Transcript Chapter 9: Behavior Therapy

Behavior Therapy
Chapter 9
Behavior Therapy
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Basic Assumptions
Overt behavior holds primacy
 Maladaptive behavior is learned in the same
way as adaptive behavior
 Assessment and evaluation is key
 Treatment is active, directive and
collaborative
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Behavior Therapy
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Based on the principles and procedures of the scientific method
Learning new behaviors is the core of the therapy
Interventions tailored to fit individual needs
Therapy deals with client’s current problems and the factors
influencing them
Does not deal with historical determinants
Treatment goals are stated in concrete and objective terms
Conclusions are made based on what is observed
Therapy is a collaboration between therapist and client
Clients are expected to be active
Clients ‘do something’ to bring about a change: engage in new
behaviors
Interventions are monitored and frequently revised
Clients monitor their behavior outside of sessions, learn coping
skills, role-playing
Several behavioral techniques are often combined in a treatment
package to increase efficacy of treatment
Behavior Therapy
Behavior therapy does not provide insight
 Behavior therapists treat symptoms rather
than causes
 Therapy involves control and manipulation
by the therapist
 Therapists use empirically supported
techniques
 Treatment is as brief as possible
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Behavior Therapy
Therapists are willing to examine the
effectiveness of their procedures in terms
of generalizability and durability of change
 Therapists are ethical in their practice
 Clients have control and freedom
 Clients can monitor and manage their
interventions
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Behavior Therapy: Therapeutic
Relationship
Varies
 Between psychoanalysis and personcentered on
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Genuineness
 Empathy
 Warmth
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Positive regard not as important
 Positive expectancy and credibility very
important
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Behavior Therapy: The 3 Cs
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Counterconditioning
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Contingency Management
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Joseph Wolpe
B.F. Skinner
Cognitive-Behavior Modification
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Donald Meichenbaum
Counterconditioning
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Also known as reciprocal inhibition
Based on respondent conditioning
Follows directly from the work of Pavlov
UCS
NS/CS
UCR/CR
Chapter 9
Copyright © 2007 Brooks/Cole, a division of
Thomson Learning, Inc.
Counterconditioning
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Psychopathology
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Conditioned Anxiety (i.e. respondent conditioning)
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Anxiety is a response of sympathetic nervous system
Anxiety can be conditioned to any stimuli
Anxiety is cause of most behavioral disorders
Thoughts associated with threatening stimuli can elicit anxiety
Therapeutic Process – Unlearning responses
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Desensitization
Assertiveness Training
Stimulus Control
Contingency Management
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Psychopathology
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Behavior controlled by CONSEQUENCES
 Reinforcement/Punishment
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Excesses, deficits, inappropriateness
Therapeutic Process
Various forms of control procedures
 Functional Analysis
 A-B-C
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Theory of Therapeutic Processes
Environmental contingencies shape,
maintain, & extinguish behavior
 Behavior modification systematically
controls contingencies to shape
behavior
 Change the contingencies and the
behavior will change
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Chapter 9
Copyright © 2007 Brooks/Cole, a division of
Thomson Learning, Inc.
6 Steps of Effective
Contingency Management
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Chapter 9
State problem in behavioral terms
Identify behavioral objectives
Take baseline measures
Conduct naturalistic observations
Modify existing contingencies
Monitor the results
Copyright © 2007 Brooks/Cole, a division of
Thomson Learning, Inc.
Cognitive-Behavior Modification
Behaviorism was established as a radical
alternative to mentalist theories
 Conditioning replaced cognition as the
critical determinate of human behavior
 Cognition gradually reintroduced in tx of
human disorders
 Most behavior therapists now incorporate
cognitive techniques
 Meichenbaum spearheaded this change
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Chapter 9
Copyright © 2007 Brooks/Cole, a division of
Thomson Learning, Inc.
CB Modification
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Psychopathology
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Distorted information processing, expectancies and
skill deficits
Problems are characterized by
 Lack of coping response
 Use of inappropriate cognitive responses (e.g.,
mislabeling)
 Ineffective strategies for problem solving
Therapeutic Process
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Biofeedback
Self-instructional training
Stress inoculation
Phases of CBM
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Conceptualizing the problem
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Understand the nature of problem and enlist
active collaboration
Trying on the conceptualization
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Explore, sample and consolidate this view
Modifying cognitions & producing new
behavior
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Modify internal dialogues and enact new
behavior to realign reciprocal interactions
between mood cognition and behavior
STRESS INOCULATION
Behavior Therapy
CONTRIBUTIONS
 Wide variety of techniques available
 Therapy stresses ‘doing’
 Techniques have been extended to more
areas of human functioning than any other
therapeutic approach
 Emphasis on research into and
assessment of treatment outcomes
Behavior Therapy
LIMITATIONS OF BEHAVIOR THERAPY
 Behavior therapy may change behaviors,
but it does not change feelings
 Does not deal with the emotional process
as fully as other approaches
 Relationship between client and therapist
is discounted