Wk 5 - Behavioural Therapy Flashcards

1
Q

What is the timeline of psychotherapies from 1900/psychoanalysis on?

A

1940s- Person Centred therapy
1950 accidental discovery of lithium and phenothiazines=> second biological psychiatry (start of modern pharmacology)
Late 1950s behaviour therapy
1966 American Assoc of Behaviour Therapy
1971 Skinner’s Beyond Freedom and Dignity
1970s IPT; CBT
1990s DBT 1993; Schema therapy 1990s; Mindfulness meditation added to CBT to reduce relapse into depression;
1999 ACT

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2
Q

How did behaviour therapy start/form? (x5)

A

In 50s - reaction to psychoanalysis
Early therapists did modelling on animals - contingencies, reinforcers etc
Rejected intrapsychic phenomena that can’t be observed/measured
Current determinants of behaviour rather than childhood origins
Strong empirical basis

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3
Q

What are the two central tenets of behavioural therapy?

A

Scientific psychology must focus on relationship between environmental contingencies and behaviour, rather than presumed contents of consciousness
That principles governing behaviour of humans and other animals are essentially identical

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4
Q

How does classical conditioning work? (Pavlov - Russian scientist 1849-1936; Nobel prize in 1904)
(x3)

A

Repeated pairing of conditioned stimulus (bell) (CS) and
Naturally occurring (unconditioned) stimulus (food) (US)
Produced a conditioned response (salivation upon hearing the bell ring) (CR)

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5
Q

What famous experiment on classical conditioning did JB Watson and Rosalie Rayner do? (x3)

A

Little Albert – white rat paired with sudden loud noise => conditioned fear response
Generalised to other white furry objects - cotton wool, santa mask, watson’s own hair etc
Fear persisted after noises were stopped, even after 31 days

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6
Q

What are five conditions of operant conditioning?

A

Positive reinforcement - adding something (praise or reward) after target behaviour will increase the likelihood it will happen again
Negative reinforcement - removal of something will increase likelihood that behaviour will happen again
Positive punishment - adding something after behaviour decreases likelihood it will happen again
Negative punishment - removing something after behaviour decreases likelihood of repetition
Extinction - lack of contingency leads to cessation of behaviour

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7
Q

How did Skinner’s operant conditioning box work? (x3)

A

Training rat behaviour of pressing lever using stimuli lights
Reinforcements – food pellets;
Punishments - electric shocks.

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8
Q

What are 3 RL egs of operant conditioning?

A

Children learning ways to behave in various situations through praise or reprimand
Extinction of begging through planned ignoring
Pet obedience training

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9
Q

What was revolutionary about Bandura’s Social Learning Theory was published in 1969.

A

Work on aggression in adolescents = behaviour could be learned through modelling, which requires cognitive processes
• We learn not just from contingencies on our own behaviour, but from those of others behaviour around us.

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10
Q

What non-observable processes explain Bandura’s modelling? (x3)

A
Past reinforcement, ala traditional behaviorism. 
Promised reinforcements (incentives) that we can imagine. 
Vicarious reinforcement - seeing and recalling the model being reinforced.
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11
Q

What capacities must the observer have in order to practice modelling (Bandura) (x5)

A

Be able to attend and understand
Remember and recall, and
Be capable of performing

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12
Q

What was Skinner’s view of human nature? (x5)

A

Deterministic
Behaviour caused by contingencies in environment -
Radical behaviourism – no internal mechanisms.
But it’s a myth that it doesn’t consider any emotions, thoughts etc
Model is related to Banduras version

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13
Q

What was Bandura’s view of human nature? (x3)

A

Reciprocal determinism
Behaviour is a product of our environment but
Also behaviour influences our environment

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14
Q

How does Behavioural theory account for development of psychopathology? (x6)

A
Debunking the psychodynamic/unconscious stuff – it's just what you can observe, have reported to you
o	Failure of learning
o	Inappropriate learning 
   •	Modelling
   •	Reinforcement
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15
Q

Explain Mowrer’s (1960) two factor theory of anxiety avoidance

A

Classical conditioning:
• UCS (growling) leads to UCR (fear)
• CS (dog) leads to CR (fear)
Operant conditioning:
• See dog = fear dog = run away = fear is reduced/running is reinforced
So it’s both acting together…
• Learn fear through classical conditioning
• Then operant kicks in, which reinforces the running away

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16
Q

How would classic behaviourism model anxiety? (x3)

A

Approach situation
Increase in anxiety
Future approach less likely

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17
Q

How would anxiety be modelled under Mower’s two factor model?

A

Anxiety present in situation
Situation left/avoided
Anxiety decreases
Avoidant behaviour is negatively reinforced by anxiety reduction

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18
Q

What is one behavioural explanation for depression?

