Practitioner Development

The dimensions of clinical behavior analysis.

Kohlenberg et al. (1993) · The Behavior analyst 1993
★ The Verdict

Clinical behavior analysis turns your therapy talk into real contingencies that can shape adult clients’ outside behavior.

✓ Read this if BCBAs doing outpatient talk therapy with adults.
✗ Skip if Clinicians who only work with toddlers or non-verbal clients.

01Research in Context

01

What this study did

Szempruch et al. (1993) mapped out clinical behavior analysis. This is a verbal-behavior way to do talk therapy with grown-ups.

The paper is a how-to guide, not an experiment. It shows you how to use Skinner’s words-and-thoughts ideas inside a therapy hour.

02

What they found

The big idea: the words you and the client trade in session can be real contingencies. Those words can later shape what the client does outside the office.

No numbers were tested. The paper simply lays out the rules so your talk therapy follows ABA principles.

03

How this fits with other research

Rutter et al. (1987) came first and listed ABA’s seven core dimensions. Szempruch et al. (1993) keeps those rules but moves them into the adult therapy room.

Rajaraman et al. (2022) and Austin (2025) extend the same adult model. They add trauma-informed safeguards and a research agenda for safety checks.

Vollmer et al. (2025) also extends the idea. They say keep checking social validity while you use this verbal-behavior style with clients.

04

Why it matters

If you run talk therapy with adults, this gives you an ABA backbone. You stop flying blind and start using clear, trackable verbal contingencies. Try writing the client’s in-room words as behavior. Then plan how those words can contact real-life reinforcers before the next session.

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Take one client statement, write it as a verbal operant, and list what outside reinforcers could strengthen it.

02At a glance

Intervention
not applicable
Design
theoretical
Population
not specified
Finding
not reported

03Original abstract

In most talk therapies for outpatient adults, the therapist has no contro over the client's daily life or contingencies outside the treatment session. The fundamental theoretical issue facing the behavior analyst is, "How can the talking that goes on during the session help the client with problems that occur outside the session in the client's daily life?" An historical analysis and the application of verbal behavior principles are used to answer the question and form the basis of clinical behavior analysis (CBA). The implications of CBA range from providing a theoretical base for psychotherapy to suggesting new forms of treatment.

The Behavior analyst, 1993 · doi:10.1007/BF03392636