Behavior Therapy
Techniques
Lesson 18
Behavior Therapy
Behavior Modification
1. Clarifying the clients
problem
1. Goal setting
2. Formulating initial goals
for therapy
2. Behavioral Definitions
3. Designing a target
behavior
4. Identifying the maintaining
conditions
3. Functional Analysis
4. Objective
measurement
5. Designing a treatment plan
5. Data collection
6. Implementing the
treatment plan
6. Evaluation ~
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 ~
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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 ~
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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 ~
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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 ~
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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 ~
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Standard Procedure
Some trials: CS+ --- US
 Other trials: CS+ / CS- --- No US
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Example: traffic light
 CS+ (red)  CR?
 CS- (police officer) / CS+  CR?
 Respond differently under different
circumstances ~
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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) ~
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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 ~
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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) ~
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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 ~
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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 ~
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Systematic Desensitization:
Theoretical Explanations
Counterconditioning
 Substitution of competing response
 Reciprocal inhibition
 Neurophysiological processes
 Parasympathetic vs Sympathetic
 Extinction
 Cues present but no danger (US) ~
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Flooding
Prolonged/Intense Exposure Therapy
 Also called implosive therapy
 In vivo or imaginal
 Treatment for
 Phobias
 Obsessive-compulsive disorder
 Post-traumatic stress disorder
 Agoraphobia ~
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Flooding
Aversive CS  escape/avoidance
 Limits opportunity for extinction
 Confront individual w/ fearprovoking situations/ images
 No relaxation
 Not graded
 Extinction process
 Potential for intensifying fear ~
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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 ~
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“More Acceptable” Punishers
Punisher
Target Behavior
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Trichotillomania
(Pulling out hair)
Compulsive eating
Nail biting
Face slapping
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Bruxism
Biting other children
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Snap rubber band
on wrist
Cigarette smoke
Bitter substance
Water mist
sprayed in face
Loud noise
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 ~
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