the antecedent or trigger of the behavior, identifying the behavior itself as it has been operationalized, and identifying the consequence of the behavior which continues to maintain it.
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