Chapter 6 - Behaviour therapy Flashcards
behaviour =
a broad category of motor behaviours, physiological responses, emotions and cognitions
common features of different behavior therapies:
- changing behaviour (decrease maladaptive behaviours, increase adaptive behaviours)
- empiricism
- all behaviours are assumed to have a function
- emphasis on maintaining factors instead of triggering factors
- directive (therapist provides advice and suggestions, client is also active)
- transparent (detailed rationale and instructions for each strategy)
rational emotive behavior therapy =
a type of cognitive behavioral therapy (CBT) that aims to help a person challenge unhelpful thoughts to avoid negative emotions or behaviors.
overeenkomsten behavior therapy en rational emotive behavior therapy =
time limited, directive, transparent, evidence-based, focused on maintaining factors
behavior therapy vs psychoanalysis=
psycho analysis is more non-directive, less transparent, less evidence based, more reliant on the therapists interpretation and more focused on factors that might have triggered/developed the problems. syptoms are regarded as manifestations of unconscious conflicts and motivations, leading to symptom substitution.
in BT: generalization of improvement to multiple areas of functioning (ipv symptom substitution)
symptom substitution=
an underlying problem showing up in another form when a surface symptom is treated
the most influential approach to personality=
the five factor model of personality (Big Five)
= a model of personality with 5 core domains: openness, conscientiousness, extraversion, agreeableness, neuroticism
heo staan behavioural approaches tegenover personality
BT rejects the idea that personality can predict behaviour. this is because they believe that behaviour is mainly influenced by the environment (therefore challenging the existence of stable characteristics).
however, reasearch shows that individual temperaments can influence behaviour.
classical conditioning =
a form of learning in which a previously neutral stimulus (CS) comes to predict the occurrence of a second stimulus (US), thereby eliciting a conditioned response (CR)
extinction in classical conditioning =
presentation of the CS in the absence of the US so that the CR eventually stops occuring.
reinstatement=
a repairing of the US and the CS after extinction, leading to a return of fear
operant conditioning=
a form of learning in the frequency or strength of behavior is influenced by its consequences.
- reinforcement: increase in behaviour
- punishment: decrease in behaviour
positive reinforcement =
rewarding stimulus
negative reinforcement =
the removal of an aversive stimulus
positive punishment =
an aversive stimulus
negative punishment =
the removal of a desired stimulus
extinction in operant conditioning=
behaviour is no longer reinforced, therefore it stops
discrimination learning=
when a response is reinforced or punished in some situations but not in others, which leads to the response becoming context dependent
generalization =
the occurence of a learned behaviour in other situations than where it was acquired
vicarious learning=
a form of learning by watching the behavior of others
instructional learning =
a behaviour that is learned through information that one hears or reads
corrective learning =
behaviour therapy assumes that all behaviour is learned through association (classical conditioning), consequences (operant conditioning), observation (vicarious learning) or rules learned through communication and language (instructional learning). thus, BT aims to help clients by providing corrective leraning experiences that lead to changes in behaviour
is de therapeutische relatie van belang?
ja, het kan sociale reinforcement geven en motiveren
format of BT
- individual
- group
- families
- couples
- therapist
- self-help books
- internet based programmes
- apps
setting of BT
can include other activities than talking in the office (riding the bus when one is scared of that)
duration of BT
very time-limited, ranging from 10-20 sessions of 1-2 hours.
mechanisms of BT (traditionally and now)
traditionally: learning principles
nu: information processing, emotional processing, and congitive reappraisal models
emotional processing theory =
the idea that exposure changes the association between stimulus, response, and meaning components of emotional memories.
