Behavioural Therapy

Question 1

What is the basic overview of behaviour therapy?

Answer 1

Behavioral therapy is an umbrella term for types
of therapy that treat mental health disorders. It’s based on the
idea that all behaviors are learned and that behaviors can be changed.

This form of therapy looks to identify and help change potentially self-destructive or unhealthy behaviors.

Question 2

Who is associated with Behaviour Therapy?

Answer 2

Pavlov

Skinner

Lazarus

Question 3

What are the key concepts of Behaviour Therapy?

Answer 3

Among the most widely used treatment interventions for psychological and behavioural problems today

3 significant developments of behaviour therapy
The continued emergence of cognitive behaviour therapy as a major force
The application of behavioural techniques to the prevention and treatment of health-related disorders
The emergence of the third-wave behavior therapies
Mindfulness based stress reduction (MBSR)
Mindfulness based cognitive therapy (MBCT)
Dialectical behaviour therapy (DBT)
Acceptance and commitment therapy (ACT)

Best understood by considering:
- Classical conditioning
- Operant conditioning
- Social cognitive/learning theory
- Cognitive behaviour therapy

Question 4

what is behaviour therapies view of human nature?

Answer 4

FIND

Question 5

what is the focus of behaviour therapy?

Answer 5

Focus is on directly observable, current determinants of behaviour,
learning experiences that promote change, tailoring treatment
strategies to individual clients, with rigorous assessment and evaluation.

Utilizes assessments as an ongoing process of observation
and self-monitoring that focuses on the current determinants of behaviour, including identifying the problem and evaluating the change
- Informs the treatment process and involves attending to the culture of clients as part
of their social environments, including social support networks relating to target behaviours
- Evaluates the interventions utilized to determine whether the behaviour change
resulted from the procedure

Question 6

What are the goals of behaviour therapy?

Answer 6

1. Increasing personal choice
2. Creating new conditions for learning
3. Help an individual understand how
   changing their behavior can lead to changes in how they are feeling
4. Increasing a person’s engagement in positive or socially reinforcing activities.

Question 7

What is the role of the therapist in behaviour therapy?

Answer 7

Conduct a thorough functional assessment (behavioural analysis) to identify the maintaining conditions

Identify the particular antecedent and consequent events that influence, or are functionally related to, an individuals behaviour

Counsellors are active and directive, functioning as consultants and problem solvers

Use techniques common to other approaches, such as summarizing, reflection, clarification and open-ended questions.

Strive to understand the function of a clients behaviour, including how they originated and are sustained.

Evaluate the success of a change plan by measuring progress toward pre-established goals

Conduct follow up assessments to determine if change is durable over time

Question 8

What is the client experience of behaviour therapy?

Answer 8

Clients are expected to actively participate and be aware in the therapeutic process
Without active participation, success is slim
Motivational interviewing is a good technique to motivate clients to want to change and to be active participants in the therapeutic process
Engages in behaviour rehearsal with feedback until skills are well learned
Therapist teaches the client concrete skills and they are practiced
Clients often receive homework assignments
Typically consists of active monitoring of problem behaviours
Changes that clients make in therapy must also be translated into everyday life
Clients need to be motivated to change

Question 9

What is the client therapist relationship in behavioural therapy?

Answer 9

Relationship is critical to a successful therapeutic outcome

Consists of a collaborative working relationship

Warmth, empathy, authenticity, permissiveness, and acceptance by part of the therapist are necessary, but not sufficient for behaviour change to occur

The client-therapist relationship is the foundation on which behavioural strategies are built to help clients change in the direction they wish

Question 10

what are the methods, techniques and procedures of behavioural therapy?

Answer 10

Behavioural approaches utilize specific therapeutic procedures that demonstrate effectiveness by providing continuous and direct feedback to the counsellor from the client
Techniques are empirically supported and evidence-based

Procedures are individually tailored to meet the particular needs of each client

Techniques include:
- Applied Behavioural Analysis
- Relaxation trining
- Systematic desensitization
- Exposure therapies
- Eye Movement Desensitization and Reprocessing (EMDR)
- Social skills training
- Self management training
- Multimodal therapy
- Mindfulness and acceptance based approaches
(midfulness based stress reduction, mindfulness based cognitive therapy, dialectical behaviour therapy, acceptance/commitment therapy)

Question 11

What are the strengths and limitations from a cultural perspective of behavioural therapy?

