Transcript Theory and Practice of Counseling and Psychotherapy

Behavior Therapy
View of Human Nature
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People have the capacity to actually make
changes in their environment
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Increasing people’s freedom and skills allows
them to have more options for responding to the
environment
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Change occurs by taking actions rather than only
reflecting on the problems
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People need to take responsibility for their own
behavior
Therapeutic Goals
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Focus on what the client wants to do
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Help clients accept responsibility for change
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Discuss advantages and disadvantages of the goals
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Reduce maladaptive behaviors and learn more
adaptive behaviors
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Client and therapist collaboratively decide on
concrete, measurable, and objective treatment goals
Therapist’s function and Role
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Be active and directive
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Serve as an consultant, problem solver, or educator
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Conduct a thorough functional assessment
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formulate initial treatment goals, use strategies for
behavior change, evaluate the success of the change,
and conduct a follow-up assessment
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Serve as a role model for the client
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Focus on current problems
Client’s Experience in Therapy
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To be taught concrete skills
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To be motivated to change
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To expand their adaptive behaviors
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To implement new behaviors
Therapeutic Relationship
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Therapeutic relationship still can contribute
significantly to the process of behavior change
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The client’s positive expectations for change
contribute to successful outcomes
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Common factors (warm, empathy, or acceptance)
are necessary but not sufficient for behavior
change to occur.
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The progress is due to specific behavioral
techniques instead of therapeutic relationship
Therapeutic techniques and procedures
Operant conditioning techniques
 Positive reinforcement
 A child gets a good grade and is praised by teachers.
 Negative reinforcement
 Escape from aversive (unpleasant) stimuli
 Extinction
 Withholding reinforcement from a previously
reinforced response
 Positive punishment
 Spanking a child for misbehavior
 Negative punishment
 Taking TV time away from a child for misbehavior
Therapeutic techniques and procedures
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Progressive Relaxation
 Tense and relax muscle including face, neck,
shoulders, chest, stomach, arms, and legs
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Systematic Desensitization – Joseph Wolpe (1958)
 1st step: Learn relaxation
 2nd step: Make a list of anxiety hierarchies
 3rd step: Imagine anxiety-evoking situation
while being relaxed
Therapeutic techniques and procedures
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Modeling
 Observe another person’s behavior and make
use of that observation
 Live modeling
 Symbolic modeling
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Assertion Training
 People have the right to express themselves
 Identify irrational beliefs
 Practice assertive behaviors
Therapeutic techniques and procedures
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In Vivo therapies
 Approach the actual fear-inducing situation or
event gradually or directly
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Imaginal Flooding therapies
 Expose to the mental image of a frightening or
anxiety-producing object or event
 Experience the image of the event until the
anxiety gradually reduces
Therapeutic techniques and procedures
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Self-management strategies
 Self-monitoring, self-reward, or selfinstruction
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Three phases integrating behavioral techniques
with contemporary psychodynamic approach
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Assessment and relationship-building
Insight—understand how early relational patterns are
related to present difficulties
Behavioral techniques
Research on Behavior Therapy
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In general, studies indicated that more improvement for
behavioral therapy or CBT than for psychodynamic,
client-centered, or control group.
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Behavioral treatments are more effective than nonbehavioral treatments regardless of the type of problem,
client age, or therapist experiences.
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A considerable research has been conducted behavioral
therapy treatment of depression, anxiety, OCD, phobias,
alcoholism, sexual dysfunction, panic attack, or other
disorder.
Summary and Evaluation
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Contributions
 Use Empirical-Validated Treatment
 In general, behavior therapy is more effective than no
treatment
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Limitations
 Change behavior, but not feelings
 Ignore relational factors
 Ignore insight
 Treat symptoms rather than causes
 Control and manipulation by the therapist