Social Work in Public Health, 26:471–481, 2011 Copyright © Taylor & Francis Group, LLC ISSN: 1937-1918 print/1937-190X online DOI: 10.1080/19371918.2011.591629 Social Learning Theory and Behavioral Therapy: Considering Human Behaviors within the Social and Cultural Context of Individuals and Families ANNIE McCULLOUGH CHAVIS Department of Social Work, Fayetteville State University, Fayetteville, North Carolina, USA This article examines theoretical thoughts of social learning theory and behavioral therapy and their influences on human behav- ior within a social and cultural context. The article utilizes two case illustrations with applications for consumers. It points out the abundance of research studies concerning the effectiveness of social learning theory, and the paucity of research studies re- garding effectiveness and evidence-based practices with diverse groups. Providing a social and cultural context in working with diverse groups with reference to social learning theory adds to the literature for more cultural considerations in adapting the theory to women, African Americans, and diverse groups. KEYWORDS Social learning theory, behavioral therapy, human behavior, social context, cultural context, environment, effective- ness, evidence-based practice, African Americans, diverse groups INTRODUCTION Social learning theory is one of the most recent approaches to addressing people in need and applying the theory to human problems within a social context. The utilization of the theory as an applicable approach to change human behaviors began in earnest in the 1950s. Its use in the social and behavioral sciences as a mental health intervention grew in popularity in the Address correspondence to Annie McCullough Chavis, Fayetteville State University, Department of Social Work, 1200 Murchison Road, Fayetteville, NC 28301. E-mail: [email protected] uncfsu.edu 471 472 A. McCullough Chavis late 1950s as interest in insight-oriented approaches waned. Social learning theory is one of the most influential theories of learning and human develop- ment and is rooted in many of the basic concepts of traditional learning. The theory focuses on learning that occurs within a social context and that people learn from one another (Ormond, 1999); however, the theory adds a social element. It proposes that people can learn new information and behaviors by observing other people. Thus, the use of observational learning, imitation, or modeling explains a wide variety of human behaviors using social learning theory and approach. Behavioral therapy has its roots and basic principles within social learning theory. Centered on principles of learned behavior that occurs within a social context, behavioral therapy focuses upon the principles of classical con- ditioning developed by Ivan Pavlov and operant conditioning developed by B. F. Skinner. Coady and Lehmann (2008) noted that Pavlov (1927) demonstrated that, through association in .

1. Social Work in Public Health, 26:471–481, 2011
Copyright © Taylor & Francis Group, LLC
ISSN: 1937-1918 print/1937-190X online
DOI: 10.1080/19371918.2011.591629
Social Learning Theory and Behavioral
Therapy: Considering Human Behaviors
within the Social and Cultural Context of
Individuals and Families
ANNIE McCULLOUGH CHAVIS
Department of Social Work, Fayetteville State University,
Fayetteville,
North Carolina, USA
This article examines theoretical thoughts of social learning
theory
and behavioral therapy and their influences on human behav-
ior within a social and cultural context. The article utilizes two
case illustrations with applications for consumers. It points out
the abundance of research studies concerning the effectiveness

2. of social learning theory, and the paucity of research studies re-
garding effectiveness and evidence-based practices with diverse
groups. Providing a social and cultural context in working with
diverse groups with reference to social learning theory adds to
the
literature for more cultural considerations in adapting the theory
to women, African Americans, and diverse groups.
KEYWORDS Social learning theory, behavioral therapy, human
behavior, social context, cultural context, environment,
effective-
ness, evidence-based practice, African Americans, diverse
groups
INTRODUCTION
Social learning theory is one of the most recent approaches to
addressing
people in need and applying the theory to human problems
within a social
context. The utilization of the theory as an applicable approach
to change
human behaviors began in earnest in the 1950s. Its use in the
social and
behavioral sciences as a mental health intervention grew in
popularity in the
Address correspondence to Annie McCullough Chavis,
Fayetteville State University,

