Skinner: Radical Behaviorism Bandura, Ellis, Beck Meicheanbaum

1. Behavior and Cognitive Behavior Therapy Skinner: Radical Behaviorism Bandura, Ellis, Beck Meicheanbaum

2. Compare -- Contrast Humanistic Theories Person Centered-Existential-Gestalt • Common Themes • List ways in which the three approaches are similar • Distinct aspects each approach emphasizes • Central focus of each approach • Unique ideas, constructs, and/or techniques each brought to counseling practice

3. Areas of Major Emphasis • Psychoanalytic/Psychodynamic • Basic drives and the contribution of early emotional experiences to the person’s presenting concern • Humanistic • The therapeutic process -- the relationship-- and emotional states in the here and now • Behavioral • observable behaviors & learning principles; congnitions

4. Skinner: Radical Behaviorism • Placed primary emphasis on the role of the environment in producing behavior • Applied learning principlesto psychology • Experimental psychologist: examined learning principles with rats in the laboratory • Books • 1948 Walden Two • 1953 Science and Human Behavior • 1971 Beyond Freedom and Dignity

5. Behavior/Cognitive Behavior Theory • Classical Conditioning • Operant Conditioning • Social Learning Approach • Cognitive Behavior Therapy

6. Classical Conditioning • If you pair a conditioned stimulus to a natural stimulus, after time, the conditioned stimulus produces the same response as the natural one: Learning by association Pavlov discovery (1900) • Meat (us) >> Salivation (ur) • Bell (cs)>>Meat (us) >>Salivation (ur) • Bell (cs) >> Salivation (cr) • Bell (cs) >> Extinguished response

7. Wolpe: 1950 • Applied classical conditioning to treat anxiety by pairing stimuli that cause anxiety(taking an exam) with a state of relaxation, to break the connection between the stimulus and the anxious response Exam (us)>>>Anxiety (ur) Relaxation> Images Exam>Anxiety>Relaxation (cs) (us) (ur) (cr) Images Exam (us) >>> Relaxation(cr) Exam (us) >>> Relaxation(cr)

8. Behavior Therapy: Learning by Association: Exposure Techniques • Systematic Desensitization - anxiety • Relaxation training/ Anxiety hierarchy • Pairing (+) stimulus with (–) stimulus (shot-lollipop) • Aversive Counter Conditioning • Exposure Techniques • In vivo desensitization • Flooding (in vivo, imaginary)

9. Anxiety: Facilitating and Debilitating

11. Aversive Counter-Conditioning

12. Exposure Techniques

13. Operant Conditioning • Behavior is controlled by its consequences • Desired Consequences – Increase Behavior • Reinforcement • No consequences - Decrease Beh. • Not-desired consequences - Decrease Beh. • Punishment

14. Environmental Consequences • ReinforcementIncrease a behavior • Positive R Adds a pleasant consequence • Negative R Takes away an aversive stimulus • PunishmentExtinguisha behavior • Positive P: Add an aversive consequence • Negative P: Takes away a desired stimulus • Lack of consequence - Extinguish behavior

15. Applied Behavioral Analysis: Functional Assessment Model • Examine the antecedents and consequences of problem behaviors • Conduct a functional assessment using interviews and direct observations (e.g. keeping a diary) to identify • Antecedents:conditions that contribute to the behavior of interest • Consequences: what happens after specific behavior occurs • Behavioral treatments are devised to replace problem behaviors with more adaptive behaviors using reinforcement and extinction strategies

16. Behavior Modification Program • Reinforcement Token economy • Extinction Time out, loose privileges, punishment • Stimulus control Change environmental antecedents of problem behaviors

17. Cognitive Behavior Therapy • Emphasizes cognitive processes and self-talk as mediators of behavior change • Reciprocal Determinism Bandura • Rational Emotive Therapy Ellis • Cognitive Therapy Beck • Cognitive Behavior Modification Meichenbaum

18. Bandura: Social Learning Approach • Psychological functions involve a reciprocal interaction between: Environment<><><>Behavior <> <> <> <> <> Cognitive Process<>

19. Modeling Vicarious Learning

20. Cognitive-Behavior Techniques • Assertiveness Training • Provide Information • Examine beliefs and self-talk • Role play assertive behaviors • Modeling – therapist demonstrates behavior • Behavioral rehearsal – client demonstrates behavior

21. Cognitive-Behavior Techniques

22. Cognitive Behavior Theory • Mental disorder- problem with thinking in which a client distorts reality, including: • Specific misconceptions • Unrealistic expectations • Maladaptive attributions • Therapy’ aim is to identify and change • Faulty patterns of thinking • Faulty premises and attitudes • Distressing emotions result from maladaptive thinking

23. Rational Emotive Behavior Therapy: (REBT) Albert Ellis • Stresses thinking,judging, deciding, analyzing, and doing • Assumesthat cognitions, emotions, and behaviors affect ach other • Is highly didactic,directive, • Emotions stem mainly from our beliefs,evaluations and interpretations

24. RET: The ABC Theory

25. RET: Therapy Process • Therapy is seen as an educational process • Clients learn: • To identify and dispute irrational beliefs • To replace ineffective ways of thinking with effective and rational cognitions • To stop absolutistic thinking, blaming, and repeating false beliefs

26. RET: Therapy Process • Rational Emotive Imagery • Imagine being in the worst situation- train to change irrational thoughts/feelings for retional ones • Homework • REBT Self-Help Form • Act as if… to challenge self-limiting • Biblio-therapy – Psycho-education