predictors of outcome =
worse outcome:
- personality disorders
- severe depression or anxiety
- more stressful life events
- poor insight into excessiveness of symptoms
- poor motivation
- negative patterns of communication among family members
- poor compliance
BT in panic disorder:
- psychoeducation
- exposure
- cognitive reevaluation
BT in obsessive compulsive disorder:
- exposure with response prevention
- cognitive strategies
BT in specific phobia:
- exposure
waar is BT ook effectief voor, naast anxiety disorders
- unipolar depression
- schizophrenia (met antipsychotic medication)
- substance related disorders
functions of behavioural assessment
- identifying target behaviours
- determining the most appropriate course of treatment
- assessing the impact of therapy over time
- assessing the final outcome
target behaviour may include…
- behavioural deficits (behaviours that occur less than desired)
- behavioural excesses
- problems in the environment (desirable behaviours not being followed by reinforcement, etc)
behavioural assessment relies on multiple…
- methods (interview/direct observation, diary)
- informants (client, family members, friends)
- situations (home, work, office)
components of behavior assessment
- functional analysis
- behavioural interviews
- behavioural observation
- monitoring forms and diaries
- self-report scales
- psychophysiological assessment
functional analysis =
identifying variables that maintain behaviours by maniulating variables in the environment and measuring thei impact on the target behaviours.
measure: antecedents, behaviour, consequences (ABC method)
behavioural interview =
obtaining a detailed description of the problem behavior, including its frequency, duration, severity, development, and course.
behavioural observation =
observing the client in order to assess behavior and its antecedents and consequences, which can occur in a natural environment (naturalistic observation) or in a simulated situation (analog observation). One possible problem is reactivity.
Reactivity =
when one’s behavior is affected by the assessment itself so that it does not provide an accurate picture of one’s actual behavior under normal circumstances.
montioring forms and diaries=
completing diaries and monitoring forms between therapy sessions to track behaviors as they occur.
exposure=
a BT technique that involves confronting feared stimuli directly instead of avoiding them
different kinds of exposure therapy
- in vivo exposure
- imaginal exposure
- interoceptive exposure (purposely experiencing frightening physical sensations until they are no longer frightening
exposure hierarchy=
a list of feared situations in order of difficulty. Typically, this hierarchy is used to gradually expose patients to fear-provoking stimuli.
reinforcement based strategies =
operant conditioning procedures that rely on the principle of reinforcement:
- differential reinforcement (reinforcing the absence of unwanted behaviours and the occurrence of desired alternative behaviours)
- contingency management (changing the environment so that unwanted behaviours are no longer reinforced, or getting rewards)
- token economy
punishment based strategies =
- aversion therapy
(deze zijn meestal niet effectief: veel relaspes)
response prevention =
inhibiting an unwanted behaviour in order to break the association between a stimulus and response. clients are encouraged to tolerate their discomfort until it subsides. a competing behaviour may also be included (gum ipv smoking)
relaxation training soorten
- breathing retraining (use diaphragm instead of chest muscles)
- guided mental imagery (bringing to mind relaxing mental imagery to manage stress and reduce feelings of tension)
- progressive relaxation (tensing and relaxing various muscle groups in the body to reduce feelings of muscle tension)
stimulus-control procedures
arraging the environment in such a way that a given response is either more or less likely (not buying chocolate/cigarettes)
modeling=
when a therapist models how to approach a feared object, often in combination with other strategies such as exposure
behavioural activation=
therapeutic scheduling of activities for the client to complete in their daily life that function to increase contact with diverse, stable and personally meaningful sources of positive reinforcement.
usually for depression (due to lack of inactvity and withdrawal)
social-skills training=
the use of modeling, corrective feedback, behavioural rehearsal and other strategies to help communication
problem-solving training=
- defining the problem (specific, and prioritize)
- identifying possible solutions
- evaluating the solutions
- choosing the solutions
- implementing
acceptance based behavioural therapies =
fostering acceptance and encouraging clients to become more aware of their values and to take action so that behaviours match them
dialectical behaviour therapy=
combination of traditional cognitive behavioural techniques with mindfulness-based strategies for acceptance and tolerating distress
empirical therapy approach
betekent dat je individuele verschillen mee moet nemen, zoals biases, en data moet blijven verzamelen om te kijken of de therapie succesvol is
the focus of research should be on:
- improving effectiveness
- understanding mechanisms
- enhancing dissemination
- understanding the role of cognitive enhancers
- adapting to diverse populations
