Behavioral Therapy Flashcards
Primary focuses of behavioral therapy
- Observed behaviors (rather than internal personality traits)
- The importance of learning (grounded in learning theory)
- Directive and active nature of treatments
- Importance of assessment and evaluation (treatment is of an empirical nature)
3 C’s of behavioral therapy
- counter conditioning
- contingency management
- cognitive-behavior modification
Theory of psychopathology
- Anxiety is the root of most behavior disorders
- Anxiety is primarily a pattern of responses of the sympathetic nervous system when an individual is exposed to a threatening stimulus.
- Anxiety is learned when a neutral stimulus can be paired contiguously with a threatening stimulus classical conditioning
- Through the process of generalization stimuli physically similar to the original conditioned stimulus such as other dogs, can also evoke anxiety
Techniques
- counter- conditioning
- systematic desensitization
- anxiety hierarchy
- exposure therapy
- behavioral activation
Counter-conditioning (Wolpe, 1958)
- Follows directly from Pavlov’s classical conditioning
- The principle of counter conditioning is to replace a maladaptive behavior with a more adaptive one by teaching the client to associate the adaptive behavior with the stimulus through classical conditioning.
Systematic desensitization (Jacobson, 1938)
- It is impossible to be both relaxed and anxious at the same time (Wolpe 1973)
- Teach clients to discriminate between muscle tension and relaxation
- Client progresses through muscle groups, contracting muscles for 10-15 sec and then releasing tension, resulting in a state of relaxation
Anxiety hierarchy
- Next, the client constructs an anxiety hierarchy in which the person ranks stimuli from the most anxiety provoking to the least anxiety provoking along a 10-point scale
- Then a person imagines some relaxing situations (e.g., being at the beach)
- The therapist asks the client to go through the anxiety hierarchy
- If the patient becomes anxious they are instructed to go back to their “happy place”
- After the hierarchy is conquered the client moves toward in vivo desensitization in which they conquer that shit in real life.
Exposure therapy
full and immediate confrontation to the disturbing stimulus (systematic desensitization proceeds more gradually)
Other counter-conditioning techniques
- Assertiveness training (used for anxiety related to interpersonal interactions)
- Sexual arousal (sexual anxiety)
- Stimulus control (avoid the problem – for example, fast food when losing weight)
Behavioral activation
- When people avoid anxiety-provoking situations they may begin to avoid even pleasurable activities
- Avoidance exacerbates their depressed mood
- Patients are presented with graduated exercises to promote activities that are reinforcing
Therapeutic process (6 steps) in contingency management
(1) Operationalize the behavior (state the problem in behavioral terms)
(2) Identify behavioral objectives, specifying target behaviors, and whether behaviors should be increased, decreased, or reinforced only when appropriate
(3) Develop behavioral measures (set baseline in order to measure progress)
(4) Conduct naturalistic observations
(5) Modify existing contingencies, which involves specifying the conditions under which reinforcements are or are not to be given, what the reinforcements will be, and who will administer them
(6) Monitor the results by continuing to chart the rate of responses – modify if necessary, terminate when objectives have been met.
Application of contingency management carries somewhat according to who and what:
- Institutional Control (e.g., schools, hospitals – token economies)
- Self-Control (this is self-explanatory)
- Mutual control (e.g., couples – contracting)
- Therapist control (within therapy)
- Aversive Control (as a last resort when positive alternatives have failed)