3. Department of Social Work, 1200 Murchison Road, Fayetteville,
NC 28301. E-mail: [email protected]
uncfsu.edu
471
472 A. McCullough Chavis
late 1950s as interest in insight-oriented approaches waned.
Social learning
theory is one of the most influential theories of learning and
human develop-
ment and is rooted in many of the basic concepts of traditional
learning. The
theory focuses on learning that occurs within a social context
and that people
learn from one another (Ormond, 1999); however, the theory
adds a social
element. It proposes that people can learn new information and
behaviors by
observing other people. Thus, the use of observational learning,
imitation, or
modeling explains a wide variety of human behaviors using
social learning
theory and approach. Behavioral therapy has its roots and basic
principles
within social learning theory.
Centered on principles of learned behavior that occurs within a
social
context, behavioral therapy focuses upon the principles of
classical con-
ditioning developed by Ivan Pavlov and operant conditioning
developed

4. by B. F. Skinner. Coady and Lehmann (2008) noted that Pavlov
(1927)
demonstrated that, through association in time and space, the
sound of a
bell could have the effect of cueing a dog to produce a
biological reaction
of salivation-classical conditioning/learning. B. F. Skinner
(1953, 1974) docu-
mented that when behavior occurs, whatever follows it (the
consequences of
behavior) can either increase or decrease the frequency,
duration, or intensity
of the behavior (Coady & Lehmann, 2008). Albert Bandura
(1977) added
to the development of the therapy by exploring the role of
cognition and
emphasizing that people learn vicariously. Burman (1997) stated
behavior
therapy is an approach to psychotherapy based on learning
theory that aims
to treat psychopathology through techniques designed to
reinforce desired
and extinguish undesired behaviors. Today, with the thrust for
evidence-
based practice and measurable results, behavioral therapies are
widely used
to change general as well as dysfunctional behaviors such as
depression,
anorexia, chronic distress, substance abuse, anxiety, obesity,
phobia, pas-
sivity, obsessive behavior, self-mutilating behavior, anger
disorders, mental
retardation, and alcoholism (Mehr, 2001). The explanation of
these behaviors
is based largely on culture. Culture is a major factor in
explaining and

5. intervening in human behaviors.
Culture shapes human behavior and the social environment. The
social
environment of today is one of many challenges and warrants
the use of
evidence-based practices that focus on culture to meet the needs
of con-
sumers seeking help with problem behaviors. All individuals are
social beings
and carry within them their cultural experiences that affect all
aspects of
behavior. This article focuses on two case illustrations and
discusses learned
behaviors: the usability of social learning theory and behavioral
therapies
within the social and cultural context. The cultural context
refers to the
environment and cultural influences but recognizes that society,
community,
as well as cultural heritage, values, beliefs, thinking, and
traditions affect indi-
viduals and families (McCullough-Chavis & Waites, 2004). For
this article, the
social and cultural context includes the culture, community,
family, school,
Social Learning Theory and Behavioral Therapy 473
work, and all systems within the social environment of
consumers. The article
concludes with a discussion of the importance of social learning
theory and
approaches to usability with individuals from varied cultural

6. backgrounds
such as African Americans and women.
LITERATURE REVIEW
Interventions and Effectiveness
Social learning interventions and behavioral approaches to
changing human
behaviors are among the most studied and reported in the
literature. Ac-
cording to Mehr and Kanwisher (2007), persons conduct more
controlled
outcome research on behavioral therapies than on any other
psychotherapy
due to the use of scientific methods and the ability to measure
outcomes us-
ing evidence-based practice techniques and instruments.
Behavioral therapy
points toward the new emphasis in the social sciences on
empiricism (ob-
servable evidence) in evaluating the outcomes of intervention
with children,
adults, couples, and families (Mehr & Kanwisher). They stated
the surge in
the therapy movement toward efficiency, research-supported
methods, and
evaluation of outcomes, is a credit to behaviorists, and there is
evidence that
these approaches do change behaviors. Uses of the approaches
in systems
or settings include public school programs for emotionally
handicapped
children, residential programs for people who are mentally
retarded, resi-
dential and outpatient programs for children identified as

