* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Behavior Therapy
Prosocial behavior wikipedia , lookup
Classical conditioning wikipedia , lookup
Symbolic behavior wikipedia , lookup
Insufficient justification wikipedia , lookup
Observational methods in psychology wikipedia , lookup
Verbal Behavior wikipedia , lookup
Status dynamic psychotherapy wikipedia , lookup
Equine-assisted therapy wikipedia , lookup
Applied behavior analysis wikipedia , lookup
Neuroeconomics wikipedia , lookup
Emotionally focused therapy wikipedia , lookup
Thin-slicing wikipedia , lookup
Attribution (psychology) wikipedia , lookup
Behavioral modernity wikipedia , lookup
Transtheoretical model wikipedia , lookup
Relationship counseling wikipedia , lookup
Residential treatment center wikipedia , lookup
Sociobiology wikipedia , lookup
Psychological behaviorism wikipedia , lookup
Theory of planned behavior wikipedia , lookup
Descriptive psychology wikipedia , lookup
Theory of reasoned action wikipedia , lookup
Adherence management coaching wikipedia , lookup
Behavior analysis of child development wikipedia , lookup
Social cognitive theory wikipedia , lookup
Behaviorism wikipedia , lookup
Nowak 1 Jenna Nowak Professor Robert Woolfolk Systems of Psychotherapy 13004831 Behavior Therapy Behavior Therapy has been an expanding approach to psychotherapy since the 1950s. It has advanced and thrived since its beginnings, and contains a wide range of strategies. The focus of behavior therapy is to change factors in the environment that influence an individual’s behavior as well as the ways in which individuals respond to their environment (Antony, 193). As one of the most extensively researched forms of psychotherapy, many studies provide evidence for the effectiveness of behavior therapy. From its beginnings, behavior therapy has evolved, but has always emphasized the role of empiricism in the process. Learning is an integral part of behavior therapy. A change in harmful behaviors to beneficial behaviors is the way in which learning occurs. Behaviors of individuals in different situations have a function. Certain situations create different behaviors. Based on those behaviors, a scientific approach is taken to change them. Behavior therapists focus on the way in which clients can learn skills to benefit them in times of need. Because behavior therapy focuses on the client’s change in behavior, the client takes an active role in therapy. Data that is collected through the course of therapy is used as a reference to patterns of behavior that the client experiences. This collected data is readily shared with the client and both the client and therapist set goals for treatment. The therapist suggests certain strategies and the client uses the strategies both in session and for homework in between sessions. Behavior therapy views maladaptive behaviors as acquired the same way adaptive behaviors are acquired. The behaviors 2 are not viewed as a problem, just developed through reinforcement and punishment. Behavior therapy is concerned with repeated behaviors rather than the root cause of the behaviors, such as early forms of psychotherapy. The beginning of behavior therapy can be traced back to events from the 1920s and 1930s. One of the first events was the first of the classical conditioning experiments with the Russian physiologist, Ivan Pavlov. Pavlov was the first to show the process with dogs. Two stimuli are paired in classical conditioning. The first stimulus is a stimulus that is introduced that causes no response in an individual. This is called the conditioned stimulus. The second stimulus is an unconditioned stimulus that elicits a response based on the nature of the individual. The response that the unconditioned stimulus elicits is called an unconditioned response. After pairing the conditioned stimulus with the unconditioned stimulus many times, the conditioned stimulus comes to elicit the same response as the unconditioned stimulus. After the conditioned stimulus starts eliciting the unconditioned response, without the unconditioned stimulus, it is then called a conditioned response. When dogs were shown food, the dogs would start salivating. Pavlov would set off a neutral light or tone (the conditioned stimulus) and would pair it with food (the unconditioned stimulus). The dogs would salivate from the food (the unconditioned response). After pairing the light or tone with the food, the dogs would salivate at the neutral light or tone without the food. The salivation from the light or tone was the dogs’ conditioned response. After classical conditioning has occurred, the repeated presentation of the conditioned stimulus without the unconditioned stimulus can lead to the extinction of the conditioned response. A dog will stop salivating if the food is repeatedly not presented after the light or tone. However, even after extinction has occurred, reinstatement can take place. Reinstatement can Nowak 3 occur when the same conditioned stimulus and unconditioned stimulus are paired together again, eliciting the same response as before. Reinstatement usually returns quickly and can suggest that previous learning is not fully erased