Behavioral Psychotherapy

1. Behavioral Psychotherapy Learning the A-B-Cs

2. Defining Behavior • What we do…Outward manifestation of our inner selves • Communication (to others) of how we feel and think and who we are • Tool we use to accomplish goals, but…may also prevent us from reaching goals

3. Behaviorist Manifesto Psychology as the behaviorist views it is a purely objective experimental branch of natural science. Its theoretical goal is the prediction and control of behavior. Introspection forms no essential part of its methods, nor is the scientific value of its data dependent upon the readiness with which they lend themselves to interpretation in terms of consciousness. The behaviorist, in his efforts to get a unitary scheme of animal response, recognizes no dividing line between man and brute. The behavior of man, with all of its refinement and complexity, forms only a part of the behaviorist's total scheme of investigation (Watson, 1913).

4. History • Two historical events are foundations for BT • Experimental research on animal learning • Ivan Pavlov’s classical conditioning • Aversion therapy • Systematic desensitization • Flooding • E.L. Thorndike’s research on the influence of consequences 1905: Law of effect “Responses that produce a satisfying effect in a particular situation become more likely to occur again in that situation, and responses that produce a discomforting effect become less likely to occur again in that situation.” • Behavior management /modification (using token economies) • Behavior and response prevention (Tx for OCD) • Rise of behaviorism in the 1900s • John Watson’s emphasis on environmental events Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select – doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. I am going beyond my facts and I admit it, but so have the advocates of the contrary and they have been doing it for many thousands of years. (Watson, 1930) • B.F. Skinner’s radical behaviorism: Operant conditioning explains all blank slate

5. History (continued) • Rise of behaviorism in the 1900s • John Watson’s emphasis on environmental events Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select – doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. I am going beyond my facts and I admit it, but so have the advocates of the contrary and they have been doing it for many thousands of years. (Watson, 1930) • B.F. Skinner’s radical behaviorism: Operant conditioning explains all Letter from Skinner’s daughter

6. History (continued) • “Little Albert” experiment • Watson forced out of psychology in 1920 (Rosalie Rayner, Mary Ickes, Harold Ickes) • Formal beginnings of BT were in the 1950s, primarily with children • By the 1970s, emphasis shifted to social learning theory & cognition • The 1980s and 1990s showed increased attention to affect • Currently, 14% of clinical faculty are “behaviorists” while 42% emphasize cognitive-behavioral or social learning approaches

7. Basic Concepts • Three main approaches • Applied Behavior analysis (the focus today!) • Based on Skinner’s radical behaviorism • Behavior is considered to be a function of its consequences • Cognitions are considered private events and not proper subjects for scientific study • Makes use of reinforcement, punishment, and other operant conditioning principles • Mediational Stimulus-Response (S-R) model • Private events, including thoughts and feelings are integral • Examples include systematic sensitization and flooding • Social-cognitive theory • Person is his/her own agent of change • It is not the experience, but person’s interpretation of the experience

8. Common characteristics 1. Commitment to consistent empirically determined theory 2. Abnormal behaviors are nonpathological “problems of living” 3. Abnormal behavior assumed to be acquired and maintained in the same manner as normal behavior 4. Behavior assessment focuses on current determinants rather than on the analysis of possible historical antecedents 5. Rooted in the notion of mutual influences: Parents effect children, but children also effect parents 6. Specificity is vital. Person is best understood by what he/she does in a particular situation 7. Treatment is individually tailored to different problems in different individuals 8. Understanding origins of problem NOT essential for producing change

9. Process of psychotherapy • Considerations for starting treatment • Must identify specific problem (jointly with client or parents) • deficit behavior • excessive behavior • Does the problem require treatment • What will happen if nothing is done • What treatment is likely to be most effective • Who is the best person to deliver the treatment (e.g., therapist, parents, teachers) • Someone present in environment is better • Someone capable and willing to implement plan • What is the best context for treatment (e.g., school, home) • Do a thorough assessment (e.g., identify discriminant stimuli for problematic behavior)

10. Process of psychotherapy (treatment) • Design an appropriate treatment plan using positive reinforcement, negative reinforcement, and punishment techniques • Figure out the most appropriate reinforcers • a. Resistant to saturation (M&Ms are bad, what’s better?) • b. Able to be administered in small units (trip to Florida?) • c. Able to be administered immediately following behavior • d. Must be in control of agent (e.g., not dependent on weather) • e. Must be compatible with treatment plan • f. Must be practical • g. Conditioned reinforcers work well (token reinforcers that are associated with other positive reinforcers (points, tokens) • Establish reinforcement schedule, based on behavior frequency • a. Low frequency = continuous reinforcement • b. High frequency = fixed interval, fixed ratio, or variable ratio

11. Treatment (cont.) • Break behavior into components and use shaping techniques • Reward approximations (homework example) • Know the assignment • Bring homework materials home • Go to study area without prompt • Remain in study area on task • Get the work done • Turn in the assignment • Use prompting and modeling • Have a contingency contract (an agreement about what is expected and the consequences of not doing it)

12. Treatment (for unwanted behaviors) • For unwanted behaviors • Extinguish by removing reinforcers that used to follow the unwanted behavior • Give reinforcers for a competing behavior • If punishment is used, it should follow these rules • As intense as possible (start with maximum intensity) • As frequent as possible • As immediate as possible • Relatively brief • Can’t be a way out of doing something • Can’t associate w/ positive reinforcers (don’t apologize)

13. Applied Behavioral Analysis: Central Constructs • Client-counselor relationship is imperative and counselors exhibit high levels of empathy, self-congruence and interpersonal contact. The relationship is collaborative and relationship variables differ according to client and culture. • Operationalization of Behavior: Focuses on the concreteness and specifics of behavior. Vagueness is transformed into objective, observable actions. • Functional Analysis: The ABC’s of behavior. An individual's behavior is directly related to events and stimuli in the environment. • Reinforcement: Behavior develops and maintains itself through a system of punishments and rewards. • Goals: These are designed to make specific behavioral changes. • concrete, specific, observable and measurable • meet biological and social needs; adaptive • avoid pain and discomfort ”

14. Child wants a cookie Parent says “no” Child stops screaming Child starts screaming Parent gives in, gives child cookie Coercive Cycles (version 1)

15. Child wants a cookie Parent says “no” Child stops screaming, whimpers quietly Child starts screaming Parent yells at child and gives solid smack on bottom Coercive Cycles (version 2) Interactive Exercises

16. Behavioral Therapies • Operant Conditioning (Applied Behavior Analysis) • Progressive Muscle Relaxation (demo) • Systematic Desensitization • Flooding • Exposure and Response Prevention • Eye Movement Desensitization and Reprocessing (EMDR) • Social Skills Training • Mindfulness, Acceptance and Commitment Therapy (ACT)