A

That we model parents depression -
• Often there’s family history of depression
• Observational learning that going away/hiding is a coping method for stress

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19
Q

How did Seligman explain depression? (x1)

Through what experiment? (x2)

A

As the result of learned helplessness
The yoked do experiment – one tied to the one getting shocked couldn’t escape = learned helplessness
• They never learn to run, even when no longer tied
Same with abusive relationships, horrid work environments etc

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20
Q

What is explained by learned helplessness theory? (x1)

A

Depression can result from a perceived absence of control over the outcome of a situation

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21
Q

How did Peter Lewinsohn et al 1979 explain depression? (x5)

A

Can result from stressor which disrupts normal behaviour patterns
Causing low rate of positive reinforcement
Lots of daily activities get us pleasurable reinforcements, or sense of achievement (even if activity wasn’t that fun)
So if there’s a balance in favour of the fun things, less depression
If more not-fun stuff, depression

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22
Q

What did Lewinsohn propose as an intervention for depression? (x1 plus explain x2)

A

Activity scheduling
Every single day, at least one thing that’s reinforcing, to restore balance with the aversive behaviours
Behavioural activation therapy for depression = increase rate of reinforcing (pleasant or achievement) activities

23
Q

How do you do ‘Activity Scheduling’, as per Lewinsohn’s depression intervention?

A

For each hour of the week, fill in what you plan to do, and how much pleasure and mastery you think you will experience.
To rate pleasure, use a scale where 0=non and 10=the most you can imagine
To rate mastery (feeling of accomplishment), use similar 0-10

24
Q

When behavioural theory is applied to addictive behaviours, what role does classical conditioning play? (x1, plus 5 egs)

A

Stimuli repeatedly associated with substance use behaviour may become a cue to future use.
• Visual cues - seeing drug equipment
• Olfactory cues - smelling marijuana, alcohol
• Other contextual cues – evening; Fridays; with particular friends
• Any of these cues can become paired with addictive behaviours…
• Auditory cue: Music often associated with specific substance use

25
Q

How does operant conditioning explain addictive behaviours? (x2)

A

Negative emotional states (anxiety, stress, depression, anger) can be avoided /removed by substance use (negative reinforcement),
Thus making future use more likely

26
Q

How would Bandura explain addictive behaviours?

A

Modelling behaviour of parents / siblings / peers / media

27
Q

What are the basic characteristics of behavioural therapy? (x7)

A

Based on scientific method
Deals with current problems/determinants – not about early childhood
Client is active – self-monitoring, reporting outside of sessions
Carried out in natural environment – eg fear of flying by going to airport, getting on plane, eventural actual flight
Self-control approach
Tailored to fit needs of client – conditions can be very different, even if target behaviour is same as other client
Collaborative partnership

28
Q

What are the therapeutic goals of behavioural approaches? (x5)

A

Increase in desirable behaviours
Decrease/stop unwanted behaviours (symptoms)
Generalise session to daily life – ie across time, setting, behaviours
• Eg agoraphobia, client needs to state initial goal/target
Goals set by client
Create new conditions for learning

29
Q

What is therapist’s role in behavioural therapies? (x7)

A
Collect information for functional analysis
Formulate goals of therapy 
Identify maintaining conditions
Implement a change plan
Evaluate success
Conduct follow-up assessment
Modelling
30
Q

What is the client’s role in behavioural therapies? (x7)

A

More than just talking, client must undertake to DO something to bring about change –
o Behaviour is about changing the contingencies – don’t care about (psychodynamic) insight
Active participation
Self monitoring
Self management
Homework
Practice

31
Q

How does behavioural therapeutic relationship differ from psychodynamic and PCT, IPT? (x5)

A

Rapport is necessary but not sufficient for change
o Is an assumed background – it’s de-emphasised
As opposed to:
o Psychoanalytic – transference
o PCT – relationship forms core conditions for therapy
o IPT – the relationship is key

32
Q

How is assessment structured in behavioural therapy? (x4)

A

Focus on what person DOES, not personality traits - not dreams etc
Determination of antecedents (A) and consequences (C) of target behaviour (B)
Use of self-monitoring
Ongoing process

33
Q

What is the aim of a SORCK analysis? (x1)

In order to facilitate… (x4)

A

To identify factors that are driving (maintaining) the target behaviour
Once you know the factors, you can start to change them
• Remove the triggers
• Replace the reinforcers with more helpful alternatives
• Make the punishers more salient so that the client considers them before engaging in the behaviour

34
Q

What are the five columns in a SORCK table for?

A

Stimuli: historical, contextual and immediate causes
Organismic: internal stuff - personality, contributing health/body issues
Response: the target behaviour
Consequence: immediately subsequent behaviour performance
Contingency: positive/negative reinforcement/punishment for each consequence

35
Q

What are some behavioural techniques? (x8)

A
Relaxation
Systematic desensitisation
In vivo desensitisation
Exposure
Flooding
Social skills training
Assertion training
Self-management
36
Q

What is involved in behavioural technique ‘relaxation’? (x2 plus considerations)

A

Breathing - into the diaphragm (doesn’t work for when laboured breathing is trigger for further anxiety)
Progressive muscle relaxation
Good when antecedents are stress/anxiety/anger etc
Takes practice in ‘normal’ time
Used in conjunction with other strategies

37
Q

What is involved in behavioural technique ‘systematic desensitisation’? (x4 plus 2 considerations)

A

Wolpe – anxiety and relaxation are incompatible
• Relaxation training (PMR) – teach this first
• Development of anxiety hierarchy – then practice it while imagining up the hierarchy
Can be practiced in vivo
Good for anger too
Largely overtaken by exposure therapy….

