BEHAVIOUR

THERAPY

Roselyne A Okoth
Doctor of philosophy Fellow
WHO consultant
Department of psychiatry, School of Medicine
University Of Nairobi
18/02/2015
 Behavior Therapy
J.B. Watson:

Emphasized the overriding importance

of the environmental events, rejecting
covert aspects of the individual. He
claimed that all behavior could be
understood as a result of learning.
(Nature vs. Nurture)
 Definition

Behaviour therapy is a form of

psychotherapy which focuses on modifying
faculty behavior rather basic changes in the
personality. Instead of probing the
unconscious or exploring the patient’s
thoughts &feelings, behavior therapist tries
to eliminate the symptoms & modify
ineffective or maladaptive pattern by
applying basic learning techniques.
 Behaviour Therapy
Techniques
1. Behavioral modification
2. Systematic desensitization
3. Aversion therapy
4. Assertiveness training
5. Cognitive behavior therapy
6. Implosive (flooding) therapy
7. Positive reinforcement
a. Response shaping
b. Modelling c. Token economy
Behaviour Modification
• It is also called “simple Extinction”.
• Learned behavior pattern disappears if it
is not reinforced.
• To eliminated a maladaptive behavior
one has to remove the reinforcement for
it.
• It is effective when reinforcement is
being used without the knowledge of the
affected individual
 Systemic Desensitization
• It is a form of behavior therapy developed by Joseph
Wolpe.
• The objective of the therapy is to reduce or eliminate
fear or anxiety where by the therapist
I.Trains the patient in deep muscles relaxation.
II. The pt could be presenting with anxiety-
provoking situation or specific phobia, such as fear
of death, fear of animals. These problems are placed
from the strongest to the weakest order i.e. the client
is anxious about which one is causing anxiety the
least.
 Aversion Therapy
• It is a form of behavior therapy in which the patient
is conditioned to avoid an undesirable behavior or
symptoms by associating them with painful or
unpleasant experiences, such as putting a bitter taste
on nails or tongue for nail biting, giving drug like
apormorphine which cause nausea & vomiting on
taking alcohol or an electric shock to treat a child
with enuresis.
 Aversion Therapy
• Aversion therapy has been used for alcoholism,
transvestism, compulsive unacceptable social
behavior like homosexuality & other sexual
deviation.
• Typically, 20-40 session are given, with each session
lasting about 1 hour. After completion of treatment,
booster session may be given
 Assertiveness Training
• A behavior therapy technique in which the patient is
given training to bring about changes in emotional &
other behavioral pattern by asserting him/herselfself.
• One is encouraged not to be afraid of showing an
appropriate response, negative or positive, to an idea
or suggestion.
• The assertive behavior training is given by the
therapist first by role playing & then by practice in a
real life situation we use this to discourage students
to experiment with drugs or antisocial behaviours.
 Assertiveness Training
• Attention is focus on more effective interpersonal-
skill.
• The most techniques used in assertiveness training is
behavioral rehearsal, in which the patient act out
problematic interpersonal interactions with the
therapist.
• After this role-playing specific maladaptive behavior
are identified & the client behavior can be adapted.
• This training can be used for client with bulimia
nervosa & major depression, mentally healthy &
mentally ill persons.
 Cognitive Behaviour
Therapy
• It is a psychotherapeutic approach based on the idea
that emotional problems in an individual arise due to
faulty ways of thinking & distorted attitude towards
oneself & others.
• The therapist takes the role of a guide who helps the
patient to correct & revise his perceptions &
thoughts.
• This helps the patient to change his thoughts,
feelings & behavior about himself.
• Cognitive behavior therapy is considered effective in
the treatment of depression & adjustment
difficulties.
 Implosive Therapy
(Flooding)
• It is a behavior therapy technique opposite to
systematic desensitization
• No prior relaxation techniques are taught to the
patient.
• In this therapy, an individual is exposed directly to a
maximum intensity fear-producing situation either in
imagination or in real life. The patient gradually feels
no actual danger in the situation.
 Implosive Therapy
(Example)
• He has developed intense phobia of a lizard.
• During psychotherapy session suddenly the therapist
puts a rubberized lizard on the table. For a minute
the patient may get scared but gradually may start
handling a rubberized lizard while taking.
 Positive Reinforcement
• It is a stimulus or stimulus situation which is given to
a patient or individual after the response.
• When the stimulus is given after the response it is on
the basis that the strength of the response is
increased & that the response will appear again
• Examples ; as soon as the infants gets up & walks,
the mother claps & gives the infant a piece of
chocolate to enjoy.
 Positive Reinforcement
• Positive Reinforcement can be done by

