1. Skinner: Radical Behaviorism Bandura, Ellis, Beck Meicheanbaum
Behavior and Cognitive Behavior Therapy
Skinner: Radical Behaviorism
Bandura, Ellis, Beck Meicheanbaum

2. Distinct aspects each approach emphasizes
Compare -- Contrast Humanistic Theories Person Centered-Existential-Gestalt
Common Themes
List ways in which the three approaches are similar
Distinct aspects each approach emphasizes
Central focus of each approach
Unique ideas, constructs, and/or techniques each brought to counseling practice

3. Areas of Major Emphasis
Psychoanalytic/Psychodynamic
Basic drives and the contribution of early emotional experiences to the person’s presenting concern
Humanistic
The therapeutic process -- the relationship-- and emotional states in the here and now
Behavioral
observable behaviors & learning principles; congnitions

4. Skinner: Radical Behaviorism
Placed primary emphasis on the role of the environment in producing behavior
Applied learning principles to psychology
Experimental psychologist: examined learning principles with rats in the laboratory
Books
1948 Walden Two
1953 Science and Human Behavior
1971 Beyond Freedom and Dignity

5. Behavior/ Cognitive Behavior Theory
Classical Conditioning
Operant Conditioning
Social Learning Approach
Cognitive Behavior Therapy

6. Classical Conditioning
If you pair a conditioned stimulus to a natural stimulus, after time, the conditioned stimulus produces the same response as the natural one: Learning by association
Pavlov discovery (1900)
Meat (us) >> Salivation (ur)
Bell (cs)>>Meat (us) >>Salivation (ur)
Bell (cs) >> Salivation (cr)
Bell (cs) >> Extinguished response

7. Wolpe: 1950 Exam (us)>>>Anxiety (ur)
Applied classical conditioning to treat anxiety by pairing stimuli that cause anxiety (taking an exam) with a state of relaxation, to break the connection between the stimulus and the anxious response
Exam (us)>>>Anxiety (ur)
Relaxation> Images Exam>Anxiety>Relaxation
(cs) (us) (ur) (cr)
Images Exam (us) >>> Relaxation (cr)
Exam (us) >>> Relaxation (cr)

8. Behavior Therapy: Learning by Association: Exposure Techniques
Systematic Desensitization - anxiety
Relaxation training/ Anxiety hierarchy
Pairing (+) stimulus with (–) stimulus (shot-lollipop)
Aversive Counter Conditioning
Exposure Techniques
In vivo desensitization
Flooding (in vivo, imaginary)

9. Anxiety: Facilitating and Debilitating

11. Aversive Counter-Conditioning

12. Exposure Techniques

13. Operant Conditioning Behavior is controlled by its consequences
Desired Consequences – Increase Behavior
Reinforcement
No consequences Decrease Beh.
Not-desired consequences - Decrease Beh.
Punishment

14. Environmental Consequences
Reinforcement Increase a behavior
Positive R Adds a pleasant consequence
Negative R Takes away an aversive stimulus
Punishment Extinguish a behavior
Positive P: Add an aversive consequence
Negative P: Takes away a desired stimulus
Lack of consequence - Extinguish behavior

15. Applied Behavioral Analysis: Functional Assessment Model
Examine the antecedents and consequences of problem behaviors
Conduct a functional assessment using interviews and direct observations (e.g. keeping a diary) to identify
Antecedents: conditions that contribute to the behavior of interest
Consequences: what happens after specific behavior occurs
Behavioral treatments are devised to replace problem behaviors with more adaptive behaviors using reinforcement and extinction strategies

16. Behavior Modification Program
Reinforcement Token economy
Extinction Time out, loose privileges,
punishment
Stimulus control Change environmental antecedents of problem behaviors

17. Cognitive Behavior Therapy
Emphasizes cognitive processes and self-talk as mediators of behavior change
Reciprocal Determinism Bandura
Rational Emotive Therapy Ellis
Cognitive Therapy Beck
Cognitive Behavior Modification Meichenbaum

