Behavioural Interventions

Question 1

What does behavioural theory assume that psychodynamic theory doesn’t?

Answer 1

That behaviour is the problem rather than a simple manifestation of some underlying psychodynamic issue

Question 2

Underlying assumptions of behavioural interventions

Answer 2

Psychological problems are based on faulty learning or genetic loading or both combined

Question 3

Seligman (1971)

Answer 3

Biological preparedness theory of fear conditioning

Question 4

Occam’s razor

Answer 4

Make it simple unless it needs to be complex

You don’t need all the explanations as long as the simple one works

Question 5

Theoretical basis of behaviour therapy

Answer 5

Classical conditioning of fear responses

Based in adaptive reflex actions that become maladaptive

Question 6

What differs in anxiety disorders?

Answer 6

The specific cognitions

Question 7

Cognitions in phobias

Answer 7

That object can harm me

Question 8

Cognitions in PTSD

Answer 8

I am at risk of harm

Question 9

Cognitions in GAD

Answer 9

Worry about uncontrollable events

Question 10

Cognitions in social anxiety

Answer 10

Fear of negative evaluation

Question 11

Cognitions in OCD

Answer 11

If I do not think/do X, then there will be negative consequences

Question 12

Cognitions in panic disorder

Answer 12

I will die if I do not get away

Question 13

Extinction

Answer 13

Unlearning a link as the link disappears

As the positive or negative event stops happening, we stop reacting to it

Question 14

Habituation

Answer 14

Getting used to something sensory and repetitive, such as slamming a door

Question 15

Reacquisition

Answer 15

One negative experience brings the fear back and very fast

Question 16

Spontaneous recovery

Answer 16

The fear can recover over time, but more weakly than originally

Question 17

Disinhibition

Answer 17

Any arousal just after extinction can result in some return of the fear

Question 18

Renewal

Answer 18

The fear can be brought back by return to the setting where it was learned

Question 19

What are the problems with extinction

Answer 19

Reacquisition
Spontaneous recovery
Disinhibition
Renewal

Question 20

Stimulus generalisation

Answer 20

A similar object can come to evoke similar fears

Question 21

Latent inhibition

Answer 21

Harder to learn to fear a familiar object than an unfamiliar one

Question 22

Blocking

Answer 22

Learning that something is positive makes it harder to learn subsequently that it is negative

Question 23

Exposure therapy basics

Answer 23

Anxiety reactions are normal and short lived

Interactions between physiological, cognitive, emotional and behavioural aspects

Exposing the participant to the threatening stimulus and teaching them that no harm comes to them despite the anxiety reaction

Question 24

Why is our anxiety response limited?

Answer 24

Limited by the amount of adrenaline the body can pump

Some inter-individual differences related to cortisol

Question 25

What is chronic anxiety?

Answer 25

Usually low level and maintained by rapid use and failure of safety behaviours

Question 26

How is anxiety maintained?

Answer 26

Patient experiences anxiety and uses safety behaviours to calm themselves down in the short term

This enhances anxiety in the long-term as the patient never learns that the anxiety goes away anyway

Question 27

Graded exposure

Answer 27

Gradually approaching the feared object/situation

Tolerating the anxiety until it declines

Takes several sessions of moderate anxiety

Question 28

How is graded exposure delivered?

Answer 28

In vivo or imaginally according to the disorder

Cannot repeat the trauma in PTSD for example

Question 29

Systematic desensitisation

Answer 29

As with graded exposure but with methods to reduce anxiety

Question 30

Types of anxiety reduction in systematic desensitisation

Answer 30

Relaxation, biofeedback

Mindfulness/distraction

Reciprocal inhibition mechanism

Question 31

Flooding

Answer 31

Immersion in the feared situation immediately

One or two sessions of very high anxiety

Can feel deeply unpleasant to both the patient and the psychologist

Question 32

Recommendations for better exposure outcomes

Answer 32

Aim for high levels of fear in the session

Widen context to reduce stimulus generalisation

Vary the type, frequency and duration of practice to enhance stimulus specificity

Beware of efforts to induce calm

Question 33

Behavioural modification

Answer 33

A general approach to modifying behaviours, based on positive and negative reinforcement patterns

Used flexibly to understand and modify behaviours that are maladaptive

Question 34

Token economy

Answer 34

Encourage change to more pro-social behaviour via reinforcement of such behaviour

Question 35

Skills training via successive approximation/chaining/shaping of behaviours

Answer 35

Teaching someone with a learning disability to undertake a shopping trip

Question 36

Behavioural self-control/habit reversal

Answer 36

Identification of problems and self-directed change

Question 37

Behavioural activation

Answer 37

Specific methods used to target low self-esteem/depression

Overcoming learned helplessness, where the person has ceased making efforts that might bring positive outcomes and reduce depressive mood

Question 38

What does behavioural activation involve?

Answer 38

Activity planning

Activity scheduling

Making small behavioural changes

Question 39

Roth & Fonagy (2005)

Answer 39

In most disorders, CBT is more effective than other therapies and medication

Question 40

Ougrin (2011)

Answer 40

Compared exposure therapy with CBT via a meta-analysis

Concluded that ET is as effective as CBT in all anxiety disorders except social phobia

Question 41

Jacobson et al. (1996) three conditions

Answer 41

Full CBT
- Addresses schemas, automatic thoughts, behaviours

Activation of thoughts
- Addresses automatic thoughts, behaviours

Behavioural activation
- Addresses behaviours only

Question 42

Jacobson et al. (1996) results

Answer 42

No difference at all in outcomes

Question 43

Harned et al. (2013)

Answer 43

Exposure therapy has the dubious distinction of being one of the most empirically supported yet the least used psychological treatments