Behavior Therapy

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Behavior Therapy

• C6436 Individual Counseling Theory and Practice
• James J. Messina, Ph.D.

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Behavior Therapy

• A set of clinical procedures relying on
  experimental findings of psychological research
• Based on principles of learning that are
  systematically applied
• Treatment goals are specific and measurable
• Focusing on the clients current problems
• To help people change maladaptive to adaptive
  behaviors
• The therapy is largely educational - teaching
  clients skills of self-management

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Key Names in Behavioral Therapy

• Arnold Lazarus-role of therapeutic change-brief,
  efficient effective psychotherapy-Multimodal
  Therapy
• Albert Bandura-introduced cognition as focus of
  behavior therapy
• Albert Ellis-Rational Emotive Therapy
• Aaron Beck-Cognitive therapy for depression
• Donald Michenbaum-treatments for stress
  inoculation self-instructional training

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Traditional Behaviorists

• Determinists People are controlled by their
  environment
• Ivan Pavlov 1849-1936-Conditioning
• John B. Watson 1878-1958-Behaviorism
• B. F. Skinner 1904-1990-operant conditioning

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Principle of Reinforcement

• Frequency of Behavior depends on the its
  consequences. The response is contingent on a
  sought after outcome.
• Reinforcementevent that strengthens a behavior
  increases likelihood of repeating behavior in
  future
• Partial Reinforcementa rare rewarding event
  strengthens a behavior to increase its repetition
  in search of such rewards in future
• Negative Reinforcementaversive event ends if we
  perform a behavior-increases repetition of
  behavior-attention to bad behavior

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Modern Behavior Therapy Elevates Individual
Freedom

• Focuses on therapy as action-oriented-clients
  asked to act rather than to reflect passively
  introspect at length on problems
• Concern how stimulus events are mediated by
  cognitive processes private or subjective
  meanings
• Emphasis on personal responsibility for ones
  behaviors-with techniques skills of
  self-change-people can improve lives

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Characteristics of Behavior Therapy

• Based on principles and procedures of scientific
  method-stated explicitly, tested empirically,
  revised continually
• Deals with clients current problems current
  influences
• Clients are active-doing specific actions
• Carried out in clients natural environment
• Emphasis on self-control
• Tailored to fit unique needs of client
• Collaborative partnership of client therapist

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Criticisms of Behavior Therapy

• May change behaviors but does not change feelings
• Ignores important relational factors in therapy
• Does not provide insight-it is change directed
• Treats symptoms not causes-focuses on new
  learning to cope with problems-rise of symptom
  substitution due to this
• Involves control manipulation by therapist

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Four Aspects of Behavior Therapy

• 1. Classical Conditioning
• In classical conditioning certain respondent
  behaviors, such as knee jerks and salivation, are
  elicited from a passive organism
• 2. Operant Conditioning
• Focuses on actions that operate on the
  environment to produce consequences
• If the environmental change brought about by the
  behavior is reinforcing, the chances are
  strengthened that the behavior will occur again.
• If the environmental changes produce no
  reinforcement, the chances are lessened that the
  behavior will recur

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Four Aspects of Behavior Therapy

• 3. Social Learning Approach
• Gives prominence to the reciprocal interactions
  between an individuals behavior and the
  environment
• 4. Cognitive Behavior Therapy-Covered in Lecture
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• Emphasizes cognitive processes and private events
  (such as clients self-talk) as mediators of
  behavior change

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Classical Conditioning-Wolpe, Lazarus, Eysenck

• An unconditional stimulus causing an
  unconditioned or automatic response is paired
  with neutral stimulus so that eventually the
  neutral stimulus evokes the same response
  FoodBellSaliva
• Conditioned stimulus(bell)elicits conditioned
  response(saliva)
• Conditioned to automatic association
• Used to treat phobias

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Operant Conditioning-Skinner

• Used with Psychotics
• Behavior is changed by consequences
• Manipulate environment-change behaviors
• By shaping successive approximations to desired
  behavior
• Deterministic theory with NO FREE WILL
• Personalitygroup of responses to environment

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Neurotic Behavior Conditioning

• If the environment (stimulus) is unpredictable
  greater chance of anxiety, depression and
  frustration
• Dysfunctional environments are unpredictable thus
  stimulating unhealthy response patterns
• What is needed is a healthy predictable
  environment to encourage new conditioned
  responses Unconditional Love in a boundary
  respecting predictable environment

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Habit Hierarchy

• Individuals experiences result in learning the
  likelihood that a specific response in a
  particular situation results in a
  reward-reinforces which is social in nature
• Responses are then ranked in a habit hierarchy
• Hierarchy results in individual personality
  styles or differences

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Shaping

• Process in which undifferentiated operant
  behaviors are gradually changed(shaped) into a
  desired behavior pattern by the reinforcement of
  success approximations, so that the behavior gets
  closer closer to the target behavior.

