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TOPIC 4-BEHAVIOR THERAPY Introduction Behavior therapy - Moris (1996) - as therapeutic approaches that are based On the belief that all behavior normal and abnormal is learned and that the objective of therapy is to teach people new and more satisfying ways of behaving. - Behaviour therapy it is not simple approach to therapy but a diverse collection of methods used to treat maladaptive behaviors. - Originally definations attempting to collectively to describe forms of behavior therapy emphasised the application of learning principles to the clinical treatment of psychological disorders e.g. (Ullman & Krasner 1965) - Recently however emphasis of general define for the various behavior therapies have been on the reliance on scientific principles. Approaches To Behavior Therapy - In this course the various forms of behavior therapy will be classified in term of 5 models. 1. Applied Behavior Analysis The ABA model can be traced directly to Skinner’s radical behaviorism which is characterized (1953) by both its reliance on principle and techniques of operant conditioning and by its methodology – experimental analysis of the environmental factors that control behavior. Proponents of the behavior analysis model view overt observable behavior as the only appropriate subject matter of psychology. 2. Neo – Behaviorist Stimulus – Response Approach - This was derived from the work of Wolpe and presents the application of the stimulus – response work of Pavlov et al to the treatment of maladaptive behavior. - In contrast to applied behavior analysis model the SR approach recognizes unobservable meditational factors that underline behavior e.g (neurosis is viewed as a manifestation of underlying anxiety). However although private and symbolic processes are recognized treatments are described in terms of operationally described stimulus response events. 1|Page 3. Cognitive – Behavior Modification Approach - The approach emphasis the cognitive symbolic processes involved in the acquisition and maintenance of abnormal behavior e.g. the individual’s irrationals subjective perceptions, self statements and cognitive strategies. Best known of the CBM therapy are the cognitive restructuring techniques which attempt to replace the individual’s irrational thoughts and self statements with rational ones. 4. Social – Learning Theory - Altributed to to A. Bandura and J. Rotter which incorporates elements of the 3 previously described models. Acc to SLT behavior is from combination of (a) Stimulus control – behavior under the control of certain stimuli as a result of repeated association with these stimuli (b) Based on observational learning 5. Self control procedures These are implemented by the clients themselves. CLASSICAL CONDITIONING TECHNIQUES 1) Systematic desensitization a) Relaxation training The first step in sd is to teach the client t deeply relax . this can be in the form of taking a deep breath, tensing and relaxing different muscle groups and listening to mood music . SD works on the reciprocal inhibition technique which postulates that an individual cannot be both anxious and relaxed at the same time. b) Construction of the anxiety hierarchy Scenes are ordered from least to most anxiety producing. To maximize effectiveness of treatment scenes must be evenly spaced in terms of the degree of anxiety they evoke eg if a person is anxious of writing exam the hierarchy can be as follows reading, preparation for the test, going to write the test and writing the test (i.e evenly spaced) 2|Page (When items are too far apart the client’s anxiety can be exacerbated / when items are too close together, the treatment progress may be slowed) - To ensure an even spacing between hierarchy items Wolpe used a subjective unit of distress scale (SUDS) which involves having the client subjectively assign each scene a numerical value from 0 – 100 based on the amount of anxiety that the scene invokes. - Items are then selected and ordered in terms of their assigned values. Generally, the least anxiety provoking scenes in the hierarchy contain the first 10 – 15 item (Suds is also used during the course of desensitization to access the difficulties client’s level of anxiety). NB- before the hierarchy can be constructed the therapist must clearly define the client’s problem i.e he/she must accurately identify any secondary fears the client has e.g. a client’s fear of driving might be secondary to his fear of visiting his parents (which involves driving to the house). - In this state the client’s phobia isn’t automobiles only but also a result of his disturbed relationship his parents. In such cases two hierarchies are usually constructed (c) Inter – Position Beginning Of Actual Desensitization - During this stage, relaxation is paired with presentation of the scenes contained in the hierarchy. Specifically the therapist instructs the client to establish a relaxed state by using the deep muscle relaxation procedure. - Once relaxation has been established, the therapist asks the client to imagine the least anxiety producing hierarchy item. If the client to imagine the least anxiety producing hierarchy item. If the client experience any anxiety, he/she signals the therapist who help him/her re-establish a state relaxation. - Once relaxation has been established the therapist continues to exert hierarchy items. This procedure is repeated until the client is able to imagine the most anxiety producing item without producing anxiety. Individual desensitization session is usually limited to 15 – 30minutes. Treatment is typically completed within 3 months. 