38
Q

What is involved in behavioural technique ‘exposure’? (x3 plus 2 egs)

A

Both imaginal and in vivo exposure used to treat phobias
• Imagination is often highly sensitised in those with anxiety/fear of particular thing/situation
Aim is to stay with (rather than avoid) the feared stimulus until anxiety reduces and something is learned
Exposure with response prevention (OCD): exposure to obsession without negative consequence
Emotional exposure and processing for trauma / PTSD

39
Q

What is involved in behavioural technique ‘flooding’? (x4 plus 2 egs)

A

Start with top of fear hierarchy
Prolonged exposure until anxiety subsides
Very effective
Involves high levels of client distress
Heights; OCD exposure to dirty untidy house

40
Q

What is involved in behavioural technique ‘social skills training’? (x6)

A
Identification of problem situations
Discussion and role play to identify inappropriate behaviours
Discussion of alternatives
Modelling of alternatives
Client practices in session 
Client practices in vivo
41
Q

Who is the behavioural technique ‘assertion training’ good for? (x5)
And it aims to… (x2)

A

Cannot express anger or irritation
Have difficulty saying no
Are overly polite and allow others to take advantage
Find it difficult to express positive emotion
Feel they do not have a right to express feelings, beliefs, thoughts

Increase behavioural repertoire (rehearsal)
Challenge beliefs

42
Q

What is involved in behavioural technique ‘self-management’? (x1 plus x4 strategies)

A
Teaching people to help themselves
•	Self-monitoring
•	Self-reward
•	Self-contracting
•	Stimulus control
43
Q

What are the key differences between systematic desensitisation and exposure therapy? (x3 and x4)

A

SD uses relaxation during the procedure
• Used for anxiety, anger, health symptoms, insomnia, eg hypochondrias
• Is imaginal
ET does not use relaxation or distraction
• As it would take them out of dealing with the exposure – pointless
• Focus on anxiety
• May be in vivo or imaginal

44
Q

What are the basic stages of behavioural technique of ‘self-management’? (x4)

A
  • Select goal
  • Define target behaviour
  • Self-monitoring
  • Plan for change
45
Q

What did Conroy et al establish regarding behaviour change apps for physical activity? (x1)

A

Most apps contained fewer than four behaviour change techniques (out of list of 20-ish possibles)

46
Q

What did Conroy et al find were the most common behaviour change techniques in apps aimed at changing exercise behaviour? (x5)

A
Providing instruction on how to perform exercises, 
Modelling how to perform exercises, 
Providing feedback on performance, 
Goal-setting for physical activity, and 
Planning social support/change.
47
Q

What was involved in Thompson et al: Arousal, mood and the Mozart effect? (x2)
Which found… (x1)

A

N = 24 Uni students
10 min silence; and 10 min listening to Mozart’s Sonata for Two Pianos or 10 min from Albinoni’s Adagio in G Minor
DV = performance on the Cutting and Folding task (visuospatial functioning)
Uplifting music had cognitive benefit, depressing music lessened capacity

48
Q

What was involved in Perham et al’s study into music and memory performance? (x5)
Which found… (x3)

A

25 Uni students assigned to three sound conditions:
o Liked music = fast-tempo dance track
o Disliked music condition = 3 songs from band Repulsion
o Silence
DV: words accurately recalled from 8 word lists
Best performance for Quiet condition, followed by disliked music - liked music last

49
Q

Name 13 applications for behavioural therapies

A
Specific phobias
Social phobias
Panic disorder & Agoraphobia
Obsessive-compulsive disorder
Childhood behaviour disorders
Depression
Habit disorders and tics
Interpersonal problems 
Health and medical problems 
Lifestyle management 
Anxiety/PTSD
Eating disorders
Weight and obesity management
50
Q

What is involved in behavioural treatment of eating disorders? (x4)
With what evident for effectiveness? (x2)

A

Self-monitoring, ERP, relaxation training, relapse prevention
Evidence for BT in anorexia (cf medication)
Effective for bulimia (CBT better outcomes)

51
Q

What is involved in behavioural treatment of weight and obesity management? (x6)
With what evident for effectiveness? (x1)

A
Self-monitoring, 
Slowing rate of eating, 
Reducing eating cues, 
Responding to social pressures, 
Pre-planning and 
Relapse prevention

Greatest weight loss associated with addition of BT to diet and exercise

52
Q

What are the theoretical contributions/benefits of behavioural therapy? (x5)

A
  • Focus on specifics
  • Wide range of techniques
  • Emphasis on empirical research
  • Willingness to assess effectiveness
  • Time-limited
53
Q

What are the limitations of behavioural therapy? (x2)

A

Insufficient emphasis on cognition, emotion and individual differences
De-emphasis on role of past in explaining current behaviours