Behavior Therapy

Techniques
Lesson 18
 Behavior Therapy Behavior Modification
1. Clarifying the clients 1. Goal setting
problem
2. Formulating initial goals 2. Behavioral Definitions
for therapy
3. Functional Analysis
3. Designing a target
behavior
4. Objective
4. Identifying the maintaining measurement
conditions
5. Designing a treatment plan 5. Data collection

6. Implementing the 6. Evaluation ~

treatment plan
7. Evaluating the success of
treatment
8. Conducting follow-up
assessment ~
 Changing Behavior
 Acceleration Target Behaviors
 Increase behavioral deficits

 Primarily positive reinforcement

 Deceleration Target Behaviors

 Punishment   behavior

 “Dead” person rule

 Include acceleration behaviors ~

 Deceleration Techniques
 Differential RFT (DRO & DRI)
 Direct Deceleration Therapy
 Consequential deceleration

 Aversion therapy

 Token Economies
 Pos RFT & response cost

 Exposure therapies
 Brief / graduated

 Prolonged / intense ~
Counter-Conditioning: Joseph Wolpe
 Reciprocal inhibition
 Buzzer sounded when cat was eating
 Buzzer (CS) : eating (US)  pos CER

 Buzzer (CS) : shock (US)  fear

 Substitution of competing responses

 Respondent Learning

 Can also replace fear with pos CER ~

 Mary Cover Jones & “Peter”
 Treatment of phobias
 Peter fearful of white rabbit

 Counterconditioning
 Pairing favorite food & rabbit

 Exposure therapy
 Gradually moved rabbit closer

 Peter watched another child play

with rabbit ~
 Inhibitory learning
 Conditioned Inhibition
 Learning to withhold conditional

response
 CS-: US will not occur
 no US for period of time

 US must be a significant event

 Occurs only if there is an excitatory

context ~
 Standard Procedure
 Some trials: CS+ --- US
 Other trials: CS+ / CS- --- No US

 Example: traffic light

 CS+ (red)  CR?

 CS- (police officer) / CS+  CR?

 Respond differently under different

circumstances ~
Negative CS-US Contingency
 Similar to standard procedure
 Some trials: CS+ & US

 Other trials: CS- & no US

 CS-  no response
 Example: Traffic light
 Red (CS+) – Danger (US)

 Green (CS-) – no Danger (no US) ~

 Inhibitory Conditioning & Stress
 Panic attacks  extreme stress
Carter, Hollon, Carson, & Shelton (1995)
triggered by CS+ for aversive stimuli


 Panic attack experimentally induced

 accompanied by trusted friend

 or alone ~

 Friend acted as CS- for stress

  stress compared the alone group

 trusted friend was a safety signal ~

 Exposure Therapies
 For fear/anxiety & other negative CERs
 Intense, maladaptive, or

inappropriate
 Some strong fears adaptive

 Based on Extinction
 Fear-provoking events (CS+)

 Safe environment (no US) ~

 Exposure Therapies Models
 Brief/graduated exposure therapy
 Short exposure periods

 Gradually increase intensity of CS

 Prolonged/intense
 Lengthy exposure periods

 Immediate exposure to intense CS

 Mode of exposure on continuum

 Imaginal ---------------------- in vivo ~
 Systematic Desensitization
 Brief/Graduated Exposure Therapy
 Relaxation Training
 Tense then relax muscle groups

 Fear Hierarchy
 Rank fear-provoking situations

 Graded Pairing
 CS for fear with muscle relaxation

 Thru hierarchy: lowest highest ~

 Systematic Desensitization:
Theoretical Explanations
 Counterconditioning
 Substitution of competing response

 Reciprocal inhibition
 Neurophysiological processes

 Parasympathetic vs Sympathetic

 Extinction
 Cues present but no danger (US) ~
 Flooding
 Prolonged/Intense Exposure Therapy
 Also called implosive therapy

 In vivo or imaginal

 Treatment for
 Phobias

 Obsessive-compulsive disorder

 Post-traumatic stress disorder

 Agoraphobia ~
 Flooding
 Aversive CS  escape/avoidance
 Limits opportunity for extinction

 Confront individual w/ fear-

provoking situations/ images
 No relaxation

 Not graded

 Extinction process

 Potential for intensifying fear ~

 Aversive Therapy
 Punishment of target behaviors
 Instrumental conditioning

 Raversive stimulus

 E.g., chronic vomiting  shock

 Problems
 Avoidance of therapy (drop out)

 Disruptive CERs

  punishment of others

 Ethics concerns ~
 “More Acceptable” Punishers
Target Behavior Punisher

 Trichotillomania  Snap rubber band

(Pulling out hair) on wrist
 Compulsive eating  Cigarette smoke
 Nail biting  Bitter substance
 Face slapping  Water mist
sprayed in face
 Bruxism  Loud noise
 Biting other children  Mild mouthwash
 Aversive Therapy:
Covert Sensitization
 Classical & instrumental conditioning
 Use of imaging
 Therapist describes behavior

 & aversive outcome

 Advantages
 Safe & more acceptable to clients

 Clients can self-administer in vivo

 Effectiveness equivocal ~