Behavior Therapy

View of Human Nature People have the capacity to actually make changes in their environment Increasing people’s freedom and skills allows them to have more options for responding to the environment Change occurs by taking actions rather than only reflecting on the problems People need to take responsibility for their own behavior

Therapeutic Goals Focus on what the client wants to do Help clients accept responsibility for change Discuss advantages and disadvantages of the goals Reduce maladaptive behaviors and learn more adaptive behaviors Client and therapist collaboratively decide on concrete, measurable, and objective treatment goals

Therapist’s function and Role Be active and directive Serve as an consultant, problem solver, or educator Conduct a thorough functional assessment formulate initial treatment goals, use strategies for behavior change, evaluate the success of the change, and conduct a follow-up assessment Serve as a role model for the client Focus on current problems

Client’s Experience in Therapy To be taught concrete skills To be motivated to change To expand their adaptive behaviors To implement new behaviors

Therapeutic Relationship Therapeutic relationship still can contribute significantly to the process of behavior change The client’s positive expectations for change contribute to successful outcomes Common factors (warm, empathy, or acceptance) are necessary but not sufficient for behavior change to occur. The progress is due to specific behavioral techniques instead of therapeutic relationship

Therapeutic techniques and procedures Operant conditioning techniques Positive reinforcement A child gets a good grade and is praised by teachers. Negative reinforcement Escape from aversive (unpleasant) stimuli Extinction Withholding reinforcement from a previously reinforced response Positive punishment Spanking a child for misbehavior Negative punishment Taking TV time away from a child for misbehavior

Therapeutic techniques and procedures Progressive Relaxation Tense and relax muscle including face, neck, shoulders, chest, stomach, arms, and legs Systematic Desensitization – Joseph Wolpe (1958) 1st step: Learn relaxation 2nd step: Make a list of anxiety hierarchies 3rd step: Imagine anxiety-evoking situation while being relaxed

Therapeutic techniques and procedures Modeling Observe another person’s behavior and make use of that observation Live modeling Symbolic modeling Assertion Training People have the right to express themselves Identify irrational beliefs Practice assertive behaviors

Therapeutic techniques and procedures In Vivo therapies Approach the actual fear-inducing situation or event gradually or directly Imaginal Flooding therapies Expose to the mental image of a frightening or anxiety-producing object or event Experience the image of the event until the anxiety gradually reduces

Therapeutic techniques and procedures Self-management strategies Self-monitoring, self-reward, or self-instruction Three phases integrating behavioral techniques with contemporary psychodynamic approach Assessment and relationship-building Insight—understand how early relational patterns are related to present difficulties Behavioral techniques

Research on Behavior Therapy In general, studies indicated that more improvement for behavioral therapy or CBT than for psychodynamic, client-centered, or control group. Behavioral treatments are more effective than non-behavioral treatments regardless of the type of problem, client age, or therapist experiences. A considerable research has been conducted behavioral therapy treatment of depression, anxiety, OCD, phobias, alcoholism, sexual dysfunction, panic attack, or other disorder.

Summary and Evaluation Contributions Use Empirical-Validated Treatment In general, behavior therapy is more effective than no treatment Limitations Change behavior, but not feelings Ignore relational factors Ignore insight Treat symptoms rather than causes Control and manipulation by the therapist