behavior therapy

Question 1

discovery of therapy

Answer 1

Discovered in 1950s, albert bandura, Arnold lazarus, bf skinner, individuals obtain psychopathology and maladaptive behavior as a result of what they have learned, we learn how to maintain that behavior in order to avoid undesirable consequences

Question 2

what is the basis of this therapy

Answer 2

A set of clinical procedures relying on experimental findings of psychological research (organized and structure in order to reduce symptoms, any problem or issue can be solved in structured and organized manner)
Ex. Someone is experiencing stress eating, there is a way to address this by helping them manage stress better and challenging some of the thoughts they might have; moving away from insight oriented/relational focuses (wanted something more engaging, what can individual do right now to manage issues)

Based on principles of learning that are systematically applied  -Treatment goals are specific and measurable

Focusing on the client’s current problems (second characteristic, below)
-To help people change maladaptive to adaptive behaviors

The therapy is largely educational - teaching clients skills of self-management

Question 3

nine characteristics

Answer 3

1) First: (one of the characteristics, based on scientific method= see issue form hypothesis, try ways to navigate issue and then evaluate)
2) Second: focus on current problems
3) Third characteristic: clients play an active role in therapy, by engaging in specific actions to deal with problems
4) Four: emphasizes client skills of self-management
- Practice, help them regulate, client is practicing techniques before session
5) Five: focus on assessing overt and covert behavior changes
6) Six: emphasizes self-control, not focused on insight but what the individual can do
- Sense of efficacy
7) Seven: interventions are individually tailored
- Ex. Working with client with trauma, you might not access this initially, but focus on what is impacting them right now
8) Eight: collaborative approach
- Sometimes behavioral work is seen as cold distant or isolated, but it is a collaborative approach, often a warm approach
9) Nine: behavior therapy bases its work on the fact that everything should be practical, emphasis on practical application
- Interventions should be applied to all facets of daily life, decrease maladaptive behavior and increase adaptive behaviors
- How can person transfer skills they learned in one situation to another situation
- Will require readjustment

Question 4

explain systematic approach

Answer 4

Systematic approach, based on principles, teaching client, will not go into patterns of behaviors and relationships but they look at what is the issue where they might have learned this from and how does it impact them currently (how can they make changes now)

Question 5

what is one critique of this therapy surrounding diversity

Answer 5

Manualized treatment is not always inclusive of diversity (critique)

Question 6

different kinds of exposure therapies

Answer 6

in vivo, flooding, eye movement desensitization and reprocessing (EDMR)

Question 7

what is in vivo desensitization

Answer 7

(part of systematic desensitization)

-Brief and graduated exposure to an actual fear situation or event

Question 8

what is flooding

Answer 8

• Flooding (exposed fully to stimulus, before you prep them for flooding you are helping them find relaxation techniques and ways to manage stress)
• Prolonged & intensive in vivo or imaginal exposure to stimuli that evoke high levels of anxiety, without the opportunity to avoid them
• Designed to treat fears and emotional phobias, giving steps to combat anxieties
• Two kinds of flooding/ different approaches: some people will give relaxation techniques and other people will not (anxiety will decrease on its own)
• Can be real or imagined
• Create hierarchy (subjective units of distress SUDs), ask client what is the least anxiety provoking situation to the most anxiety provoking
• Help them meet each of these steps

Question 9

what is eye movement desensitization and reprocessing (EDMR)

Answer 9

(trying to reduce the eye movement or extensive tapping, trying to calm it down during stressful events, not feel the anxiety, engage in more positive behaviors)
-An exposure-based therapy that involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders and fearful memories of clients

Question 10

what are the several phases of desensitization treatment

Answer 10

1) assessment/evaluation/history taking (readiness to talk about trauma and expose selves to it), create treatment plan (talk about distressing memory and how it impacts), start to develop specific skills and behaviors they might need in order to navigate the traumatic event or situation
2) expanding on different ways of handling emotional distress, ways to reduce stress, ways to engage in imagery where they can feel relief between sessions, if you are practicing between sessions you are going to find it more accessible (if you do not practice deep breathing it will not come to you when you are anxious)

phases 3-6) target identified stressor, go back to where they are in that stressful moment/event are there ways they can insert different ways of handling it differently
-directed focus on the more exposure you have the more you are able to decrease anxiety and manage situation in a different way