7. mentally ill, and
juvenile and adult corrections facilities (Mehr & Kanwisher). In
many settings
and systems, behavioral therapies are the primary approaches
employed to
change unacceptable learned behavior in children and adults.
Therefore,
the service delivery environment, with its focus on outcome
indicators and
evidence-based practice, owes a great debt to behaviorists who
remain the
most proficient group of practitioners in measuring intervention
outcomes
(Granvold, 1994).
Behavioral therapies are efficient therapies and several research
studies
document effectiveness for a wide range of behaviors. Mehr and
Kanwisher
(2007) postulated that the effectiveness of behavioral
approaches seems
well documented, particularly for consumers who have behavior
problems
that use behavioral approaches. Weisz, Hawley, and Doss
(2004) statistically
examined 236 published randomized trials on treatment for
youth (age 3–18
years) spanning the years 1962 through 2002. They found that
across various
outcome measures, 80% of treated youngsters improved after
treatment more
than those not treated. Behavioral treatments proved more
effective than
nonbehavioral treatments regardless of client age. Mehr and
Kanwisher re-
ported that a major positive feature of behavioral strategies is

8. that a majority
of their proponents are thoroughly indoctrinated in the scientific
method
474 A. McCullough Chavis
and extremely concerned with proving whether the techniques
of behav-
ioral therapy work. Therefore, many behavioral studies, and
particularly
controlled studies, support the claims of significant behavior
evaluations,
as well as evidence-based practices claims. Prochaska and
Norcross (2007)
described several meta-analyses conducted on adults, couples,
and families
concerning the effectiveness of behavioral therapy that
produced similar
results. For example, in a 1983 study conducted by Norcross
and Wogan
(cited in Prochaska & Norcross, 2007) behavior therapists
reported seeing
clients less frequently and for a shorter duration than
psychotherapists of
other persuasions; and only 7% of their clients, on average, had
more than
a year of treatment.
Literature documents the use of behavior approaches to deal
with
persons in individual, group treatment, and family settings.
Mehr (2001)
discussed a 1986 study, reported by Nardone, Tryon, and
O’Conner on

9. a cognitive-behavioral group treatment for reducing impulsive–
aggressive
behavior in adolescent boys in a residential setting for boys.
During the
course of the project, the frequency of impulsive–aggressive
behavior on
the part of the boys declined dramatically. However, during a
follow-up
period, the therapist discovered that the positive gains slowly
eroded and
disappeared within 5 weeks. With more focus on evidence-based
practices,
this finding clearly emphasizes the need for maintenance
reinforcement
programs after behavior therapy programs.
Other studies point to the use of social learning theory as a
family
intervention. Kilpatrick and Holland (2009) suggested that
social learning
theory utilization as a family intervention is particularly
effective with fami-
lies that have issues with internal and external environmental
factors. They
reported that families who experience high levels of disruptions,
communi-
cation problems, and families that have children who experience
difficulty
with social systems within the community are a few examples of
intervention
utilizing social learning theory. In other studies, as cited in
Kilpatrick and
Holland (2006, 2009); Sayger, Horne, and Glaser; Sayger,
Horne, Walker,
and Passmore; and Szykula, Sayger, Morris, and Sudweeks
measured the

10. effectiveness of social learning family interventions with
children with be-
havioral disorders and their families in a variety of settings.
The results
according to the authors have been remarkable, with significant
decreases
in negative behaviors of children in the study and subsequent
increases in
positive behaviors at home and in school. Sayger et al. (1988)
reported the
maintenance of positive behavioral changes after a 9- to 12-
month follow-
up. Behavioral approaches have proved to be effective with
children and
their families in child psychiatric outpatient treatment. Szykula
et al. (1987)
avowed in a comparison of strategic and behavioral family
therapies in an
outpatient child psychiatric facility, that 100% of the families
participating
in social learning theory family-intervention treatment
demonstrated gains
toward their treatment attainable goals and 67% of those in the
strategic
Social Learning Theory and Behavioral Therapy 475
family therapy group made gains toward treatment goals. In
treatment with
parents, Sayger et al. (cited in Kilpatrick and Holland (2006,
2009)) found
that parents participating in social learning family interventions
reported
significant more positive than negative side effects of their

11. participation in
treatment.
The literature review suggests social learning and behavioral
interven-
tions are effective in changing human behaviors across several
environmental
settings in treating children, adults, and families. The theory
and approaches
have a strong research and evidence-based background that
demonstrate
effectiveness within the social context of human behaviors.
However, the
literature does not provide sufficient information concerning
effective inter-
ventions with all target groups, particularly diverse groups such
as women,
African Americans, and people of color consumers. Today, any
efforts at
interventions and problem resolutions must be in tune with the
distinctive
culture, values, and community customs of all consumers within
their social
and cultural context.
Understanding theory and the impact of behaviors on human
devel-
opment are collectively a part of interventions in the social and
behavioral
sciences. For example, in social work, the influence of theory
driving practice
is evident, and all the social sciences expound evidence-based
practices as
sufficiently interrelated to outcomes pertaining to human
behaviors within
the social context. To illustrate the relationship concerning

