Behavior
Therapy developed by Arnold Lazerus and Joseph Wolpe in the 1950’s, in radical
departure from Psychoanalytic therapy
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Major phases in its development over the years are:
§
the
classical conditioning trend
§
the
operant conditioning model
§
the
social learning approach
§
cognitive
behavior therapy
Philosphy
and Basic assumptions:
Behavior
is the product of learning, yet we are both the product and producer of our
environment.
Due to the diversity of assumptions
about behaviors there is not a unified approach.
Instead think in terms of the Behavioral Therapies
Key
Concepts
- Emphasis is on:
§
Current
behavior rather than on historical antecedents
§
Precise
treatment goals
§
Diverse
therapeutic strategies tied to these goals
§
Objective
Evaluation of therapeutic outcomes
Therapeutic
goals
§
Eliminate
maladaptive behaviors
§
Learn
more effective behavior
§
Client
and therapist collaborate on the goals
Therapy
focuses on behavior change in the present and action programs…In other words,
lets not just talk about change…
Therapeutic
relationship
- Good
working relationship – essential precondition
Therapist’s
Role
- Exploring alternative courses of action and their possible consequences
Client
Role -
Actively involved in process and willing to experiment with new behaviors in
session and for homework
Techniques
and Procedures
- Tailored to fit unique needs of client
Relaxation Technique
§
Used
to cope with stress & anxiety
§
Aimed
at teaching muscle and mental relaxation
§
Requires
daily practice
Exposure therapies
Systematic Desensitization Technique
§
Based
on the principle of Classical conditioning
§
Used
to treat Anxious and avoidant reactions
§
Phobias,
nightmares, obsessions, anorexia depression…
In vivo desensitization:
§
Actual
exposure to feared situation in graduated series of exposures – balloons, tin
foil, spiders, etc
Flooding:
§
Prolonged
exposure to phobia
§
Feared
consequences do not occur
§
Clients
prevented from using maladaptive behaviors – running, avoidant behaviors
§
Ethical
considerations – adequately inform client of prolonged exposure therapy
techniques
EMDR –
Eye
Movement Desensitization and Reprocessing - Developed by Dr. Frank Shapiro
Uses rhythmic eye movements and other
bilateral stimulation to treat traumatic stress and memories of clients. Helps
clients restructure cognitions or reprocess information
8 Essential Phases See Pages 271-272
OBJECTIVE: Associate the traumatic event with an adaptive belief so that the memory no longer has power to result in anxiety and negative thinking
FOCUS is on the strength of the
client’s positive self-assessment.
1.
Client then asked to visualize the traumatic event and the positive
cognition and to scan his/her body mentally from top to bottom and identify any
bodily tensions states
2.
Adequate closure important – Keep log or journal of disturbing
thoughts, etc.
3.
Re-evaluation of last phase – implemented at beginning of each new
session
EMDR
believed to be more efficient than other treatments of PTSD
Assertivness
Training
For those who cannot express anger
Who have trouble saying “no”
Who are overly polite and allow others
to take advantage of them
Who find it difficult to express
affection
Who feel they do not have the right to
express their thoughts, beliefs and feelings
Underlying assertion: People have a
right to express themselves
Goals:
§
Increase
Behavioral repertoire to include choice to assert or not
§
Teach
people to assert self in ways that reflect sensitivity to the feelings and
rights of others
§
Many
training methods based on CBT because it deals with faulty beliefs
§
Include
behavioral rehearsal and assessment of program
Self-Management
Programs
Applicable to many populations and many
problems: anxiety, depression, pain, addictions. See page 275 for list of Program Characteristics
Strategies
include: Self-monitoring, Self-reward, Self-contracting, Stimulus control
See
Page 276 for the 4 stage model for self-directed change:
1.
Select goal
2.
Translate goal into target behaviors
3.
Self-monitoring
4.
Work out plan for Change
5.
Evaluate plan for change
Multimodal
therapy
Lazarus
believed that our complex personality could be broken up into seven major areas
of functioning
Behavior
Affect
Sensations
Images
Cognitions
Interpersonal
relationships
Drugs,
biological functions, nutrition and exercise
The
above modalities are interconnected and must be treated as an interactive
system. Accurate evaluation comes through systematically assessing each modality
and the interaction among them. A comprehensive approach involves the specific
correction of the significant problem across the BASIC ID
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issues that therapists should examine in order for therapy to be short term,
comprehensive, and effective Pg 279
- 280
Conflicting or ambivalent feelings
Maladaptive behaviors
Misinformation
Missing
information
Interpersonal pressures and demands
Severe traumatic
experiences
Biological dysfunctions
External Stressors outside the immediate interpersonal network.
Applications
of Behavior Therapies
Effective on phobias, Depression, Sexual Disorders, Children’s
Disorders, Geriatrics,
Pediatrics, Stress management, Behavioral Medicine, Business and
Management, Education, Prevention and TX of
cardiovascular disease.
Contributions
Short term approach with wide
applicability, Emphasizes Research and assessment of techniques –
Thus providing accountability, Can be
appropriately integrated into multicultural applications
Limitations
§
Success
of approach depends on the ability to control the environmental variables
§
Institutional
settings could impose conforming behavior standards and exert too much control
– Walden Two
§
Therapists
can manipulate clients towards their goals
§
Does
not address broader human issues as in search for meaning, values, identity
issues
§
Focus
is on very specific and narrow behavior problems.