7th phase: keep a log during week
-any material that might arise, focus on any calming activity

PURPOSE: used a lot with trauma to reduce response to trauma

Question 11

what are the 4 aspects of behavior therapy

Answer 11

classical conditioning, operant conditioning, social learning approach, cognitive behavior therapy

Question 12

what is classical conditioning

Answer 12

• In classical conditioning certain respondent behaviors, such as knee jerks and salivation, are elicited from a passive organism
• Unconditioned stimulus, conditioned stimulus, unconditioned response, conditioned response

Question 13

what is operant conditioning

Answer 13

• Focuses on actions that operate on the environment to produce consequences
• If the environmental change brought about by the behavior is reinforcing, the chances are strengthened that the behavior will occur again. If the environmental changes produce no reinforcement, the chances are lessened that the behavior will recur
• Positive punishment, negative punishment, positive reinforcement, negative reinforcement
• Punishment is to weaken behavior (can be done by adding something or taking something away)
• Reinforcement is to strengthen behavior (can be done by adding something-positive; or taking something away-negative)
• Negative reinforcement: taking away burn by adding sunscreen, cars that have beeping when you do not have seatbelt on

Question 14

what is social learning approach

Answer 14

Gives prominence to the reciprocal interactions between an individual’s behavior and the environment

• Albert bandura
• Bobo doll experiment
• What we believe about ourselves our abilities based off of what we see
• Representation is so important
• Seeing someone in position of power that looks like you, gives you more efficacy (this is something I can do)

Modeling: who are our role models and how do we integrate these individuals into our lives and identities

• How to help client build self efficacy
• Mentoring programs

Question 15

what is cognitive behavior therapy

Answer 15

• Emphasizes cognitive processes and private events (such as a client’s self-talk) as mediators of behavior change
• How one’s cognitions impact our behaviors and emotions

Question 16

what is functional assessment of behavior in terms of cognitive behavioral work

Answer 16

ABC model

Question 17

what is the ABC model

Answer 17

Antecedent(s)
-Thing that starts behavior 
Behavior(s)
-What happens as result of antecedent
Consequence(s)
-Result of the behavior

Question 18

what is applied behavior analysis

Answer 18

Applied behavior analysis is what you learn from the behavior

• Different ways to help individual manage behavior
• Have to understand the function of the behavior, and the purpose it serves (every behavior has a functionality)
• First step is observing client in natural environment, then create behavioral intervention plan based on hypothesis of what is going on, teaching new ways of engaging, then have them try it
• IF a child lacks attention they might engage in behavior to get attention
• Ex. Punching someone else in school
• Finding purpose of behavior has psychodynamic undertones, but you are not expanding on it as much

Question 19

what are the therapeutic techniques

Answer 19

Relaxation Training – to cope with stress
-Deep breathing, PMR

Systematic Desensitization – for anxiety and avoidance reactions
-Helping client slowly find way to experience stimulus causing them fear, learn you are able to do things you previously thought you could not

Modeling – observational learning
-Model appropriate behavior for clients

Assertion Training– learning to express one’s self

Social Skills Training– learning to correct deficits in interpersonal skills
-Asking clients a better way to handle that, giving them resources worksheets and practicing with them

Self-Management Programs “giving psychology away”
-Self-help, teaches you how to work with self, people can practice techniques and behaviors (but at the same time it minimizes what is done in behavioral work)

Question 20

is behavior therapy too simple?

Answer 20

this is a critique, but it is not true

Question 21

what are the different kinds of therapy

Answer 21

applied behavior analysis, dialectical behavior therapy, mindfulness based stress reduction therapy, acceptance and commitment therapy, Lazarus multimodal therapy

Question 22

what is applied behavioral analysis

Answer 22

training new behaviors

-Particularly effective in working with developmental concerns

Question 23

what is dialectical behavior therapy

Answer 23

learning emotional regulation and mindfulness

• Designed for the treatment of Borderline Personality Disorder
• Marsha Linihan
• Four different areas of focus; mindfulness, distressed tolerance, interpersonal effectiveness, emotional regulation (how to change and navigate emotions)
• Often used with clients with trauma or borderline personality
• Dialectical pieces, you need all four of these things to help client navigate issues