3|Page (d) In Vivo Desensitization/ (Transfer Training) - About 74% - 85% of the way through the hierarchy in vivo desensitization is ordinary became. This in vivo involves the actual confrontation of the fear producing stimulus of the client. - In vivo desensitization must be highly structured. generally the therapist asks the client to practice in real life- only these scenes that correspond to the scenes included in the hierarchy that have been successfully competed - because in vivo desensitization is centered with greater generalization and persistence of effects, Schwarts (1982) proposed the use of systematic (imagery) desensitization for certain phobic conditions. - Agora – phobic (fear of public space) e.g. appeared to respond best to vivo desensitization . Clinical experiments indicated that Agora phobic is actually experiencing two kinds anxiety. The first type which is the kind most similar to normal nervousness becomes the signal that the second type, a panic attack is about occur. - This type of assertion is analogues to interceptive counseling in which the conditional stimulus is an internal bodily sensation. Thus because nervousness always signals and the agora – phobic that a panic attack will soon fellow, his / her phobia (fear of panic attacks) quickly becomes associated with a variety of stimuli that evoke even mild sensation of nervousness and anxiety. - In vivo desensitization appears to be most effective for treating agora – phobic because it facilitates generalization i.e. the agora – phobic client is not merely desensitized to the specific situations included in the anxiety hierarchy but is given opportunity to become desensitized to all real life situations that involve anxiety. Evaluation of systematic desensitization - SD has undergone extensive evaluation and has been found to be a successful treatment for such diverse problems as phobias e.g. snake and social phobias, recurrent night mares and insomnia, chronic alcoholism and interpersonal problems involved in such fears as fear of rejection and fear of intimacy ( Karzden and Wilson 1978 )and (Rimm and Masters (1979). 4|Page - In addition controlled experiments have shown that the complete desensitization procedure is more effective in inhibiting anxiety than either relaxation or exposure to an anxiety hierarchy alone - symptoms substitution seems to be rare and success has frequently have been found to generalize to other areas of the clients lives. - With Wolpe originally proposed at reciprocal inhibition is the mechanism underlying the success of SD. recent scholars have suggested that other mechanisms are also involved e.g. according to the reports “ expectancy hypothesis” (Kazed Wilcoxcon 1996) SD is effective at least in part simply from the client’s behalf (expectation) that the treatment will be successful to reduce his fears. - In addition studies utilizing a “dismantling strategy” to access the effectiveness of various components sd have suggested that the key factor of this type of therapy is repeated nonreinforced exposure to anxiety provoking situation e.g. Lang (1969). 2. Assertion training - Assertion refers to behavior that protect one’s own rights without interfering with the rights of others. - Assertion training is a therapy based on counter conditioning. Current assertion training technique can be traced to the work of Andrew Salter. Salter in his book Conditioned Reflex Theory (1949) suggested that neurosis is a result of over-socialisation which causes excessive inhibition of feelings and emotions. He outlined six technique to help overcome exhibition these are 1) Feeling Talking – verbalization of emotions 2) facial talk – expressing 3) expressing contradictory opinions. 4) Deliberate us of the word “1” and not we 5) Agreeing when praised or complemented 6) Improvising – spontaneous self expression - these techniques can be viewed as important component of assertive behavior 5|Page - popular interest in assertiveness training was subsequently generated by Wolpe (1958, 1973) who defined assertive as the proper expression of any emotion other than anxiety towards another person. The primary goal of AT is to reduce the occurrence of anxiety or other maladptive responses in interpersonal situations by increasing the occurrence of assertive responses. NB: that aggressive and assertiveness are not synonymous assertiveness- refers to behaviors that protect ones own rights without interfering with the right of others. In contract to systematic dissertation AT is not defined by a set of structured techniques. Listed a variety of procedures are usually used in AT including - Behavior rehearsal - didactic discussion - Relaxation training - modeling - In vivo practice Behavior rehearsal is the mostly used procedure. It involves construction of a hierarchy at consists of a list of situation related to the client’s non- assertive behavior (role playing) - The client and the therapist role play these situations with the client and the therapist alternating assuming the roles of the client and significant others e.g. parent spouse or employer. - Lack of assertiveness may be a result of a lack of social skills and not inhibitory anxieties- client is taught the things to say. Lazarus (1966) behavior rehearsal is a specific procedure which aims to replace deficient’s or inadequate social