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behavior therapy

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Behavioral therapy is a treatment that helps change potentially self-destructing behaviors. It is also called behavioral modification or cognitive behavioral therapy. Medical professionals use this type of therapy to replace bad habits with good ones. The therapy also helps you cope with difficult situations.

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behavior therapist

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professionals who apply behavior therapy

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cognitive therapy

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The basic assumptions are that the problems requiring psychotherapy are caused by dysfunctional cognitions or faulty thinking. Accordingly, cognitive therapists typically help clients to rid themselves of unproductive, debilitating thoughts or beliefs

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cognitive processes/cognitions

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verbalizations or images that are frequently called believing, thinking, expecting or perceiving.

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cognitive behavior modification or Cognitive behavior therapy

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There are similarities between the goals and procedures of cognitive therapists and behavior therapists, and cognitive therapists adopted some behavior modification methods, leading to this merged group

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Acceptance and commitment therapy (ACT)

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Developed by Hayes-1999. 1st - through the use of metaphors, paradox, stories and other verbal techniques presented by the therapist, the client learns that past attempts to control troublesome thoughts have only served to increase the frequency of such thoughts and emotions. 2. Through the use of mindfullness training and acceptance exercises, the client learns to experience and nonjudgementally embrace thoughts and emotions, including those that are troublesome. This is the acceptance portion of ACT 3. Regardless of whether the troublesome thoughts and emotions are eliminated, clients are encouraged to identify values of various life domains, such as work, family, health, and intimate relationships. The client is then encouraged to translate these values into achievable, concrete goals, and to identify and emit specific behaviors to achieve these goals This is the commitment portion of ACT: clients are encouraged to identify valued goals in their lives and commit actions to pursue these goals.

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Cognitive restructuring

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Strategies for recognizing maladaptive thinking and replacing it with adaptive thinking.

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Dialectical behavior Therapy (DBT)

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Originally developed by Marsha Linehan -1987 to treat borderline personality disorder is another approach that incorporates mindfulness and acceptance procedures. 1. The early part of therapy focuses on helping the client express what he or she hopes to get out of therapy 2. The client is encouraged to nonjudgementally observe and describe his or her overt and covert behaviors, especially those that are potentially harmful to the client or others, or that might interfere with the course of treatment. 3. Interpersonal skills are eventually targeted so that clients learn to say no, ask for what they need, and appropriately interact with others in their lives 4. After clients learn to accept aspects of their lives without distortion, judgement, or evaluation, they are much more likely to be able to learn and follow specific behavioral strategies for achieving their therapeutic goals. effective for treating BPD, women with bulimia nervosa, and elderly people with depressoin

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Rational - Emotive therapy (RET)

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The original name of Ellis's approach. Based on the premise that most everyday emotional problems and related overt behaviors stem from irrational interpretations that people make of events in their lives. Teaches people to counteract irrational self-statements with more positive and realistic statements. People tend to think in aboslute terms -all or nothing People tend to overgeneralize - i must be perfect at everything and catastrophize - exaggerating failures

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Rational - Emotive Behavior Therapy (REBT)

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Ellis added 'behavior' to his definition because he frequently used behavioral 'homework' assignments. The homework assignments are usually designed to help the client challenge irrational beliefs and confront trouble some emotions. Examination of studies of REBT that do not include the behavioral component suggest that big part of the success is due to the behavioral homework assignments rather than to the disputataion of irrational beliefs.

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Reinterpretation phase

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(first phase of stress inocuLAtions by Meichenbaum) clients are taught that its not the stressor that is the cause of their nervousness, or stress reaction, rather its the way they view the event. Clients are also taught to verbalize that they are capable of learning to take steps to deal with the situation

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Coping training phase

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(2nd phase of stress inoculations by Meichenbaum) Clients learn a variety of appropriate coping strategies such as relaxation, self-instruction, and self-reinforcement

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Application phase

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(3rd phase of stress inoculations by Meichenbaum) Clients practice self-talk and coping skills ot stressful stimuli, such as having an arm immersed in freezing water. Just prior to and during exposure to such stressful situations, the client practices appropriate coping skills.