Answer 11

FIND

Question 12

Give a description of behavioural therapy

Answer 12

Behaviourists believe that personality is attributed to the effects of the laws of learning as a person interacts with his or her environment. There are three main areas of behaviour therapy: classical conditioning, operant conditioning, and social learning theory. These three basic models are used in some combination by most behaviourists.

The early period of development in behaviourism is associated with the work of Ivan Petrovich Pavlov (1849-1936), a Nobel Laureate in physiology, who established the foundations of classical conditioning. In the United States, J. B. Watson was a key figure in the development of behaviourist ideas. His position was quite radical in that he claimed that all behaviour could be understood as a result of learning. Watson’s position was later refined by subsequent theorists, most notably Burrhus Frederic Skinner (1904-1990). Among other behaviourists, E. L. Thorndike, a pioneer in research on animal learning, showed the influence of consequences (reward or punishment) on behaviour. Thorndike formulated the “law of effect” which states that responses which have satisfying consequences are strengthened and those followed by discomfort or annoyance are weakened. Clark Hull applied the principles of classical and operant conditioning to learning theory: the Stimulus-Response model. Joseph Wolpe introduced several therapeutic techniques based on Pavlov’s conditioning principles and Hull’s stimulus-response theory; in particular, he applied learning principles to adult neurotic disorders. Another landmark in the development of behaviour therapy was the research done by Hans J. Eysenck at the Institute of Psychiatry of London University. Eysenck defined behaviour therapy as the application of modern learning theory to the treatment of behavioural and emotional disorders.

In his seminal work Science and Human Behavior, Skinner (1953) criticized psychodynamic concepts and reformulated psychotherapy in behavioural terms. Up to the end of his life, Skinner (1990) remained dedicated to the theory of contingencies of reinforcement as the only viable scientific approach to the study of human behaviour.

Toward the end of the 1960s, behaviour therapists increasingly turned their attention to social and cognitive aspects of personality development. An illustration of this trend is the work of Albert Bandura. His social learning theory emphasizes modelling (vicarious learning), the importance of symbolic processes and motivational aspects, as well as self-regulatory mechanisms. More recently, Bandura (2001) has been referring to his perspective as social cognitive theory.

The Multimodal Therapy developed by Arnold Lazarus is a relatively brief and practical approach to counselling, which draws most heavily from the behaviourist and cognitive tradition. It is cited often as an example of technical eclecticism, as interventions are borrowed from various schools of counselling with the purpose of matching the wide variety of client needs, styles, or presenting concerns. Arnold Lazarus (Lazarus & Lazarus, 1993) is also the author of the Multimodal Life History Inventory (MLHI), a 15-page assessment instrument for adult counselling. The MLHI is divided into five sections: general information, personal and social history, description of presenting problems, expectations regarding therapy, modality analysis of current problems. The comprehensive modality analysis section helps therapists design a treatment program that is tailored to specific client needs. It addresses seven important areas: behaviours, feelings, physical sensations, images, thoughts, interpersonal relationships, biological factors.

Question 13

Upon completion of the lesson you should be able to:

describe the key concepts of the behavioural approach;
describe the aspects of the theory as they pertain to the general descriptors listed in Lesson 1;
outline the therapeutic process regarding the therapist, the client, and the relationship between the two;
evaluate the degree to which the theory behind the behavioural approach is consistent with your theoretical notions of a counsellor.

Question 14

The text reading for this lesson is Chapter 9 of Corey’s Theory and Practice of Counselling and Psychotherapy. Read the chapter before you begin to do the work in the lesson to get an overview of the theory. Supplement the information in the textbook by reading Bandura’s (1997) article on Self-efficacy and the articles by Guercio (2020, 2022) on the theoretical developments in behaviour therapy. Remember that you can always look up a technical term in the on-line Glossary.

Question 15

What are the basic concepts of behaviour therapy?

