Introduction to Behaviorism

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Introduction to Behaviorism Cognitive Behavior
Therapies

• Anne Farrell, Ph.D.
• New York Medical College

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Introduction and goals

• Background
• Knowledge and experience
• Goals
• Familiarize participants with tenets of
  behaviorism and basis for cognitive behavior
  therapies
• Background and interrelationships
• Common adult and pediatric applications
• References and resources

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Behavior Therapy

• Commonly used to treat
• anxiety, mood, eating disorders, parasuicidality
• impulse, anger control disorders, disruptive
  behavior
• sexual dysfunction, substance abuse
• behavioral medicine and compliance
• Two models of conditioning
• Classical (Pavlovian) conditioning model
• Operant (Skinnerian) conditioning model

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Classical conditioning

• Pavlovian conditioning model
• unconditioned reflexes (UCR)
• salivation, eye blink
• Contingency pair with neutral stimulus (UCS)
• bell, tone, bang, ash
• Conditioning (CS)
• Previously neutral stimulus becomes conditioned
  stimulus
• Conditioned response (CR)
• Reflex now occurs in response to CS
• Common examples?

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Classical conditioning

• Relation to specific disorders
• Post-traumatic stress
• Specific phobias (Little Albert)
• Panic disorder with agoraphobia
• Related principles
• Contingency, extinction, generalization,
  discrimination
• Schedules of reinforcement and resistance
• Background
• First applied as BT by Wolpe, Lazarus

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Operant Conditioning

• Skinnerian conditioning (B-mod)
• consequences of a behavior change future
  probability of occurrence
• key influence
• association between response and consequences
• Thorndikes Law of Effect
• positive outcomes strengthen behaviors
• negative outcomes weaken them

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Operant Conditioning (Skinner)

• Positive reinforcement
• Probability of response ? when it is followed by
  a rewarding stimulus
• examples
• Negative reinforcement
• Probability of response ? when it is followed by
  removal of an unpleasant stimulus
• examples
• Punishment
• frequency of response ? due to consequence

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Operant Conditioning Principles

• timing
• learning is more efficient under immediate rather
  than delayed circumstances
• shaping
• reward successive approximations of desired
  behavior
• primary reinforcement
• reinforcer is innately satisfying
• secondary reinforcement
• reinforcer acquires its value through experience

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Schedules of Reinforcement

• Continuous reinforcement
• response is reinforced every time it occurs.
• Partial reinforcement
• a response is reinforced only part of the time.
• Schedules rules for partial reinforcement
• fixed ratio after set target responses
• variable ratio after average (unpredictable)
  of responses
• fixed interval after a fixed amount of time
• variable interval after an unpredictable amount
  of time

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Resistance to extinction
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Operant Conditioning

• extinction
• a response is not reinforced and it decreases
• spontaneous recovery
• occurs in operant conditioning (and CC)
• discrimination
• learning to repeat only reinforced responses
• generalization
• giving the learned response to similar stimuli
• Applied behavioral analysis (ABA)
• operant conditioning principles to change behavior

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BT and disorders

• Assumptions about etiology?
• Anxiety disorders
• Acquired classical conditioning
• Maintained operant conditioning
• Role of avoidance
• Highly reinforcing
• Manualized treatments
• Barlow panic disorder, GAD
• Stress innoculation, panic induction, biological
  challenge
• Foa OCD, PTSD
• Exposure with response prevention
• Relaxation strategies and retelling
• Frequently combined with meds, cog therapies

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Basics of CBTs

• Assessment and intervention
• Empirical support for practice
• Characteristics of treatment
• Active, structured, focused
• Past v. present v. future
• Brief therapies
• Change is achieved by
• Altering connections between troublesome
  situations and habitual reactions to them
• Challenging and changing distorted beliefs and
  thoughts that relate to dysfunction

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Applications

• Operant conditioning
• Applied behavior analysis (ABA)
• Single case designs
• Children with autism, challenging behavior
• Educational interventions
• Functional behavioral assessment (FBA) and
  behavior intervention plans (BIP)
• Mandated under IDEA
• Generic parenting strategies
• Reinforcement and punishment
• ABCs
• Antecedent behavior - consequence

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Single case design (ABA)
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Cognitive therapies

• Emerge from behavioral models
• Use BT techniques
• Assume interrelationship among cognition, affect,
  behavior
• Beck, Ellis, Young
• Situation, thoughts, feelings, behavior
• Common elements
• Ellis (RET) core irrational ideas
• Beck (CT) maladaptive beliefs
• Young Early maladaptive schemas

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CBT techniques

• Relaxation and imagery
• Self monitoring (mood monitoring, impulse
  control, self-mutilation)
• Exposure
• Response prevention
• Flooding
• Behavioral rehearsal
• Thought stopping
• Coping statements
• Cognitive disputation

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Outcomes

• Empirical support evidenced via
• Single case design (A-B-A-B)
• Controlled studies
• Comparison to no treatment, wait-list,
  placebo-controls comparison to other therapies
  and combinations of therapies
• Meta-analyses
• Group differences expressed in sds

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Resources

• Association for the Advancement of Behavior
  Therapy (AABT.org)
• American Institute for Cognitive Therapy
  (AICT.com)
• Ellis Institute, Beck Institute
• National Institutes of Mental Health
• Web site Facts about