Chapter 7: Behavioral Theory & Therapy Flashcards
Behaviorism and Behavior Therapy
Sprang from efforts to describe, explain, predict, and control observable animal and human behavior; considered reactions to unscientific psychoanalytic approaches to psychology; philosophically opposed to psychoanalysis
Difference between Behaviorism and Psychoanalysis
Psychoanalysts subjectively focus on inner dynamics or mentalistic concepts, whereas behaviorists objectively focus on observable phenomena or materialistic concepts. Behaviorists use techniques derived from scientific research, whereas psychoanalytic techniques are usually derived from clinical practice
Similarities between Behaviorism and Psychoanalysis
Both are highly mechanistic, positivistic, and deterministic approaches to understanding humans
Historical Stages in the Evolution of Contemporary Behavioral Approaches to Human Change
Behaviorism as a scientific endeavor
Behavior Therapy
Cognitive Behavior Therapy
Third Force in American Psychology
Existential-Humanistic Psychology; alternative to psychoanalysis and behaviorism; Contrast their theory with psychoanalytic theory and academic-scientific behaviorism as an explanation for human behavior and motivation
Behaviorism
Led by John B. Watson; Excludes consciousness and introspection, and believed in determinism rather than free will
William James
Credited with launching the field of psychology in the US; litlle regard for the scientific foundation of psychology;
John B. Watson
Believed in psychological science; immersed himself in experimental psychology; interested in the application of behavioral scientific principles to human suffering
Little Hans
Freud analyzed his fear because of unresolved Oedipal issues and castration anxiety
Little Albert
Watson used him to demonstrate that severe fears and phobias were not caused by obscure psychoanalytic constructs but by direct classical conditioning of a fear response
Little Peter
studied by Mary Cover Jones to investigate the effectiveness of counterconditioning or deconditioning
Contibutions of Early Behaviorists
Discovery by Pavlov, Watson, and their colleagues that emotional responses could be involuntarily conditioned in animals and humans via classical conditioning procedures.
The discovery by Mary Cover Jones that fear responses could be deconditioned by either (1) replacing the fear response with a positive response or (2) social imitiation
The discovery by Thorndike and its later elaboration by Skinner that animal and human behaviors are powerfully shaped by their consequences
Research Groups which Introduced the term Behavior Therapy to Modern Psychology
B.F. Skinner in the United States
Joseph Wolpe, Arnold Lazarus, and Stanley Rachman in South Africa
Hans Eysenck and the Maudsley Group in the United Kingdom
B.F. Skinner (U.S.)
Early work was an experimental project on operant conditioning with rats and pigeons in the 1930’s; Empasis was on the extension of Thorndike’s law of effect; Demonstrated power of positive reinforcement, negative reinforcement, punishment, and stimulus control in the modification of animal behavior;
Behavior Therapy (Skinner)
Clinical term referring to the application of operant conditioning procedures to modify the behavior of psychotic patient
Joseph Wolpe
Interested in conditioning procedures as a means for resolving neurotic fear; conducted experiments in neurosis production; established the first nonpsychoanalytic, empirically validated behavior therapy thechnique
Systematic Desensitization
Josephy Wolfe’s therapeutic procedure; Involves training the anxious patient is first trained in progressive muscle relaxation exercises and then gradually exposed imaginally or in vivo to feared stimuli while simultaneously relaxing
Wolpe’s Systematic Desensitizaiton & Jone’s Deconditioning Principle
Similar wherein a conditioned negative emotional response is replaced with a conditioned positive emotional response
Arnold Lazarus & Stanley Rachman (South Africa)
Contributed significantly to the behavior therapy movement
Arnold Lazarus
Advocated the integration of laboratory-based scientific procedures into existing clinical and counseling practices; adamant opponent of narrow therapy definitions or conceptualizations
Stanley Rachman
Initial unique contribution involved the application of aversive stimuli to treating neurotic behavior, including addictions
Hans Eysenck