interpersonal responses by efficient and effective behavior patterns - This reversal of roles is an important aspect of behavior rehearsal. It provides the therapist with an opportunity to model or demonstrate appropriate assertive bahaviours. - AT is often the treatment of choice for clients whose anxiety is clearly related to an inability to express feelings in both personally satisfying and socially effective ways and for clients who are aggressive. - Of the various interpersonal problems treated with AT those associated with unexpressed anger and hostility appear to be the most resistant to this form of treatment- Rimm and Masters (1974) 6|Page - AT refers to several related procedures designed to help person become more interpersonally comfortable and skillful. (3) Sexual Dysfunction - Classical conditioning techniques have also been applied to maladptive sexual behaviors e.g. CC has been found to be useful for people who experience anxiety in sexually intimate situations. - A number of behavioral therapies for such problems utilize in vivo procedures which resemble those associated with systematic desensitization - Masters and Jones e.g. used the technique of sensate focus which pairs pleasurable physical sensation and relaxation with anxiety in order to eliminate anxiety. Specifically using sensate focus sexually dysfunctional couple is initially told to refrain from sexual intercourse and to engage in a series of graduated activities that are designed to decrease anxiety and lead to sexual intercourse e.g. couples are asked to first touch each other in a non- threatening sexual carousal way, and gradually proceed through defined stages of physical contact until successful intercourse is achieved. - Masters and Jones have reported success rates of over 80% using these techniques in confusion counseling. Therapies Based on Extinction - In contract to syst desensitization which involves gradual exposure to anxiety producing stimuli the techniques of flooding and implosive therapy involve prolonged intense exposure to anxiety producing stimuli - Underlying both flooding and implosion is the mechanism of classical extinction. 1) Flooding Person is exposed to the object of the phobia suddenly rather than gradually. the fear arousing stimuli is not terminated simply because the client experiences a high level of tension. 7|Page - Also known as exposure and response prevention involves inhibiting the phobic client from making his/her normal avoidance responses in the presence of anxiety producing stimuli to produce extinction of the client’s phobia. - In classical conditioning terms flooding involves exposure to an anxiety producing stimuli (CS). In the absence of the US with which the CS was originally paired. That is in the absence of a stimulus that originally produced a UR of emotional or physical pain. Such repeated exposure to the CS without a US results in extinction of the conditioned anxiety response which is CR. - Although flooding can be conducted via imagery or in vivo it most commonly involves facing the feared stimuli in real life situations. - Flooding has been successfully used to treat strong phobias and obsessive & compulsive behavior that have been unresponsive to other forms of treatment - it is commonly used with other techniques e.g. Rachman et al (1973) successfully utilized flooding and modeling to treat a patient who was afraid of engaging in any activity that might harm another person. - Treatment involved having the client repeatedly perform activities he normally avoided e.g. driving a car, leaving matches and stones on the floor, bumping into people in public places- with modeling of thee bahaviours by the therapist. 2) Implosive Therapy - IT – a technique originally described by Stampf (1961) was designed specifically to eliminate avoidance behaviors through extinction. Rimm and Masters (1974) - The targets of implosive therapy are avoidance behaviors that have been learned as a result of their ability of keeping the individual from experiencing anxiety. - Like other forms of behavior therapy IT relies on the use of visual imagery rather than in Vivo technique . 3) Aversion therapy 8|Page 4) Covert Sensitization - technique in which engaging in an undesirable behavior and then pairing that undesirable behavior with imagined aversive stimuli eg to treat cigar smoking a client will be asked to imagine his/herself smoking a cigar, as the client imagined his/herself smoking the therapist asks her to embellish the scene by imagining that he becomes nauseated by the scene, that he vomits on the floor and then on himself e.t.c. - The therapist may also ask the client to imagine a relief or escape scene in which nonsmoking is accompanied by pleasant sensations. - While CS overcomes the primary criticisms of Aversion Therapy( it does not make use of potentially harmful dangerous stimuli) it does unfortunately share the primarily problem of imaginary procedures - It requires complete co-operation of the client to be effective. - CS can treat sexual deviancy – its effectiveness has not been consistently demonstrated for the treatment of addictive behaviors e.g. cigar , smoking, alcoholism and drug abuse (Wilson and O’Leary 1980) - Covert sensitization of a 14 year old fetish boy who performed indecent assaults of 3 women who were wearing very short skirts (but this was unplanned )he was compelled to touch the thighs of these women (Kavin 1957) - Had to imagine himself going to jail and being hanged