UNIT 3: CONTINGENCY MANAGEMENT

1.BEHAVIORAL MODIFICATION TECHNIQUES

Behavioural modification is a psychotherapeutic intervention primarily used to eliminate or

reduce maladaptive behaviour in children or adults.
It is a technique that focuses on changing behaviours through self-control techniques, shaping,
chaining, flooding, systematic desensitisation, aversion, extinction, fading.
Behavioural modification is a type of operant conditioning.

1. Self-control techniques.

- Self-control techniques are strategies individuals use to manage their impulses, emotions, and
behaviors, enabling them to make more thoughtful and deliberate choices in various situations.
- Self-control is also known as self-monitoring.
- Different self control techniques are :

A. Cognitive restructuring
Cognitive restructuring refers to the process of identifying and challenging negative
thought patterns or irrational beliefs, aiming to replace them with more balanced and
constructive thinking for improved emotional well-being.

B. Mindfulness
Mindfulness involves maintaining a moment-by-moment awareness of thoughts,
feelings, bodily sensations, and the surrounding environment without judgment. It's often
cultivated through meditation and can enhance overall well-being. Mindfulness is the
core feature of self control.

C. Meditation
Meditation is a practice that involves focusing the mind and eliminating distractions to
promote relaxation, heightened awareness, and a sense of inner peace. It often includes
techniques like mindfulness and controlled breathing.

D. Self talk
Self-talk refers to the internal dialogue or thoughts that individuals have with themselves.
It can be positive, negative, or neutral, influencing emotions and behavior. Positive self-
 talk involves constructive and affirming thoughts, while negative self-talk can be self-
critical or pessimistic.

E. Time management
: In the realm of self-control, effective time management involves prioritizing tasks,
setting realistic goals, and allocating time wisely to avoid procrastination. It helps in
maintaining focus, reducing stress, and fostering a sense of accomplishment.

2. Shaping

- Shaping is a technique in behaviour modification where behaviours are gradually shaped

through reinforcement. It involves rewarding successive approximations of the desired behaviour
until the target behaviour is achieved.

3. Chaining

- Chaining is another technique in behaviour modification where a sequence of behaviours is

taught by breaking it down into smaller steps. Each step is reinforced until the entire chain of
behaviours is learned.

4. Flooding

- Flooding is a technique where a person is exposed to a feared or anxiety-provoking situation in

a controlled and safe manner until the fear response diminishes.
- The goal is to extinguish the fear response by preventing the usual avoidance behavior,
ultimately leading to a reduction in anxiety over time.

5. Systematic Desensitisation

- Systematic desensitization is a technique in behavioural modification where a person gradually

exposes themselves to feared situations while practicing relaxation techniques. It helps reduce
anxiety and build tolerance over time.
- In SD, the first procedure is making a hierarchy of different levels of fear from 0-100.

6. Aversion

- Aversion is a technique in behavioural modification where an undesirable behaviour is paired

with a negative stimulus to decrease its occurrence.
 7. Extinction

- In behavioral modification, extinction refers to the gradual weakening and eventual elimination
of a learned behavior.
- This occurs when a previously reinforced behavior no longer results in the expected reward or
consequence, leading to a decline in the frequency of that behavior over time.

8. Fading

- Fading is a technique where gradual changes are made to a stimulus or cue to help transition to
a new behaviour or response.
- The goal is to shift from external support to independent performance, allowing individuals to
acquire and maintain new behaviors with decreasing levels of guidance.

2.RELAXATION TECHNIQUES

Relaxation procedures are the process that decreases the stress effects on an
individual’s mind and body. Relaxation techniques can help a person to cope up with
everyday stress, and these techniques can help with long term stress or stress related
to various health problems.

1.Guided Imagery:
Guided imagery is a technique where you use your imagination to create a calming
and positive mental image. It can involve visualizing a peaceful place, imagining
yourself achieving a goal, or picturing yourself overcoming a challenge.

Goals of Guided imagery:

The goals of guided imagery can vary depending on the individual and their
specific needs. Common goals include:
 • Reducing stress and anxiety
• Managing pain
• Improving focus and concentration
• Enhancing performance in sports or other activities
• Promoting relaxation and overall well-being and
• Supporting the healing process.

Advantages:

• It is cost-effective
• Non-invasive technique that can be easily learned and practiced.
• Used in various settings, such as healthcare, sports, and personal development.
• Also flexible and adaptable to individual needs and preferences.
• It can help reduce stress, manage pain, improve focus, and enhance overall well-
being.
Disadvantages:

• Guided imagery may not be suitable for everyone.