Used the term Behavior Therapy to describe the application of modern learning theory to the understanding and treatment of behavioral and psychiatric problems
Cyril Franks
Above all, in behavior therapy a theory is a servant that is useful only until a better theory and better therapy come along
Primary Convictions which Characterize Behaviorists and Behavioral Theory
Behavioral Therapists emply techniques based on modern learning theory & derived from scientific research
Main Models of Learning that form the Theoretical Foundation of Behavior Therapy
Applied Behavior Analysis
Nonbehavioristic, Mediational Stimulus-Response Model
Social Learning Theory
Applied Behavior Analysis/Radical Behaviorism
Behavior is a function of its consequences; based on the Stimulus Response Theory; focuses solely on observable behaviors; Goal is to increase adaptive behavior through reinforcement and stimulus control and to reduce maladaptive behavior through punishment and extinction
Skinner’s Demonstration that Behavior is a Function of its Consequences
When a particular behavior is followed by positive reinforcement, the tendency for an organism to engage in that specific behavior is strengthened or reinforced; When a specific behavior is followed by punishement or an aversive stimulus, the tendency for an organism to engage in that specific behavior is weakened
Neobehavioristic, Mediational Stimulus-Response Model
Based on Classical Conditioning Principles;
Classical conditioning
Referred to as Associational Learning because it involved an association or linking of one environmental stimulus with another; Pavlovian terms, an unconditioned stimulus is one that naturally produces a specific physical-emotional response;
Cognitive-Behavioral Movement
Began in the late 1950’s and became associated with mainstream behavior therapy
Behaviorists’ Theory of Psychopathology
Maladaptive behavior is always learned and can always be either unlearned or replaced by new learning; The concept of human learning is at the core of human behavior profoundly influences how behavior therapists approach the assessment and treatment of clients; inadequate learning or skill deficits
Basic Assumption in Behavioral Theory
Both adaptive and maladaptive behaviors are acquired, maintained, and changed in the same way: through the internal and external events that proceed and follow them; Behavioral case conceptualization involves a careful assessment of the context within which a behavior occurs, along with developing testable hypotheses about the causes, maintaining the factors, and treatment interventions
Behaviorists’ Procedures to the Clinical or Counseling Setting
Observe and assess client maladaptive or unskilled behaviors
Develop hypotheses about the cause, maintenance, and appropriate treatment for maladaptive or unskilled behaviors
Test behavioral hypotheses throught he application of empirically justificable interventions
Observe and evaluate the results of their intervention
Revise and continue testing new hypotheses about ways to modify the maladaptive or unskilled behavior(s) needed
Behavioral Assessment & Procedures
Main goal of behavioral assessment is to determine the external (environmental or situational) stimuli and internal (physiological and sometimes cognitive) stimuli that directly recede and follow adaptive and maladaptive client and behavioral responses
Client’s Behavioral ABC’s
A = Behavior's Antecedents (everything that happens just before the maladaptive behavior is observed) B = The behavior (the client's problem specifically defined in concrete behavioral terms C= The behavior's consequences (everything that happens just after the maladaptive behavior occurs)
Why Direct Behavioral Observation is Inefficient
Most therapists can’t afford the time required to observe the clients in their natural settings
Many clients object to having their therapist come into their home or workplace to conduct a formal obseration
Even if the client agreed to have the therapist come perform an observation, the therapist’s presence is unavoidably obtrusive and therefore influences the client’s behavior
Clinical or Behavioral Interview
Most common assessment procedure; within the context of an interview, behavior therapists directly observe client behavior, inquire about behavioral antecedents and consequences, and operationalize the primary targets of therapy
Operational Definition