of the offences. THERAPIES BASED ON PRINCIPLES OF OPERANT CONDITIONING Introduction: the origins of the therapies based on OC can be traced to BF skinner who proposed that behaviors are controlled by the consequences that follows that follow - Thus the therapies discussed in the section involve control of consequences that follow behaviors in order to increase or decrease these behaviors. - While skinner argues that observable behaviours and consequences are the only legitimate focuses of the study. Many of the studies/ therapies based on operant stimuli reflect an extension of Skinner`s work by clinicians who have applied OC to undesirable behavior like anxiety 9|Page (A) Contingency Management - The term Contingency Management is sometimes used to describe therapies based on OC principles e.g. (Rimm and Master 1979) or specifically to describe comprehensive therapeutic programs in which the operant contingencies (reinforcements and punishments that are to follow certain behaviors) are clearly defined and understood by all individuals involved. - Such programs entailed certain characteristic procedures e.g. clear different of the behaviors to be reinforced and the methods for measuring and observing those behaviours , defining of reinforcers to be used, obtaining base line reinforcements of the frequency of desirable bahaviours and delineation of methods for evaluating the effectiveness of treatment. Increasing Behaviors With Operant Techniques (a) Positive Reinforcement - Refers to the application of a positive reinforcer following a response or behavior inorder to increase the occurrence of that response or behavior. - Praising a child for cleaning its room in order to increase the probability that the child Will do so in future is an e.g. of (tve) reinforcement. - It is important to note that the word positive as used in the term positive reinforcement does not necessary refer to a stimuli that is pleasant or good e.g. a mother’s reprimands would most likely be judged by an outsider to be an unpleasant or aversive stimuli. However if the mom’s reprimands serve to increase the child’s misbehavior e.g. because they provide the child with desired attention. The reprimands are acting as (tve) reinforcers. Effectiveness Of Positive Reinforcement - The effectiveness of the positive reinforcement for increasing a behavior or response is related to several factors. (i) Contingency In order for the positive reinforcement to be effective there should be a contingency relationship between the reinforcer and target behavior i.e. reinforcement is most 10 | P a g e successful when the reinforcer is available only when the target behavior has been performed. (ii) Immediacy - The larger the delay between performance of the behavior and delivery of the reinforcement the less effective the reinforcer i.e. to maximize effectiveness of the reinforcement the reinforce should be delivered immediately following targeted behavior. This is particularly important when reinforcement is being used to established new behavior (iii)Magnitude of Reinforcement - Up to a point the greater the management of the reinforcer the higher the effectiveness the reinforcement. - Past that point- satiation can occur i.e. a rnfcr may loose its value when provided in excess - NB – primary reinforcers e.g. food, water and sex are more susceptible to satiation than secondary or conditioning refers like praise or tokens. - Generalized conditioned rfcrs are least susceptible to satiation effects. (iv) Schedule of reinforcement - Positive reinforcement can be applied on several schedules - Learning or establishment of new responses or behaviour is quickest when reinforcement is provided on a continuous schedule i.e. when rfcrs are provided following each correct response - However maintenance of a previously learned response is enhanced (rate of extinction is reduced) when on intermitant Schedule is used i.e rfcrs are delivered after a specific number of responses or after a certain time interval. - The process of switching from a continuous schedule to intermitant schedule of reinforcement is call thinning. 11 | P a g e (v) Verbal Clarification - Effectiveness of reinforcement is incresead when the contingent relationship between a behavior and the renfcr is verbally clarified - This is particularly true when reinforcement is being provided for performance of a very complex behavior or when delivery of rfcrs must be delayed. - Mother’s instruction to a child to do his bed covers may serve on a prompt for a child’s initial effort but gradually the amount of demonstration and instruction will be decreased (faded) as behavior becomes reliable. (iv) Prompts - Can be verbal e.g. instructions or physical e.g. pointing. - When a prompt is used to initiate a behavior that will be reinforced the prompt is acting as a discriminative stimuli. SD eg if a parent tells a child to clean his/her room , the child is praised when he/ she does so the parents instruction can be described as an SD - The gradual removal of a prompt e.g. progressive reduction of verbal instruction when an individual is learning a complex task in refereed to as fading. (vi) Factors facilitating generalization and transfer of training - The ability of reinforcement to produce generalized effects is enhanced by several procedures. (1) Bringing the behavior under of naturally occurring events: by e.g. selecting behaviors that are likely to be followed by the positive consequences in the natural environments