"La cita de McIntosh (1988) refleja un tema que entreteje este capítulo sobre PAF y terapias feministas. Brevemente, la psicoterapia se compone de una serie de encuentros sociales cargados de fuentes de influencia conductual que son sutiles, indirectas y generalmente indetectables por los involucrados. Examinaremos las fuentes características de influencia en la conducta social (Biglan, 1995; Glenn, 1988; Glenn y Malagoid, 1991; Guerin, 1994; Parott, 1986; Zimmerman, 1963) y argumentaremos que su papel dentro del proceso terapéutico debería ser de interés para los terapeutas. Como terapeutas, inevitablemente traemos con nosotros características distintivas que nos identifican como miembros de grupos sociales, incluyendo, pero no limitado a, nuestra raza, etnia, género y clase socioeconómica, y trabajamos con clientes de diferentes razas, etnias, géneros y clases socioeconómicas..."

Background: The goal of this study was to document the existence of psychological side effects associated with serotonin reuptake inhibitors (SSRIs) taken for depression and to determine their relationship to patients’ decisions to stop treatment, and attitudes toward taking SSRIs again. Method: We conducted 161 semi-structured telephone interviews of adults who had completed a course of treatment for depression with one of the SSRIs. We identified 29 categories of unwanted psychological effects and analyzed data in terms of responders and non-responders, the former split into those who would, and those who would not take the same drug again if depressed in the future (‘take-again responders’ and ‘not-again responders’, respectively). Results: Psychological side effects were cited just as often as physical side effects as the primary reason for quitting SSRI treatment. Non-responders cited psychological side effects rather than non-response as the primary reason for quitting, and not-again responders cited physical more than psychological side effects. Not-again responders and non-responders did not differ in the number of side effects experienced, and non-responders experienced significantly more unwanted psychological effects than either type of responder (χ2 = 6.767, p = 0.009). Conclusion: Psychological side effects might well be included in measures and discussions of side effects, even though they present no known physical danger to the patient.

This paper traces the birth, quiescence and renaissance of clinical behavior analysis (CBA). CBA is the application of radical behaviorism to outpatient adult behavior therapy. It addresses the question of how talking in the consulting room helps the client outside of the office, in his or her daily life. The answer as formulated by CBA has led to exciting and significant developments with considerable promise for improving therapeutic interventions. A brief historical account of CBA is described that involves the interplay of three strands involving clinical applications of behaviorism: behavior therapy, applied behavior analysis, and the development of the Association for the Advancement of Behavior Therapy (AABT). These strands are traced through publications in Behavior Therapy from its inception to the present. We contend that there is a need in AABT and in behavior therapy in general for what CBA has to offer. As we see it, the major problems facing the AABT membership with its current emphasis on cognitive therapy and empirically validated treatments include the lack of a coherent theoretical base that can embrace all of the techniques used by behavior therapists. Now with all the behavioral procedures that have been developed, a horrendous question arises, When do you use which procedure for what kind of person? We conclude that far from being a thing of the past, CBA has a bright future in answering this question. Behavior analysis of the therapeutic situation offers a unique, coherent theoretical base that can embrace all techniques used by behavior therapists, including cognitive therapy strategies. ********** Clinical behavior analysis (CBA) is defined as the application of radical behaviorism (Skinner 1953, 1974) to answer the most basic question about outpatient adult behavior therapy (or any other type of psychotherapy) (Kohlenberg, Tsai & Dougher, 1993). Since outpatient treatment consists of verbal interchanges (1) between client and therapist, the question is this: what is the mechanism that explains how this talking helps the client outside of the office in his or her daily life? In this paper, we contend that CBA is an exciting, new, and significant development that holds considerable promise for improving therapeutic interventions. We also recognize that most behavior therapists are only superficially familiar, if at all, with CBA and are not aware of its considerable potential as a highly effective treatment. There are several factors that account for the relative invisibility of CBA, not least of which is its mercurial appearance over the last 46 years. THE BIRTH OF CBA In Science and Human Behavior (1953), Skinner gave an analysis of psychotherapy, including behavioral interpretations of terms such as resistance, repression, and free association. Following this work, very little was published on CBA other than the insightful, but largely ignored papers by Charles Ferster (1967, 1972a, 1972b, 1972c, 1979). Neither Ferster nor Skinner intended to devise new approaches to treatment in these writings. Instead they wrote in behavioral language, demonstrating a more useful way of describing, understanding, and in Ferster's case, teaching the change process. So, CBA got its start quite early in 1953 and then all but disappeared until its reemergence in 1987 with the publication of an edited book (Jacobson, 1987). The Jacobson book contained chapters by Hayes (1987) and Kohlenberg & Tsai (1987) that described in detail their approaches to using Skinnerian principles to treat outpatient adults. We will refer to this hiatus as the quiescent period of CBA. The reasons that behavior analysts did not pursue CBA play a role in understanding the nature of its renaissance. CBA's Quiescent Period Our historical account of CBA involves the interplay of three strands involving clinical applications of behaviorism. These are behavior therapy, applied behavior analysis, and the development of the Association for the Advancement of Behavior Therapy (AABT). …

Historically, populations of color have been ignored in psychotherapy research. Fortunately with growing awareness of social justice issues, funding institutions require proportional ethnic diversity in research samples. However, psychotherapy itself is a highly culture-bound mainstream phenomenon that generally ignores and thereby perpetuates issues of power. Minority individuals likely to participate in psychotherapy tend to be a highly acculturated subset. Non-acculturated peoples often perceive their problems so differently that “psychotherapy” is a nonsensical solution. Funding agencies’ requirements that researchers recruit representative numbers of minority subjects may inadvertently amount to a campaign for cultural colonization, which is clearly unethical. Can behavior analysts tease out the issues and ethics involved? Is behavior analysis itself irrevocably culture-bound?

Two enhancements to cognitive therapy (CT)- a broader rationale for the causes and treatment of depression, and a more intense focus on the client-therapist relationship- were evaluated in a treatment development study. The enhancements were informed by Functional Analytic Psychotherapy (FAP; R.J Kohlenberg T Tsai, 1991), a treatment based on a behavioral analysis of the change process. FAP Enhanced Cognitive Therapy (FECT) includes 7 specific techniques that CT therapists can use to make their treatment more powerful and to address the diverse needs of clients more effectively. The results indicate that FECT produced a greater focus on the client-therapist relationship and is a Promising approach for improving outcome and interpersonal functioning. It also appears that a focus during sessions on clients' problematic cognitions about the therapist adds to efficacy.