12. human behaviors,
theory, and behavioral interventions, two case illustrations
discuss the need
for changes in human behaviors. The two cases demonstrate
how to use so-
cial learning theory and behavioral approaches with different
individuals and
families in different settings and disciplines, and particularly in
social work.
CASE ILLUSTRATIONS
The case illustration of Paula demonstrates the use of
behavioral therapy in a
public school setting. The second case illustration of Jamaal
exemplifies the
use of social learning theory in a family intervention case with
an emphasis
on social work.1
Paula, age 10, is one of five students in an exceptional
classroom. Her
disruptive behavior prevents her from being in a regular
classroom. Paula’s
behavior disrupts the learning environment due to her
hyperactivity and
impulsivity. She constantly squirms in her chair, snaps her
fingers, taps her
feet, talks loudly to the other students during class, and gets up
and moves
about the classroom without permission instead of listening and
following
instruction from the classroom teacher or teacher assistant.
Paula is the oldest child of John and Megan Head. She has an 8-
year-old

13. brother Tim who attends the same elementary school in a
regular class. The
parents report no major behavioral problems with him but state
that Paula
476 A. McCullough Chavis
has difficulties remaining in her seat while eating, as well as
when the family
watches television or engages in most family activities. They
use time-out
techniques when these disruptions occur. They expressed
concerns about
Paula’s behavior and often inquire from the school about her
behavioral and
educational progress.
In this case illustration modified and adapted from Mehr (2001),
to help
Paula change the undesirable classroom behaviors, the teacher,
teacher assis-
tant, school psychologist, and social worker met several times
and decided to
implement a behavioral treatment plan with Paula. After several
discussions,
they targeted two behaviors for change: talking to other students
and leaving
her seat without permission. The focus of intervention was
observation and
recording of the behaviors, verbal counseling, verbal praise, and
loss of
playtime because of breaking these two rules. If Paula spoke or
left her
seat without permission, the aide reminded her of the loss of

14. playtime for
rule breaking. If Paula behaved acceptably, she received verbal
praise. The
primary person responsible for the behavioral program was the
teacher aide,
and for a day, she observed Paula and recorded how often she
disrupted the
class concerning the targeted behaviors. The disrupted
behaviors occurred
25 times during the one day of observation before any
intervention.
The next week the teacher aide informed Paula of the program
and
the consequences if the two disrupted behaviors occurred. At
the end of
each class period when Paula did not speak out or leave her seat
without
permission, she earned a gold star beside her name on the board.
At the end
of the day, she could take a gold star home to her parents if she
earned stars
in more than one half of the classroom sessions. At the end of
the week, Paula
was down to eight disruptions a day and showed much progress
as recorded
by the teacher’s aide. The next week, the aide added another
behavior to
change and explained the addition to Paula. By the end of the
second week
Paula was down to four disruptions a day, and after another
week, Paula
took home a gold star each day. Some days there were one to no
disruptions,
and this change continued for the remainder of the school year.
More sig-

15. nificantly, Paula’s schoolwork improved with the improvement
in behavior,
and the positive changes continued until Paula did not need gold
stars to
maintain her behavior. Using predata and data during the
intervention, the
case of Paula illustrates the application of principles of learned
behavior. It
shows that humans can learn to change undesirable behavior
with behavioral
therapy and evidence-based practice within a social context.
Modified and adapted from Kilpatrick and Holland (2006), the
second
case illustration of Jamaal exemplifies the use of social learning
theory in
a family intervention case. This case illustrates the use of
treatment goals
consistent with the principles of the theory.
Jamaal, a 22-year-old African American male, is gay and the
only child
of Joe and Mary Jones. After graduating from college, he
returned home to
live and work as a high school teacher. Jamaal’s parents are
highly religious
Social Learning Theory and Behavioral Therapy 477
and do not approve of Jamaal’s sexual orientation or his
homosexual rela-
tionships. They will not converse with Jamaal about his sexual
orientation
or relationships. They believe in intimate heterosexual