e.g. self help skills that elicit praise from others and reinforcements in their natural environment and bringing the performance of a behavior To a level that is likely to be sustained by natural consequences e.g. increasing a child’s prosocial behaviors to a level that results in increased peer contact, and deliberately using naturally occurring events as reinforcers during the course of the intervention. (2) Increasing reinforcement contingencies in the natural environment by training significant others in reinforcements techniques and by introducing new sources of reinforcement into the individual’s life. (3) Gradually withdrawing reinforcement to increase resistance to extinction 12 | P a g e (4) Expanding stimuli control by increasing the range of cues that signal reinforcement e.g. varying the time, setting, people and other factors associated with the delivery the reinforcement. (5) Instructing the individual in self control procedures e.g. self reinforcement and self instruction. B) Shaping Also known as response differentiation involves the reinforcement of successive approximation to the desired behavior. When using shaping to increase a new behaviour the individual is initially reinforced for an existing behavior that has some similarity to the target behavior. - Gradually reinforcement is withdrawn for less similar behaviors and applied instead to more similar behaviors until the target behavior is performed. - The use if shaping is illustrated by Lovaas (1963,1966) work with autistic and schizophrenic children who through shaping were taught imitative speech then words and finally the context or meaning of speech. - Specifically training began with a child having to imitate the trainer’s voice. To encourage imitation the child was 1st reinforced with food for simply looking at the trainer’s mouth. Once the child accomplished this task the trainer modeled a sound and rfcd the child for any vocalization. - Eventually the child was reinforced only for sounds that resembled the modeled sound. Once the sound was maintained the trainer introduced a new sound. - This procedure was continued until the child was able to say several words. - Wolf 1964 used shaping for a 3 yr old boy who lacked verbal and social behavior did not eat properly and exhibited self injuries behaviors e.g. scratching his face ,refused to wear glasses. - (c ) The Premark Principle - According to Premack (1959) and (1965). A high probability behavior can be used to reinforce and thus increase a low probability behavior 13 | P a g e - Use of Pp can be illustrated by the clinical situations in which a therapist determines that a client whose low Prob Behavior is insufficient study time, spends a great deal of time watching television. - The therapist instructs the client to study for a specific amount of time before watching television. In this situation a high probability behavior (watching tv) is being used as a reinforce for a low probability behaviour study to increase The probability of the low probability bhvr. - The PP is useful in clinical situation when it is difficult to define a stimulus that would act as a reinforcement for a particular client. (d) The Token Economy - One of the best known applications of operant conditioning involves establishing an environment in which appropriate behaviors are constantly rnfcd by generalized conditioned refers (tokens) that can be exchanged for back up rfcrs ( desirable items or activities) e.g. money and buying some items with the money. - T.E have been successfully applied to a variety of behaviors, populations and environments e.g. to improve academic and social behaviors in the classroom Kazdine (1977) and O’ Leary (1978) to treat medical problems. Depcich – Miura and Hovel (1979) a to modify the behavior of psychiatric patient Ayllon at Azrin (1968) & paul & Lenz (1977) - Establishment of a TE involves several basic steps. Walker et.al (1941) (i) Defining the behavior that are to be reinforced i.e. target behavior (ii) Selecting the refers which are the token and back up rnfcrs. (iii)Developing a system for monitoring and accessing the TE (iv) Developing a plan for fading out the contingencies Advantages of a token economy (a) Token economies are asso which several adv. An important element of the TE is its opportunity for immediate delivery of reinforcement which permits the individual to recognize the connection between his/her behavior and a rewarding consequence. 14 | P a g e (b) Additionally the can be tailored to the needs of individual patients in institutional settings by promoting patients to choose their own backup rcnfcr e.g. cigarettes, TV privileges or library privileges. (c) Also because tokens can be exchanged for a variety of rein forcers they are less susceptible to satiation effects than other rnfcrs. (d) Finally tokens are easy to administer and they permit the parceling out of rnfcrs that would otherwise have to be provided on an all- or one basis . Disadvantages of T Economy (a) The most criticism of T.E is rltd to the transfer and maintenance of behaviors acquired as a result of this intervention. - Specifically research has suggested that behavior established through a TE rapidly extinguishes once the programme is stopped. - A number of procedures have been developed to overcome this criticism. (Ayllon and Azrin 1968) e.g. have suggested that maintenance and generalizability can be increased by teaching only those behaviors which will continue to be reinforced