Behavioral and Cognitive-Behavioral Therapies

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Behavioral and Cognitive-Behavioral Therapies
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The Behavioral Approaches

• Behavior, Learning, Social Context
• Peoples unique learning histories
• Commonalities in rules, values, and learning
  histories
• Principles of learning
• Behavioral consistency vs. behavioral specificity

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Three Main Versions

• 1). Classical Conditioning
• (Respondent Learning)
• Joseph Wolpe,
• Hans Eysenck
• emphasize the association of conditioned
  and unconditioned stimuli

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• 2). Operant Conditioning
• B.F. Skinner
• Functional Analysis focus on describing
  and explaining functional relationships among
  stimuli, responses, and consequences
• 3). Social-Cognitive (Cognitive-Behavioral)
  Theories
• a). Albert Bandura
• Observational Learning
• Self-Efficacy

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ABC Functional Analysis

• Antecedent
• Event Behavior
  Consequence
• organismic variable

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• b). Walter Mischel
• Cognitive Social Learning Person
  Variables(Table 2.2, p.49)
• Competencies, Encoding Strategies and Personal
  Construct, Expectancies, Subjective Value,
  Self-Regulatory Systems and Plans
• c). Aron Beck
• Cognitive Theory of Depression

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• d). Seligman et al.
• Attribution (Habitual explanations)
• Internality, Stability, Globalness
• e). Albert Ellis
• Rational-Emotive Behavioral Therapy
  (REBT)
• Irrational Beliefs should
  statement, unrealistically high standards

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Behavior Therapy

• May be regarded as the attempt to apply data from
  behavioral science research to the process of
  behavior change for remediation and treatment for
  individuals experiencing difficulty in coping
  with problems of living (Walker et al., 1981)
• Learning-theory approach to therapy

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Assumptions of behavioral approach

• 1). Any behaviors are developing through the
  same law of learning
• 2). Therapy methods should be guided by the
  results of research on learning
• 3). Aimed at modifying overt, maladaptive
  behaviors, as well as the cognitions, physical
  changes, emotions that accompany overt behavior

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• 4). Treatment should address clients current
  problems by dealing with the contemporary
  environmental forces, learned habits, and
  cognitive factors that maintain them
• 5). Commitment to the experimental evaluation of
  treatment
• Learning-oriented, empirical, here and now

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The beginnings of behavior therapy

• The term behavior therapy first appeared in a
  paper (Lindsley, Skinner, Solomon, 1953)
• Groundwork 1920s
• studying the role of conditioning and
  learning in development of anxiety
• Ivan Pavlov experimental neuroses
• J.B. Watson Rosalie Rayner(1920) little
  Albert
• Mary Cover Jones(1924)

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What is behavior?

• 1). Respondents antecedent-controlled
• somatic reflexes, emotional reaction,
  sensations
• 2). Operants consequence-controlled
• actions, instrumental responses, cognition
• a). Behavioral excesses, b). Behavioral
  deficits,
• c). Behavioral anomalies, d). Behavioral assets

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• Martin Pear
• Behavior therapy Behavior modification
• 1). Pavlovian-Hullian Skinnerian tradition
• -Wolpean tradition
• 2). Clinical Nonclinical
• 3). Therapeutic setting Natural setting
• 4). Experimental foundation Experimental
  foundation
• based on clinical setting based
  on animal or human
• 
  operant research
• 5). European tradition American tradition

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Systematic Desensitization

• Joseph Wolpe (1958)
• Rationale Reciprocal Inhibition
• responses incompatible with anxiety
• 1). deep muscle relaxation, 2). interpersonal
  assertion, 3). sexual arousal
• combination of 1). counter-conditioning 2).
  extinction

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Procedures of SD

• 1). Diagnosis evaluation
• History Taking, Behavioral Inventory
• 2). Hierarchy construction
• Anxiety hierarchy (table 7.2, p.247)
• 3). Teaching anxiety-inhibiting responses
• Progressive relaxation training(Jacobson,
  1938)
• 4). Conducting the therapy session
• Imagery (imagination training)
• In vivo