a. Responsive shaping

b. Modelling

c. Token Economy
 Response Shaping
• Positive reinforcement is used in response shaping
or incorporating or establishing a response which is
not existing in an individual’s behavior.
• This technique is used in a behavior problem or
mental retardation.
 Modelling
• Modelling is a behavior therapy technique in which
learning occurs through observation.
• The client watches someone else perform a
particular action such as answering telephone.
• Models are often parents or other adults & children
• Modelling is a form of social learning & is often
called observation learning.
 Token Economy
• It is a behavioral therapy programme usually
conducted in a hospital or classroom setting.
• In token economy the desired behavior is reinforced
by offering tokens that can be exchanged for special
food, games, comics or other rewards.
• For example; a patient with schizophrenia does not
maintain personal hygiene. The day he maintains he
gets a token as reinforcer that he can watch T.V.
when he desire. Like this he is able to collect many
tokens & adapt behavior which is socially acceptable.
like maintaining personal hygiene. Sometimes in
return of tokens the patient may exchange then by
asking for PAROLE money is usually discouraged.
 BEHAVIOR THEORY OF PERSONALITY

 Discrimination:
Responding differentially to stimuli that are
similarly based on different cues or antecedent
events.

 Extinction:
The process of no longer presenting a
reinforcement. It is used to decrease or eliminate
certain behaviors.
 SOCIAL COGNITIVE
THEORY
(or Social Learning Theory)
 Albert Bandura:
Believed behavior was based on three
interacting systems;

a) external stimulus,
b) external reinforcement, and
most importantly,
c) cognitive mediational processes.
 SOCIAL COGNITIVE
THEORY
(or Social Learning Theory)
 Reciprocal Determinism:

Psychological functioning involves a reciprocal

interaction among three interlocking sets of
influences: behavior, cognitive processes, and
environmental factors.
 OBSERVATIONAL LEARNING CONCEPTS

 Observational learning:
A type of learning is which people are
influenced by observing the behaviors of others.
 Covert behavior:
Behavior that others cannot directly perceive,
such as thinking or feeling.
 OBSERVATIONAL LEARNING CONCEPTS

 Attentional processes:
The act of perceiving or watching something
and learning from it.
 Retention processes:
This basically refers to remembering that which
has been observed.
 Motor reproduction processes: This refers to
translating what one has seen into action using
motor skills.
 OBSERVATIONAL LEARNING CONCEPTS

 Motivational processes:
For observations to be put into action and then
continued for some time, reinforcement must be
present. Reinforcement brings about motivation.
 Self-Efficacy: The individual’s perceptions of
their ability to deal with different types of events.
 GOALS OF BEHAVIOR THERAPY

 “It is fundamental to behavior therapy that the

patient should have the major say in setting
treatment goals, it is important that the pt is
fully informed, and consents to and participates
in setting goals.

 Provide a direction to therapy

 Provide a basis for selecting and using
strategies & interventions.
 Provide a framework for evaluating the outcome.
 Process of Setting Goals

1. The therapist explains the purpose of goals.

2. Pt specifies the positive changes desired as a result of the
therapy.
3. Together they explore whether the goals are realistic.
4. They discuss advantages and disadvantages of the goals.
5. On the basis of the information obtained about client-stated
goals, the counselor and the client make one of the following
decisions: to continue counseling, to reconsider the client’s
goals, or the seek a referral.
 Advantages of goal setting

 It increases the chances of making the counselor/client alliance

operational.

 It emphasizes the importance of their active participation in the

process, rather than fostering an attitude of being a passive
spectator.

 It is the basic link between whatever therapeutic procedures or

techniques are used and the concrete goals of the client.
Therapist’s Function and Role
 Behavior therapists must assume an active,
directive role in treatment.

 Behavior therapists function as teacher, director,

and expert in prescribing curative procedures
that will lead to improved behavior.
Therapist’s Function and Role
 Use techniques such as summarization,
reflection, clarification, and open-ended
questions.
 They focus on specifics, systematically getting
information about specific antecedents, the
dimensions of the problem behavior, and the
consequences of the problem. (Goldried &
Davison, 1976)
 MODELING TECHNIQUES
The therapist’s role is also modeling behavior for
the client.

 Because clients often view their therapist as

worthy of emulation, they pattern attitudes,
values, beliefs, and behavior after him or her.
 Therapists need to be aware of the power they
play in this process.
 Relationship between Therapist
and Client
 Exemplified by warmth, empathy, authenticity,
permissiveness, and acceptance as necessary but not
sufficient conditions for behavioral change.

 Behavior therapists are more self-disclosing when it

benefits the motivation of the client.
ANY QUESTIONS???????

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