Download The History of Family Therapy

CHAPTER 11:
Behavioral and CognitiveBehavioral Family Therapies
Family Therapy: History, Theory, and
Practice
6th Edition
Samuel T. Gladding
Developed by Nathaniel N. Ivers, Wake Forest
University
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
Overview
Behavioral Family Therapy (BFT)
•
•
Functional Family Therapy
•
Cognitive-Behavioral Family Therapy (CFBT)
•
Major theorists
•
Premises
•
Techniques
•
Roles of the therapist
•
Processes and Outcomes
•
Unique Aspects of BFT and CBFT
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-2
Behavioral Family Therapy (BFT)
•
Fairly recent treatment methodology
•
Origins in research on modification of children’s
actions by parents
•
Treatment procedures based on social learning
theory
•
Functional Family Therapy
•
Cognitive-behavioral family therapy (CBFT)
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Major Theorists
Early Pioneers
•John
B. Watson
•Mary
Cover Jones
•Ivan
Pavlov
•B.
F. Skinner
•
First to use the term, behavioral therapy
•
Originator and proponent of operant conditioning
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Gerald Patterson
•
Credited with being the primary theorist who
began the practice of applying behavioral theory
to family problems
•
Instrumental in writing programmed workbooks
for parents to employ in helping their children
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-5
Neil Jacobson
•
Found that 20% of male batterers, have lower
hear rates during times of physical assault
•
Found that acceptance, or loving one’s partner as
a complete person and not focusing on
differences, may lead to an ability to overcome
fights that continually focus on the same topic
•
Challenged marriage and family therapy
practitioners to be more innovative and reflective
in their work
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Premises of the Theory
•
Based on the theoretical foundations of behavioral
therapy, particularly operant and classical
conditioning
•
Maladaptive behaviors and not underlying causes
should be the targets of change
•
Not everyone in the family has to be treated for
change to occur
•
Emphasizes the major techniques of behavioral
theory, such as stimulus, reinforcement, shaping,
and modeling
•
Many behavioral therapists also emphasize
cognitive aspects of treatment
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-7
Types of BFT and CFBT Therapies
Behavioral Parent Training
•
•
Authoritative Parenting
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Authoritarian Parenting
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Permissive Parenting
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Neglectful Parenting
•
One of the main tasks is to define a specific
problem behavior
•
Parents are trained in social learning theory
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-8
Types of BFT and CFBT Therapies
Functional Family Therapy
•
•
All behaviors are adaptive and serve a function
•
Behaviors represent an effort by the family to
meet needs in personal and interpersonal
relationships
•
Relationships help family members achieve one
of three interpersonal states
• Contact/closeness (merging)
• Distance/independence (separating)
• A combination of states 1 and 2 (midpointing)
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Functional Family Therapy Continued
Three-stage process of Functional Family
Therapy:
•
•
Assessment
•
Change
•
Maintenance
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Types of BFT and CFBT Therapies
•
Behavioral Treatment of Sexual Dysfunctions
•
Four phases of sexual responsiveness
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Excitement
•
Plateau
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Orgasm
•
Resolution
Model for Sexuality
•
•
PLISSIT
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-11
PLISSIT
•
P – Permission to talk about sexuality and sexual
issues
•
LI limited information about the prevalence and
etiology of problems
•
SS – specific suggestions
•
IT – intensive therapy
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-12
Types of BFT and CFBT Therapies
•
Heavy emphasis placed on modifying personal or
collective core beliefs, or schemas.
•
Important to help change stable, entrenched, and
long-standing beliefs that family members have
about family life
•
Teach families to think for themselves and think
differently when it is helpful
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-13
CBFT Continued
Behavioral component of CBFT focuses on the
following actions:
•
•
“Excess negative interaction and deficits in
pleasing behaviors exchanged by family
members
•
Expressive and listening skills used in
communication
•
Problem solving skills
•
Negotiation and behavior change skills”
(Dattilio, 2001, p. 11)
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-14
BFT: Treatment Techniques
General BFT and CBFT techniques:
•
Education
•
Communication and problem-solving strategies
•
Operant conditioning
•
Contracting
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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BFT Treatment Techniques
Specific behavioral and cognitive-behavioral
techniques
•
•
Classical conditioning
•
Coaching
•
Contingency contracting
•
Extinction
•
Positive reinforcement
•
Quid pro quo
•
Reciprocity
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-16
Specific BFT and CBFT Techniques Continued
•
Reciprocity
•
Shaping
•
Systematic desensitization
•
Timeout
•
Job Card Grounding
•
Grounding
•
Charting
•
Premack Principle
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-17
Specific BFT and CBFT Techniques Continued
•
Disputing irrational thoughts
•
Thought stopping
•
Self-instructional training
•
Modeling and role playing
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-18
Role of the Therapist
•
Expert
•
Teacher
•
Collaborator
•
Coach
•
Helps families to set up behavioral and cognitivebehavioral management programs
•
Behavioral and CBT family therapists must learn
to play man roles and to be flexible.
•
CBT family therapists concentrate on modifying or
changing family members’ cognitions as well as
their interactions.
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-19
Process and Outcome
If successful:
•
•
Family members learn to modify, change, or
increase certain behaviors to function better
•
Family members learn how to eliminate or
decrease maladaptive or undesirable behaviors
and/or dysfunctional thoughts.
•
Focuses on increasing parenting skills, facilitating
positive family interactions, and improving sexual
behaviors
•
CBFT helps families deal with stress, addiction,
and adult sexual dysfunctions
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-20
Unique Aspects of BFT and CBFT
•
The theory behind the approaches
•
The research
•
Their continued evolution
•
Their short term treatment
•
Their rejection of the medical model of abnormal
behavior
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
11-21