Specific, Measurable characteristics of client symptoms and goals which are crucial behavioral assessment components
Behavioral Assessment Issues and Procedures
Clinical/Behavioral Interview
Self-Monitoring
Standardized Questionnaires
Other Measures
Self-Monitoring
Training clients to observe and monitor their own behavior; Clients observe and monitor their own behavior; They are made to keep thought or emotional logs that include the following components:
- Disturbing emotional states
- The exact behavior engaged in at the time of the emotional state
- The thoughts that occured when the emotions emerged
Standardized Questionnaires
Objective assessment meaures are used; Prefer instruments with established reliability and validity; a way of determining whether a specific treatment is working; helps keep therapist on track
Other Measures
Intermittent or ongoing video or audiotape recordings or photographs to obtain direct samples of client behavior; physiological measures such as heart rate, blood pressure, and galvanic skin response
Specific Behavioral Therapy Techniques
Operant Conditioning and Variants
Relaxation Training
Token Economy
Patients or students are provided with points or poker chips (symbolic rewards) for engaging in positive or desirable behaviors. can be used as money to obtain goods or privileges
Fading
The progressive decrease of punishments and reinforcements as desirable behavior patterns are established;
Punishment/Aversive Conditioning
Used to reduce undersirable and maladaptive behavior
For Punishment to be Effective
Immediate (delay increases anxiety and decreases learning)
Intense (punishment is more effective if it is more averse)
Salient (it should be individually defined)
Delivered early in the behavioral chain (before a problem intensifies)
Delivered on a continuous schedule (because if the punishment does not always occur, the behavior you want to eliminate may be intermittently rewarded, which makes it much more difficult to eliminate)
Provided across all stimulus situations (otherwise punishment is simply avoided)
delivered in a calm manner (so the recipient doesn’t react to the punisher’s anger instead of the punishment)
Accompanied by teaching of alternative adaptive behaviors (so the recipient clearly learns what is desirable behavior)
Relaxation Training
Introduced by Edmund Jacobson;
Progressive Muscle Relaxation (PMR)
Initially based on the assumption that muscular tension is an underlying cause of a variety of mental and emotional problems; by pairing muscle-tension conditioned stimulus with pleasurable relaxation, muscle tension as a stimulus or trigger for anxiety is extinguished
Systematic Desensitization
Combination of Jone’s deconditioning approach and Jacobson’s PMR procedure; To be relaxed is the direct physiological opposite of being excited or disturbed
How Systematic Desensitization Works
The client identifies a range of various fear-inducing situations or objects.
Typically, using a measuring system referred to as Subjective Units of Distress (SUDs), the client, with the support of the therapist, rates each fear-inducing situation or object on a scale from 0-100 (0=no distress; 100=total distress)
Early in the session the client engages in PMR
While deeply relaxed, the client is exposed, in vivo or through imagery, to the least feared intem in the fear heirarchy
Subsequently, the client is exposed to each feared item, gradually progressing to the most feared item in the heirarchy
If the client experiences significant anxiety at any point during the imaginal or in vivo exposure process, the client reengages in PMR until relaxation overcomes anxiety
Exposure Treatment
Based on the principle that clients are best treated by exposure to the very thing they want to avoid: the stimulus that evokes intense fear, anxiety, or other painful conditions
Negative Reinforcement
Defined as the strengthening of a behavioral response by reducing or eliminating an aversive stimulus
Ways to expose Clients to their Fears
Mental Imagery
Virtual Reality
In Vivo Exposure
In Vivo Exposure
Involves direct exposure to real-life situations
Systematic Desensitization
Combination of Jone’s deconditioning approach and Jacobson’s PMR procedure; To be relaxed is the direct physiological opposite of being excited or disturbed
How Systematic Desensitization Works
The client identifies a range of various fear-inducing situations or objects.