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Systematic Desensitization

• Deconditioning of phobias
• Extinguishes fear by gradually relaxing subject
  and simultaneous gradual introduction of the fear
  inducing stimulus
• Focus is on conditioning from the
  outside-contradicts Freuds unconscious model of
  fear and phobia development from inside

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Exposure Therapies

• In Vivo Desensitization
• Brief and graduated exposure to an actual fear
  situation or event
• Flooding
• Prolonged intensive in vivo or imaginal
  exposure to highly anxiety-evoking stimuli
  without the opportunity to avoid them
• Eye Movement Desensitization and Reprocessing
  (EMDR)
• An exposure-based therapy that involves imaginal
  flooding, cognitive restructuring, and the use of
  rhythmic eye movements and other bilateral
  stimulation to treat traumatic stress disorders
  and fearful memories of clients

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Extinction

• When pairing of conditioned and unconditional
  stimulus stops
• Association weakens-conditioned response less
  frequent-till disappears
• Personality pattern of responses- changes - by
  exposure to feared stimuli under relaxed and
  supportive conditions

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Generalization

• Conditioned response occurs in response to
  stimuli which are similar to the conditioned
  stimulus
• Discrimination conditioned response does not
  occur to all possible similar stimuli-learned
  difference between stimuli
• Reaction Patterns specific reactions-conditioned
  responses-past experience-
• positive response likes
• negative response dislikes
• Reactions-learned not innate
  

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Social Learning Theory-Bandura

• Reciprocal interactions between individuals
  behaviors and the environments
• People are capable of self-directed behavior
  change
• People perceive, evaluate, and regulate personal
  behavior so that it is appropriate to the
  environment and effective in achieving their
  goals.
• Observational learning inner person demands
  of situation combine to determine behaviors

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Self-Efficacy

• An expectancy or belief (expectation) about how
  competently one will be able to enact a behavior
  in a particular situation
• Positive belief will be able to perform
• Determines if we try, how long we persist, how
  results influence future behavior

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Self-Efficacy results from four types of
information

• Our experiences trying to perform the behavior
  (failure or success)
• Watching others perform same or similar behavior
  (vicarious)
• Verbal persuasion (encouragement)
• How we feel about the behavior (emotional
  reactions)

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Observational Learning

• How new behaviors are acquired in absence of
  reinforcement
• Observational learning-vicarious learning- gained
  second hand by watching the experience of another
• Modeling person forms self in image of another

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Outcome Expectancy

• Expected consequence of the behavior is most
  significant influence on whether an observer will
  reproduce an observed behavior
• Individuals are more likely to imitate behavior
  that they believe leads to positive outcomes.
• Outcome expectancy is based on both consequences
  of rewards and punishments and on anticipated
  consequences

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Four Components of Observational Learning

• Attention influenced by characteristics of the
  model situation
• Retention influenced by cognitive ability of
  observer and ability to encode the
  behavior-images or verbal representation
• Motor reproduction turn mental representation
  into physical action-mentally rehearse the
  behavior
• Motivation most influences actual performance of
  the behavior which has been observed-valued vs
  negative outcomes

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Self-Regulation

• Individuals internal processes of goals,
  planning, self-reinforcement result in
  self-regulation of behavior
• Self-punishment feelings of self-disgust, shame
  or withhold desired object
• Internal standards used to measure own success or
  failure-gained by both observation and past
  behavior acting

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Resilience

• Ability to absorb failure and disappointment and
  still believe in oneself
• Take the hard knocks and survive to be justified
  by success in ones life
• Stuff that overcomes adversity
• Bolstering ones self-efficacy against all types
  of challenges to succeed in the end

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Approach-Avoidance Conflict

• If punishment results in the conditioning of a
  fear response to a drive, the primary secondary
  drives may conflict
• Drawn to and away from desired object-resulting
  in anxiety and neurotic behavior

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Multimodal Approach-Lazarus

• Provide information, instruction, reactions
• Challenge self-defeating beliefs, offer
  constructive feedback, positive reinforcement,
  appropriate self-disclosing
• Start where the client is

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BASIC I.D.-7 areas of functioning

• BBehavior
• AAffective Response
• SSensations
• IImages
• CCognitions
• IInterpersonal Relations
• DDrugs, Biological Functions, Nutrition, Exercise

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Comprehensive Brief Multimodal Therapy Strives to
Correct

• Irrational beliefs
• Deviant behaviors
• Unpleasant feelings
• Bothersome images
• Stressful relationships
• Negative sensations
• Possible biochemical imbalances

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Principles of Multimodal Therapy

• Humans act interact across seven areas of BASIC
  I.D.
• These modalities are interconnected must be
  treated as an interactive system
• Accurate evaluation(diagnosis)is best
  accomplished by systematically assessing the 7
  modalities their interaction
• Comprehensive approach to treatment involves
  specific correction of significant problems
  across the BASIC I.D.

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Multimodal Therapy - Technical Eclecticism-teach,c
oach, train, model direct clients using other
therapy techniques - Lazarus

• Anxiety-management techniques,
• Behavioral rehearsal,
• Bibliotherapy,
• Biofeedback,
• Communications Training,
• Contingency contracting, Hypnosis,
• Meditation,
• Modeling

• Paradoxical strategies,
• Positive imagery,
• Positive reinforcement,
• Relaxation training,
• Self-instructional training,
• Sensate-focus training,
• Social Skills Assertiveness training,
• Empty chair,
• Time projection,
• Though stopping