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Treatment Components Behavioral Reconditioning

Treatment Components Behavioral Reconditioning. Anna C. Salter. Behavioral Reconditioning. Easy to Do Wrong Hard to Do Right (Steve Jenson, personal communication 11/30/09). Behavioral Principles: 1. Don’t let person become highly aroused Use minimal arousal conditioning

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Treatment Components Behavioral Reconditioning

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  1. Treatment ComponentsBehavioral Reconditioning Anna C. Salter

  2. Behavioral Reconditioning Easy to Do Wrong Hard to Do Right (Steve Jenson, personal communication 11/30/09)

  3. Behavioral Principles: 1 Don’t let person become highly aroused Use minimal arousal conditioning Being highly aroused is reinforcing (Steve Jenson, personal communication 11/30/09)

  4. Two Components to Deviance • Sexual urge • Cognitions that support it (Steve Jenson, personal communication 11/30/09)

  5. Normal and Deviant Normal Deviant Some urges Intense & frequent Controlled by urges supported cognition by deviant cognitions

  6. Minimal Arousal Conditioning Aversive conditioning Minimizing victim contact Dealing with spontaneous arousal Cognitive restructuring Peer relationships

  7. Minimal Arousal Conditioning Punish at first signs of minimal arousal Do not wait Until full arousal

  8. Instructions “We would like you to write a two to three page description of one of the most exciting sexual encounters you had with your victim. The description should include: a) where you were, b) how you approached your victim, c) how you got your victim to cooperate, d) what you did sexually, e) how your victim responded, (what did they say or do) and f) how the sexual contact concluded.” (Jensen 2002, p. 2)

  9. 1) Aversive Conditioning At home Every day for 12 weeks Ammonia simplest Wide mouth jar Lid on Read scenario to point of first arousal (well before sexual behavior) Open jar – close enough for startle Repeat 20 times Every day 12 weeks

  10. If Working Dramatic reduction 2 weeks (Steve Jensen, personal communication, 11/30/09)

  11. 1) Covert Sensitization Two to three weeks after starting No irrational punishers Develop 10 to 20 punishers “My wife walks in . . . “ “I’m at work and the police come to arrest me. . .”

  12. Where and When Aversive Conditioning & Covert Sensitization In the morning Place that is private, comfortable Rate their arousal as they do it from 1-10

  13. “Write a two to three page description of any other deviant behavior or fantasies not previously represented.” Write a list of at least 10 consequences of your sexual behavior to your victim.” Write a list of at least 10 consequences of your sexual behavior to your victim and others.”

  14. “Write a list of at least 10 consequences to you if you were to reoffend.” “Write a list of all the reasons that you used to make it OK to sexual abuse your victim.” (Jensen, 2002, p. 2)

  15. Combining Techniques After arousal is controlled by aversive 10 repetitions of aversive Read 10 different consequences to the victim 10 repetitions of aversive Read 10 different consequences to self

  16. Time Line Takes 8 to 10 weeks to develop clear lists of faulty cognitions (risky thinking)

  17. 1) Covert Sensitization After 2 months make a decision – working or not? If not working, ammonia every other day and slowly reduce

  18. 1) Covert Sensitization If doesn’t work, use maintenance ammonia – 10 repetitions a month If fantasies more than once a month, go back to aversive

  19. Behavioral Principles: 2 Aversive conditioning = phobic response Being around victim ages will desensitize (Steve Jenson, personal communication 11/30/09)

  20. Behavioral Principles: 2 Do not permit nonaversive contact with victim ages Exit situations with victim ages Could not be in home with victims (Steve Jenson, personal communication 11/30/09)

  21. Behavioral Principles: 2 Nonaversive contact is re-enforcing Punishment or aversive conditioning Only works If consistent (Steve Jenson, personal communication 11/30/09)

  22. Behavioral Principle:2 Single arousal or deviant masturbation Can undo Months of work (Steve Jenson, personal communication 11/30/09)

  23. 2) Minimize Contact with Sources of Arousal • No going to places where victims congregate • Hanging around kids sports, etc. • Playing with victims • Living in home if victims there (Steve Jensen, personal communication, 11/30/09)

  24. 3) Dealing with Spontaneous Arousal Whenever begins to have inappropriate sexual thoughts Punish within 10 seconds – Ammonia wipes Remove from situation Before sexual arousal Report to support person Had this encounter Recognized it This is how I handled it

  25. 4) Cognitive Restructuring Not enough to look at consequences Above works for “dumb decision” Doesn’t work for deeply held beliefs

  26. What Does Work Deep relaxation (similar to hypnosis) – tapes Generate as many faulty cognitions as possible – may have 50 excuses Pick 10 to 20 Identify why they are faulty Write out appropriate responses

  27. Appropriate Responses 3 to 6 words Faulty Cognition: “Some children really enjoy sex with older kids.” Counter: “It’s hurtful for young kids to have sex with older kids.”

  28. 4) Cognitive Restructuring Add appropriate response to tape “There are some thoughts I want to change about myself.” Do not record faulty responses Every day play tapes – 3 to 4 months

  29. 4) Cognitive Restructuring Universal Cognitive Distortions “I won’t get caught.” “It really doesn’t do any harm.”

  30. Plethysmograph Used to monitor change or no change

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