Typically, using a measuring system referred to as Subjective Units of Distress (SUDs), the client, with the support of the therapist, rates each fear-inducing situation or object on a scale from 0-100 (0=no distress; 100=total distress)
Early in the session the client engages in PMR
While deeply relaxed, the client is exposed, in vivo or through imagery, to the least feared intem in the fear heirarchy
Subsequently, the client is exposed to each feared item, gradually progressing to the most feared item in the heirarchy
If the client experiences significant anxiety at any point during the imaginal or in vivo exposure process, the client reengages in PMR until relaxation overcomes anxiety
Exposure Treatment
Based on the principle that clients are best treated by exposure to the very thing they want to avoid: the stimulus that evokes intense fear, anxiety, or other painful conditions
Negative Reinforcement
Defined as the strengthening of a behavioral response by reducing or eliminating an aversive stimulus
Ways to expose Clients to their Fears
Mental Imagery
Virtual Reality
In Vivo Exposure
In Vivo Exposure
Involves direct exposure to real-life situation
Kinds of Exposure Sessions
Massed (Intensive) Exposure Session
Spaced (Graduated) Exposure Session
Massed (Intensive) Exposure Session
Involves direct exposure to feared stimuli during a single session for a prolonged time period
Spaced (Graduated) Exposure Session
Slow and incremental exposure to a feared stimulus during a series of shorter periods
Virtual Reality Exposure
A procedure wherein clients are immersed in a real-time computer-generated computer environment
Interoceptive Exposure
The target exposure stimuli are internal physical cues; client must be educated about bodily sensations, has learned relaxation techniques, and has been taught cognitive restructring skills
Mowrer’s Two Factor Theory
When a client avoids or escapes a feared or distressing situation or stimulus, the maladaptive avoidance behavior is negatively reinforced
Participant Modeling
Effective in Group therapy
Skills Training Technique
Based on skill deficit models of psychopathology
Kinds of Skills Training Technique
Assertiveness and Other Social Behavior
Problem Solving
Social Behavior Styles
Passive
Aggressive
Assertive
Passive Individuals
Behave in submissive ways; they say yes when they want to sa no, avoid speaking up and asking for instructions or directions and let others take advantage of them
Aggressive Individuals
Dominate others, trying to get their way through coercive means
Assertive Individuals
Speaks up, expresses feelings, and lets needs be known without dominating others
Strategies Used to Teach Assertive Behavior
Instruction Feedback Behavior Reversal or Role Playing Coaching Modeling Social Reinforcement Relaxation Training
Instruction
Clients are instructed in assertive eye contact, body posture, voice tone, and verbal delivery
Feedback
The therapist or group members give clients feedback regarding how their efforts at assertive behavior come across to others
Behavior reversal or Role Playing
Clients are given opportunities to practice specific assertive behaviors, such as asking for help or expressing disagreement without becoming angry or aggressive
Coaching
Therapists often whisper feedback and instruction in the client’s ear as a role-play or practice scenario progresses
Modeling
The therapist or group members demonstrate appropriate assertive behavior for specific situations
Main Goal of the Behavioral treatment Protocol
To teach the client to become his own therapist
Relaxation training
FNeeded to reduce anxiety in social situations
Problem Solving
TEaching the clients to follow a systematic, logical, and effective approach to solving problems
Steps for Problem Solving
Define the problem. Identify the Goal Generate Options Choose the best solution Evaluate the outcome
Five-Component Panic Disorder Protocol
Education about the nature of anxiety Breathing retraining Cognitive restructuring Interoceptive exposure Imaginal or In Vivo Exposure
Parts of Each Session for the Panic Disorder Protocol
General check-in and homework review
Educational information about panic and behavior therapy
In-Session behavioral or cognitive tasks
New set of homework assignments
Main Goal of the Behavioral treatment Protocol
To teach the client to become his own therapist
Behavioral Treatments are Effective For
Exposure treatment for Agoraphobia Exposure or guided mastery for Specific Phobia Exposure and response prevention for OCD Behavior therapy for depression Behavior therapy for headache Behavior modification for Enuresis Parent training programs for children with oppositional behavior Behavioral marital therapy