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problem solving therapy

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focuses on teAching people how to proceed through logical reasoning to satisfactory solutions to personal problems - developed by goldfired and D'Zurilla.

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Mindfulness

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involves non-judgmental awareness, observation, and description of one's covert or overt behaviors as they occur and, in some cases, observation of the antecedents and consequences of those behaviors.

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Acceptance/Experiential Acceptance

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refers tO refraining from judging one's sensations, thoughts, feelings, and behaviors as good or bad, pleasant or unpleasant, useful or useless, and so on. Used to teach individuals that they can feel their feelings and think their thoughts even though they might be aversive, and still take constructive action that is consistent with their values and life goals

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What are the 3 differences between cognitive therapy and ACT?

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1. CT assumes that troublesome thoughts constitute the primary cause of disturbing emotions, whereas ACT considers both thoughts and emotions simply as responses and assumes that both are caused by various environmental contingencies 2. Focus of CT is the use of cognitive restructuring to change troublesome thoughts directly, while ACT teaches the client to embrace and accept various thoughts and emotions. 3. With CT, a primary purpose of behavioral homework assignments is to help the client overcome distorted thinking. With ACT, behavioral homework assignments are used to build larger patterns of effective action in the pursuit of valued goals.

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why might cognitive restructuring be effective?

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Cognitive restructuring techniques from a behavioral point of view might be effective when 1 - they decrease the frequency of irrational self-statements that elicit the respondent component of troublesome emotions and 2 - they teach a client to rehearse rules through verbal discourse and homework assignments that identify specific circumstances for specific behaviors that are likely to be maintained in the natural environment

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Why might self-instruction and problem solving training be effective?

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Because there is a focus on performing the behavior successfully, there is a greater chance of successful behavior change than if the focus had just been on self-instructions alone. In problem solving, whereas the first 3 steps involve self-talk, the last 3 steps - decision making, implementation, and verification - require the individual to take action and solve the problem. Self talk that is appropriately linked to overt behaviors and to supportive environmental consequences is more likely to be effective than self talk that is not .

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Why might mindfulness and Acceptance based procedures be effective?

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1. nonjudgmentally observing ongoing sensations displaces the behavior of irrational thinking and the negative emotions elicited by it. 2. Mindfulness and acceptance of one's sensations would appear to be largely contingency shaped behavior. *contingency shaped behavior is natural, reactive, and intuitive, as opposed to rule governed which is inflexible and rigid. 3. ACT and DBT use strategies to enhance contingency shaped behavior early in therapy and then capitalize on both rule governed and contingency shaped behavior later in therapy.

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Empirically supported treatments (ESTs)

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specific treatments that have been shown to be efficacious in controlled clinical trials see www.psychologicaltreatments.org for the most updated list.

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Co-morbidity

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When a patient has more than one condition co-occurring

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Specific Phobia

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intense fears that virtually incapacitate people. They usually know their fears have no rational basis and would like to eliminate them, but they cannot because the fears are automatically elicited by specific stimuli.

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What are the 4 categories of specific phobias?

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animal type natural environment type blood-injury-injection type situational type

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Systematic counterconditioning/Systematic desensitizatioin

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a procedure for overcoming a phobia by having a client in a relaxed state successively imagine the items in a fear hierarchy. This is a treatment for specific phobia.

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Fear Hierarchy

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a list of fear-eliciting stimuli arranged in order from the least to the most fear-eliciting.

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In vivo

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from the Latin 'in Life', in the presence of the actual stimuli that elicit fear in the natural environment Often used when clients have difficulty imagining scenes.

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Flooding

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a method of extinguishing fear by exposure to a strongly feared stimulus for an extended period of time. The basic assumption behind flooding is that the client is exposed to the feared stimulus, is not allowed to escape from it, and no aversive event follows, then the fear response to that stimulus will extinguish. This is a treatment for specific phobia.

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Participant Modeling

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a method for decreasing fear in which a client imitates another individual approaching a feared object.