from extinction. Another occurrence that set the rise of behavior therapy was with the work of John B. Watson. Watson was the first to study classical conditioning in humans. Through classical conditioning, Watson and Rayner had an infant, Albert, learn to become afraid of a white rat when its presence was paired with a loud noise. Watson is commonly known as the father of behaviorism. Watson believed that only observable behaviors can be studied, and did not believe that emotions and thoughts should be studied. Modern behavior strategies were introduced in the 1920s and 1930s because of classical conditioning. A student of Watson, Mary Cover Jones, treated a young boy for his fear of rabbits. Another treatment, by Mowrer and Mowrer, helped children that had a problem with urinating the bed. Their treatment was named the bell and pad and is still used for children today. Operant conditioning had a great impact on the rise of behaviorism as well. Edward Thorndike and B.F. Skinner are credited as the founders of operant conditioning. Operant conditioning focuses on behavior as it is affected by the contingencies in the environment. It is a form of learning in which the frequency, form, or strength of a behavior is influenced by its consequences (Antony, 201). Two methods involved in operant conditioning are reinforcement and punishment. Reinforcement causes a behavior to increase, while punishment causes a behavior to decrease. Behavior can increase or decrease in the frequency or intensity. Positive reinforcement occurs when something desired is awarded to an individual after a certain behavior. Negative reinforcement occurs when something not desired is taken away after a 4 behavior, causing a sense of relief. Punishment comes in the form of positive and negative as well. Positive punishment happens when an individual is punished after a certain behavior; such as getting yelled at when uttering a curse word. Negative punishment occurs when something desired is taken away after a given behavior. An example of negative punishment would be if a child received no dinner after getting into a fight at school that day. Changing the patterns of reinforcement and behavior can result in changing an individual’s behavior. The 1949 Boulder Conference on Graduate Education in Clinical Psychology had a significant impact on the field of psychology when it started to abandon the most influential psychotherapy at the time, psychoanalysis. The discipline of psychology started to embrace the scientist-practitioner model. This model emphasized a scientific, hypothesis driven approach to the work of therapists. As this more empirically based model started to emerge, many psychologists started to abandon psychoanalysis for more scientific approaches to therapy. Psychoanalysis and other related psychodynamic approaches differ the most in psychotherapy from behavior therapy. Psychoanalysis believes that observable behaviors are the result of unconscious conflicts and inner desires. Behavior therapy typically takes behaviors at face value. Watson did not believe in unobservable behaviors, but contemporary behavior therapists accept that humans are not always conscious of their behaviors and information can be processed outside of their awareness. Unlike psychoanalysis, behavior therapy also does not accept the role of psychosexual conflicts and the interpretations of dreams. Behavior therapy is more directive than psychoanalysis, with the patient being active throughout the course of treatment. As an active part in therapy, the client is less reliant on the interpretation of the therapist than in psychoanalysis. Psychoanalysis is more concerned with the root of the problem behavior than the actual behavior itself. Behavior therapy focuses on the maintaining behaviors, Nowak 5 not focusing on the root cause. Because traditional psychoanalysis focuses more on the root of the problem, it cannot predict or explain the successful results of behavior therapy. Not being able to explain the results of behavior therapy can lead to a contradiction in psychoanalytic theory. Although psychoanalysis was the most prominent and influential form of psychotherapy at the time, the need for a more scientific approach lead to the rise of behavior therapy. As behavior therapy started to rise, research groups in South Africa, the United Kingdom, and North America began to apply the techniques of classical conditioning and operant conditioning to problems of behavior. In South Africa, a physician named Joseph Wolpe started studying the process of classical conditioning as a medical student. After taking an interest in the area, he developed systematic desensitization. Systematic desensitization involves gradually confronting feared situations in imagination while simultaneously practicing progressive relaxation to relax the muscles of the body (Antony, 197). The treatment is one of the first to be formally researched, and has results that support the effectiveness of it. However, it is not formally used today. Rather than exposure in the imagination, exposure to real life situations is used. Although contemporary behavior therapists use the