assigned work on the ward, and so on. When clients show inappropriate
behaviors, they might be punished by having tokens taken away.
Biofeedback is another type of operant conditioning used to treat psycho-
logical problems. Biofeedback requires special equipment that provides infor-
mation about somatic processes. A woman suffering from anxiety might use a
machine that tells her when she is tightening and relaxing certain facial and
back muscles, a reaction she is otherwise not aware of. After several muscle
relaxation sessions with the immediate feedback of the machine, she maylearn to reduce tension on her own and thereby overcome her anxiety. In op-
erant conditioning terms, the woman was reinforced for producing the re-
sponse that lowered her muscle tension, as indicated by the machine. As withother reinforced behaviors, she soon learned to make the relaxation response.
One of the most common targets of biofeedback treatments is the tension
headache. To reduce these headaches, psychologists use electromyographymonitors to inform clients about muscle constriction that they otherwise
might not be aware of. A review of studies using this procedure found it was
highly effective in reducing the frequency, intensity, and duration of tensionheadaches (Nestoriuc, Rief, & Martin, 2008). Moreover, the procedure was
relatively quick and efficient. Participants averaged fewer than 11 biofeed-
back sessions, and the improvements were seen in follow-up assessments 15
months later. Other bodily indicators that may be controlled through biofeed-
back include blood pressure, heart rate, and brain waves.
Self-Efficacy
Every year millions of Americans seek professional help to stop smoking or lose
weight. Although many of these people go several weeks without cigarettes or
succeed in dropping a few pounds, only a small percentage permanently end
their habit or keep the lost pounds off. What is it about these few successful cases
that separate them from the others? The answer may lie in what Bandura calls
self-efficacy . People stop smoking and lose weight when they convince them-
selves they can do it. Many smokers complain that they have tried to quit many
times but just can ’t. From a social-cognitive analysis, one reason these smokers
are unable to kick their habit is precisely because they believe they cannot.
According to Bandura (1977b, 1997), people aren ’t likely to alter their be-
havior until they make a clear decision to expend the necessary effort. Bandura
draws a distinction between outcome expectations and efficacy expectations.
Anoutcome expectation is the extent to which people believe their actions will
lead to a certain outcome. An efficacy expectation is the extent to which they
believe they can bring about the particular outcome. Simply put, it is the differ-
ence between believing that something can happen and believing that you can
make it happen. You may hold the outcome expectation that if you devote sev-
eral hours to studying each night and abandon social life on weekends, you
will get good grades this term. However, you may also hold the efficacy expec-
tation that you are incapable of such devoted work and sacrifice.
Bandura argues that efficacy expectations are better predictors of behav-
ior than outcome expectations. Students are unlikely to work hard for good362 CHAPTER 13 The Behavioral/Social Learning Approach