Question 24

what is mindfulness based stress reduction therapy

Answer 24

meditation and yoga

-Accepting the present, where you are

Question 25

what is acceptance and commitment therapy

Answer 25

learning acceptance and non-judgment of thoughts and feelings as they occur
-Accepting values and beliefs and are committing to it

Question 26

what is Lazarus multimodal therapy

Answer 26

7 dimensions of personality and engagement, basic id, behavior, affect, sensations, imagery, cognition, interpersonal relationships, drugs and alcohol

• More holistic approach
• Tailor treatment to fit various dimensions, list of problems and list of solutions, look at how one thing impacts another
• List of issues stemming from problem and how to address, more integrative and unique approach

Question 27

pros of behavior therapy

Answer 27

-Structured, see what fits best in client’s life, time limited, works with people culturally (many people come in with medical model perspective)

Question 28

limitations of behavior therapy

Answer 28

• Heavy focus on behavioral change may detract from client’s experience of emotions
• Some counselors believe the therapist’s role as a teacher deemphasizes the important relational factors in the client-therapist relationship
• Behavior therapy does not place emphasis on insight
• Behavior therapy tends to focus on symptoms rather than underlying causes of maladaptive behaviors
• There is potential for the therapist to manipulate the client using this approach
• Some clients may find the directive approach imposing or too mechanistic

Question 29

what is Rational Emotive Behavior Therapy (REBT)

Answer 29

Branch of behavioral therapy and CBT (how they first understood CB work), created by Albert Ellis

• How we maintain behaviors, and they can be unlearned
• People have potential to think rationally but we tend to judge and maintain maladaptive thoughts, we have potential to change way we are doing things

Question 30

what are the important components of REBT

Answer 30

• Stresses thinking, judging, deciding, analyzing, and doing
• Assumes that cognitions, emotions, and behaviors interact and have a reciprocal cause-and-effect relationship
• Is highly didactic, very directive, and concerned as much with thinking as with feeling
• Teaches about what someone is doing and how someone can combat thoughts
• Teaches that our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations

Question 31

therapeutic process of REBT

Answer 31

Therapy is seen as an educational process

• We are born with ability to be rational or irrational, and we have the ability to change these things
• Ex. Monster under the bed, kids can describe it; we constantly do this and catastrophize (we take an event and end up adding to it and make it more complicated than it actually is)

Question 32

what do clients learn

Answer 32

• To identify the interplay of their thoughts, feelings and behaviors
• To identify and dispute irrational beliefs that are maintained by self-indoctrination
• To replace ineffective ways of thinking with effective and rational cognitions
• To stop absolutistic thinking, blaming, and repeating false beliefs
• Ability to change self, behavior, and rigid way of thinking

Question 33

ABCD model in REBT

Answer 33

ABCD model: A: activating event (what causes someone to get upset or sparks specific belief about one’s identity); B: belief (about event); C: consequence (emotional and behavioral); D: disputing intervention (therapist, what else can you do); E: effect (what effect does disputing intervention have on individual, new change they end up having); F: new feeling

Question 34

how behaviors change in REBT

Answer 34

Behaviors can change if we learn, therapy is educational and based on thinking and acting, we have to practice self-help, people naturally maintain maladaptive thoughts therapists have to restructure them

Question 35

what is musterbation in REBT

Answer 35

we engage in “I must do X Y and Z”, irrational ideas and beliefs that are self-defeating

Question 36

some exercises done in therapy

Answer 36

Talks about role playing, rational emotive imagery (think about worst case scenario and how to combat it), shame attacking exercises (bring about things that have people stare at you as a way to navigate anxiety)
-People only change if they actually try to change behavior

Question 37

REBT view of human nature

Answer 37

• We are born with a potential for both rational and irrational thinking
• We have the biological and cultural tendency to think crookedly and to needlessly disturb ourselves
• We learn and invent disturbing beliefs and keep ourselves disturbed through our self-talk
• We have the capacity to change our cognitive, emotive, and behavioral processes

Question 38

irrational beliefs in REBT

Answer 38

-Irrational ideas lead to self-defeating behavior

Some examples:

• “I must have love or approval from all the significant people in my life.”
• “I must perform important tasks competently and perfectly.”
• “If I don’t get what I want, it’s terrible, and I can’t stand it.”