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Behavior Therapy Chapter 9 Behavior Therapy Basic Assumptions Overt behavior holds primacy Maladaptive behavior is learned in the same way as adaptive behavior Assessment and evaluation is key Treatment is active, directive and collaborative Behavior Therapy Based on the principles and procedures of the scientific method Learning new behaviors is the core of the therapy Interventions tailored to fit individual needs Therapy deals with client’s current problems and the factors influencing them Does not deal with historical determinants Treatment goals are stated in concrete and objective terms Conclusions are made based on what is observed Therapy is a collaboration between therapist and client Clients are expected to be active Clients ‘do something’ to bring about a change: engage in new behaviors Interventions are monitored and frequently revised Clients monitor their behavior outside of sessions, learn coping skills, role-playing Several behavioral techniques are often combined in a treatment package to increase efficacy of treatment Behavior Therapy Behavior therapy does not provide insight Behavior therapists treat symptoms rather than causes Therapy involves control and manipulation by the therapist Therapists use empirically supported techniques Treatment is as brief as possible Behavior Therapy Therapists are willing to examine the effectiveness of their procedures in terms of generalizability and durability of change Therapists are ethical in their practice Clients have control and freedom Clients can monitor and manage their interventions Behavior Therapy: Therapeutic Relationship Varies Between psychoanalysis and personcentered on Genuineness Empathy Warmth Positive regard not as important Positive expectancy and credibility very important Behavior Therapy: The 3 Cs Counterconditioning Contingency Management Joseph Wolpe B.F. Skinner Cognitive-Behavior Modification Donald Meichenbaum Counterconditioning Also known as reciprocal inhibition Based on respondent conditioning Follows directly from the work of Pavlov UCS NS/CS UCR/CR Chapter 9 Copyright © 2007 Brooks/Cole, a division of Thomson Learning, Inc. Counterconditioning Psychopathology Conditioned Anxiety (i.e. respondent conditioning) Anxiety is a response of sympathetic nervous system Anxiety can be conditioned to any stimuli Anxiety is cause of most behavioral disorders Thoughts associated with threatening stimuli can elicit anxiety Therapeutic Process – Unlearning responses Desensitization Assertiveness Training Stimulus Control Contingency Management Psychopathology Behavior controlled by CONSEQUENCES Reinforcement/Punishment Excesses, deficits, inappropriateness Therapeutic Process Various forms of control procedures Functional Analysis A-B-C Theory of Therapeutic Processes Environmental contingencies shape, maintain, & extinguish behavior Behavior modification systematically controls contingencies to shape behavior Change the contingencies and the behavior will change Chapter 9 Copyright © 2007 Brooks/Cole, a division of Thomson Learning, Inc. 6 Steps of Effective Contingency Management 1. 2. 3. 4. 5. 6. Chapter 9 State problem in behavioral terms Identify behavioral objectives Take baseline measures Conduct naturalistic observations Modify existing contingencies Monitor the results Copyright © 2007 Brooks/Cole, a division of Thomson Learning, Inc. Cognitive-Behavior Modification Behaviorism was established as a radical alternative to mentalist theories Conditioning replaced cognition as the critical determinate of human behavior Cognition gradually reintroduced in tx of human disorders Most behavior therapists now incorporate cognitive techniques Meichenbaum spearheaded this change Chapter 9 Copyright © 2007 Brooks/Cole, a division of Thomson Learning, Inc. CB Modification Psychopathology Distorted information processing, expectancies and skill deficits Problems are characterized by Lack of coping response Use of inappropriate cognitive responses (e.g., mislabeling) Ineffective strategies for problem solving Therapeutic Process Biofeedback Self-instructional training Stress inoculation Phases of CBM Conceptualizing the problem Understand the nature of problem and enlist active collaboration Trying on the conceptualization Explore, sample and consolidate this view Modifying cognitions & producing new behavior Modify internal dialogues and enact new behavior to realign reciprocal interactions between mood cognition and behavior STRESS INOCULATION Behavior Therapy CONTRIBUTIONS Wide variety of techniques available Therapy stresses ‘doing’ Techniques have been extended to more areas of human functioning than any other therapeutic approach Emphasis on research into and assessment of treatment outcomes Behavior Therapy LIMITATIONS OF BEHAVIOR THERAPY Behavior therapy may change behaviors, but it does not change feelings Does not deal with the emotional process as fully as other approaches Relationship between client and therapist is discounted