Week 5: Behavioural Psychotherapy: British Tradition of Behavioural Psychotherapy

Question 1

British Tradition of Behavioural Psychotherapy

Answer 1

• Primary Influencers: Mary Cover-Jones, John B. Watson, Ivan Pavlov, and Clark Hull
• Methods: Classical Conditioning, de-conditioning, extinction
• Targets: Neuroses, anxiety, fear
• Major Driver: Return of soldiers following WW1 suffering from ‘shell shock’ or ‘war neurosis’

Question 2

Maudsley Hospital

Answer 2

Located in South London, next to the IoPPN was established in 1907 as the first modern hospital for the treatment of mental illness.

By the time it was built and opened in 1916, the First World War was well underway, and its first role was in the assessment and treatment of soldiers suffering from shell shock.

Question 3

Shell Shock

Answer 3

Psychological trauma experienced by soldiers during and after World War I. It encompasses a range of symptoms, including anxiety, flashbacks, and emotional numbness.

Question 4

Clark Hull (neobehaviorist)

Answer 4

Emphasized the role of motivation or drive in shaping
behaviour.

Question 5

Extinction

Answer 5

The expected outcome of experiments in classical conditioning in animals shows that the conditioned response does not usually persist forever but tends to extinguish when a conditioned stimulus ceases to be paired with the unconditioned stimulus.

Question 6

Neurosis

Answer 6

An outdated term used to describe a group of mental disorders characterized by anxiety, obsessive thoughts, compulsive behaviors, or irrational fears.

It was often used to describe conditions that caused significant distress but did not involve a complete loss of touch with reality (unlike psychosis).

Question 7

MaryCover-Jones (1897 - 1987)

Answer 7

American psychologist who investigated the potential of classical conditioning to remove fear or phobic responses in young children.

Question 8

Mother of Behavioral Psychotherapy

Answer 8

Mary Cover-Jones

Question 9

Transferred Fear / Generalized Conditioned Response

Answer 9

A fear response that is generalized from one stimulus to another, often due to perceived similarities

Question 10

Toleration Scale

Answer 10

Cover-Jones tracked Peter’s progress by measuring his ability to tolerate the rabbit’s presence, rather than relying on subjective measures of fear.

Question 11

Tolerant Series

Answer 11

Exposure or Stimulus Hierarchy

Question 12

Modeling

Answer 12

A form of observational or social learning where one learns by observing and imitating others.

Question 13

Mary Cover-Jones Legacy of Behavioural Psychotherapy

Answer 13

Application of Evidence and Theory. Experimental approach. Methodological innovations.

• Deconditioning
• Systematic Exposure
• Stimulus Hierarchy
• Observation and Modeling
• Systematic Measurement of Behavior
• Objective Measurement

Question 14

Deconditioning

Answer 14

The process of eliminating a conditioned response (e.g., fear) by associating the conditioned stimulus (e.g., rabbit) with a new, positive response (e.g., pleasure from food).

Question 15

Systematic Exposure

Answer 15

Gradually expose an individual to a feared stimulus or situation in a controlled and incremental manner.

Question 16

Stimulus Hierarchy

Answer 16

A ranked list of anxiety-provoking stimuli, ranging from least to most feared, used in systematic exposure therapy.

Question 17

Observation and Modeling

Answer 17

Learning by observing and imitating the behavior of others.

Question 18

Systematic Measurement of Behavior

Answer 18

The consistent and standardized observation and recording of target behaviors to evaluate the effectiveness of an intervention.

Question 19

Objective Measurement

Answer 19

Using quantifiable data, such as heart rate or behavioral counts, to assess changes in behavior rather than relying solely on subjective reports.

Question 20

Joseph Wolpe (1915 - 1997)

Answer 20

South African psychologist who experimented in animals on fear conditioning and deconditioning, used punishment techniques, and applied to the treatment of neuroses.

Question 21

Reciprocal Inhibition

Answer 21

This proposed that it was impossible to be both anxious or afraid, while at the same time carrying out behavior that indicated the opposite, in other words, relaxation, and fearlessness.