real life exposure, they rarely use relaxation in the process. It seems that the relaxation paired with the exposure is not effective. In 1965, Wolpe moved to Temple University and began to train a team of psychologists including Arnold Lazarus and Stanley Rachman. They began to direct a form of therapy that they referred to as conditioning therapy. Although they were using conditioning therapy as the name, Lazarus was the first person to use behavior therapy in a published article. In the UK, Hans Eysenck was studying behavioral treatments at the Institute of Psychiatry in London. Eysenck was the first to found a behavior therapy journal in 1963, 6 Behaviour Research and Therapy. Rachman, both a student of Wolpe and Eysenck, worked on successful behavioral treatments for different disorders, such as agoraphobia, obsessivecompulsive disorder, and other anxiety based problems. Another one of Eysenck’s students, Cyril Franks, founded the Association for the Advancement of the Behavioral Therapies in 1966. The name was changed in 2005 to the Association for Behavioral and Cognitive and Cognitive Therapies. The name change reflected the changing scope of behavior therapy as recognizing the importance of cognitive approaches. Behavior therapy in North America was focused more on operant conditioning than classical conditioning. One of Skinner’s students, Nathan Azrin helped establish the field of applied behavior analysis. He also started developing treatments based on operant conditioning. He developed reinforcement-based programs that were used to help substance-use disorders. Azrin also started developing behavioral treatments for having unwanted habits reversed. Token economy was another one of Azrin’s contributions to the field of behavior psychology. In token economy, behavioral problems were managed through reinforcement of desirable behaviors by providing tokens that could later by exchanged for rewards (Ayllon & Azrin, 1968). The method of token economy was widely used for managing disruptive behavior, until more contemporary methods, such as medication, were available. All of the contributions from the past have led to the expansion of behavior therapy today. Most therapists practicing behavior therapy today refer to their work as cognitivebehavior therapy. Early forms of behavior therapy did not pay much attention to unobservable experiences, and as behavior therapy advances, cognitive methods are recognized as an important role in how an individual responds to the environment. Nowak 7 Behavior therapy is most closely aligned with cognitive therapy and rational emotive behavior therapy. Cognitive-behavioral therapists make use of strategies from not only behavior therapy, but also cognitive approaches to therapy, paying more attention to thoughts and emotions. In 1955, Albert Ellis was the first to start practicing rational psychotherapy. It was then renamed to rational emotive behavior therapy in 1993. Therapists such as Rachman and Lazarus began integrating cognitive strategies into their therapy. Learning had also been noted by observing others, which Albert Bandura discovered. This type of learning could have both the same desirable and undesirable outcomes as classical conditioning and operant conditionings both had. Behavioral treatments today make use of observing others and modeling after their behavior. An advancement in behavior therapy has taken place in the past ten years. The “third wave” of behavior therapy refers to the development of the acceptance-based behavioral therapies, which emphasize the importance of accepting unwanted thoughts, feelings, and emotions rather than trying to control of directly change them (Antony, 199). These therapies encourage clients to seek out and realize what they want in life and begin to make changes and live in a way that is more harmonious with their values. Because of how new acceptance-based behavioral therapies are, it is hard to determine what kind of impact they will have on the role of psychotherapy. One approach of acceptance-based behavioral therapies is the use of mindfulness. Mindfulness is about being present in the moment and listening with no judgments. Mindfulness training includes thoughts, sensations, and emotions being recognized as they occur. No matter what feelings may come about, they are to be accepted as they are. Mindfulness practices may include meditation, mindful breathing exercises, mindful scanning of the body, mindful eating 8 and others (Antony, 216). Although meditation can date back to early forms of Buddhism, the new concept is studying the effectiveness it has in behavioral treatment. Another strategy for facilitating acceptance is acceptance and commitment therapy. This is a form of psychotherapy that was introduced by Stephan Hayes. The first component of acceptance and commitment therapy is the promotion of acceptance. When unwelcome thoughts or feelings come a client’s way, they are encouraged to first notice them and then accept them instead of trying to change or control them. Clients are encouraged to take note of their thoughts as if they were not their own and view them as an outsider. Putting a different