Behavior and Cognitive Therapy

1. Behavior and Cognitive Therapy Topic 5

2. View of human nature • the person is the producer and the product of his or her environment

3. Six key characteristics of BT: • 1. BT is based on the principles and procedures of the scientific method. • 2. BT deals with the client’s current problems and the factors influencing them, as opposed to an analysis of possible historical determinants.

4. Cont’d • 3. Clients involved in BT are expected to assume an active role by engaging in specific actions to deal with their problems. • 4. BT assumes an approach that change can take place without insight into underlying dynamics.

5. Cont’d • 5. BT focuses on assessing overt and covert behavior directly, identifying the problem, and evaluating changes. • 6. Behavioral treatment interventions are individually tailored to specific problems experienced by clients.

6. Therapeutic process • General Goal: •  To increase personal choice and to create new conditions of learning. • * The client, with the help of the Thist, defines specific treatment goals at the outset of the therapeutic process. • * Goals must be clear, concrete, understood, and agreed on by the client and the Thist.

7. Therapist’s function and role: • 1. Thist formulates initial treatment goals and designs and implements a treatment plan to accomplish these goals. • 2. Thist uses strategies that have research support for use with a particular kind of problem

8. Cont’d • 3. Thist evaluates the success of the change plan by measuring progress toward the goals throughout the duration of the treatment. • 4. Thist conduct follow-up assessments to see whether the changes are durable over time.

9. Client’s Experience in therapy • 1. The client engages in behavioral rehearsal with feedback until skills are well-learned and generally receives active homework assignments. • 2. Changes clients have in therapy are translated into their daily lives.

10. Cont’d • 3. Clients are motivated to change and are expected to cooperate in carrying out therapeutic activities, both during therapy sessions and in everyday life. • 4. If clients are not motivated, they undergo motivated interviewing.

11. Cont’d • 5. Clients are encouraged to experiment for the purpose of enlarging their repertoire of adaptive behavior. • 6. Clients are aware when the goals have been meet.

12. Relationship bet. Thist and Client • 1. BT stress the value of establishing a collaborative working relationship. • 2. BT contends that factors such as warmth, empathy, authenticity, permissiveness, and acceptance are necessary, but not sufficient, for behavior change to occur

13. Application: Therapeutic techniques and procedures • ABA: Operant conditioning techniques • - use of the following principles: positive reinforcement, negative reinforcement, extinction, positive punishment, and negative punishment

14. Cont’d • Relaxation training and related methods - method of teaching people to cope with stresses produced by daily living.

15. Cont’d • Systematic desensitization - based on the principle of classical conditioning where clients imagine successively more anxiety-arousing situations at the same time that they engage in a behavior that competes with anxiety.

16. Cont’d • In vivo exposure - involves client's exposure to the actual anxiety-evoking events rather than simply imagining these situations.

17. Cont’d • Flooding - consists of intense and prolonged exposure to the actual anxiety-producing stimuli.

18. Cont’d • Social skills training - deals with an individual's ability to interact effectively with others in various social situations; it is used to correct deficits clients have in interpersonal competencies. (i.e. assertion training)

19. Cont’d • Self-modification programs and sel-directed behavior - includes self-monitoring, self-reward, self-contracting, stimulus control and self-as-model.

20. Cont’d • Basic steps in SMPs: • 1. Selecting goals • 2. Translating goals into target behaviors. • 3. Self-monitoring. • 4. Working out a plan for change, • 5. Evaluating an action plan.

21. Class Activity • Instructions: • 1. Select one behavior that you want to work on. • 2. Describe those behaviors so that they can be observed and counted. • 3. Identify rewards that will help provide motivation to do well. Utilize a reinforcing-event menu.

22. Cont’d • . (let your partner) Keep track of your behavior and give out reward when the desired behavior is exhibited or met. • 5. Write a contract. • 6. Collect data. • 7. Rewrite the contract if the goal is not achieved.

23. Sample contract • Effective dates: From 26 August 2009- 2 September2009 •     We, the undersigned parties, agree to perform the following behaviors: • If Mark will not utter swear words each day then Dr. Phil will allow Mark  to watch a movie of his own choice at the University theater. • Bonus: • If Mark expresses what he feels calmly and directly he will be given food when he watches a movie. •                                 Signed  ____________________(Mark) •                                 Signed  ____________________ (Dr Phil)