after training eg self reinforcing bhvrs or bhvrs that will rnfcd by self approval. - Alternatively, maintenance and generalizability of behaviors acquired through a TE can be enhanced by continuing aspects of the TE outside the therapeutic setting e.g. by teaching family members to reinforce appropriate behaviors. (b) Other critics of the TE have suggested that this method is artificial and does not resemble the environment outside the situation or therapeutic setting. - Supporters of TE however refute this criticism pointing to work environments in which individuals work for pay cheques a type of generalized conditioned reinforcement. (c) More damaging criticism are those related to ethical and legal issues especially those of TE in Institutions - The Albama decision in Wyatt Vs Stickney (1972) eg enumerated a list of patient rights that must be granted to all institutionalized patients - A number of these rights represent activities that have traditionally been used as backup rnfcrs in TE e.g. use of recreational facility. Such legal standard require designers of TE 15 | P a g e to be more creative in defining backup rnfcrs to avoid denying institutionalized patients’ rights guaranteed to them by law. (e) Contigency Contracting (CC) - CC refers to the use of a formal agreement between 2 or more individuals e.g. therapist and client, parent and child, husband and wife, lecturer and students that defines what behaviours are to be changed and what consequences will follow performance of those bhvrs. - there are two types of contingency contracts (Rimm and Masters 1979) (1) A personal contingency contract - The PCC involves bahaviour change by one person only e.g. client in a client therapist contract. It describes what behaviours are to be increased and what rnfcrs the individual will apply when he performs this behaviour. (2) An Interpersonal Contract - Involve two or more people and many require a behavior change by one or all parties to the agreement e.g a contingency contract between a parent and child might define what behaves are to be performed by the child and what information the parent will provide when the child performs this behavior. - CC between a husband and a wife would define what behavior changess are expected by both parties. - Cc has been used in the treatment of a variety of problems including marital problem. ( Stuart 1969), deliquency (Stuart and Lott 1972), ( Weathers and Liberman 1975)), academic deficiencies (Homene 1971) & drug and alcohol addiction ( Fredricksen et al 1976), - the success of CC appears to be related to its opportunity for active participation and agreement by the parties whose behaviors are to be modified/ acc to Stuart 1971, 1976 ,5 elements are necessary to ensure effective CC. (1) The contract must be explicit in defining what each party will receive as a result of his/her responsibility/ needs (2) The behavior included in the contract must be capable of being monitored . (3) A system of sanction for failure to meet the contract terms should be defined. 16 | P a g e (4) The contract should define bonuses for consistent compliance which the terms of he contract. (5) A record keeping system should be best to provide constant feedback to the parties about the frequencies of target behaviors and the delivery of rnfcrs (F) Negative reinforcement increases the probability that a behavior will occur by terminating or removing a stimuli whenever the target behavior is performed. Unlike punishment (with Which punishment positive reinforcement is confused) the goal of negative reinforcement is to increase occurrence of a behavior / response. - Herckel et al 1962 used noxious noise as stimuli to increase verbalization by group therapy members (illustrates the use on negative reinforcement in a clinical setting) in this study a loud noxious noise was sounded until a group participan spoke during therapy sessions. - Herckel et al reported that conversation in therapy increased considerably as a result of such negative reinforcement. - Negative reinforcement is not used as frequently as positive reinforcement for several reasons. (1) Use of negative reinforcements requires that an undesirable and often aversive stimuli continue until the target behavior is performed (2) Additional studies have indicated that an ongoing aversive stimuli can produce undesirable side effects. (3) Use of positive reinforcements requires that the stimuli can be carefully controlled and the behavior to be carefully monitored so that the target is consistently reinforced. - Such consistent control and monitoring is often impossible - Also called escape or avoided concluding e.g. writing a good course work so much that you will not be expected to write the final exam. Wearing a jersey. 17 | P a g e DECREASING BEHAVIOR WITH OPERANT TECHNIQUES - In the previous section methods for increasing operant behaviors’ were discussed which involved either presentation of a positive rnfcr or termination of an undesirable stimulus following the occurrence of a target behavior. - In this section therapies used to decrease Operant behaviors are discussed. In contrast to the previously described techniques These therapies rely primarily upon the removal of positive rnfcmnt or the application of an undesirable stimulus. 