Cognitive-Behavioral Therapies

Classical conditioning and operant conditioning.

It focuses on unlearning maladaptive or abnormal behaviors or behavioral patterns.

Behavioral therapy is based upon what two principles?

What does this type of treatment focus on?

It is based upon using the persons own cognitive abilities to recognize maladaptive or abnormal behavior and modify it through conscious awareness of the behaviors.
What is the basis of cognitive therapy?
Cognitive therapy and behavioral therapy.
CBT is a combination of what two types of therapy?
The goal is to help the patient break the learned association between a stimulus (CS) and the unwanted response such as anxiety (CR).
Some therapies for psychological conditions involves classical conditioning through counterconditioning and/or extinction. How does this work?
The patient has an association between a stimulus (CS) and a response (CR). Through systematic desensitization the patient is taught relaxation techniques and slowly presented with the anxiety or fear producing stimuli. They are put through relaxation prior to stimulus presentation which, through reciprocal inhibition, dampens down the anxiety. Slowly the person is introduced, maybe through thinking about a stimulus, then seeing a picture of a stimulus, etc. until they are able to deal with the stimulus in a non-maladaptive manner.
An example of counterconditioning is systematic desensitization. How does this work to remove an unwanted phobia? Use reciprocal inhibition in your explanation.
No, because the patient already understands that their phobia is likely irrational so cognitive therapy, which involves using your cognitive abilities to break a behavior, would likely not be helpful.
Are purely cognitive approaches typically effective in treating phobias? Why?
At some point sexually arousing situations and thoughts were associated with anxiety/performance anxiety which lead to the erectile dysfunction problem.
Describe the classical conditioning that causes erectile dysfunction.
It is the application of pleasurable stimuli without the perceived anxiety associated with sexual intercourse. So the stimulation allows erection and dissipation of that erection in a relaxing environment and then sexual acts are slowly added to the activities as they are then associated with relaxation instead of anxiety.

Systematic desensitization.

How can sensate focus be used to treat erectile dysfunction?

Sensate focus is a type of what sort of therapy?

The male becomes focused on his own anxiety about performance or ability (or lack there-of) to get and maintain an erection and becomes so focused on his own state of arousal (or lack there-of) that he does not focus on the erotic aspects of the act that would naturally cause arousal and erection.
How does spectatoring have an influence on performance anxiety and erectile dysfunction?
A CS that was initially paired with pleasure is paired with a US that is associated with an unpleasant response like shocks (faradic aversion therapy) or vomiting (emetic aversion therapy).

Pedophilia, alcohol addiction, and cigarette addiction.

No, it should be used in conjunction with some other form of therapy.

It is aversion therapy using imaginative aversive stimuli.

Aversion therapy applies an aspect of counterconditioning. How does aversion therapy work?

Name three behaviors discussed that aversion therapy can be used to treat?

Can aversion therapy be used as a sole means of therapy?

How does covert sensitization relate to aversion therapy?

Exposure – the gradual exposure to anxiety provoking stimuli without training in the relaxation response used in systematic desensitization.

Flooding – prolonged and full-intensity exposure to the anxiety provoking stimuli in an attempt to first see a spike in the anxiety response followed by a gradual extinction curve.

Two types of classical extinction techniques are exposure and flooding. Describe each.
Patients are exposed to the anxiety provoking stimulus (ex. touching door knobs) but prevented from taking part in the compulsive behavior in an attempt to curb the association.

The exposure is a classical extinction technique whereas the prevention of the compulsive behavior is based on the operant perspective of preventing the avoidance response.

Exposure & Ritual Prevention is a first-line treatment approach for patients with OCD. Describe the treatment.

Is this classical extinction or prevention of operant avoidance response?

Increasing desirable or appropriate behaviors through reinforcement and weakening the undesirable/inappropriate behaviors through punishment or extinction.
Treatment using operant techniques are based on what?
Operant conditioning technique.

It is the pairing of reinforcement/punishment/extinction with behaviors that the therapist and patient would like to strengthen or weaken.

Is contingency management a classical extinction or operant conditioning technique?

What is it?

Operant conditioning.

Teaching a dog how to shake.

Is shaping a classical extinction or operant conditioning technique?

Give an example of shaping.

Operant conditioning technique.
It is a technique where the patients physiological response is monitored and displayed to the patient and the patient is taught ways to regulate these responses.
It is operant conditioning because the visual feedback and ability to regulate the physiological functioning is a type of reinforcement to the patient.
Is biofeedback therapy a classical extinction or operant conditioning technique? Why?

What is it?

Operant conditioning.

Negative punishment.

Is time out a classical extinction or an operant conditioning technique?

What type of operant conditioning is it?

CC – individuals make a contract whereby certain behavior is either rewarded in a set method or punished in an agreed upon method.

TE – individuals are given tokens for desired behavior or tokes are taken away from the individual for undesired behavior. These tokens can then be exchanged for things that the individual would like.

The tokens are secondary reinforcers.

Two other methods of operant conditioning therapy are contingency contracts and token economies.
Describe each.

In token economies, are the tokens primary or secondary reinforcers?

They can develop a reinforcing behavior in which their brain begins to associate complaining with getting pain medication. It is a behavior that can be avoided by giving pain medication on a timed basis instead of an as needed basis.

Administer pain medication on a time contingent basis instead of an as needed basis as stated above.

Pain management can involve a level of behavioral changes or management. What can occur if patients are given pain medication every time that they complain about feeling pain?

How can we avoid pain medication becoming highly reinforcing behavior?

It is based on the patients own cognitive abilities and their ability to alter their thoughts and beliefs through therapy. Its emphasis is on changing negative cognitive associations with positive cognitive associations.
Describe a purely cognitive therapy approach.
This therapy is based on the idea that it is our perception of events and the world that leads to our troubling emotional states. The therapists job is to identify and challenge these distorted ways of viewing the world.
Describe how rational-emotive therapy (a form of cognitive therapy) work to help patients.
The result of negative views of self, life events, and the future.

It is still unclear whether the triad is the cause of depression or whether depression is the cause of the triad.

What is considered the negative triad of depression?

Is the triad the cause of depression or visa versa?

It basically states that behaviors can be learned through modeling or vicarious learning, that is, we can see someone else get injured by acting in a certain way, see some be successful by acting in a certain way, etc. and then model the positive and avoid the negative behavior.

Self efficacy is the belief that we are able to do whatever behavior it is that we would like to. With self efficacy behavior can be changed.

Bandura’s Social Cognitive Theory is a theory of how we learn certain behavior. What does this theory state about how we obtain behavior?

How does self efficacy play into this theory?

Severely troubled patients who don’t respond well to other therapies. (ex. suicidal, borderline, chronic eating disorders, drug dependence, etc)

The basis is two fold, the person, in therapy, learns to accept themselves for who they are and through mindfulness training they learn to recognize the behaviors and feelings and lead up to their self destructive or unpleasant behavior and break the chain that leads to destructive behavior.

Marsha Linehan developed Dialectical Behavior Therapy to treat what sort of patients?

What is the basis of this type of therapy?

It is a method of stress reduction and pain management through mindfullness meditation like yoga.
What is Mindfullness-Based Stress Reduction developed by Jon Kabat-Zinn?
Family therapy is targeted at families where there is likely a disturbance in the family and the family directs the disturbance at an individual in the family who then displays the “symptoms” that the family projects upon that person.
Think Family Guy and Meg Griffin.
Why would a therapist recommend family therapy?

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