Answer 15

Classical conditioning

Operant conditioning

Systematic Desensitization

Extinction

Flooding

Reciprocal Inhibition

Reinforcement (positive and negative)

Modelling

Self-efficacy

Multimodal therapy

Question 16

What are the basic assumptions of Behaviour therapy?

Answer 16

All behaviour is learned. What can be learned can also be unlearned. Behaviour therapy is based on the principles and procedures of the scientific method. Feelings are of minor concern. The emphasis is on behavioural change.

Question 17

What is the prof’s commentary on classical and operant conditioning?

Answer 17

Many concepts from behaviour theory have contributed significantly to the effectiveness of psychotherapy.

Classical conditioning is a type of learning made famous by Pavlov’s experiments with dogs. The gist of the experiment is this: Pavlov presented dogs with food, and measured their salivary response (how much they drooled). Then he began ringing a bell just before presenting the food. At first, the dogs did not begin salivating until the food was presented. After a while, however, the dogs began to salivate when the sound of the bell was presented. They learned to associate the sound of the bell with the presentation of the food. As far as their immediate physiological responses were concerned, the sound of the bell became equivalent to the presentation of the food. Therefore, classical conditioning forms an association between two stimuli.

Operant conditioning was developed by B. F. Skinner. Operant conditioning forms an association between a behaviour and a consequence. It is also called Response-Stimulus or R-S conditioning because it forms an association between the organism’s response (behaviour) and the stimulus that follows (consequence). The term “operant” refers to how an organism operates on the environment, and hence, operant conditioning comes from how we respond to what is presented to us in our environment. It can be thought of as learning due to the natural consequences of our actions. In operant conditioning, the process is not trial-and-error learning: behaviour can be strengthened or reinforced by a single consequence. Consequences have to be immediate, or clearly linked to the behaviour. With verbal humans, we can explain the connection between the consequence and the behaviour, even if they are separated in time.

For a long time classical and operant conditioning were considered distinct categories of learning requiring distinct pathways in the brain. Some observations, however, seem to indicate that most learning situations contain operant and classical components at various degrees.

Classical and operant conditioning share many of the same basic principles and procedures. For example, Kimble (1967) has pointed out that the basic principles of acquisition, extinction, spontaneous recovery, and stimulus generalization are common to both types of learning. There are several differences, however, between classical and operant conditioning. Although a basic feature of operant conditioning is reinforcement, classical conditioning relies more on association between stimuli and responses. A second distinction is that much of operant conditioning is based on voluntary behaviour, while classical conditioning often involves involuntary reflexive behaviour. These distinctions are not as strong as they once were believed to be. For example, Neal Miller (1978) has demonstrated that involuntary responses, such as heart rate, can be modified through operant conditioning techniques. It now appears that classical conditioning does involve reinforcement and many classical conditioning situations may involve operant behaviour.

Question 18

What is the heredity in Behaviour Therapy?

Answer 18

Heredity/Environment: Heredity is of minor importance. Some behaviour is, at least in part, determined by heredity, but this is beyond direct control and is not of clinical interest to the behavioural counsellor. Behaviourists minimize the importance of heredity because biological variability cannot be directly measured, manipulated, or controlled. Behaviour is learned through interaction with the environment and it can be explained and controlled purely by the manipulation of the environment that contains the behaving organism. Personality is a learned repertoire of responses based on environmental conditions.

Question 19

What are cognitions in behaviour therapy?

Answer 19

Cognitions: The earlier behaviourists believed that all that can be known about human nature can be derived from behaviour. In this empirical approach, behaviour is operationally defined and the data are rigorously quantified. More recently, the role of cognitions has started to be included in behavioural theory.
Motivation: As with the role of cognitions, early behaviourists believed that inner motivational constructs are unscientific, hence misleading. The later social learning theory of Albert Bandura introduced motivational constructs in behavioural theory.

Question 20

What is the time orientation of behaviour therapy?

Answer 20

Cognitions: The earlier behaviourists believed that all that can be known about human nature can be derived from behaviour. In this empirical approach, behaviour is operationally defined and the data are rigorously quantified. More recently, the role of cognitions has started to be included in behavioural theory.
Motivation: As with the role of cognitions, early behaviourists believed that inner motivational constructs are unscientific, hence misleading. The later social learning theory of Albert Bandura introduced motivational constructs in behavioural theory.

