Arnold Lazarus and Multimodal Therapy

Arnold Lazarus and Multimodal Therapy

Arnold Allan Lazarus was born in Johannesburg, South Africa in 1932 to Benjamin and Rachel Lazarus. He was also raised and educated there at Witwatersrand University in Johannesburg. In 1956, he earned a B.A. degree with honors, his M.A. in 1957, and his Ph.D. in 1960 all in clinical psychology. His doctoral dissertation included for the first time systematic desensitization and had been conducted in groups. He later married Daphne Ann Kessel, with whom he has a son and daughter.

In 1959, he began a private practice in Johannesburg, South Africa. He came to the United States in 1966 as the director of the Behavior Therapy Institute in Sausalito, California. He published a book Behavior Therapy Techniques with Joseph Wolpe in 1966, as well. The following year he became a professor at Temple University Medical School as a professor of behavioral science. After becoming a professor and chairman of the psychology department at Rutgers University, he began to examine the inadequacies in long-term results of cognitive behavior therapy clients. Using these findings and interviews with clients he began to develop the multimodal therapy.

Lazarus has established the Lazarus Institute, which offers many services to best fit the needs of every client. The institute's practices go beyond cognitive behavior therapy and use also a multimodal therapy catered to each individual client. Lazarus has received many awards for his contributions to clinical psychotherapy and the many societies and association he has worked with.

Development of Behavior Therapy

Lazarus is responsible for the terms "behavior therapy" and "behavior therapist" in one of his first publications in 1958. During the 1950s he worked with Joseph Wolpe on making a major development in behavior therapy, systematic desensitization. They used animals to research the treatment of phobias in clinical settings. The process developed by Wolpe and Lazarus is used to make clients less sensitive to what causes clients to have high anxiety levels. The process is not a short-term process; it requires a lot of time and dedication from both the client and the therapist.

The Desensitization Process

Before any type of desensitization can take place an in depth interview with the client occurs, usually over a few sessions, this is to pinpoint causes of anxiety and to get to know the client better. The client needs to build a

relationship with the therapist and allow him or herself to delve deeper than just a general comment about his or her fear.

The first step in the desensitization process is to distinguish between basic and secondary fears. Specific recollections of events that may lend to the fear or bad memory needs to occur because general memories and fears cannot be handled by the desensitization, if the core of the anxiety is not pinpointed the process will not work as it is supposed to (Lazarus, 1971, pp. 98, 105).

The second step is to rank the specifics according to degree of increasing anxiety. It should not be a tedious and time-consuming process, yet make clear what causes the most anxiety. For, example a person may not like going to a hospital, yet may have more anxiety specifically in a hospital hallway. When desensitizing, a concentration can be put on the hallways rather than the general hospital (Lazarus, 1971, pp.105-106).

The third step is to decide the best anxiety reducer for the client. For most clients graded real-life exposure and modeling are the most effective. Desensitization is designed to increase the anxiety levels in clients so that they can overcome what it is that causes them anxiety. Working on using relaxation skills before anxiety is applied is usual. The client can then evaluate his or her progress. Once the client shows mastery in one level, the next session the level of anxiety is increased slightly. This can be done with both real-life anxiety or imagined images that produce anxiety (Lazarus, 1971, pp.106-107).

Integration of Various Techniques in Therapy

Although Wolpe is credited with the desensitization process more than Lazarus, he still implements it into his practices. Lazarus believes in using various techniques in therapy. Corey (2005) states, "According to Lazarus, behavioral practitioners can incorporate into their treatment plans any technique that can be demonstrated effectively change behavior. Lazarus advocates the use of diverse techniques, regardless of their theoretical origin" (p. 237)

Behavior therapy is not restrictive for a therapist; it allows him or her to explore the individual and what works for him or her. In Lazarus's book Behavioral Therapy and Beyond, he explores and demonstrates the need to go further than the basic foundations of behavior therapy. He believes that therapists should worry less about the label that they attach to his or her practices and clients, and focus more on the client. Lazarus (1971) stated, "The most essential ingredients for an effective psychotherapist are flexibility and versatility. This implies an ability to play many roles and to use many techniques in order to fit the therapy to the needs and idiosyncrasies of each patient" (p. 33). He feels that when therapists have a special treatment of theory that he or she favor he or she tends to use that technique with his or her clients regardless of what is really going to work. Most therapists adjust the specific treatment to fit the client, instead of exploring other treatments to fit the client personally.

Development of Multimodal Therapy

After using and analyzing behavior therapy, Lazarus knew that more needed to be implemented into the therapy. There was more than desensitizing that had to be done. At the 2002 APA Convention, when discussing multimodal therapy, Lazarus discussed the following:

"I noticed time and again, the ABC model -- Affect-Behavior-Cognition." But he felt there must be more. During efforts to follow up with patients who had "relapsed", Lazarus even questioned if "maybe the psychoanalysts were right about needing to address deeper unconscious aspects. But that's not it. Certain aspects were not focused on, and some sensory aspects were overlooked. So I went back to basic psychology, imagery ... and more... affect, sensation, cognition, interpersonal relations.... For the first time I was noticing that people were maintaining their gains." And