perspective on their thoughts and feelings leads the client to not hold the thoughts and feelings with such value. The second component encourages the clients to explore and recognize what they find important and start taking action to align their behaviors with it. This helps the client start leading a richer life, as their actions follow their beliefs. There are many other strategies that behavior therapy includes. Because behavioral therapy also aligns with cognitive strategies, it covers a wide range. One strategy of behavioral therapy is behavioral assessment. Behavioral assessment starts before the treatment even begins. The client is first evaluated to determine what course the treatment should take. Behavioral assessment distinguishes the behaviors that are to be changed throughout the course of treatment. Many methods are determined to be of help to the client based on the target behaviors from the assessment. And because behaviors can come about from different contexts or because of different people, multiple methods are necessary to see what helps. The target behaviors are determined by both the client and the therapist because the client takes an active role during behavior therapy. Behavioral assessment relies on functional analysis to determine the variables that result in the patterns of target behaviors. Identifying the variables Nowak 9 includes switching things around in the environment and observing the behaviors that emerge. Most therapists also concentrate on internal variables. An assessment can include a behavioral interview. This includes getting a background on the behavior. The therapist can also observe the client and take note of any other subtle things about the client that the client themselves do not notice. Hearing from the client directly what it is that sets off the given behavior and why it is a problem for them is another way the therapist can deduce a treatment plan. The client can also be observed in an environment that evokes the behavioral response through behavioral observation. This assessment determines the antecedents and consequences of a behavior in the given context it arises in. There are two different types of behavioral observation. The first is a naturalistic observation, where the client is in the natural environment where the behavior occurs. The second is analog observation, where the client is observed in a manipulated environment. A problem with behavioral observation can be if the client’s behavior is affected because it is a known assessment. This is called reactivity. Reactivity can be reduced if the therapist can act as an unobserved observer, allowing the clients to act in a natural way. Another way of reducing reactivity is allowing the client to become acclimated to the situation before taking notes on the behavior patterns. Exposure-based strategies are one of the most effective forms of behavioral techniques. Exposure primarily treats anxiety disorders and fear. Exposure involves confronting feared stimuli directly instead of avoiding them (Antony, 210). There are different forms of exposure. One form of exposure is in vivo exposure; this is where clients are exposed to feared situations in real life. In vivo exposure may occur in session or between sessions for homework. Another type of exposure is imaginal exposure. This type of exposure involves imagining a feared 10 situation. Imaginal exposure usually is used for clients that block out or fear their own thoughts, not for external situations. A third type of exposure strategy is interoceptive exposure. Interoceptive exposure involves purposely experiencing frightening physical sensations until they are no longer frightening (Antony, 210). There are many guidelines that make sure exposure will be positive. Predictability, and control of the client are important in exposure-based strategies. Frequent cases of exposure work better than cases spaced far apart. Longer sessions of exposure are better than short sessions. Also modeling, by either the therapist or another trusted individual can lead to better results. From its beginnings, behavioral therapy has expanded and has shown to be an effective form of psychotherapy. Although behavior therapy covers a wide range of strategies, it is focused on learning. A change in behavior through learning is what makes these strategies effective. The abandonment of psychoanalysis for behavior therapy was the result of the newly accepted scientific based approach to psychology. Because behavior therapy was so deeply rooted in empiricism helped shift the focus of psychology at the time. Behavior therapy has continued to expand and adopt new beliefs in comparison to early models. The focus for the future of behavior therapy is to improve effectiveness of treatments as they develop over time. Nowak 11 Bibliography Antony, M. M., & Roemer, L. (2011). Behavior therapy. Washington, DC: American Psychological Association. Ayllon, T., & Azrin, N. H. (1968). The Token economy: A motivational system for therapy and rehabilitation. New York: Appleton-Century-Crofts. Wedding, Danny, and Raymond J. Corsini. Current Psychotherapies. 10th ed. 193-229. Print.