Question 21

What is the time orientation of behaviour therapy?

Answer 21

Time Orientation
Present: In general, behaviour therapy has a strong focus on the here-and-now. A client does not have to examine the past in order to attain positive changes in the present. The expansion of present response repertoire (adaptive responses) allows clients to deal with all future contingencies. Clients can learn to plan for and evaluate their own responses to the environment.

Question 22

What is the view of human nature in behaviour therapy?

Answer 22

Behaviourism considers humans to be a blank slate at birth. People are viewed as being neither intrinsically good nor bad, but as learning organisms who have the potential for all kinds of behaviours. Each individual learns through experience to perceive situations as satisfying (rewarding) or dissatisfying (punishing) and then reacts to those situations on the bases of that learned behavioural repertoire. Given the right schedule of reinforcement, anything can be learned and unlearned. For behaviourists, psychotherapy is verbal conditioning.

Question 23

Does behaviour therapy use holistic/atomistic explanations?

Answer 23

Holistic/Atomistic: The behaviourist takes the atomistic approach. Behaviour change is examined. The emphasis is on specific behavioural responses and symptoms, rather than on the total person.

Question 24

Does behaviour therapy use External/Internal Determinants explanations?

Answer 24

External/Internal Determinants: In radical behaviourism, all behaviour is externally determined by contingencies of the environment. Inner subjective experience is irrelevant.

Question 25

Does behaviour therapy use Nomothetic/Idiographic explanations?

Answer 25

Nomothetic/Idiographic: Behaviourism takes a nomothetic approach to the explanation of behaviour. The goal is to identify the general laws of learning that can be applied to all behaviour.

Question 26

Does behaviour therapy use Longitudinal/Cross Sectional explanations?

Answer 26

Longitudinal/Cross Sectional: Behaviourists apply the principles of learning to specific current behaviours. Symptoms, or maladaptive behaviours that are more entrenched by repeated reinforcement of past contingencies may take longer to extinguish.

Question 27

Does behaviour therapy use Tension Production/Reduction explanations?

Answer 27

Tension Production/Reduction: Behaviour therapy generally follows a tension reduction model. With the exception of some ethically controversial applications of aversion techniques and implosive therapy, the model is based on the assumption that people learn to avoid discomfort and seek out pleasure or comfort.

Question 28

What is the observer frame of reference in behavioural therapy?

Answer 28

Behaviour therapy emphasizes objective and systematic observation of behaviour as the only scientific method for psychology.

Question 29

What is the basis for inference in behavioural therapy?

Answer 29

Behaviour modification is viewed as a systematic process of symptom reduction based on a clearly defined schedule of reinforcement and behavioural goals. Compared to any other school of psychotherapy, behaviourism has been the strongest advocate of statistically controlled outcome studies based on clearly defined, observable, and measurable behavioural goals.

Question 30

What is the basis for psychopathology in behaviour therapy?

Answer 30

From a behaviourist perspective, the following are characteristics of psychopathology:

Presence of learned maladaptive responses (behavioural symptoms);
Behaviour that no longer brings satisfaction to the individual, which brings him/her into conflict with the environment;
Behaviour that is disadvantageous or dangerous to the individual and/or to others.

Question 31

What is the basis of a healthy personality for behavioru therapy?

Answer 31

A healthy individual is one who has learned appropriate, adaptive, and efficient ways of responding to environmental stimuli. In Skinner’s (1990) own words, the application of behaviour analysis based on operant conditioning principles would make it possible “to design better environments – personal environments that would solve existing problems and larger environments or cultures in which there would be fewer problems” (p. 1210).

Question 32

What is the role of the therapist in behaviour therapy?

Answer 32

The therapist acts as a teacher or trainer and is highly active.

Question 33

What are the implications for the helping relaitonship in behaviour therapy?

Answer 33

Since behaviour is learned, it can also be unlearned or modified. Through the application of a few basic principles of learning, a wide variety of people can be trained to bring about desired changes in their behaviour. Behaviour change can be measured and quantified. This approach makes it easy to research the effectiveness of therapy. According to Blackham and Silberman (1971), there are four initial stages in a typical behaviour therapy process:

defining the problem;
eliciting the client’s developmental and social history;
establishing specific goals for counselling;
determining methods to be used to bring about desired change.