• Difficulty in visualizing
• Distractions that can hinder the effectiveness
• The possibility of triggering negative emotions or memories.

2.Jacobson’s Progressive Muscle Relaxation Technique:

Jacobson’s relaxation technique is a type of therapy that focuses on tightening

and relaxing specific muscle groups in sequence. It’s also known as progressive
relaxation therapy. By concentrating on specific areas and tensing and then relaxing
them, you can become more aware of your body and physical sensations.
Dr. Edmund Jacobson invented the technique in the 1920s as a way to help his
patients deal with anxiety.

Goals of JPMR:

The goals of JPMR are to help individuals reduce muscle tension and promote
relaxation. It is a technique where a person systematically tense and then relax muscle
groups in body. JPMR aims to increase body awareness, reduce physical symptoms
and promote overall relaxation
.
Advantages:

Practicing relaxation techniques can have a variety of health benefits, such as:
• Relieving anxiety
• Reducing work-related stress
• Lowering your blood pressure
• Reducing the likelihood of seizures
• Improving your sleep

Disadvantages:

• Doesn’t Relieve Stress All Together:

While PMR does help relieve muscle tension caused by stress, it does not help
relieve mental or emotional symptoms of stress. Even after relieving the physical
symptoms, the mental and emotional signs of stress may remain.

• Can Worsen Depression & Anxiety:

In people with high severity of depression and anxiety, PMR may just worsen the
symptoms instead of relieving them. Deliberately tensing muscles may make
their physical symptoms worse.

• Doesn’t Reduce Cortisol Levels:

Progressive muscle relaxation may help balance serotonin levels but it does not
help in reducing cortisol, the stress hormone. When cortisol levels are high, it can
lead to an array of health problems. Physical exercises can help reduce cortisol
but PMR is not a physical exercise, so it might not help with regulating the
cortisol levels

3.AVERSION THERAPY

• Reduce or avoid undesirable behavior pattern by conditioning the person to associate

the behavior with an undesirable stimulus
• Mostly used in treatment of addictive behaviors
• It works on the principal of classical conditioning
• Stimulus : electrical , chemical or imagined aversive situations
• Electrical :
painful shock given when undesirable behavior occurs .
Eg : used in treatment of sexual deviation (unethical)
• Chemical :
unpleasant drugs are given which caused chemically induced nausea when the
person drinks alcohol.
Eg : Used in alcohol dependency syndrome and substance abuse
• Imagined aversive situations :
Joseph Cautela (covert conditioning) images of undesirable are paired with images of
aversive stimuli (negative imagery; sometimes through visualization)
Eg : disturbed images, videos of smoking and its effect on body

Uses of aversion therapy:

• Bad habits

• Addictions

• Alcoholism

• Smoking

• Gambling

• Violence or anger issues

Other treatment uses :

• Eating disorders
• Oral habits , such as nail-biting
• Self injurious and aggressive behavior
• Certain inappropriate sexual behaviors ,such as voyeuristicdisorder

How effective it is :
• Aversion therapy can be controversial so it isn’t often a first line treatment rather
other therapies are preferred

• Recent research found that participants who craved alcohol prior to the therapy
reported avoiding alcohol 30 and 90 days after treatment.

• Yet, research is still mixed on the effectiveness of aversion therapy. While many
studies have shown promising short-term results, the long-term effectiveness is
questionable.
• In some of the most comprehensive research on aversion therapy in the 1950s,
researchers noted a decline in abstinence over time. After 1 year, 60 percent
 remained alcohol-free, but it was only 51 percent after 2 years, 38 percent after 5
years, and 23 percent after 10 years or more.

It’s believed that the lack of long-term benefit occurs because most aversion therapy
happens in-office. When you’re away from the office, the aversion is harder to
maintain.

Criticisms and controversies

Some experts believe that using negative stimulus in aversion therapy is equal to
using punishment as a form of therapy, which is unethical.

Aversion therapy may be helpful for stopping specific types of unwanted behaviors or
habits. Yet, experts believe that even if used, it shouldn’t be used alone.

It may not address the underlying causes of problematic behaviors.

It can lead to psychological distress and trauma.
Its effectiveness is debated, with some studies showing limited long-term success.