16. relationships and
that God condemns any other relationships. Jamaal is very close
to his
parents and expresses concern about their denial or disapproval
of his
relationships. He desires the acceptance of his choice of
relationships and
sexual orientation by his parents. Jamaal believes in God but
has concerns
about being gay and being accepted within his social
environment. Many in
his family, church, and extended family are homophobic.
Other family members suspect that Jamaal is gay but are not
quite sure
of his sexual orientation so he selects and guards his
communication with
extended family, except for his cousin, James. Although Jamaal
interacts with
James more than with other extended family, Jamaal has never
revealed any
information regarding his sexual orientation or ambivalent
feelings about be-
ing gay or nonacceptance by his parents to James. However,
Jamaal suspects
that James is aware of his sexual orientation. His parents avoid
the subject
and are consistent in their disapproval. Jamaal feels lonely,
ashamed, angry,
and isolated. Consequently, he is having considerable difficulty
managing
his needs for intimacy. The negative social pressure he feels
from his family
and social environment are burdensome and depressing.
Jamaal came to counseling seeking assistance in learning how to

17. manage
his intimacy, loneliness, shame, anger, and pain. Additionally,
he needs help
learning to accept his homosexuality and help with
communication skills to
assist in facilitating meeting other persons. There is also a need
to learn new
ways of conversing with his parents and family members
concerning their
homophobia and his sexual orientation.
In this case illustration, the focus of intervention is with Jamaal
and
his parents as they are experiencing difficulties with an
ineffective family
structure and boundaries (Kilpatrick & Holland, 2006) that
could inhibit
problem solving (homosexuality, intimacy, communication and
feelings of
shame, pain, anger, and confusion). The communication within
the family
as dictated by the family rules is weakened by unrealistic
expectation and
appears complicated by these rigid family rules and family
roles. There is
also confusion within the family and clearly with Jamaal. This
confusion
limits the family’s capacity to overcome their life challenges
and feelings of
insecurities, dissatisfaction, and discomfort with the level of
intimacy within
the family and the environment (Kilpatrick & Holland, 2006).
The family
operates as a closed family system concerning family rules,
boundaries, and
communication, and dealing with Jamaal’s sexual orientation.

18. Also Jamaal’s
communication is poor regarding his feelings, and he finds it
difficult to
maintain intimate relationships. Utilizing social learning theory,
it would be
very appropriate and useful to work with Jamaal and his family
concerning
the following goals as stated by Kilpatrick & Holland (2006)
and modified
for this case.
478 A. McCullough Chavis
1. Learn to develop coping strategies to manage fear and loss
(son’s sexual
orientation, family, and son’s acceptance of sexual orientation)
within the
social and cultural context.
2. Develop skills and knowledge concerning self-control to
manage, family,
life, and the social environment of extended family and
religious family
more effectively.
3. Help in communication skills that will permit family rules,
roles, and
boundaries to be more open that will allow greater means and
ways of
expressing feelings, meeting people, and sharing with family
and friends
that includes the cultural context in meeting the unique style,
life experi-
ences, and worldview of the family.

19. Social learning theory interventions are appropriate for use with
Jamaal
and his family. Cognitive thoughts, beliefs, and development of
communica-
tion skills from a cultural perspective are major focal points of
intervention
with Jamaal. The case also focuses on appropriate learned
behaviors by
normalizing the problems of the family and focusing on
strengths within the
social and cultural context. Social learning theory and
behavioral approaches
are applicable in a variety of environments and disciplines.
DISCUSSION AND IMPLICATIONS
Social learning theory offers a structured and learned approach
to dealing
with a variety of behavioral concerns in many different
disciplines and set-
tings. Although, I only discuss two case illustrations, this
article presents the
importance of treating and focusing on learned behaviors using
theory and
strategies in an effort to change behaviors from a social and
cultural context.
The target population of the two cases consisted of a female
consumer and
an African American male consumer from diverse groups. The
question of
the applicability of the theory and approaches with diverse
groups is a major
criticism and of concern to this author and others. Kilpatrick
and Holland
(2009) stated that in some cultural groups, the specific

