Chapter 14 Behavioral Psychotherapy - PowerPoint Presentation

1. Chapter 14Behavioral Psychotherapy

2. Behavioral PsychotherapyBehavioral therapy represents a reaction against the lack of empiricism inherent in psychodynamic and humanistic approaches A reaction against mental processes that can’t be precisely defined, directly observed, or scientifically tested

3. Origins of Behavioral PsychotherapyThe clinical application of behavioral principlesRoots of behaviorism includeIvan Pavlov’s classical conditioning studies with dogs in Russia John Watson’s efforts to bring classical conditioning to U. S.B. F. Skinner’s and E. L. Thorndike’s studies of operant conditioning

4. Goal of Behavioral PsychotherapyThe primary goal of behavioral psychotherapy is observable behavior change No emphasis on internal, mental processesIn contrast to previous approaches (e.g., psychodynamic and humanistic)

5. Goal of Behavioral Psychotherapy (cont.)Emphasis on empiricismStudy of human behavior should be scientificClinical methods should be scientifically evaluated via testable hypotheses and empirical data based on observable variablesFor example, baseline measures of problem behavior at outset; subsequent measures after some therapy

6. Goals of Behavioral Psychotherapy (cont.)Steps of the Scientific MethodHow Applied by Behavioral Therapists1. Observing a phenomenonAssessing client behavior via observation, interview, or testingDefining a target behaviorEstablishing a baseline level of target behavior2. Developing hypotheses to explain the phenomenonFunctional analysis of target behavior to determine the factors that cause or influence itEstablishing specific behavioral goals for treatmentPlanning interventions to alter behavior in preferred manner3. Testing the hypotheses through experimentationImplement interventions as planned4. Observing the outcome of the testsCollect data on changes in the target behaviorCompare data collected during or after treatment to baseline dataCompare data to goals5. Revising the hypothesesModify treatment plan as suggested by observed outcomesRestart scientific process with revised hypotheses

7. Goal of Behavioral Psychotherapy (cont.)Defining problems behaviorallyClient behaviors are not symptoms of some underlying problem—those behaviors are the problem Behavioral definitions make it easy to identify target behaviors and measure changes in therapy Clients’ own definitions can be very hard to assess or measure

8. Goal of Behavioral Psychotherapy (cont.)Measuring change observablyOther kinds of therapists may measure change in clients in more inferential ways, but behavioral therapists use more unambiguous indications of progress Introspection is not an acceptable way to measure progress—not directly observable

9. Two Types of Conditioning Classical conditioningExemplified by Pavlov’s dog studiesUCS evokes UCRUCS and CS are paired (occur together)CS evokes CRCR is essentially the same as UCR, but in response to CSGeneralization or discrimination to similar stimuli may take place

10. Two Types of Conditioning (cont.)Operant conditioningThe organism “operates” on the environment, notices the consequences of the behavior, and incorporates those consequences into decisions regarding future behavior More active style of learning than classical conditioningContingencies, or internal “if…then…” statements, are the product of operant conditioning

11. Techniques Based on Classical ConditioningExposure therapySystematic desensitizationAssertiveness training

12. Techniques Based on Classical Conditioning (cont.)Exposure therapyVersion of “facing your fears” Often used to treat anxiety disordersClient is repeatedly “exposed” to the feared object and the expected aversive outcome does not take place  client no longer experiences the fear response

13. Techniques Based on Classical Conditioning (cont.)Exposure therapy (cont.)Exposure is typically gradual (“graded” exposure), following an anxiety hierarchyExposures can be imaginal or in vivo (real)

14. Techniques Based on Classical Conditioning (cont.)Exposure therapy (cont.)Exposure-plus-response-prevention is a particular form of exposure with empirical evidence in the treatment of OCDAnxiety hierarchyStimulusSubjective Distress (0 = No Fear; 100 = Maximum Fear)Hearing a dog bark in another room 5Standing within 20 feet of a dog on a leash25Standing within 5 feet of a dog on a leash45Petting a dog for 1 second65Petting a dog continuously for 10 seconds75Petting a dog continuously for 3 minutes95

15. Techniques Based on Classical Conditioning (cont.)Systematic desensitizationOften used for phobias and other anxiety disordersSimilar to exposure therapy, but relaxation training is includedRelaxation is incompatible with anxietyCounterconditioning occurs when relaxation response replaces anxiety response

16. Techniques Based on Classical Conditioning (cont.)Assertiveness trainingA specific application of classical conditioning that targets clients’ social anxieties Benefits people whose timidity negatively influences their livesIncludes elements of exposure and systematic desensitizationFacing interpersonal fearsIncludes direct instructions, modeling, rehearsal, and homework

17. Techniques Based on Operant ConditioningContingency managementExtinctionToken economiesShapingBehavioral activationObservational learning (or modeling)

18. Techniques Based on Operant Conditioning (cont.)Contingency managementPowerful way to change behavior  change the contingencies controlling itIf consequences change, behavior changesReinforcement and punishment should be identified and altered as neededReinforcement is typically preferred over punishmentAversion therapy is one type based on punishment of unwanted behavior

19. Techniques Based on Operant Conditioning (cont.)ExtinctionRemoval of an expected reinforcement that results in decreased frequency of a behavior Effective way to decrease unwanted behaviorsInitially, can cause extinction burst (an increase in unwanted behavior), but ultimately, if reinforcement is still withheld, decrease will occur

20. Techniques Based on Operant Conditioning (cont.)Token economiesSetting in which clients earn tokens for participating in predetermined target behaviors Tokens can be traded for reinforcementsMost feasible in sites where behavior is continuously monitorede.g., Inpatient unit, correctional facility

21. Techniques Based on Operant Conditioning (cont.)ShapingReinforcing successive approximations of the target behavior Reward each “baby step” toward the desired behaviorBest for changing behaviors that are complex, challenging, or novel for client

22. Techniques Based on Operant Conditioning (cont.)Behavioral activation Based on simple idea that depressed people lack positive reinforcementGoal is to increase frequency of positively reinforcing behaviorsStructured daily routine including rewarding behaviors (recalled from non-depressed time)May have classical conditioning components too

23. Techniques Based on Operant Conditioning (cont.)Observational learning (or modeling)Learning from the contingencies applied to other peopleClient observes demonstration of desired behavior and its consequences  client given chances to imitate it Both imitation and vicarious learning can occurCertain qualities of the model influence effectiveness of observational learningFor example, similarity to client increases learning

24. Alternatives to Behavior TherapyBehavioral consultationIndirect way for a behavior therapist to modify a client’s behavior Three parties involved: the client, the consultee, and the consultant (therapist) Consultee spends significant time in natural setting with cliente.g., Parent, caretaker, manager

25. Alternatives to Behavior Therapy (cont.)Parent trainingSpecific form of behavioral consultationParents seek help with problematic behaviors of their children Teacher trainingSpecific form of behavioral consultationTeachers seek help with problematic behaviors of their students

26. How Well Does Behavioral Therapy Work?Behavioral therapies have a significant amount of empirical support, especially in comparison to most other forms of therapyEspecially for anxiety disorders, depression, and children’s behavior disordersMay also be most empirically testable forms of therapy