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Behavior Therapy

1. Classical Conditioning  In classical conditioning certain respondent behaviors, such as knee jerks and salivation, are elicited from a passive organism

2. Operant Conditioning  Focuses on actions that operate on the environment to produce consequences

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3. Social‐Learning Approach  Gives prominence to the reciprocal interactions between an individual’s behavior and the environment

4. Cognitive Behavior Therapy  Emphasizes cognitive processes and private events (such as a client’s self‐talk) as mediators of behavior change

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 A set of clinical procedures relying on experimental findings of psychological research

 Based on principles of learning that are systematically applied

 Focus is on the client’s current problems and on assessing behavior through observation or self‐ monitoring

 Largely action‐oriented and educational – therapist teaches clients skills of self‐management

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 Behavior is something that can be operationally defined; it includes overt actions as well as internal processes such as cognitions, images, beliefs, and emotions

 Change can take place without insight into underlying dynamics and the origins of a psychological problem

 Behaviorists ask: “What treatment, by whom, is the most effective for this individual with that specific problem and under which set of circumstances?”

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 A‐B‐C model  Antecedent(s)  Behavior(s)  Consequence(s)

Antecedent Behavior Consequence

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 The following techniques are used in applied behavior analysis

 Positive reinforcement

 Negative reinforcement

 Extinction

 Positive punishment

 Negative punishment Theory and Practice of Counseling and Psychotherapy - Chapter 9 (6)

 Progressive muscle relaxation is a popular method of teaching people to cope with the stresses produced by daily living

 Relaxation becomes a well‐learned response, which can become a habitual pattern if practiced daily

 Relaxation procedures have been applied to a variety of clinical problems ranging from chronic pain to panic disorder

 Based on the principle of classical conditioning, SD is a basic behavioral procedure developed by Joseph Wolpe

 SD is an effective treatment in the reduction of maladaptive anxiety and the treatment of anxiety‐related disorders, particularly in the area of specific phobias

 DS entails relaxation training, development of a graduated anxiety hierarchy, and DS proper (the presentation of hierarchy items while the client is deeply relaxed)

 In Vivo Desensitization  Brief and graduated exposure to an actual fear situation or event

 Flooding  Prolonged and intensive in vivo or imaginal exposure to stimuli that evoke high levels of anxiety, without the opportunity to avoid them

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 Eye Movement Desensitization and Reprocessing (EMDR)  An exposure‐based therapy that involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders and fearful memories of clients

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 Helps clients develop and achieve skills in interpersonal competence

 May involve various behavioral procedures such as assessment, direct instruction and coaching, modeling, role‐ playing, and homework assignments

 The feedback and reinforcement clients receive assists them in conceptualizing and using a new set of social skills that enables them to communicate more effectively

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 One specialized form of social skills training consists of teaching people how to be assertive in varied situations

 One goal of AT is to increase people’s behavioral repertoire so that they can make the choice of whether to behave assertively in certain situations

 Most AT programs focus on clients’ negative self‐ statements, self‐defeating beliefs, and faulty thinking

 Often used in a group format

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 In S‐M programs people make decisions concerning specific behaviors they want to control or change

 S‐M strategies include self‐monitoring, self‐reward, self‐ contracting, and stimulus control

 The process includes selecting goals, translating goals into target behaviors, self‐monitoring, working out a plan for change, and evaluating an action plan

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 A comprehensive, systematic, holistic approach to behavior therapy developed by Arnold Lazarus

 Grounded in social‐cognitive theory

 Applies diverse behavioral techniques to a wide range of problems; it encourages technical eclecticism

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 The complex personality of human beings can be divided into seven major areas of functioning:

B = behavior A = affective responses S = sensations I = images C = cognitions I = interpersonal relationships D = drugs, biological functions, nutrition, and exercise

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 DBT is a promising blend of behavioral and psychoanalytic techniques for treating borderline personality disorders

 DBT treatment strategies include both acceptance‐ oriented and change‐oriented strategies

 Skills are taught in four modules: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance

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Mindfulness-Based Stress Reduction

 The program assists people in learning how to live more fully in the present rather than ruminating about the past or being overly concerned about the future

 The skills taught in MBSR include sitting meditation and mindful yoga, aimed at cultivating mindfulness

 Didactic instruction is minimized and experiential learning and self‐discovery are emphasized

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Mi ndfu I ness-Based Cognitive Therapy

 MBCT is an 8‐week group treatment program adapted from MBSR that includes components of cognitive behavior therapy

 The primary aim is to change clients’ awareness of and relation to their negative thoughts, rather than on merely challenging the content of thoughts

 Experiential learning, in‐session and out‐of‐session practice, learning from feedback, and homework assignments are emphasized

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 ACT involves fully accepting present experience and mindfully letting go of obstacles

 In ACT there is little emphasis on changing the content of a client’s thoughts. Instead, the emphasis is on acceptance (nonjudgmental awareness) of cognitions

 The goal of ACT is to allow for increased psychological flexibility

 There is evidence demonstrating the effectiveness of ACT for a variety of disorders

 Treatments  rely on empirical support and tend to be brief  emphasize self‐management skills and thought restructuring

 Leaders  use a brief, directive, psychoeducational approach  conduct behavioral assessments

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 Leaders and members  create collaborative, precise treatment goals  devise a specific treatment plan to help each member meet goals

 objectively measure treatment outcome

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Strengths IFrom a Diversity Perspective

 Behavior therapy may appeal to diverse client populations due to its:  specificity, task orientation, focus on objectivity, focus on

cognition and behavior, action orientation, brevity, emphasis on the present, commitment to teach coping strategies, and problem‐solving orientation

 Behavior therapy focuses on environmental, social, and political conditions that contribute to a client’s problems

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Limitations IFrom a Diversity Perspective

 Some behavioral counselors may focus on using a variety of techniques in narrowly treating specific behavioral problems

 Therapists who fail to conduct a thorough assessment of the interpersonal and cultural dimensions of the client’s problem may not adequately prepare him/her for the possible consequences of newly acquired social skills

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 The specificity of the behavioral approaches helps clients translate unclear goals into concrete plans of action

 Behavior therapists have a wide variety of specific behavioral techniques at their disposal

 Behavioral interventions have been subjected to more rigorous evaluation than those of any other form of psychological treatment

 Behavior therapy emphasizes ethical accountability

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 Heavy focus on behavioral change may detract from client’s experience of emotions

 Some counselors believe the therapist’s role as a teacher deemphasizes the important relational factors in the client‐ therapist relationship

 Behavior therapy does not place emphasis on insight

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 Behavior therapy tends to focus on symptoms rather than underlying causes of maladaptive behaviors

 There is potential for the therapist to manipulate the client using this approach

 Some clients may find the directive approach imposing or too mechanistic

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