1) PUNISHMENT Punishment designed to suppress undesirable instrumental bahaviour by introducing aversive consequences e.g. taking a bike from a child who always rides on the lawn to stop the behavior. - Removal of the reinforcer or use of an aversive stimuli to avoid the “temptation value” of stimuli that elicit the undesirable behavior. - Refers to the application of an aversive stimuli after a response or behavior has occurred with the goal of reducing the probability that the response / behavior would occur again . - To be appropriately referred to as punishment the stimuli presented contingent on performance of a response must suppress that response. (Arzin and Holz 1966) - Thus the term aversive in aversive stimuli refers to the consequences of applying the stimuli rather than to the nature of the stimuli. Some authorities include under the rubric of punishment the removal of a positive reinforcement that normally follows a response. - In this discussion however this later technique is included under time- out, response cost and extinction. Effectiveness of punishment - The effectiveness of punishment in reducing a response or behavior dependent on many factors. a) Intensity Generally the greater the intensity of the punishment stimulus the greater the effectiveness of punishment in suppressing the target behavior. 18 | P a g e In addition punishment is more effective when the stimuli is initially administered in its full intensity rather than when it is initially administered in a weaker form and then gradually increased in intensity. b) Immediacy Like positive reinforcement punishment is most effective when the stimulus is applied immediately following the target response. Long delays in the punishing consequences of smoking e.g., HIV AIDS e.g. Explain why individuals continue to smoke or engage in high risk behavior in spite of the potential from negative effects. c) Consistency Punishment is more effective when it follows each performance of the target behavior. However with milder forms of punishment continues application of a punishing stimuli is more likely to result in recovery of a behavior when punishment is stopped than is an intermittent application of a stimuli d) Reinforcement For Competing Behaviors Because punishment only teaches a person what not to do (does not teach new behavior) its effectiveness is reinforced when it is combined with reinforcement of alternative behaviors. Criticism Of Punishment a) In addition to ethical criticism e.g. application of an unpleasant aversive stimuli is always inhuman, punishment has been criticized on practical ground b)Research has found that effects of punishment are transitory i.e. (sessation of punishment is often associated with recovery of a response) c) inconsistency -individuals often learn to discriminate when punishment will occur and thus engage in the target behavior which we want to suppress at times when punishment is unlikely. d)In addition punishment is associated with several undesirable side effects including increased aggression, escape and avoidance responses such as lying, running away and either undesirable behaviors such as crying and anger. e)The punishing agent e.g. therapist, teacher, parent often becomes identified as an aversive stimuli himself because of the negative consequences associated with punishment. Its use is generally limited to situation involving self injuries behaviors i.e. when the individual’s behavior is more harmful than punishment and when less harsh treatments have been unsuccessful. 19 | P a g e f) It provides a model for the subject in demonstrating the effective use of force to control others behavior. 2)Time Out Reinforcement -Time out refers to the removal of the reinforcement for a specific undesirable in order to decrease The occurrence behavior - The key feature of TO is its removal of reinforcement for a specific period of time following performance of an undesirable behavior inorder to decrease the occurance of that behavior, most ideally all sources of reinforcement commonly used to involves removal or isolation of the individual then the source of reinforcement e.g. Drabman and Spitalmik (1973) used a time out procedure to reduce the disruptive behaviors of male adolescents at a psychiatric hospital school. Each participant in the programme was removed from the classroom and placed in a small room for 10 minutes each time he displayed aggressive behavior. - Thus while in the small room the student was isolated from all sources of reinforcement e.g. attention of teachers and peers. Use of the time- out procedure as expected resulted in a decrease in disruptive behavior. - Alternatively rather that isolating the individual from sources of the reinforcement he can be partially removed from the reinforcing situation e.g. a child who misbehaves can be placed on the periphery of the playroom. Another method involves removal of the positive reinforcement from the situation for a specific period of time before using the time out procedure it is important to determine if the environment in which the misbehavior occurs e.g. classroom is actually reinforcing the individuals behavior e.g. disruptive behavior may be due to boredom or frustration with the task rather than due to reinforcement. - In such cases time out procedure will not be effective. In addition when using time out procedure it is necessary that the individual understands specifically what behaviors will result in a time our procedure (Schwartz 1982).time out has been successfully used to decrease the occurrence of a variety of undesirable behaviors including thump sucking 20 | P a g e (Baer 1962) alcohol consumption (Mourray and Hobbs 1977), improper