1. Behavior Therapy Techniques Lesson 18

2. Behavior Therapy 1.Clarifying the clients problem 2.Formulating initial goals for therapy 3.Designing a target behavior 4.Identifying the maintaining conditions 5.Designing a treatment plan 6.Implementing the treatment plan 7.Evaluating the success of treatment 8. Conducting follow-up assessment ~ 1.Goal setting 2.Behavioral Definitions 3.Functional Analysis 4.Objective measurement 5.Data collection 6.Evaluation ~ Behavior Modification

3. Changing Behavior n Acceleration Target Behaviors l Increase behavioral deficits l Primarily positive reinforcement n Deceleration Target Behaviors l Punishment   behavior l “Dead” person rule l Include acceleration behaviors ~

4. Deceleration Techniques n Differential RFT (DRO & DRI) n Direct Deceleration Therapy l Consequential deceleration l Aversion therapy n Token Economies l Pos RFT & response cost n Exposure therapies l Brief / graduated l Prolonged / intense ~

5. Counter-Conditioning: Joseph Wolpe n Reciprocal inhibition n Buzzer sounded when cat was eating l Buzzer (CS) : eating (US)  pos CER l Buzzer (CS) : shock (US)  fear n Substitution of competing responses l Respondent Learning l Can also replace fear with pos CER ~

6. Mary Cover Jones & “Peter” n Treatment of phobias l Peter fearful of white rabbit n Counterconditioning l Pairing favorite food & rabbit n Exposure therapy l Gradually moved rabbit closer l Peter watched another child play with rabbit ~

7. Inhibitory learning n Conditioned Inhibition l Learning to withhold conditional response n CS-: US will not occur l no US for period of time l US must be a significant event n Occurs only if there is an excitatory context ~

8. Standard Procedure n Some trials: CS+ --- US n Other trials: CS+ / CS- --- No US n Example: traffic light l CS+ (red)  CR? l CS- (police officer) / CS+  CR? n Respond differently under different circumstances ~

9. Negative CS-US Contingency n Similar to standard procedure l Some trials: CS+ & US l Other trials: CS- & no US n CS-  no response n Example: Traffic light l Red (CS+) – Danger (US) l Green (CS-) – no Danger (no US) ~

10. Inhibitory Conditioning & Stress n Panic attacks  extreme stress u Carter, Hollon, Carson, & Shelton (1995) l triggered by CS+ for aversive stimuli n Panic attack experimentally induced l accompanied by trusted friend l or alone ~ n Friend acted as CS- for stress l  stress compared the alone group l trusted friend was a safety signal ~

11. Exposure Therapies n For fear/anxiety & other negative CERs l Intense, maladaptive, or inappropriate l Some strong fears adaptive n Based on Extinction l Fear-provoking events (CS+) l Safe environment (no US) ~

12. Exposure Therapies Models n Brief/graduated exposure therapy l Short exposure periods l Gradually increase intensity of CS n Prolonged/intense l Lengthy exposure periods l Immediate exposure to intense CS n Mode of exposure on continuum l Imaginal ---------------------- in vivo ~

13. Systematic Desensitization n Brief/Graduated Exposure Therapy n Relaxation Training l Tense then relax muscle groups n Fear Hierarchy l Rank fear-provoking situations n Graded Pairing l CS for fear with muscle relaxation l Thru hierarchy: lowest  highest ~

14. Systematic Desensitization: Theoretical Explanations n Counterconditioning l Substitution of competing response n Reciprocal inhibition l Neurophysiological processes l Parasympathetic vs Sympathetic n Extinction l Cues present but no danger (US) ~

15. Flooding n Prolonged/Intense Exposure Therapy l Also called implosive therapy l In vivo or imaginal n Treatment for l Phobias l Obsessive-compulsive disorder l Post-traumatic stress disorder l Agoraphobia ~

16. Flooding n Aversive CS  escape/avoidance l Limits opportunity for extinction n Confront individual w/ fear- provoking situations/ images l No relaxation l Not graded l Extinction process n Potential for intensifying fear ~

17. Aversive Therapy n Punishment of target behaviors l Instrumental conditioning l R  aversive stimulus l E.g., chronic vomiting  shock n Problems l Avoidance of therapy (drop out) l Disruptive CERs l  punishment of others l Ethics concerns ~

18. “More Acceptable” Punishers n Snap rubber band on wrist n Cigarette smoke n Bitter substance n Water mist sprayed in face n Loud noise n Mild mouthwash n Trichotillomania (Pulling out hair) n Compulsive eating n Nail biting n Face slapping n Bruxism n Biting other children Target Behavior Punisher

19. Aversive Therapy: Covert Sensitization n Classical & instrumental conditioning n Use of imaging l Therapist describes behavior l & aversive outcome n Advantages l Safe & more acceptable to clients l Clients can self-administer in vivo n Effectiveness equivocal ~