4.SELF CONTROL PROCEDURES :

the ability to regulate and alter your responses to avoid undesirable behavior, increase desirable
ones, and achieve long-term goals

Self-control techniques are strategies individuals can use to manage their impulses, emotions,
and behaviors effectively. Developing self-control is valuable for achieving personal goals,
making rational decisions, and maintaining emotional well-being.

Here are some self-control techniques:

*Mindfulness Meditation*:Practicing mindfulness can help you become more aware of your
thoughts, emotions, and physical sensations. This awareness enables you to respond to them in a
more controlled and balanced way.

*Delay Gratification:* Learn to delay immediate rewards for larger, more significant rewards
in the future. For example, saving money instead of spending it impulsively.
*Goal Setting:* Set clear and achievable goals. Having specific objectives in mind can help you
stay focused and resist distractions.

*Stress Management:* Stress can undermine self-control. Implement stress reduction

techniques like deep breathing, progressive muscle relaxation, or engaging in calming activities.

*Cognitive Restructuring:* Identify and challenge irrational or impulsive thoughts. Replace

them with more rational and constructive thinking patterns.

*Time Management:* Efficiently managing your time can reduce stress and help you allocate
your energy to the most important tasks, improving self-control.

*Self-Awareness:* Recognizeyour triggers and weaknesses. Knowing what leads to

impulsive behavior allows you to proactively address those situations.

*Accountability*: Share your goals with a trusted friend or family member who can help hold
you accountable for your actions.

*Positive Self-Talk:* Encourage yourself with positive self-talk. Remind yourself of your goals
and reasons for practicing self-control.

*Behavioral Rehearsal:* Practice responding to challenging situations with self-

control. Visualization can help you prepare for real-life scenarios.

*Self regulation:* Use techniques like the "cool-down" period to control emotional reactions
before responding to a situation.

*Limit Exposure:* Reduce exposure to situations or environments that trigger

impulsive behavior.

*Practice Gratitude:* Cultivating a sense of gratitude can help you appreciate what you have
and reduce the desire for immediate gratification.
*Seek Professional Help:* If self-control issues are seriously affecting your life, consider
consulting a therapist or counselor who can provide guidance and strategies tailored to your
needs.

SELF-CONTROLPROCEDURES IN CONTINGENCY MANAGEMENT

In contingency management, the self-control procedure is a technique that helps individuals

develop and maintain self-control over their behaviors. It involves setting up a system of rewards
and consequences to reinforce desired behaviors and discourage unwanted behaviors
The first step in the self-control procedure is to clearly define the target behavior that the
individual wants to change or control. This could be anything from reducing substance abuse to
improving study habits. Once the target behavior is identified, specific goals are set to track
progress.

Next, a system of rewards is established. These rewards can be tangible, such as earning points
or tokens that can be exchanged for desired items or privileges, or they can be intangible, such as
praise or recognition. The rewards should be meaningful and motivating to the individual.

To earn rewards, the individual must demonstrate the desired behavior consistently. This is
where self-monitoring comes into play. The individual keeps track of their behavior, noting
when they engage in the target behaviorand when they resist it. This self-monitoring helps to
increase awareness and accountability.

When the individual successfully demonstrates the desired behavior, they are rewarded. This
positive reinforcement strengthens the connection between the behavior and the reward, making
it more likely that the behavior will be repeated in the future. Over time, as the
desired behavior becomes more ingrained, the frequency and intensity of the rewards may be
gradually reduced.

Conversely, if the individual engages in the unwanted ye behavior, there may be consequences.
These consequences can be mild, such as losing points or privileges, or they can be more
significant, depending on the severity of the behavior. The consequences serve as a deterrent and
motivate the individual to avoid the unwanted behavior.
The self-control procedure in contingency management is effective because it harnesses the
power of rewards and consequences to shape behavior. By providing immediate reinforcement
for desired behaviors and consequences for unwanted behaviors, individuals can develop greater
self-control and make positive changes in their lives.

There are many self control procedures and strategies that can be used depending on the specific
situation and individual.

5.SOCIAL SKILLS TRAINING

INTRODUCTION

• Social skills training (SST) is a type of behavioral therapy used to improve social skills in people
with mental disorders or developmental disabilities.
• Social skills training consists of learning activities that utilizes behavioral techniques that enable
persons with schizophrenia and other disabling mental disorders to acquire interpersonal , disease
management and independent living skills for improved functioning in their communities.

WHAT ARE SOCIAL SKILLS ?

