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Comparative Analysis of Behavioral and Cognitive Behavior Therapy Theories

Explore the similarities and differences between Skinner's Radical Behaviorism, Bandura, Ellis, Beck, and Meichenbaum's approaches in counseling practice. Learn about central focuses, unique ideas, and major areas of emphasis.

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Comparative Analysis of Behavioral and Cognitive Behavior Therapy Theories

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  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

  10. Aversive Counter-Conditioning

  11. Exposure Techniques

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

  13. 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

  14. 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

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

  16. 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

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

  18. Modeling Vicarious Learning

  19. 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

  20. Cognitive-Behavior Techniques

  21. 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

  22. 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

  23. RET: The ABC Theory

  24. 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

  25. 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

  26. 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

  27. 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

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

  29. CT’s Cognitive Distortions

  30. CT’s Cognitive Distortions

  31. 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

  32. 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

  33. 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

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

  35. 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

  36. 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

  37. 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

  38. 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

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

  40. 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

  41. 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)

  42. 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

  43. 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

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

  45. 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

  46. 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

  47. 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

  48. 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

  49. 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)

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