Chapter 11 - Behavioral & Cognitive Behavioral Fam Therapies Flashcards
cognitions
thoughts
Cognitive-behavioral theory
notes cognitions such as irrational beliefs and overgeneralization are primary factors in causing maladaptive behaviors and psychological disorders
therapists work with their clients to challenge unproductive and detrimental beliefs and construct useful ones
Overall, behavioral and cognitive-behavioral theories provide interventions that disrupt homeostasis by changing old patterns of thinking and behavior
John B. Watson, Mary Cover Jones, and Ivan Pavlov, B. F. Skinner
He argued convincingly that behavior problems can be dealt with directly, not simply as symptoms of underlying psychic conflict.
operant conditioning
people learn through REWARDS and PUNISHMENT to respond behaviorally to their environments in certain ways.
Patterson
credited as being the primary theorist who began the practice of applying behavioral theory to family problems in the 1960s.
BFT
based on the theoretical foundations of behavioral therapy especially classical and operant conditioning.
An assumption underlying this premise is that all behavior is learned and that people, including families, act according to how they have been previously reinforced. Behavior is maintained by its consequences and will continue unless more rewarding consequences result from new behaviors.
The primary concern of behaviorists is with changing present behavior, not with dealing with historical developments.
believes that not everyone in the family has to be treated for change to occur. Many behavioral family therapists work with only one member of a couple or family
assertiveness
asking for what one wants
desensitization
overcoming unnecessary and debilitating anxiety associated with a particular event
CBT
In the cognitive-behavioral approach, attention focuses on what family members are thinking, as well as on how they are feeling and behaving.
believe that it is important to gain insight into how cognitions influence a problem (Watts, 2001).
The premise behind cognitive-behavioral theory is that “the relationship-related cognitions individuals hold, shape how they think, feel, and behave in couple and family relationships”
Four styles of parenting
authoritative,
authoritarian,
permissive,
neglectful.
One style, authoritative, is more effective than the others. As a group, authoritative parents “use developmentally appropriate demands, maintain control of children when needed yet… are responsive, affectionate, and communicate effectively with their children”
Functional family therapy (FFT)
is a family-based, empirically supported treatment for behavioral problems, especially with adolescents
functional family therapists support that all behavior is ADAPTIVE and SERVES A FUNCTION. Behaviors represent an effort by the family to meet needs in personal and interpersonal relationships.
Ultimately, behaviors help family members achieve one of three interpersonal states
- Contact/closeness (merging). In the contact/closeness state, family members are drawn together (e.g., in their concern over the delinquent behavior of a juvenile).
- Distance/independence (separating). In separating, family members learn to stay away from each other for fear of fighting.
- A combination of states one and two (midpointing). In this situation, family members fluctuate in their emotional reactions to each other, so that individuals are both drawn toward and repelled from each other.
A three-stage process.
1. assessment—the focus is on the function that the behavioral sequences serve.
- change. The purpose is to help the family become more functional.
- maintenance—focuses on educating the family and training them in skills that will be useful in dealing with future difficulties.
behavioral treatment of sexual dysfunctions
four phases of sexual responsiveness:
- excitement
- plateau
- orgasm
- resolution
PLISSIT
with P signifying PERMISSION to talk about sexuality and sexual issues
LI signifying LIMITED INFORMATION (about the prevalence and etiology of problems)
SS signifying SPECIFIC SUGGESTIONS:
IT signifying INTENSIVE THERAPY.
A major emphasis in CBFT
to teach families how to think for themselves and to think differently when it is helpful.
“behavioral component of CBFT focuses on several aspects of family members’ actions
1. excess negative interaction and deficits in pleasing behaviors exchanged by family members
- expressive and listening skills used in communication
- problem-solving skills
- negotiation and behavior change skills.” (Dattilio, 2001, p. 11)
A major emphasis in CBFT
teach families how to think for themselves and to think differently when it is helpful.
When schemata are modified, the “behavioral component of CBFT focuses on several aspects of family members’ actions. These include:
- excess negative interaction and deficits in pleasing behaviors exchanged by family members
- expressive and listening skills used in communication 3. problem solving skills
- negotiation and behavior change skills.” (Dattilio, 2001, p. 11)
4 BFT Interventions
- EDUCATION: families encouraged to attend lectures, read books together, view videos as a group,
- COMMUNICATION AND PROBLEM SOLVING: intended to help families develop mutually enhancing social exchanges. Instruction, modeling, and positive reinforcement.
- OPERANT CONDITIONING: The most common approach involves teaching parents to use shaping and time out procedures to increase the desirable behavior patterns in children
- CONTINGENCY CONTRACTING: Contracts build in rewards for behaving in a certain manner.
Specific Behavioral and Cognitive-Behavioral Techniques: CLASSICAL CONDITIONING Coaching Contingency contracting Extinction Positive reinforcement Quid pro quo Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
Classical conditioning is the oldest form of behaviorism.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning COACHING Contingency contracting Extinction Positive reinforcement Quid pro quo Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
therapist helps individuals, couples, and families make appropriate responses by giving them oral instructions.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching CONTIGENCY CONTRACTING Extinction Positive reinforcement Quid pro quo Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
Where one action is contingent, or dependent, on another.
For example, a child and her parent may write up an agreement whereby the daughter will receive an allowance of $5 a week upon taking the garbage out every day after supper.