18. Bandura: Social Learning Approach
Psychological functions involve a reciprocal interaction between:
Environment <><><> Behavior
<> <>
<> <>
<> Cognitive Process <>

19. Modeling Vicarious Learning

20. Cognitive-Behavior Techniques
Assertiveness Training
Provide Information
Examine beliefs and self-talk
Role play assertive behaviors
Modeling – therapist demonstrates behavior
Behavioral rehearsal – client demonstrates behavior

21. Cognitive-Behavior Techniques
2. Steps: Self-Management Program
1. Identify goal in behavioral terms
2. Behavioral assessment
environmental and cognitive contingencies
3. Plan for change
4. Self-Monitoring and Self-Reinforcement
Behaviors, thoughts, self-talk
5. Evaluation of action plan - results

22. Cognitive Behavior Theory
Mental disorder- problem with thinking in which a client distorts reality, including:
Specific misconceptions
Unrealistic expectations
Maladaptive attributions
Therapy’ aim is to identify and change
Faulty patterns of thinking
Faulty premises and attitudes
Distressing emotions result from
maladaptive thinking

23. Rational Emotive Behavior Therapy: (REBT) Albert Ellis
Stresses thinking, judging, deciding, analyzing, and doing
Assumes that cognitions, emotions, and behaviors affect ach other
Is highly didactic, directive,
Emotions stem mainly from our beliefs, evaluations and interpretations

24. RET: The ABC Theory

25. RET: Therapy Process Therapy is seen as an educational process
Clients learn:
To identify and dispute irrational beliefs
To replace ineffective ways of thinking with effective and rational cognitions
To stop absolutistic thinking, blaming, and repeating false beliefs

26. RET: Therapy Process Rational Emotive Imagery Homework
Imagine being in the worst situation- train to change irrational thoughts/feelings for retional ones
Homework
REBT Self-Help Form
Act as if… to challenge self-limiting
Biblio-therapy – Psycho-education

27. Aaron Beck’s CT: Human Nature
Cognitive structures or schemas
We all have implicit assumptions or premises that influence what we attend to and how we interpret events
Confirmatory bias
We tend to electively attend to events that confirm our beliefs
Schemas and Disorders
Anxiety Threat and Danger
Depression Social rejection and failure

28. Cognitive Therapy (CT)
Insight-focused therapy
Emphasizes changing negative thoughts and maladaptive beliefs
Theoretical Assumptions
People’s internal communication is accessible to introspection
Clients’ beliefs have highly personal meanings
These meanings can be discovered by the client rather than taught by the therapist

29. CT’s Cognitive Distortions
Arbitrary inferences
Selective abstraction
Overgeneralization
Magnification and minimization
Personalization
Labeling and mislabeling
Polarized thinking

30. CT’s Cognitive Distortions
Arbitrary inferences
Gloria: relationships with the eligible men do not work out because she feels anxious and acts flippantly
Selective abstraction
Focuses on only on one aspect of a situation: typically a negative aspect-
Overgeneralization
This relationship did not work, no relationship will ever work
Magnification and
minimization
Emphasize negatives and minimize positives

31. CT’s Cognitive Distortions
Presonalization
A mother blames herself for child’s problems
A man blames himself for partner's lack of interest in the relationship
Labeling and mislabeling
Type of generalization:
I made a mistake vs. I am a looser
Polarized thinking
Either co-workers praise me or they hate me
Gloria: Men are either eligible or “icky”

32. Therapy Process
Teach clients to recognize, observe and monitor negative "automatic" thoughts &
Subject their automatic thoughts to reality testing: examine evidence for and against them
Clients learn to substitute realistic and accurate interpretations for biased cognitions
Process is collaborative an interactive: Socratic dialogue

33. Beck’s Approach to Depression: Cognitive Triad
Have a negative view of themselves; attribute setbacks to themselves w/o looking at the environment
Tend to interpret experiences in a negative manner.
Screen out positive experiences not consistent with negative view of themselves (selective abstraction)
Gloomy vision and projections about the future

