Behavior Therapy

Basic Philosophies of Behavior Therapy
Behavior is the product of learning. We are both the product and the producer of the environment. No set of unifying assumptions about behavior can incorporate all the existing procedures in the behavioral field.
Key Concepts of Behavior Therapy
Focus is on overt behavior, precision in specifying goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes. Present behavior is given attention. Therapy is based on the principles of learning theory. Normal behavior is learned through reinforcement and imitation. Abnormal behavior is the result of faulty learning.
Goals of Behavior Therapy
To eliminate maladaptive behaviors and learn more effective behaviors. To focus on factors influencing behavior and find what can be done about problematic behavior. Clients have an active role in setting treatment goals and evaluating how well these goals are being met. To increase personal choice and to create new conditions for learning
Behavior Therapy
on observable behavior, current determinants of behavior, learning experiences that promote change, tailoring treatment strategies to individual clients, and rigorous assessment and evaluation.
Classical conditioning (respondent conditioning)
refers to what happens prior to learning that creates a response through pairing.
Operant conditioning
involves a type of learning in which behaviors are influenced mainly by the consequences that follow them.
Social learning approach (or the social-cognitive approach)
is interactional, interdisciplinary, and multimodal. The environmental events on behaviors are mainly determined by cognitive processes governing how these events are interpreted.
Cognitive Behavior Therapy
– emphasizing the interaction among ffective, behavioral and cognitive behaviors
Four Areas of Development –
Classical Conditioning, Operant Conditioning, Social Learning Approach, Cognitive Behavior Therapy
View of Human Nature of Modern Behavior Approach
the person is the producer and the product of his or her environment.
Six key characteristics of behavior therapy
(1) Behavior therapy is based on the principles and procedures of the scientific method. (2) Behavior therapy deals with the client’s current problems and the factors influencing them, as opposed to an analysis of possible historical determinants (3) Clients involved in behavior therapy are expected to assume an active role by engaging in specific actions to deal with their problems. (4) This approach assumes that change can take place without insight into underlying dynamics (5) The focus is on assessing overt and covert behavior directly, identifying the problem, and evaluating change. (6) Behavioral treatment interventions are individually tailored to specific problems experienced by clients
ABC Model
– antecedents, behaviors, and consequences
(B) Behavior
is influenced by some particular events that precede it,
(A) Antecedent
are ones that cue or elicit a certain behavior
(c) Consequences
are events that maintain a behavior in some way either by increasing or decreasing it.
Assessment interview
the therapist’s task is to identify the particular antecedent and consequent events that influence or are functionally related to an individual’s behavior
key principles of operant conditioning –
positive reinforcement, negative reinforcement, extinction, positive punishment, and negative punishment.
Positive reinforcement
involves the addition of something of value to the individual (such as praise, attention, money, or food) as a consequence of certain behavior. The stimulus that follows the behavior is the positive reinforcer.
Negative reinforcement
involves the escape from or the avoidance of aversive (unpleasant) stimuli. The individual is motivated to exhibit a desired behavior to avoid the unpleasant condition.
Extinction
which refers to withholding reinforcement from a previously reinforced response
Punishment
sometimes referred to as aversive control, in which the consequences of a certain behavior result in a decrease of that behavior
Goal of Reinforcement
to increase target behavior
Goal of punishment
to decrease target behavior
Two kinds of punishment
positive and negative punishment
Positive Punishment
an aversive stimulus is added after the behavior to decrease the frequency of a behavior (such as withholding a treat from a child for misbehavior or reprimanding a student for acting out in class)
negative punishment
a reinforcing stimulus is removed following the behavior to decrease the frequency of a target behavior (such as deducting money from a worker’s salary for missing time at work, or taking television time away from a child for misbehavior).
Relaxation Training
It is aimed at achieving muscle and mental relaxation and is easily learned. They assume a passive and relaxed position in a quiet environment while alternately contracting and relaxing
Systematic desensitization –
clients imagine successively more anxiety- arousing situations at the same time that they engage behavior that competes with anxiety.
Steps use in systematic Desensitization –
(1) relaxation training; (2) development of anxiety hierarchy; (3) systematic desensitization proper
Exposure therapies
are designed to treat fears and other negative emotional responses by introducing clients, under carefully controlled conditions, to the situations that contributed to such problems. Exposure is a key process in treating a wide range of problems associated with fear and anxiety.
In vivo exposure
involves client exposure to the actual anxiety-evoking events rather than simply imagining these situations.
Live exposure
has been a cornerstone of behavior therapy for decades
Flooding
which refers to either in vivo or imaginal exposure to anxiety-evoking stimuli for a prolonged period of time.