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Exposure Techniques

• Exposed to the most anxiety-provoking stimulus
  for an extended period of time
• Rationale Extinction
• Implosion Therapy Thomas Stampfl(1957)
• use of hypothetical construction
• Flooding (Polin, 1959)
• use to objective anxiety-related stimuli
• Combine with Response Prevention

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Social Skills Training

• Social skill deficits
• Assertiveness Training
• appropriate expression of feeling in ways
  that do not infringe upon the rights of others
• 1). Teach clients how to express themselves
  appropriately
• 2). Eliminate cognitive obstacles to clear
  self-expression

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Modeling

• Observational Learning (Bandura, 1969)
• 1). Attention process
• 2). Retention process
• 3). Motor production process
• 4). Incentive motivation process
• Model Characteristic similarity, high status,
  be rewarded for their actions
• Participant Modeling

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Aversion Therapy

• A set of techniques in which painful or
  unpleasant stimuli are used to decrease the
  probability of unwanted behaviors
• Rationale
• 1). Punishment
• 2). Escape and Avoidance Conditioning
• 3). Classical Conditioning
• Debate problems

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Contingency Management

• Behavior modification procedures
• Rationale Status of
  Stimulus
• present()
  removed(-)
• Nature positive positive
  indirect
• of () reinforcement
  punishment
• Stimulus negative direct
  negative
• (-) punishment
  reinforcement

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Reinforcer

• Reinforcer vs. Punisher
• Primary vs. Secondary Reinforcer
• Social Reinforcer
• Choice rules
• 1). Personal values needs
• 2). Premack Principle
• 3). Trial error

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Schedules of Reinforcement

• Continuous reinforcement(CRF)
• Intermittent reinforcement (Partial)
• 1). Ratio schedule
• a). Fixed ratio schedule(FR)
• b). Variable ratio schedule(VR)
• 2). Interval schedule
• a). Fixed interval schedule(FI)
• b). Fixed variable schedule(VI)
• Extinction

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• Shaping
• successive approximation
• Time Out
• a special sample of extinction
• Contingency Contract
• five components 1). Responsibilities, 2).
  Rewards, 3). Monitoring system, 4). Bonuses, 5).
  Penalties for failure
• Response Cost

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Token Economies

• A system for implementing the principles of
  contingency management to alter a variety of
  behaviors
• Four elements
• 1). Target behaviors
• 2). Token system
• 3). Back-up reinforcers
• 4). Rules of exchange governing

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Biofeedback

• Behavioral methods used to control heart rate,
  blood pressure, muscle tension, physiological
  responses are known as biofeedback
• Monitor feedback apparatus
• meter reading, graph, or auditory signal
• Used to treat several clinical disorders

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Cognitive-Behavioral Therapy(CBT)

• Cognitive therapy directed toward changing
  clients maladaptive cognition
• The behavioral and cognitive approaches have
  tended to merge, called CBT
• 1). Becks Cognitive Therapy
• approach to treatment of depression

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• 2). Rational Emotive behavior Therapy(REBT)
• Albert Ellis
• ABC Model
• A B
  C
• (Activating event) (Belief) (emotional
  consequence)
• D (Dispute)
• E
  F
• (Effect)
  (new Feeling)

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• 3). Dialectical Behavior Therapy (DBT)
• Marsha Linehan
• Borderline Personality Disorder
• helps the client confront any traumatic
  experiences
• 4). Relapse Prevention
• Alan Marlatt Judith Gordon
• Alcoholism Substance Use Disorder
• teach the client to monitor risky cognition
  and to replace them with different thinking
  strategies

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• 5). Cognitive Behavior Modification(CBM)
• Meichenbaum, D.
• Self-talk or Self-instruction
• Coping-Skills Programs
• Stress Inoculation Training (SIT)
• a). Conceptualization Phase
• b). Skill Acquisition Rehearsal Phase
• c). Application Phase