Transcript Behaviourist Treatments and Therapies

Behaviourist Treatments and
Therapies
Unit 5: Treatment and Therapies
Last Lesson
We identified and
discussed treatments
and therapies offered
from the biological
perspective
This lesson
Next lesson
Must: identify
treatments and
therapies offered from
the biological
perspective
Identify and discuss
treatments and
therapies offered
from the humanistic
perspective
Should: explain these
Task: write on a post treatments and
it note- 1 thing you therapies
remember and
place on white
board
Compare and
contrast with the
others (Biological
Could
1. Weigh up the success and Behaviourist)
of these treatments
2.compare and contrast
these with those offered
from the biological
perspective
Behaviourism introduction
• What do we remember?
• What do they believe about human
behaviour?
The basic principles: why do people
experience mental illness?
• See psychological disorders as the result of
maladaptive learning- example self harming?
• Acquired through classical and operant conditioningreinforcement/association
• Treatment focuses on helping the child unlearn this
conditioning
• Teaching patient alternative responses to stress and
within situations
• Mainly treats phobias
• In Some cases can treat behaviours associated with
psychoticism
We are going to look at
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Flooding
Systematic Desensitisation
Token economy
Flooding
Behaviour modification
Procedure in treatments other then
token Economy
• Functional analysis:
• Therapist analysis the patient’s problem in
terms of:
• 1. which behaviours are actually the problem
• 2. which environmental stimuli trigger the
behaviour..
• For example, panic attacks due to being in a
social environment
Flooding (Implosion):
Discovering the stimulus is harmless…
http://www.mindfulexposurebook.com/exposure-therapy-implosion
• fear exposure therapy
• Developed by Levis &
Stampl
• The underlying theory
behind flooding is that a
phobia is a learned fear, and
needs to be unlearned by
exposure to the thing that
you fear.
• Total immersion:
• forced, prolonged exposure
to the actual stimulus that
provoked the original
trauma- not possible for
every phobia
Info slide: to read later
Link: http://www.psychologistworld.com/behavior/flooding.php
In the mid-1960s, Thomas Stampfl, pioneered a technique called
'implosion therapy' to treat phobias. He found that phobic patients
who were bombarded with detailed descriptions of the situations
that they feared for six to nine continuous hours lost their fear of
those situations. His research was expanded upon and refined by Zev
Wanderer, who used biofeedback machines to monitor patients
listening to verbal descriptions of what they most feared. By
concentrating on the phrases that sparked the most intense
reactions, Wanderer reduced the time needed for the first flooding
session from nine hours to about two hours. Patients then returned
for further sessions, usually as short as half an hour
AN EXAMPLE:
Psychiatrist Joseph Wolpe (1973)
carried out an experiment which
demonstrated flooding. He took a
girl who was scared of cars, and
drove her around for hours. Initially
the girl was hysterical but she
eventually calmed down when she
realized that her situation was safe.
From then on she associated a
sense of ease with cars.
• How it works
• The initial hysteria and panic is time
constrained because the physical arousal
(feelings of hysteria) will subside eventually
• At this point the patient will relax, and hence
that new behaviour and calmness will be
associated with the once fearful stimulus!
So. How would I treat by phobia of
cows?
Is this treatment effective and
appropriate
• Effective-Harris (1992) wrote that flooding is an
effective treatment and is more cost effective
than other methods due to the treatment length
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Harris, C.V. (1992). An analysis of response prevention and flooding procedures in the treatment of
adolescent obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 23,
107-115. doi: 10.1016/0005-7916(92)90008-7
• Appropriate: because it is a quick result with no
prolonged therapy and chances are there is no
relapse
• Patients hold this therapy in high esteem (Olatunji et
al 2009)
However…
The problems with Flooding
s
• Ethical: Can be a very
stressful situation for
the patient.
• You have to keep them
with the stimulus for a
long period.
• Could be linked to
human rights (torture)
• However- Informed
consent!
Systematic Desensitisation
• Developed by Joseph
Wolpe in the 1950s
• Relaxation responses are
trained to occur through
progressive relaxation
training , a technique
initially perfected by
Edmund Jacobson during
the 1930s.
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Read more:
http://www.minddisorders.com/Py
-Z/Systematicdesensitization.html#ixzz3ZO5c5hB
f
Systematic Desensitisation: Intro
http://www.minddisorders.com/Py-Z/Systematic-desensitization.html
• Handout:
• Mostly used for treatment of phobias/OCD
• Aims to substitute a anxiety response with a relaxation
response
• Happens gradually on average 6-8 lessons (more if its
an intense phobia)
• Goals are met but patient could still leave with a
phobia
• Constructing an hierarchy of fearful situations, ranked
by both patient and therapist
• But first: learn relaxation techniques --------
Relaxation techniques
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Trained in methods of relaxation:
Control of breathing
Visualisation techniques
An example: Handouthttp://www.simplypsychology.org/Systematic-Desensitisation.html
Systematic Desensitisation: how it
works
Lets do another example
• A volunteer…
Effectiveness
• Handout:
appropriateness
• Works for:
• Simple phobias- arachnophobia
• Social phobias – if anxiety is the problem, not
if the behaviour is due to lack of social skills!
• Eating disorders: help overcome anxiety
associated with eating, but wont tackle the
core problem
However
Ethics
• Because of the potential for extreme panic reactions to occur,
which can increase the phobia, this technique should only be
conducted by a well-qualified, trained professional. Also, the
relaxation response should be thoroughly learned before
confronting the anxiety-provoking hierarchy.
Read more: http://www.minddisorders.com/Py-Z/Systematicdesensitization.html#ixzz3ZO4n5KU
• Successful treatment is not based solely on success in terms of
cure- only if you met the goals!
• Does not treat underlying causes- chromosome disorders and
behaviour stemming from brain trauma
• Could the therapist intentionally cause harm?
• Takes a lot of trust
Token economy:
http://vkc.mc.vanderbilt.edu/assets/files/tipsheets/tokeneconomytips.pdf
https://www.youtube.com/watch?v=kfygN6zKGYI
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Used in:
Nurseries
Schools
Prison
Institutions
In your own home
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Used for:
Autism/ ADHD
Child behaviour (typical)
Violent behaviour
associated with wither
criminal (prisons) or
mental (institutions)
• Learning (schools)
Token economy: Intro
• Based on the works of B.F
Skinner :
• https://www.youtube.com/wa
tch?v=wW7pvVMmZ6k
• Montrose Wolf (1935-2004)
• Inventor of ‘time-out’, first
workable token economy
system amongst many more:
• Less aggressive ways (hence
more fun) of teaching
expected behaviour
• Read more here:
http://www.ncbi.nlm.nih.gov/
pmc/articles/PMC1226164/
Token Economy: institutions
• Functional analysis:
• Management of institution decides:
• 1. Which specific behaviours they wish to
promote
• 2. Which( if any) specific behaviours they wish
to extinguish
• Any examples?
How it works
• Handout
• Monitor patient’s behaviour
• When patient displays desired behaviour, they
receive a token
• Different number of tokens can be exchanged
for different reinforcers (sweets, access to TV,
Trips out, increased freedom)
Effectiveness and Appropriateness
• Handout
However
Ethics
• Is it dehumanising?
• Does it make people dependant?
• Requires in most cases to deprive humans of
basic rights (link to human rights)
• Goals are not set by therapist- they control
the patient
• Is it done for the patient or the institution?