• Social skills are the abilities and behaviors that enable effective interactions and communication
with others, including listening, empathy, verbal and non-verbal communication, and the capacity
to build and maintain relationships.
• Basic social skills include
® active listening
® making eye contact
® using appropriate body language
® speaking clearly
® showing empathy

SST IN THERAPY
• The goal of social skills training is to teach people about verbal and nonverbal behaviors that are
involved in typical social interactions.
•SST may be used by teachers,, therapists, or other professionals to help those with anxiety
disorders, mood disorders, personality disorders, and other diagnoses.
• It is delivered either individually or in a group format, usually once or twice a
week.

• It'softenintegratedintoabroader treatment plan that may include medication, psychotherapy and

other interventions.

PROCESS OF SST
• Therapists who practice social skills training first focus on breaking down more complex social
behaviors into smaller portions.
• Next, they develop an individualized program for patients, depending on what social skills they
need to work on, and gradually introduce those skills to their patients, building up their confidence
through gradual exposure.
• For instance, a person who has anxiety in social situations might be first given strategies to
maintain eye contact by the therapist then on how to give a firm handshake and so on , one at a
time.

BENEFITS OF SST
• Better relationships
• Higher self esteem
• Reduce anxiety
• Increased independence
• Reduce isolation
• Improved mental health
• Effectiveconflictresolution
• Improves communication skills
CONCLUSION
• In conclusion, Social Skills Training (SST) offers individuals the essential tools to improve their
social interactions, fostering better relationships, personal growth, and an overall enhanced quality
of life.

6.BIO FEEDBACK PROCEDURES

Biofeedback is a type of mind-body technique you use to control some of your body’s functions,
such as your heart rate, breathing patterns and muscle responses. During biofeedback, you’re
connected to electrical pads that help you get information about your body.
During a biofeedback session, a practitioner uses monitoring equipment and instruments to
measure your body’s functions.
Definition: Biofeedback is a process that enables an individual to Learn how to change
physiological activity for the purpose of improving health and performance .
Types of biofeedback:
1. Breathing: During breathing biofeedback, bands are placed around your stomach and chest.
Sensors on the bands check your breathing rate and patterns. You can control your breathing and
feel better.
2. Brain waves: During this type of biofeedback, an electroencephalograph (EEG) uses scalp pads
to monitor your brain waves. There are certain brain waves that show different mental states, such
as relaxation, wakefulness and sleep. With biofeedback training, you can see a change in the brain
waves that improve your health.
3. Heart rate: In this type of biofeedback, pads are placed on your chest, lower trunk or wrists.
These pads are connected to an electrocardiogram (ECG) that measures your heart rate and how
your heart rate changes. A sensor also can be placed on your finger to measure your heart rate.
When you are relaxed, your heart rate may decrease.
4. Muscle activity: A machine called an electromyograph (EMG) uses sensors to measure muscle
tightening. This helps make you aware of muscle tension so you can take steps to control it.
5. Sweat gland activity: Pads attached to the fingers, palm or wrist measure the activity of the
sweat glands. The amount of perspiration on your skin warns you of nervousness.
6. Temperature: Pads attached to your fingers or feet measure blood flow to your skin. Because
your temperature often drops when you’re under stress, a low reading can prompt you to begin
relaxation methods. As you become more relaxed, your fingers and toes may become warmer.

Purpose of biofeedback;
• Asthma
• Nervousness or stress
• ADHD
• Long lasting pain
• Heading
• High blood pressure
• Stroke
• Depression
• Heart rate
Benefits of biofeedback:
• It’s non - invasive
• It can complement other treatments
• It can help put you in control of your emotions

Risks
Biofeedback is generally safe, but it might not be right for everyone. Biofeedback machines might
not work on people with some medical problems, such as heartbeat issues or some skin diseases.
Be sure to talk with your health care provider first.
During biofeedback, a therapist connects electrical pads or sensors to different parts of your body.
These pads might be used to:
• Monitor your brain waves.
• Check the temperature of your skin.
• Measure muscle tightness.
• Monitor your heart rate.
• Monitor your breathing rate and patterns.
The pads send information to a nearby screen. The therapist uses that information and makes
suggestions to help you control your body’s responses. For example, if the pads sense tight muscles
that may be causing headaches, you then learn how to relax those muscles.
A typical biofeedback treatment lasts 30 to 60 minutes. How many treatments you have and how
long they last depend on your health problem and how quickly you learn to control your body’s
responses. The goal of biofeedback is to learn to use these methods at home on your own without
a machine or sensors