In vivo flooding
consists of intense and prolonged exposure to the actual anxiety-producing stimuli
Imaginal flooding
is based on similar principles and follows the same procedures except the exposure occurs in the client’s imagination instead of in daily life
Eye movement desensitization and reprocessing (EMDR)
is a form of exposure therapy that involves imaginal flooding, cognitive restructuring, and the use of rapid, rhythmic eye movements and other bilateral stimulation to treat clients who have experienced traumatic stress.
Social skills training
a broad category that deals with an individual’s ability to interact effectively with others in various social situations; it is used to correct defi cits clients have in interpersonal competencies
Social Skills
involve being able to communicate with others in a way that is both appropriate and effective.
Anger management training,
which is designed for individuals who have trouble with aggressive behavior.
Assertion Training
– It is teaching people how to be assertive in a variety of social situations. people have the right (but not the obligation) to express themselves. to increase people’s behavioral repertoire so that they can make the choice of whether to behave assertively in certain situations. The goal is teaching people to express themselves in ways that reflect sensitivity to the feelings and rights of others.
Assertion training can be useful for those
(1) who have difficulty expressing anger or irritation, (2) who have diffi culty saying no, (3) who are overly polite and allow others to take advantage of them, (4) who fi nd it diffi cult to express affection and other positive responses, (5) who feel they do not have a right to express their thoughts, beliefs, and feelings, or (6) who have social phobias.
Self-modification
Include self-monitoring, self-reward, self contracting, stimulus control, and self-as-model. The basic idea is that change can be brought about by teaching people to use coping skills in problematic situations.
basic steps such as those provided by Watson and Tharp (2007)
(1) Selecting goals (2) translating goals into target behavior (3) self-monitoring (4) working out a plan for change (5) evaluating an action plan
Multimodal Therapy
is a comprehensive, holistic approach to behavior therapy. It is grounded in social learning and cognitive theory and applies diverse behavioral techniques to a wide range of problems. This approach serves as a major link between some behavioral principles and the cognitive behavioral approach that has largely replaced traditional behavioral therapy.
Seven major areas of functioning
B = behavior; A = affective responses; S = sensations; I = images; C = cognitions; I = interpersonal relationships; and D = drugs, biological functions, nutrition, and exercise
Behavior
Overt behaviors, including acts, habits, and reactions that are observable and measurable
Affect
Emotions, moods, and strong
Sensation
Basic senses of touch, taste, smell, sight, and hearing
Imagery
How we picture ourselves, including memories, dreams, and fantasies
Cognition
Insights, philosophies, ideas, opinions, self-talk, and judgments that constitute one’s fundamental values, attitudes, and beliefs
Interpersonal relationship
Interactions with other people
Drugs/biology
Drugs, and nutritional habits, and exercise patterns
Mindfulness
is a process that involves becoming increasingly observant and aware of external and internal stimuli in the present moment and adopting an open attitude toward accepting what is rather than judging the current situation.
dialectical behavior therapy
which has become a recognized treatment for borderline personality disorder;
mindfulness based stress reduction (Kabat-Zinn, 1990)
which involves an 8- to 10-week group program applying mindfulness techniques to coping with stress and promoting physical and psychological health;
mindfulness-based cognitive therapy
which is aimed primarily at treating depression; and
acceptance and commitment therapy
which is based on encouraging clients to accept, rather than attempt to control or change, unpleasant sensations.
Dialectical behavior therapy (dbt)
is a promising blend of behavioral and psychoanalytic techniques for treating borderline personality disorders. Emphasizes the importance of the psychotherapeutic relationship, validation of the client, the etiologic importance of the client having experienced an “invalidating environment” as a child, and confrontation of resistance.
Mindfulness-based stress reduction (mbsr)
designed to teach participants to relate to external and internal sources of stress in constructive ways.
acceptance and commitment therapy –
involves fully accepting present experience and mindfully letting go of obstacles
Commitment
– involves making mindful decisions about what is important in life and what the person is willing to do
Therapeutic Relationship in Behavioral Approach
The therapist is active and directive andfunctions as a teacher or trainer in helping clients learn more effective behavior. Clients must be active in the process and experiment with new behaviors. Although a quality client-therapist relationship is not viewed as sufficient to bring about change, it is considered essential for implementing behavioral procedures.
Limitations of Behavioral Approach
Major criticisms are that it may change behavior but not feel-ings; that it ignores the relational factors in therapy; that it does not provide insight; that it ignores historical causes of present behavior; that it involves control and manipulation by the therapist; and that it is limited in its capacity to address certain aspects of the human condition.

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