Behavior Therapy

History Ivan Pavlov Emphasis on environment Conditioning Radical departure from psychoanalysis Conditioning Albert Bandura & B.F. Skinner Integration with Cognitive Theory

View of Human Nature Human behavior is governed by basic learning principles Humans are neither good nor bad; they react to their environment All people are capable of modifying behaviors under the right circumstances

Basic Characteristics of all Behavior Therapy Practical Symptoms seen as problems in living Empirically derived Requires patient collaboration Acknowledges underlying precursors of symptoms, but focuses on the present Sees behavior (normal and abnormal) as learned Treatment driven by functional analysis of behavior (ABCs)

Sample Functional Analysis Antecedent B Behavior C Consequence Job Stress Driving Car Watching TV Anxiety Smoke a Cigarette Satisfaction Relaxation/Calm Lung Diseases Cardiac Illnesses Discoloration of Teeth/Skin

Classical Conditioning Pavlov’s Dogs Unconditioned stimulus- food Unconditioned response- salivation Conditioned stimulus- bell Watson Little Albert Joseph Wolpe counterconditioning

B.F. Skinner & Operant Conditioning Reinforcement Negative Positive Punishment Extinction Shaping Token Economies Stimulus Control

Helpful Hint Remember in behavioral terms “positive” and “negative” are used differently than in general language Positive = Add Negative = Take Away

Add Stimulus Remove Stimulus Operant Learning Add Stimulus Remove Stimulus If you want the behavior to increase Positive Reinforcement Negative Reinforcement If you want the behavior to decrease Punishment Extinction

Albert Bandura & Social Learning Paved the way for cognitive integration Importance of attitudes and perception Observational Learning/ Modeling Role Playing Self-efficacy

Therapeutic Relationship Counselor is warm educator or guide, but also expert in behavioral theory and techniques Teach clients to control their own behavior Open and honest about how and why techniques work Client and counselor agree on goals Counselor can act as a positive reinforcer

Assessment Very important! Behavioral Interview Concrete terms Look for triggers and reinforcement Inventories and ratings Personal behavior recording/ charting

Process of Therapy Action oriented Straightforward Emphasis on present and behavior Past exploration and insight are NOT emphasized Homework Brief

Desensitization and Exposure Techniques Systematic Desensitization & Relaxation Methods Progressive deep muscle relaxation Anxiety hierarchy In Vivo Desensitization Virtual Reality Exposure Therapy Exposure Therapy

Assertiveness Training 1. Learn difference between assertive, passive, and aggressive responses 2. Assess your responses 3. Develop assertive responses for specific situations 4. Think through risks of being assertive 5. Rehearse assertive behavior 6. Try out in real situation 7. Maintain new behavior

Self-Management 1. Setting a goal 2. Monitoring behavior 3. Altering environment and generating action steps 4. Generating reinforcements 5. Maintaining gains

Multimodal Therapy Arnold Lazarus BASIC ID “technical eclecticism” Behavior Affect (emotion) Sensations (physiological reaction) Images Cognitions Interpersonal Relationships Drugs (physical health)

Multicultural Effectiveness Strengths Influence of environment Affordable and short term- available to lower SES populations Limitations Separating behavior, cognition, and affect Different meaning of reinforcers

Primary Applications Children and adolescents Career Counseling schools Career Counseling Group Therapy Behavioral Medicine and Prevention Programs Substance abuse Criminal Justice Couples and families

Managed Care Love it! Concrete observable goals Empirically supported Can see progress Empirically supported Short-term

Integration Client-centered Cognitive Solution-focused Psychodynamic- rare but possible NOT Existential or Gestalt

Criticism Pro Development of techniques Grounded in research Effective Brief Clients like it’s straightforward nature Con Neglects internal processes Temporary Treats symptoms not cause