Behavioral Therapy: Evolution and Techniques

1. Chapter 8 Behavioral Therapy

2. Behavioral Therapy • Formulated at the beginning of the 20th century. • Focused on how to reinforce, extinguish, or modify a broad range of behaviors. • In its infancy (1900’s-1930’s), behaviorism was concerned almost entirely with outward observations.

3. John B. Watson • The first major advocate of behaviorism. • Worked with a child named Little Albert to demonstrate that human emotions are amenable to being conditioned.

4. Behaviorism in the 1950’s-1960’s • B.F.Skinner (1953) – operant conditioning. • Joseph Wolpe (1958) – study of respondent (i.e., classical) conditioning. • Hans Eysenck (1960) – treatment of abnormal behavior. • Albert Bandura (1963) – effects of vicarious learning.

5. John Krumboltz (1966) • Credited as one of the major personalities to popularize behaviorism in counseling. • Drew upon Bandura’s earlier work and in doing so revolutionized the counseling profession.

6. Categories of Behaviorism By the 1980’s, behavioral approaches to therapy had split into 3 main categories: • Stimulus-response model • Applied behavior analysis • Social-cognitive theory

7. B. F. Skinner • Born in 1904 in Susquehanna, Pennsylvania • Wanting to be a writer, he moved to Greenwich Village to to live among writers where he discovered the works of Ivan Pavlov, John B. Watson, Bertrand Russell, and Francis Bacon. • Soon, he gave up his writings to become a psychologist. • Classified as a behavioral determinist

8. View of Human Nature/Personality • Assumes that all behavior is learned – whether adaptive or maladaptive. • Believes that learning can be effective in changing maladaptive behavior or acquiring new behavior. • Rejects the idea that the human personality is composed of traits.

9. Stimulus-Response Model • The application of classical conditioning – sometimes called respondent learning or the S-R Model. • Learning occurs through the association of two stimuli, also known as the conditioning of involuntary responses. • Similarly, many human emotions, such as phobias, arise from paired associations.

10. Counter-conditioning • After WWII, behaviorist researcher Mary Cover Jones demonstrated a process known as counter-conditioning that was shown to help people overcome phobic reactions. • Once these phobias are learned, new paired associations can be learned to take the place of the phobic reactions.

11. Applied Behavior Analysis • Focuses on how individuals operate in the environment. • A person is rewarded or punished for actions, thereby learning to discriminate between behaviors. • When a behavior is followed closely by a reinforcer, chances increase that the behavior will recur in similar circumstances. • The successor to operant conditioning, where a person must be involved as an active participant with the environment for learning to occur.

12. Social Cognitive Behavior • People acquire new knowledge and behavior by observing other people • without engaging in the behavior themselves. • without any direct consequences to themselves. • Depends on the theory that behavior is based on three separate but interacting regulatory systems: • External stimulus events • External reinforcement • Cognitive mediational processes • Learning may occur independently of reinforcement.

13. Roles of the Counselor/Therapist • Assist the client in learning new, appropriate ways of acting or to modify or eliminate excessive actions. • Active in counseling sessions and functions as a learning specialist for the client. • S-R or applied-oriented counselors are direct and prescriptive in offering assistance. • Social cognitive learning oriented counselors serve as models. • For diagnosis, they describe clients according to the behaviors they display.

14. Goals • Focus on changing, modifying, or eliminating behaviors. • Set up well-defined therapy goals with clients. • Focus on acquiring healthy, constructive ways of acting.

15. 4 Steps to Mutually Agreed on Goals(Blackham & Silberman, 1979) • Define the problem. • Take a developmental history. • Establish specific goals. • Determine the best methods for change.

16. Process and Techniques • Behavioral therapy is a process. • Concentrate on the “here and now” as opposed to the “there and then” of behavior. • Behavioral techniques stress the importance of obtaining empirical evidence and scientific support for any technique they use.

17. General Behavioral Techniques • Use of Reinforcers • Schedules of Reinforcement • Shaping • Generalization • Maintenance • Extinction • Punishment

18. Use of Reinforcers • Events that, when they follow a behavior, increase the probability of the behavior’s recurring. • May be either positive or negative. • Positive – considered pleasurable . • Negative – removal of an aversive stimulus. • There are no universal positive reinforcers.