27. Aaron Beck’s CT: Human Nature • Cognitive structures or schemas • We all have implicit assumptions or premises that influence what we attend to and how we interpret events • Confirmatory bias • We tend to electively attend to events that confirm our beliefs • Schemas and Disorders • Anxiety Threat and Danger • Depression Social rejection and failure

28. Cognitive Therapy (CT) • Insight-focused therapy • Emphasizes changing negative thoughtsand maladaptive beliefs • Theoretical Assumptions • People’s internal communication is accessible to introspection • Clients’ beliefs have highly personal meanings • These meanings can be discovered by the client rather than taught by the therapist

29. CT’s Cognitive Distortions • Arbitrary inferences • Selective abstraction • Overgeneralization • Magnification and minimization • Personalization • Labeling and mislabeling • Polarized thinking

30. CT’s Cognitive Distortions

31. CT’s Cognitive Distortions

32. Therapy Process • Teachclients to recognize, observe and monitor negative "automatic" thoughts & • Subject their automatic thoughts to reality testing: examine evidence for and against them • Clients learn to substitute realistic and accurate interpretations for biased cognitions • Process is collaborative an interactive: Socratic dialogue

33. Beck’s Approach to Depression: Cognitive Triad • Have a negative view of themselves; attribute setbacks to themselves w/o looking at the environment • Tend to interpret experiences in a negative manner. • Screen out positive experiences not consistent with negative view of themselves (selective abstraction) • Gloomy vision and projections about the future

34. Ellis Vs. Beck • Ellis is more directional and confrontational in pointing out and refuting irrational thoughts • Beck helps clients discover their distorted patterns of thinking • Collaborative empiricism • Guided discovery • client and therapist examine and evaluate beliefs and modify and correct client’s misconceptions

35. Contributions Beh- Cog Beh • Focus on short-term behavioral goals • Emphasis on evaluation of therapy outcome • Empirical evidence of positive results

36. Limitations • May lead to symptom substitution • Too much therapist power and control • Lack of attention to relationship issues • No processing of emotions and feelings • Focus only on cognitive issues

37. Meichenbaum: Cognitive Behavior Modification • Is primarily a self-instructional therapy that • Focuses on helping clients become aware of their self-talk, - cognitive restructuring - and • acquire practical coping skills to deal with problems and behaviors • Process of Change • Self observation • Start a new internal dialogue • Learn new behaviors

38. Phase 1: Self-Observation • Observe thoughts, feelings, actions, • Realize how client contributes to own problems • Leads to new cognitive structures – see problems in a new light

39. Phase 2: Start New Internal Dialogue • Identify maladaptive behaviors • Recognize more adaptive options • Develop adaptive internal dialogue to guide behaviors • New behaviors impact cognitive structures

40. Phase 3: New Skills • Teaches more effective coping skills • Practice in real- life situations • Continue monitoring/changing internal dialogue • Observe behaviors • Assess outcomes

41. Coping Skills Program:Stress Inoculation • Stress management techniques for present and future problems • Three phases: • Conceptual phase • Skills acquisition and rehearsal • Application and follow-through

42. Conceptual Phase • Collaborative relationship (Rogers) • Didactic presentation of the role cognitions and emotions play in stress (Ellis) • Guided discovery to identify own self-talk and how it creates stress (Beck) • Systematic observation and monitoring of maladaptive behaviors and their related self-talk (Behavioral) • New cognitive structures = see problems in a new light (Beck)

43. Skills Acquisition and Rehearsal • Give clients behavioral and cognitive coping techniques to apply to stressful situations • Rehearse new self-statements • Relaxation training • Social skills training • Time management instruction • Making changes in everyday life

44. Application and Follow-Through • Arrange for transfer and maintenance of change from therapy to the real world • Homework assignments of increasing complexity • Results of assignments are carefully evaluated • Follow-up and booster sessions are scheduled in 3-, 6-, and 12 months intervals

45. Contributions • Focus on short-term behavioral goals • Emphasis on evaluation of therapy outcome • Empirical evidence of positive results

46. Limitations • May lead to symptom substitution • Too much therapist power and control • Lack of attention to relationship issues • No processing of emotions and feelings • Focus only on cognitive issues

47. Multimodal Therapy: Lazarus • Holistic approach to behavior modification • Technical eclecticism • Human experience • interplay of genetics, environment and social learning • can be accounted by examining the BASIC ID

48. BASIC ID • Framework for assessment and therapy • B – behavior • A – affective processes • S – sensation- five senses • I – imagery • C – cognition • I – interpersonal relations • D – physiological aspects - health

49. Therapy Process • Therapy is guided by what is best for the client • Starts with a thorough assessment of the BASIC ID profile • BASIC ID determines the tone or quality of the person’s functioning • Therapist functions as trainer, educators, consultant, role model • Emphasize skill learning

50. New Applications and Integrations (end of Behavior Chapter #9) • Mindfulness and Acceptance- Based Cognitive Therapies: Emotional Regulation • Dialectical – Behavior Therapy (DBT) • Combines CBT and Psychodynamic • Highly structured- requires training - Borderline PD • Minimum 1-year of frequent outpatient treatment • Mindfulness-Based Stress Reduction (MBSR) • Mindfulness-Based Cognitive Therapy (MBCT) • Acceptance and Commitment Therapy (ACT)