Transcript Behavior Therapy Tecniques

Behavior Therapy
Techniques
Lesson 18
Behavior Therapy
Behavior Modification
1. Clarifying the clients
problem
1. Goal setting
2. Formulating initial goals
for therapy
2. Behavioral Definitions
3. Designing a target
behavior
4. Identifying the maintaining
conditions
3. Functional Analysis
4. Objective
measurement
5. Designing a treatment plan
5. Data collection
6. Implementing the
treatment plan
6. Evaluation ~
7. Evaluating the success of
treatment
8. Conducting follow-up
assessment ~
Changing Behavior
Acceleration Target Behaviors
 Increase behavioral deficits
 Primarily positive reinforcement
 Deceleration Target Behaviors
 Punishment   behavior
 “Dead” person rule
 Include acceleration behaviors ~
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Deceleration Techniques
Differential RFT (DRO & DRI)
 Direct Deceleration Therapy
 Consequential deceleration
 Aversion therapy
 Token Economies
 Pos RFT & response cost
 Exposure therapies
 Brief / graduated
 Prolonged / intense ~
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Counter-Conditioning: Joseph Wolpe
Reciprocal inhibition
 Buzzer sounded when cat was eating
 Buzzer (CS) : eating (US)  pos CER
 Buzzer (CS) : shock (US)  fear
 Substitution of competing responses
 Respondent Learning
 Can also replace fear with pos CER ~
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Mary Cover Jones & “Peter”
Treatment of phobias
 Peter fearful of white rabbit
 Counterconditioning
 Pairing favorite food & rabbit
 Exposure therapy
 Gradually moved rabbit closer
 Peter watched another child play
with rabbit ~
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Inhibitory learning
Conditioned Inhibition
 Learning to withhold conditional
response
 CS-: US will not occur
 no US for period of time
 US must be a significant event
 Occurs only if there is an excitatory
context ~
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Standard Procedure
Some trials: CS+ --- US
 Other trials: CS+ / CS- --- No US
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Example: traffic light
 CS+ (red)  CR?
 CS- (police officer) / CS+  CR?
 Respond differently under different
circumstances ~
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Negative CS-US Contingency
Similar to standard procedure
 Some trials: CS+ & US
 Other trials: CS- & no US
 CS-  no response
 Example: Traffic light
 Red (CS+) – Danger (US)
 Green (CS-) – no Danger (no US) ~
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Inhibitory Conditioning & Stress
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Panic attacks  extreme stress
Carter,
Hollon, Carson, & Shelton (1995)
triggered by CS+ for aversive stimuli
 Panic attack experimentally induced
 accompanied by trusted friend
 or alone ~
 Friend acted as CS- for stress
  stress compared the alone group
 trusted friend was a safety signal ~
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Exposure Therapies
For fear/anxiety & other negative CERs
 Intense, maladaptive, or
inappropriate
 Some strong fears adaptive
 Based on Extinction
 Fear-provoking events (CS+)
 Safe environment (no US) ~
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Exposure Therapies Models
Brief/graduated exposure therapy
 Short exposure periods
 Gradually increase intensity of CS
 Prolonged/intense
 Lengthy exposure periods
 Immediate exposure to intense CS
 Mode of exposure on continuum
 Imaginal ---------------------- in vivo ~
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Systematic Desensitization
Brief/Graduated Exposure Therapy
 Relaxation Training
 Tense then relax muscle groups
 Fear Hierarchy
 Rank fear-provoking situations
 Graded Pairing
 CS for fear with muscle relaxation
 Thru hierarchy: lowest highest ~
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Systematic Desensitization:
Theoretical Explanations
Counterconditioning
 Substitution of competing response
 Reciprocal inhibition
 Neurophysiological processes
 Parasympathetic vs Sympathetic
 Extinction
 Cues present but no danger (US) ~
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Flooding
Prolonged/Intense Exposure Therapy
 Also called implosive therapy
 In vivo or imaginal
 Treatment for
 Phobias
 Obsessive-compulsive disorder
 Post-traumatic stress disorder
 Agoraphobia ~
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Flooding
Aversive CS  escape/avoidance
 Limits opportunity for extinction
 Confront individual w/ fearprovoking situations/ images
 No relaxation
 Not graded
 Extinction process
 Potential for intensifying fear ~
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Aversive Therapy
Punishment of target behaviors
 Instrumental conditioning
 Raversive stimulus
 E.g., chronic vomiting  shock
 Problems
 Avoidance of therapy (drop out)
 Disruptive CERs
  punishment of others
 Ethics concerns ~
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“More Acceptable” Punishers
Punisher
Target Behavior
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Trichotillomania
(Pulling out hair)
Compulsive eating
Nail biting
Face slapping
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Bruxism
Biting other children
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Snap rubber band
on wrist
Cigarette smoke
Bitter substance
Water mist
sprayed in face
Loud noise
Mild mouthwash
Aversive Therapy:
Covert Sensitization
Classical & instrumental conditioning
 Use of imaging
 Therapist describes behavior
 & aversive outcome
 Advantages
 Safe & more acceptable to clients
 Clients can self-administer in vivo
 Effectiveness equivocal ~
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