19. Schedules of Reinforcement • Continuous reinforcement – reinforcement every time the behavior occurs. • Best reinforcement schedule for when a behavior is first being learned. • Intermittent reinforcement – reinforcement on an intermittent or inconsistent basis. • Schedules of reinforcement operate according to either the number of responses (ratio) or the length of time (interval) between reinforcers. • Both ratio and interval schedules are either fixed or variable.

20. Shaping • Behavior learned gradually in steps through successive approximation. • May break down behavior into manageable units.

21. Generalization • The display of behaviors in environments outside where they were originally learned. • Indicates that transference into another setting has occurred.

22. Maintenance • Being consistent in doing the actions desired without depending on anyone else for support. • Accomplished through: • Self-observation • Self-recording • Self-monitoring increases client awareness of behavior.

23. Extinction and Punishment • Extinction - The elimination of a behavior because of a withdrawal of its reinforcement. • Punishment – presenting an aversive stimulus to a situation to suppress or eliminate a behavior. • Usually behaviorists do not use punishment.

24. Specific Behavioral Techniques • Behavioral Rehearsal • Environmental Planning • Systematic Desensitization • Assertiveness Training • Contingency Contracts • Implosive Therapy • Flooding • Aversive Techniques • Covert Sensitization

25. Behavioral Rehearsal • Practicing a desired behavior until it is performed the way a client wishes. • Process consists of gradually shaping a behavior and getting corrective feedback. • Sometimes called role-playing because the client is practicing a new role.

26. Environmental Planning • Setting up part of the environment to promote or limit certain behaviors. • Ex. planning a daily schedule to avoid a specific setting and avoid painful memories of a certain place.

27. Systematic Desensitization • Designed to help clients overcome anxiety in particular situations. • Reciprocal inhibition – a phenomenon based on the idea that people cannot feel anxious and relaxed at the same time.

28. Assertiveness Training • A person should feel free to express thoughts and feelings appropriately without feeling undue anxiety. • Counterconditioning anxiety and reinforcing assertiveness.

29. Contingency Contracts • Contingency contracts spell out the following: • The behaviors to be performed, changed, or discontinued. • Rewards associated with achievement of these goals. • Conditions under which rewards are to be received.

30. Implosive Therapy • Desensitizing clients to a situation by having them imagine an anxiety-producing situation that may have dire consequences. • Clients are not taught to relax first. • Should not be used by beginning counselors or with clients who have heart conditions.

31. Flooding • The imagined anxiety-producing scene does not have dire consequences. • Instead, clients are just overwhelmed with images of these anxiety-producing stimuli.

32. Aversive Techniques • Useful when one behavior must be eliminated before another can be taught. • Time-out • Over-correction

33. Covert Sensitization • Undesired behavior is eliminated by associating it with unpleasantness. • Used with clients who have problems with smoking, obesity, substance abuse, and sexual deviation.

34. Aversive Stimuli and Effectiveness • In the long run, aversive stimuli are usually not effective by themselves for three reasons: • Their negative emotional effects soon disappear. • They may interfere with the learning of desired behaviors. • They may encourage the client to try to escape, which when successful, becomes a positive reinforcer. • Furthermore, ethical and legal concerns are associated with aversive techniques.

35. Multicultural and Gender Sensitive Issues • Positive: • May help clients be more specific about what they want to do within their subculture and larger cultural groups. • Negative: • Counselors must become even more attuned to culture-specific behaviors and how to address them appropriately. • Terms and techniques are free of reference to gender.

36. Strengths and Contributions • Works well with clients who are predominantly goal- and action-oriented with a need for achievement and results. • Good with clients who are interested in changing either a discrete response or a limited number of behaviors. • Deals directly with symptoms. • Appropriate for a number of disorders. • Focuses on the here and now. • Variety of techniques available. • Based on learning theory. • Supported by exceptional research. • Popular in institutional settings.

37. Limitations and Criticisms • Does not deal well with the total person, just explicit behavior(s). • Sometimes applied mechanically. • Best demonstrated under controlled conditions that are difficult to replicate. • Techniques may be ahead of the theory. • Ignores clients’ past histories and unconscious forces. • Does not consider developmental stages.

38. Critics of Behavior Therapy • Critics charge that behaviorists: • Program clients toward minimum or tolerable levels of behaving. • Reinforce conformity. • Stifle creativity. • Ignore client needs for self-fulfillment, self-actualization, and feelings of self-worth.

39. The Case of Linda: Behavioral Therapy • How would you conceptualize this case using behavioral therapy? • What would be your treatment plan for this client using a behavioral approach?