Evidence of Effi cacy and Translational Overconfi dence in Clinical Behavioral Analysis

Abstract

The emergence of behavioral therapies followed the same strategy that had proved successful in other fi elds of science: extrapolating principles, which were empirically validated in basic research, to the solution of human problems. However, the mere transposition of this knowledge to different types of clinical problems -despite the importance of these principles for therapeutic practice -does not guarantee a priori effectiveness of the intervention. One of the defi ning characteristics of applied behavior analysis is the strong commitment to the empirical basis of its intervention procedures. That being said, the purpose of this article is to assess the current status of the evidence of effi cacy in a branch of applied behavior analysis -clinical behavior analysis or behavior-analytic therapy -and to offer a critical refl ection on the commonly widespread view that these therapies are scientifi cally sound. To accomplish these goals, this paper clarifi es terms such as Behavior Therapy, Clinical Behavior Analysis and Behavior-Analytic Therapy, summarizes the empirical evidence for the different types of therapies that are encompassed by clinical behavior analysis, and puts forth the argument that the fi eld suffers from "translational overconfi dence" (the belief that data from basic science are suffi cient to support intervention procedures). Keywords:Behavior therapy, behavior analysis, clinical psychology, psychotherapy, evidence-based practice. Evidências de Efi cácia e o Excesso de Confi ança Translacional da Análise do Comportamento ClínicaResumo O surgimento das terapias comportamentais seguiu a mesma estratégia que havia se mostrado bemsucedida em outras ciências: extrapolar princípios validados empiricamente na pesquisa básica para a resolução de problemas humanos. Entretanto, apesar da relevância desses princípios para a prática terapêutica, a mera transposição direta desse conhecimento para os diversos tipos de problemas clínicos não garante, a priori, a efetividade da intervenção. Tendo em vista que uma das características defi nidoras da Análise do Comportamento Aplicada é o forte comprometimento com a sustentação empírica de seus procedimentos de intervenção, o objetivo deste artigo é avaliar o status atual das evidências de efi cácia de um ramo da Análise do Comportamento Aplicada -a Análise do Comportamento Clínica