eating habit (Barton et al 1970). Over- Correction Involves application of a penalty following a disruptive behavior with the goal of reducing the occurrence of that behavior. The two phases of over correction which are restitution and positive practice are illustrated by Foxx and Azrin’s (1972) Use of these technique which a severely retarded hospitalized women who consistently disrupted the ward by throwing objects and overturning her bed. Whenever the women engaged in these behaviours she was 1st required to correct the effects of her behavior by straightening her room and returning her bed to its proper position. (positive practice phase) The woman was then required to practice the correct bhvr by straitening all the beds in the ward. Response Cost -involves removal of a positive reinfor contingent on performance of a behavior to reduce the occurrence of that behavior. Response cost involves the withdrawal of a conditioned reinforcement e.g. money or tokens fines. - Although its use is often associated with TE it can be applied whenever control of reinforcements is possible e.g. when misbehavior can be followed by lossof television priviledges or decrease in amount of time watching tv. the effectiveness of Response cost Is enhanced when it is used in conjunction with the positive reinforcement for alternative behavior Clark et al (1977) used RC to suppress misbehavior by children during shopping trips with parents. Specifically children were told they would be able to spend 50 cents at a shop but at the end of the trip if they did not misbehave. Each misbehavior during the trip the would result in a 5 cent fine. Results indicated that imposition of the fine markedly decreased inappropriate behavior in stores. 21 | P a g e Deferential Reinforcement of Other Behavior DRO involves the positive reinforcing all behavior except the undesirable behavior for e.g. Lowitz and Suib (1978) reduced thumb sucking in an 8year old girl by reinforcing her with cents during treatment session for every one minute interval that she did not such her thumb i.e. she was reinforced for all behavior except thumb sucking .the researchers reported that thump sucking was significantly reduces after only 5 sessions. An alternative application of DRC involves reinforcing only those behaviors that are incompatible with the target behavior e.g. reinforcing play to reduce hyperactive behavior. when used this way DRO is sometimes referred to as reinforcement of incompatible behaviors. Another alternative use involves deferential reinforcement of low response rate DRL Using DRL technique reinforcement is provided whenever an individual displays a decrease in the undesirable behavior during a specific period of time e.g. providing reinforcement when the child disrupts the class by speaking out loud only twice during a one hour period. Behaviors tend to weaken and disappear overtime if they are not reinforced. Extinction. ( Operant extinction) Involves withdrawal of reinforcement from a previously reinforced response in order to reduce the probability that the response will occur again Underlying the technique of extinction is the operant principle that behavior that fails to produce reinforcement will weaken and eventually cease. An e.g. of extinction is the situation in which a child’s misbehavior in school is reinforced by attention by a teacher and other students. If the teacher and the students subsequently, consistently ignore the girl’s inappropriate behavior those behaviors disappear. Boy teasing sister/ attention from mother. 22 | P a g e Effectiveness Of Extinction Factors that influence the effectiveness of extinction include Schedule of reinforcement The schedule of reinforcement that previously established the behavior influences the rate of extinction. Extinction is greatest i.e. the behavior in most likely to disappear following cessation of reinforcement when the behavior has been reinforced on a continuous schedule of reinforcement. Magnitude and duration of reinforcement The higher the magnitude and duration of previous reinforcement the greater the resistance to extinction. Reinforcement of other behaviours Extinction like other techniques discussed in this section is most effective when it is used in conjunction with positive reinforcement of alternative behaviours. When using extinction to decrease a behaviour it is necessary to (i) Identify all reinforcers that are maintaining the behavior (ii) Withhold these every time the behavior is formed -because it often difficult to identify and consistently withdraw all sources of reinforcement. extinction can be a slow and frustrating process. The use of extinction has the folowing characteristics. 1. It is generally a gradual i.e. previously reinforced behaviors do not disappear immediately. 2. Introduction of extinction often produces a temporary increase (response bust) in the behaviours being extinguished. This effect is often associated with the introduction of a time out procedure e.g. when using extinction to reduce a child’s tantrums(Allen at al,1979) found out that the child`s tantrums initially increased over baseline levels before they began to decrease. Extinction is also associated with spontaneous recovery – a sudden 3. temporal recurrence of the extinguished behavior without rnfcmnt. 23 | P a g e 4. The use of extinction often produces undesirable emotional problems including frustration and anger, aggression, agitation e.g (Skinner 1953) 24 | P a g e (Rekers & Lavas 1974)