Question 34

What are the techniques and procedures for behaviour therapy?

Answer 34

Operant Procedures:
Self Control: immediate feedback for undesirable behaviour.

Token Economies: Appropriate behaviour may be reinforced with tangible reinforcers (tokens) that can be later exchanged for desired objects or privileges.

Self-monitoring: Keeping a log or a journal.

Biofeedback: Quantifiable indicators of physical functioning are measured and presented to the client. The client learns to control the levels of functioning by checking them against the levels of light, sound, or meter.

Classical Conditioning Procedures:
Systematic desensitization: replacing anxiety with relaxation while gradually increasing exposure to an anxiety-producing situation or object. Relaxation is incompatible with anxiety and the fear will be deconditioned.

Assertiveness Training: teaching clients how to stand up for your rights and beliefs without infringing on the rights and beliefs of others.

Aversive Conditioning: associating a symptomatic behaviour with a painful/aversive stimulus until the unwanted behaviour is inhibited.

Social Learning Procedures
Flooding: the client is exposed to the most fear-provoking stimulus until his/her fear response is extinguished.

Modelling

Vicarious learning through observation

Implosive (or Implosion) Therapy: A procedure in which the client is flooded with experiences of a particular kind, in the absence of relaxation, to such a dramatic degree that he/she either (a) builds up a distinct aversion to them, or (b) becomes numbed and no longer responds to them. Outcome (a) is what is hoped for in order to break undesirable habits (e.g., smoking); outcome (b) is what is hoped for in the treatment of phobic disorders. In this latter case, implosive therapy is synonymous with flooding.

Question 35

Counselling Situations
Behaviour therapy focuses on concrete, specific goals. Very often clients come to counselling with vague, generalized goals. The behaviour therapist is skilled in helping clients formulate more specific, concrete goals. Practice this skill by writing a specific goal for each of the general statements, following this model:
General: I suppose my wife and I don’t communicate.
Specific: I need to learn how to tell my wife how I feel and what her actions mean to me.
General: I need to get in touch with who I am.
Specific: …
General: It is hard for me to be an outgoing person.
Specific: …
General: I am a worrier. Just about anything anyone says upsets me to the point of not being able to sleep.
Specific: …
Behavioural Techniques Exercise
The following are hypothetical yet frequent presenting concerns that clients bring into counselling. Which would be the most appropriate and effective behaviour therapy techniques you could apply in each of these situations?
I’m always crying at everything, even at the dinner table. Everything seems to make me cry.
I can’t get along with my father. I really hate him but yet a part of me tells me I shouldn’t hate him. I am so confused.
I think I’m in love with my husband’s friend. I’m scared, and feel really guilty. I just don’t know how to handle this.
There’s no excitement in my life and I’d really like to have some. Life has become so mechanical. But I’m afraid to go out and do things on my own.
I always feel insecure and suck my thumb late at night. I’d really like to have someone hold me and touch me.
Deep down inside, I’m afraid to be happy or to feel good because, whenever I do, I’m afraid something bad will happen. So I always feel guilty when I’m happy.
I keep telling myself I am such a failure. Everyone else I know seems to know much more than I do. When I go out I never say anything because whatever I say is so dumb.
I want everyone to like me so I have to be perfect all the time. I break my back trying to please others so they like me. Yet when they tell me they do like me, I don’t believe them.
Self Reflections
Compare and contrast the behaviour therapist’s assumptions about human nature with those of the psychoanalyst.
What are the key characteristics of behaviour therapy that separate it from the other therapeutic approaches?
Discuss the role of the client/therapist relationship from the behaviour therapist’s point of view.
In vivo desensitization and flooding are two forms of exposure therapy. Briefly describe each of these forms of therapy.
What are some of the uses and applications of relaxation training?
What are some of the limitations and contributions of behaviour therapy from a multicultural perspective?
Explain Skinner’s (1990) statement that “there is no place in a scientific analysis of behavior for a mind or a self” (p. 1209).