20. approaches used in
social learning theory are not valued or endorsed; rather, they
appear as
being White, middle class, or incompatible in other ways with
many cultural
groups. Although behaviorists expound empowerment and
concrete changes
of consumers, the research rarely addresses cultural,
multicultural, or African
American issues, despite important theoretical contributions
made by Cheek
(1976) and Kantrowitz and Ballou (1992).
Cheek, a pioneer in assertive training was one of the first
behaviorists to
generalize behavior theory specifically to counseling with
African Americans.
He demonstrated the validity of behavioral concepts with
African American
clients and supplied a culturally relevant view to the therapy.
Cheek affirmed
that assertive behavior varies between African American and
White cultures,
Social Learning Theory and Behavioral Therapy 479
and that both groups need to understand the frame of reference
of the
other (Ivey, Andrea, Ivey, & Simek-Morgan, 2002). The work
by Cheek had
particular implications for women.
Kantrowitz and Ballou (1992) suggested that the behavioral
focus on

21. individual skill training could neglect social issues and support
dominant
group values. They asserted that assertiveness training is an
example of
evidence-based treatment and will probably meet with the
approval of the
sexually harassed woman, and the social norm of women’s duty
to protect
themselves is not seriously questioned. The women’s distress is
temporarily
reduced, but the social status quo of the dominant society is
also decisively
protected. That is, necessary social change does not occur.
Even though the literature cites the wide use of social learning
theory
and behavioral therapies, a careful examination of the literature
found a
paucity of information to support effective and evidence-based
application
with women, African Americans, and diverse groups. A wide
array of behav-
ior therapies applying the principles is applicable for use with
these groups,
but what is not as clear is whether substantially conducted
research studies
prove efficacy and effectiveness. Empirically, behavioral
therapies yielded
a great deal of effective therapies, and some took into account
the culture
and worldview of African Americans and others, but according
to Cheek
(1976) behaviorists should not seek to ‘‘make African
Americans White’’
or to have women think like men but to recognize the
perspective and

22. worldview of different groups. His pioneering works
demonstrate how to
use the approaches effectively with African American clients
when modified
to meet the client’s unique style, life experiences, and
worldview.
The worldview and culture of African Americans and other
diverse
groups are uniquely different from the dominant group. Nobles
(1973)
argued that the African view of ‘‘self’’ is contingent upon the
existence
of others, oneness of being, and a balance and harmony with all
things.
McCullough-Chavis and Waites (2004) contended that the
cultural context
is an important aspect of individuals and families. Thus, a
criticism of
social learning theory and behavioral therapies from a cultural
perspective
is the somewhat exclusion of diverse cultures and an African
view of ‘‘self.’’
If Cheek can demonstrate effectiveness with African American
consumers
when adjusted to meet the consumer’s unique linguistic style
and life
experiences (Ivey et. al., 2002), and Kantrowitz and Ballou
(1992) with
women, then behaviorists should consider these adjustment and
adaptations
when working with consumers from diverse groups.
CONCLUSION
This article presents two case illustrations and focuses on the

23. importance
of human behaviors within the social environment. The
literature points to
480 A. McCullough Chavis
evidence-based practice and the effectiveness of the theory and
approaches.
However, the author believes that to make an unmitigated claim
of ef-
fectiveness and aggregate evidence-based practice those
utilizing the the-
ory and approaches must prove their effectiveness through more
research
with other groups as demonstrated with the dominant group. The
social
environment of today is a multicultural environment, which
warrants the
use of culturally focused evidence-based practices to meet the
needs of
consumers seeking assistance with problem behaviors in a
variety of en-
vironmental settings and disciplines. In addition, the Code of
Ethics for
social workers states there is a responsibility to ‘‘understand
culture and its
function in human behavior and society, recognizing the
strengths that exist
in all cultures’’ (National Association of Social Workers, 1996,
p. 9). Thus,
it is critical and imperative that social workers, practitioners,
counselors,
sociologists, psychologists, educators, and behaviorists practice
more from

24. a culturally focused perspective. To be effective, professionals
must acquire
further knowledge and skills about the cultures, values, beliefs,
practices,
and worldviews of individuals and families who come from
different and
varied cultural backgrounds. This article and its use of two case
illustrations
offer a structural and practical approach to dealing with human
behaviors
within the social and cultural context. It helps professionals
understand and
intervene appropriately and effectively with consumers from
various cultural
backgrounds.
NOTE
1. Please note that for this article, the names in the two case
illustrations are pseudonym.
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