34. Ellis Vs. Beck
Ellis is more directional and confrontational in pointing out and refuting irrational thoughts
Beck helps clients discover their distorted patterns of thinking
Collaborative empiricism
Guided discovery
client and therapist examine and evaluate beliefs and modify and correct client’s misconceptions

35. Contributions Beh- Cog Beh
Focus on short-term behavioral goals
Emphasis on evaluation of therapy outcome
Empirical evidence of positive results

36. Limitations May lead to symptom substitution
Too much therapist power and control
Lack of attention to relationship issues
No processing of emotions and feelings
Focus only on cognitive issues

37. Meichenbaum: Cognitive Behavior Modification
Is primarily a self-instructional therapy that
Focuses on helping clients become aware of their self-talk, - cognitive restructuring - and
acquire practical coping skills to deal with problems and behaviors
Process of Change
Self observation
Start a new internal dialogue
Learn new behaviors

38. Phase 1: Self-Observation
Observe thoughts, feelings, actions,
Realize how client contributes to own problems
Leads to new cognitive structures – see problems in a new light

39. Phase 2: Start New Internal Dialogue
Identify maladaptive behaviors
Recognize more adaptive options
Develop adaptive internal dialogue to guide behaviors
New behaviors impact cognitive structures

40. Phase 3: New Skills Teaches more effective coping skills
Practice in real- life situations
Continue monitoring/changing internal dialogue
Observe behaviors
Assess outcomes

41. Coping Skills Program: Stress Inoculation
Stress management techniques for present and future problems
Three phases:
Conceptual phase
Skills acquisition and rehearsal
Application and follow-through

42. Conceptual Phase Collaborative relationship (Rogers)
Didactic presentation of the role cognitions and emotions play in stress (Ellis)
Guided discovery to identify own self-talk and how it creates stress (Beck)
Systematic observation and monitoring of maladaptive behaviors and their related self-talk (Behavioral)
New cognitive structures = see problems in a new light (Beck)

43. Skills Acquisition and Rehearsal
Give clients behavioral and cognitive coping techniques to apply to stressful situations
Rehearse new self-statements
Relaxation training
Social skills training
Time management instruction
Making changes in everyday life

44. Application and Follow-Through
Arrange for transfer and maintenance of change from therapy to the real world
Homework assignments of increasing complexity
Results of assignments are carefully evaluated
Follow-up and booster sessions are scheduled in 3-, 6-, and 12 months intervals

45. Contributions Focus on short-term behavioral goals
Emphasis on evaluation of therapy outcome
Empirical evidence of positive results

46. Limitations May lead to symptom substitution
Too much therapist power and control
Lack of attention to relationship issues
No processing of emotions and feelings
Focus only on cognitive issues

47. Multimodal Therapy: Lazarus
Holistic approach to behavior modification
Technical eclecticism
Human experience
interplay of genetics, environment and social learning
can be accounted by examining the BASIC ID

48. BASIC ID Framework for assessment and therapy B – behavior
A – affective processes
S – sensation- five senses
I – imagery
C – cognition
I – interpersonal relations
D – physiological aspects - health

49. Therapy Process Therapy is guided by what is best for the client
Starts with a thorough assessment of the BASIC ID profile
BASIC ID determines the tone or quality of the person’s functioning
Therapist functions as trainer, educators, consultant, role model
Emphasize skill learning

50. New Applications and Integrations (end of Behavior Chapter #9)
Mindfulness and Acceptance- Based Cognitive Therapies: Emotional Regulation
Dialectical – Behavior Therapy (DBT)
Combines CBT and Psychodynamic
Highly structured- requires training - Borderline PD
Minimum 1-year of frequent outpatient treatment
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-Based Cognitive Therapy (MBCT)
Acceptance and Commitment Therapy (ACT)

51. Mindfulness and Acceptance
How to live more fully in the present (Ext)
Interventions: yoga, meditation
Experiential learning and self-discovery (Ext- Gestalt -Rogers)
Practice – In session and home-work
Acceptance (rather than challenge cognitions)
change awareness of and relation to negative thoughts (Ext)
acceptance (nonjudgmental awareness) of cognitions (Rogers)