Behavior Therapy

1. Behavior Therapy

2. The History • Rooted in Experimental Psychology • Based on Pavlovian concept of Classical Conditioning & Skinnerian Operant Conditioning • Working only on observable events to work with unobservable events

3. The Experiments • Classical Conditioning • I.P.Pavlov – Experiments on a Dog • John B. Watson – Albert & White Rat • Mowrer & Mowrer –Treatment for Bedwetting • Operant Conditioning • E.L.Thorndike – “law of effect” (consequences that follow behavior help learning) • B.F.Skinner – experiment on Pigeon • Social Cognitive Theory • A. Bandura: • - triadic reciprocal: the environment, the person, the behavioral action • Individual learns by observing others • Self-efficacy • Self-awareness, self-inducements, self-reinforcement

4. The Theory of Personality • Positive Reinforcement: a positive event presented as a consequence of a person’s performing a behavior • Extinction: withdrawn reinforcer terminates behavior • Generalization: the reinforced behavior is learned for other situations • Discrimination: ability to respond differently depending upon the stimulus condition • Shaping: reinforcing behavior approximation from the original to the desired behavior

5. The Theory of Observational Learning • Attentional Processes – seeing is not enough; one must perceive accurately by attending at varying degrees • Retention Processes – imaginal & verbal coding (self-talk) describe subvocal events for remembering • Motor Reproduction Process – translating observed phenomena into action • Motivational Process – The modeled behavior that puts into action will continue if being reinforced • Self-Efficacy – individual perception of self-ability to perform in different types of situation; the major source of this includes: • Performance accomplishment: successes are likely to create high expectations • Vicarious Expectations: expecting able to do similar as the observed model • Verbal Persuasion: impact of encouragement/ praise from others • Emotional Arousal

6. The Goals of Behavior Therapy • Changing The Target Behavior • Perform Functional Analysis • Define clearly & accurately the target behavior • Identify possible actions • Collaborate with clients on target behavior preference • Evaluate/ assess behavior, antecedents &consequence • Identify causes & reasons • Choose interventions • Select Appropriate Goals • Identify specific goals • Let clients explore the advantage/ disadvantage • Measure achievement

7. The Assessment • Behavioral Interviews: • What, When, Where, How, How Often • Behavioral Reports & Ratings: • Rating scale on behavior inventory • Behavioral Observations: • Frequency of performed target behavior • Diaries indicating date, time place, & activity of the behavior • Naturalistic Observation to eliminate Reactivity • Physiological Measurements: • Blood pressure, Heart rate, Respiratory functioning, Skin electrical conductivity

8. The Treatment • Systematic Desensitization (Joseph Wolpe) • Imaginal Flooding • Contrast to Gradual Systematic Desensitization, this technique is conducted by exposing the client to a frightening or anxiety provoking images • The mental images are indicated in SUD (subjective unit of discomfort) • Familiar condition conducted by imagining will reduce anxiety • Relaxation procedure may includes prior, during & after therapy • A specific form of this therapy: Implosive Therapy (by Thomas Stampfl) • In Vivo • Procedure is conducted in actual environment • 2 types: one similar to SD, another similar to IF • Relaxation is conducted whenever client is in a stressful / at tensed • Modeling (Bandura) • Self Instructional: Cognitive Behavioral (Meichenbaum)

9. Systematic Desensitization • Relaxation • Twice a day 10-15 minutes Relaxation (by Jacobson, 1938) • Clients learn to control muscles into relaxing condition • Relaxed state is paired with imagined anxious situation • Anxiety Hierarchies • Obtain information on specific situation producing anxiety • List the situations in order on scale 0-100 (SUD = subj units of discomfort • Determine the prioritized condition to treat • Desensitization • Ask clients about the SUD level • Presenting neutral scene • Check how vivid the client can imagine/ visualize • Rise the SUD level with more intense scene – recheck the response, conduct relaxation • continues

10. Modeling Technique (Albert Bandura) • 5 Basic Functions of Modeling: • TEACHINGthrough demonstration – sometimes therapist perform the behavior repetitiously; the clients observe the model then perform the behavior several times until achieving the expected stage • PROMPTthrough imitation – the therapist prompt the client to imitate the movement such as in sport intruction • MOTIVATEby reinforcement – thus the client perceives the enjoyment of behaving in a certain way • REDUCE ANXIETY by reinforcement – such as instructing a child to swim, when the model is in the pool, the child feel anxious knowing all right being in the pool • DISCOURAGING – watching a film on the impact of smoking onm lung cancer discourage smokers to continue smoking

11. Modeling Technique • Live Modeling: • Watch live model (sometimes the Therapist) to perform the expected behavior • The model repeats the behavior several times • Symbolic Modeling: • When live model is not present • By film/ book including read story/ story telling • Indirect modeling • Role Playing: • Learn to interact in different situations/ posititions – sometimes the therapist role play the client/ someone’s in client’s life • Participant Modeling: • Therapist model the client’s behavior • Therapist guide the client to behave as expected by participating – meanwhile get ready to give help when needed such as in mountain climbing • Covert Modeling: • Visualizing the model, visualizing the consequences • The therapist describes the situation, and let the client consider the impact of the behavior

12. Self Instructional Training (Meichenbaum) A way for people to teach themselves how to deal effectively with situations that had previously caused difficulties – the therapist models the appropriate behavior, the clients models the therapist’s behavior & repeats / practice • A form of self-management • A way people teach themselves to deal with previously difficult situations • First the client models the behavior • Second the client practices the behavior • Third the client repeats the instructions to self • Sometimes use role play • Sometimes use taped instructions

13. Stress Inoculation (Meichenbaum) • The principle • Changing the beliefs and negative inner dialogue to positive & rehearsing the behavior • The conceptual phase • Gathering the information & see how client develop the inner dialogue • Educate the client by pointing out the cognitive & emotional responses • Skill Acquisition: Use cognitive behavioral skills: • relaxation • cognitive restructuring • “I’m afraid & can’t do anything” >> “When I am afraid I pause and feel can not do things” • problem solving skills • “I will change the situation”, “ I make the plan”, “I can walk with others” • self-reinforcement • “I do better”, “ I feel comfortable” • Application • Visualize • Mentally rehearse • Action