Question 22

Assertiveness Training

Answer 22

Wolpe introduced a way to address problems with shell-shocked soldiers that we would
now see as social anxiety. In such patients, developing positive and assertive social interaction
was seen as incompatible with the fearful withdrawal in many life situations that these ex-soldiers
showed.

Question 23

Response Prevention

Answer 23

Inhibit avoidance behaviours during exposure

Question 24

Subjective Units of Distress (SUD)

Answer 24

A simple numerical scale developed by Wolpe that patients use to rate their own levels of anxiety

Question 25

Relaxation Training

Answer 25

Skills to reduce level of anxiety, both subjectively and also the physical symptoms, before enduring
exposure

Question 26

Counterconditioning

Answer 26

A behavioral technique where a positive stimulus (favorite toy) is paired with a stimulus that elicits a negative response (thunder). The goal is to replace the negative response (fear) with a positive one (less or no fear).

Question 27

Systematic Desensitization

Answer 27

A mainstay of behavioural therapy for the treatment of a range of anxiety disorders, from phobias to social anxiety to obsessive-compulsive disorders.

Question 28

Systematic Desensitization

Answer 28

• Stimulus Hierarchies
• Systematic Graded Exposure
• Response Prevention
• Subjective Units of Distress
• Relaxation Training

Question 29

Imaginal Desensitization (In vitro)

Answer 29

Therapy can be done by asking the person to imagine
exposure, rather than actually happening in real life or in vivo

Question 30

Power of Imagination

Answer 30

It is the nature of anxiety that stress can
occur when a person imagines a step on the hierarchy, as well as when it is actually experienced.
This is further evidence from brain imaging studies that show the physiological equivalence of real
and imagined exposure to fearful stimuli.

Question 31

Advantages of Imaginal Desensitization

Answer 31

• Broadens the range of target problems that can be treated
• Allows the patient to practice exposure
• Potential for more frequent practice

Question 32

Disadvantages of Imaginal Desensitization

Answer 32

• More effective when in vivo
• Worked with patients who were able to conjure strong and convincing visual images, something that not all people can do
• Virtual Reality techniques can replace this

Question 33

Virtual Reality Techniques

Answer 33

Being used to bridge the real and the imagined,
opening up new opportunities to reduce anxiety.

Question 34

Deconditioning by Observation

Answer 34

Reduce our responses to fearful or anxiety-provoking situations by watching another person experience it, rather than experiencing it directly or even imagining it.

Question 35

Social Learning Theory

Answer 35

Learning by observation (Albert Bandura).

We can and do learn important behaviour from
watching other people and observing the consequences of their actions.

We can learn without being directly reinforced ourselves.

Question 36

Albert Bandura

Answer 36

Canadian psychologist Albert Bandura. His
work formed another important strand in the so-called cognitive revolution in the 1960s

Question 37

Bobo Doll Experiment (1961)

Answer 37

• Study of incluence of observation of aggression in 72 young children (24 Aggressive role models, 24 non-agg role models, 24 control group)
• Children imitated aggressive behaviour they observed

Question 38

Social Function of Fear

Answer 38

We communicate danger to others so they can take appropriate action

Question 39

Intergenerational Transmission of Fear

Answer 39

Child observing -> Parent demonstrating fear of a spider -> Child develops the same fear of spiders

Question 40

Fear Transmission

Answer 40

Observing others expressing fear can lead to the development of similar fears in observers.

Question 41

Therapeutic Modelling

Answer 41

The patient observes another person in a situation that they themselves find distressing

Question 42

Coping Modeling

Answer 42

Observing another person (sharing the same fear) in a situation that they find distressing

Question 43

Mastery Modeling

Answer 43

Observing another person (fearless) in a situation that they themselves find distressing

Question 44

Coping Modeling and Mastery Modeling

Answer 44

Seeing someone doing something despite being afraid (Coping) is a more powerful way to help us overcome our own fears than seeing someone fearless (Mastery) doing the same thing.