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Exposure based Therapies

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involve exposure either in imagination or in vivo - of the client to the feared stimulus or stimuli

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Panic Disorder

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a susceptibility to panic attacks, which are intense fear experiences that seem to come out of the blue with no precipitating stimulus or cue.

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treatment for panic disorder

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Cognitive behavioral therapy has strong research support Applied relaxation has modest research support CBT typically includes a behavioral component involving exposure to feared situations and a cognitive component to help change the client's misconceptions about panic attacks

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Agoraphobia

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literally means 'fear of the marketplace' - an intense fear of going out in public or leaving the confines of one's home. People who suffer from panic disorder frequently also have agoraphobia because they are afraid of having a panic attack in public or outside of their home.

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Generalized Anxiety Disorder

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Constantly worrying and feeling intensely anxious about potential events that most people would consider trivial. Such a person is so consumed with anxiety that it interferes with normal functioning, often including the inability to sleep at night.

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treatment for GAD

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CBT has strong support One of the behavioral components is usually exposure therapy. Acceptance techniques may also help the client realize that worrying will not make bad events less likely to occur.

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Obsessive compulsive disorder

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A person suffering from this may experience unwanted intrusive thoughts called obsessions or feel compelled to engage in unproductive repetitive behavior called compulsions, or both.

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treatment for OCD

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Exposure and response prevention, and cognitive therapy have strong research support ACT - has modest research support Having the obsession occur without the subsequent anxiety reducing compulsive behavior allows the anxiety elicited by the obsession to occur in full strength and hence to extinguish.

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Post Traumatic Stress Disorder (PTSD)

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includes re-experiencing the intense fear that occurred during the trauma, and exhibiting other intense psychological reactions.

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treatment to PTSD

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prolonged exposure therapy and cognitive processing therapy have strong research support for treatment of PTSD

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motivational interview

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The therapist asks the client questions about the problem, the answers to which act as MEOs for change (i.e., reduced substance use becomes reinforcing and therefore strengthens behavior that leads to reduced substance abuse) The approach attempts to increase the client's awareness of the potential problems caused, consequences experienced, and risks faced as a result of the behavior in question. Alternately, therapists help clients envision a better future, and become increasingly motivated to achieve it. Either way, the strategy seeks to help clients think differently about their behavior and ultimately to consider what might be gained through change.

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Strong Research Support

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defined as a treatment for which well designed studies conducted by independent investigators converge to support a treatment's efficacy

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Modest research support

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a treatment for which one well designed study or two or more adequately designed studies support the treatment's efficacy

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coping skills training

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Teaches clients to deal with stressors that are thought to cause excessive substance use

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contingency contracting

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provides reinforcers for work, social, and recreational activities that do not involve substance use

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couple distress

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Occurs when at least one of the individuals in an intimate relationship is experiencing dissatisfaction with the relationship. Therapists start with the premise that the underlying cause is that there are more negative than positive interactions or communications in the relationship.

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habit disorder

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Many people suffer from frequent and repetitive behaviors that are inconvenient and annoying. These may include nail biting, lip biting, knuckle cracking, hair twirling, hair plucking, throat clearing, muscle tics and stuttering. Similar to OCD except they are not linked to obsessive thoughts

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habit reversal

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has been used effectively to treat a number of habit disorders. 1. The client learns to describe and identify the problem behavior 2. The client learns and practices a behavior that is incompatible with or competes with the problem behavior 3. For motivation, the client reviews the inconvenience caused by the disorder, records and graphs the behavior, and has a family member provide reinforcement for engaging in the treatment

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Albert Ellis

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Well known psychotherapist credited with being the founder of cognitive therapy. He considered negative self-statements to be irrational. Ellis believed that such irrational thoughts cause anxiety, sadness, anger, or other troublesome emotions. His approach to therapy was to help people identify which irrational thoughts or beliefs and to replace them with more rational self-statements