The way this type of contract is assessed is known as contingency management.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting EXTINCTION Positive reinforcement Quid pro quo Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
Extinction is the process by which previous reinforcers of action are withdrawn so that behavior returns to its original level.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction POSITIVE REINFORCEMENT Quid pro quo Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
A positive reinforcer is usually a material (e.g., food, money, or medals) or a social action (e.g., a smile or praise) that increases desired behaviors.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement QUID PRO QUO Reciprocity Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
marital contracts are often based on quid pro quo—that is, a spouse agrees to do something as long as the other spouse does something comparable.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo RECIPROCITY Shaping Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
The concept of reciprocity involves “the likelihood that two people will rein force each other at approximately equitable rates over time” (Piercy & Sprenkle, 1986, p. 76). Many marital behavior therapists view marriage as based on this principle
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity SHAPING Systematic desensitization Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
The process of learning in small, gradual steps.
It is often referred to as successive approximation
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping SYSTEMATIC DESENSITIZATION Time-out Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
when person’s dysfunctional anxiety is reduced through pairing it with incompatible behavior such as muscular or mental relaxation.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization TIME OUT Grounding Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
The process of time-out involves removing persons (most often children) from an environment in which they have been reinforced for certain actions.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out GROUNDING (Job Card) Charting Premack principle Thought stopping Self-instructional training Modeling role-playing
parents make a list of small jobs that take 15 to 20 minutes to complete and are not a part of the adolescent’s regular chores. These jobs are written on index cards, and materials to complete them are kept readily available. When a problem behavior begins and the adolescent does not heed a warning behavior, he or she is given one of the jobs to complete and is grounded until the job is finished successfully
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding CHARTING Premack principle Thought stopping Self-instructional training Modeling role-playing
The idea is to get the family member to establish a baseline— that is, a recording of the occurrence of targeted behaviors before an intervention is made. From this baseline, modifications can be made to reduce problem behaviors.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding Charting PREMARK PRINCIPLE Thought stopping Self-instructional training Modeling role-playing
a behavioral intervention in which family members must first do less pleasant tasks before they are allowed to engage in pleasurable activities
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding Charting Premack Principle DISPUTING IRRATIONAL THOUGHTS Thought Stopping Self-instructional training Modeling role-playing
through the use of an ABC format (A stands for the event, B stands for the thought, and C stands for the emotion)
disputing the absurdity of irrational thoughts is often stressed by cognitive-behavioral family therapists. It is hoped that through disputing, couples and families will develop more rational thoughts and behaviors.
Example: “Where is it written that you should have all your needs filled in marriage?”
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding Charting Premack Principle Disrupting Irrational Thoughts THOUGHT STOPPING Self-instructional training Modeling role-playing
used when a family member unproductively obsesses about an event or person. This is done through inviting the person involved to begin ruminating on a certain thought— for example, “My life is unfair.” In the midst of this rumination, the therapist yells, “Stop!”
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding Charting Premack Principle Disrupting Irrational Thoughts Thought Stopping SELF-INSTRUCTIONAL TRAINING Modeling role-playing
Self-instructional training is a form of self-management that focuses on people instructing themselves.
Specific Behavioral and Cognitive-Behavioral Techniques: Classical Conditioning Coaching Contingency Contracting Extinction Positive Reinforcement Quid Pro Quo Reciprocity Shaping Systematic desensitization Time Out Grounding Charting Premack Principle Disrupting Irrational Thoughts Thought Stopping Self-instructional training MODELING and ROLE PLAYING
family members asked to act “as if” they were the person they wanted to be ideally.
Family members might practice a number of behaviors to see which work best. FFeedback can be given by the therapist or by other family members.
Shame attack,- a process within role-playing, occurs when a family member does something that he or she previously dreaded. Individuals who use this technique find that when they do not get what they ask for, they are not worse off for having asked. Similarly, family members may steel themselves for what lies ahead through a stress inoculation - members break down potentially stressful events into manageable units that they can think about and handle through problem-solving techniques. Then the units are linked together so that the entire event can be envisioned and handled appropriately.
Role of the Therapist
the therapist is the COACH, COLLABORATOR, EXPERT, TEACHER
Therapist has to learn to play many roles and be flexible.
Anatomy of Intervention Model (AIM)
The process of working for change from a behavioral and cognitive-behavioral perspective AIM delineates five phases in therapy: (1) introduction, (2) assessment, (3) motivation, (4) behavior change (5) termination.
Unique Aspects of Behavioral and Cognitive-Behavioral Approaches
One unique characteristic of behavioral and cognitive-behavioral family therapies involves the THEORY behind these approaches. The behavioral and cognitive-behavioral approaches utilize learning theory, which is a well-formulated and highly researched way of working with people. Learning theory focuses on pinpointing problem behaviors and making use of behavioral and cognitive techniques, such as setting up contingency contracts, reinforcement, punishment, and extinction.
Another emphasis on behavioral and cognitive-behavioral family therapies is RESEARCH.
The third aspect of these approaches involves continued EVOLUTION. BFT has evolved from a focus on parent management to a focus on the family as a system
A fourth unique quality of behavioral and cognitive-behavioral family therapies is that treatment is SHORT TERM
The fifth emphasis of behavioral and cognitive-behavioral family therapies is that they REJECT MEDICAL MODEL of abnormal behavior.