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Aaron Beck

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Developed a cognitive therapy procedure that is similar to REBT. According to Beck, people with psychological disorders engage excessibely in aberrant, fallacious, or dysfunctional thinking, and this is what causes or exacerbates their problem. examples of dysfunctional thinking: 1. dichotomous thinking - absolutes 2. arbitrary inference - drawing inaccurate conclusions on other's thoughts 3. over-generalization - single failure means you fail at everything 4. magnification - exaggerating the meaning or significance of an event

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Joseph Wolpe

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(1958) - developed the earliest behavioral treatment for specific phobias. He hypothesized that the irrational fear characteristic of a phobia is a respondently conditioned response to the feared object or situation. He decided to treat phobia by exposing the client to the feared stimulus while conditioning another response to it. (counter-conditioning)

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Donald Meichenbaum

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develop self-instructional training Developed a strategy called 'stress inoculations'

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Marsha Linehan

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Developed Dialectical Behavioral Therapy (DBT) -1987

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Stephan Hayes

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Developed Acceptance and Commitment Therapy (ACT) -1999

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Belief, thought, and perception are the three things that describe: a. cognition. b. respondent thinking. c. self-control. d. operant thinking.

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a

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Who developed rational-emotive therapy? a. Aaron Beck. b. Albert Bandura. c. Donald Meichenbaum. d. Albert Ellis.

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d

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Drawing a conclusion on the basis of inadequate evidence, such as misinterpreting a frown on the face of a passerby to mean that the passerby is expressing disapproval, is an example of what Beck called: a. dichotomous thinking. b. irrational thinking. c. arbitrary inference. d. irrational inference.

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c

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What two approaches assume that a client's difficulty is caused by some type of inappropriate thought pattern and that the problem may stem from the client's tendency to exaggerate unpleasant things? a. Beck's cognitive therapy and Ellis's RET b. Ellis's RET and Meichenbaum's self-instructional approach c. Beck's cognitive therapy and Meichenbaum's self-instructional approach d. Ellis's cognitive therapy and Beck's RET

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a

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An approach that focus on replacing maladaptive thinking with adaptive thinking is referred to as: a. cognitive restructuring. b. contingency shaping. c. situational inducement. d. problem solving.

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a

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_____________ procedures are used to teach individuals that they can feel their feelings and think their thoughts even though they may be aversive, and still take constructive action to pursue one's values and life goals. a. mindfulness b. cognitive therapy c. stress inoculations d. acceptance

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d

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An intense fear of going out in public or leaving one's home is referred to as: a. agoraphobia. b. panic disorder. c. a simple phobia. d. a social phobia.

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a

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The major component of the treatment of agoraphobia is: a. in vivo exposure to the feared stimuli. b. thought-stopping. c. self-instructional training. d. reality checking

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a

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Which of the following types of treatment work best with obsessive-compulsive disorders? a. flooding in imagination of the feared situation in order to elicit the obsessive-compulsive behavior b. cognitive restructuring c. exposure to the feared situation in order to elicit the obsessive-compulsive behavior d. exposure to the feared situation while preventing the compulsive behavior from occurring

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d

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The habit reversal procedure typically includes: a. identifies behavior, competing response training, and a motivational strategy. b. awareness training, competing response training, and desensitization. c. competing response training, a motivational strategy, and cognitive restructuring. d. cognitive restructuring, awareness training, and desensitization.

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a

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Which of the following is not a typical component of a behavioral treatment strategy forobesity? a. self-monitoring b. stimulus control c. cognitive restructuring d. behavioral contracting

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c

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Self-Test Answer Key: (1) a, p. 271; (2) d, p. 272; (3) c, p. 274; (4) a, p. 275; (5) a, p. 272; (6) d, p.278; (7) a, p. 288; (8) a, p. 288; (9) d, p. 289; (10) a, p. 294-295; (11) c, p.293.

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+10/11 Great Job Cutie Pie! <3

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Third generation behavior therapies

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Do not try to change the client's reactions to their cognitions (unlike previous generations of behavior therapy)

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self-instructional training with children

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1. adult demonstrates self instructing 2. child performs while adult verbalizes 3. the child performs the task and verbalizes out loud 4. overt self-instructions fade - child says more softly 5. task performed with covert self instructions - self praise silently etc

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