BEHAVIORAL THERAPY PRESENTED BY: Granada, Samantha Ysabel Suarez, Leigh Justin BRIEF HISTORY OF BEHAVIORAL THERAPY • • • Behavior therapy developed during the early 1900s and became an established approach to the treatment of various mental health problems in the 1950s and 60s. It has roots in behaviorism, which emerged from the study of the relationship between stimulus, response, and reinforcement as features of the learning process (McKeena, 1995) While John B. Watson is regarded as the father of behaviorism, he developed his ideas by exploring the discoveries of Ivan Pavlov (1927/1960). It is focused not on the internal, emotional, and psychological conditions of people, but rather on their external and outward behaviors. He believed that a person's physical responses provided the only insight into internal actions. When Pavlov was researching dogs’ digestive processes, he observed the fact that associations developed when a stimulus (food) that triggered a digestive response (salivation) was paired with a stimulus that has no response (bell). EXAMPLE OF BEHAVIORAL THERAPY Ива́н Петро́вич Па́влов • • Was a Russian and Soviet experimental neurologist, psychologist, and physiologist known for his discovery of classical conditioning through his experiments with dogs. Pavlov’s discovery of conditioning principles was essential to the founding of behavior therapy in the 1950s and continues to be central to modern behavior therapy. Pavlov’s major legacy to behavior therapy was his discovery of “experimental neuroses”. Born: September 26, 1823, Ryazan, Russian Empire Died: February 27, 1936, Leningrad, Russian SFSR, Soviet Union PAVLOV AND THE FOUNDATION OF BEHAVIOR THERAPY The foundation, achievements, and proliferation of behavior therapy have largely been fuelled by the movement’s foundation in behavioral principles and theories. Although behavioral accounts of the genesis and treatment of psychopathology differ in the extent to which they emphasize classical or operant conditioning, the mediation of cognitive factors, and the role of biological variables, Pavlov’s discovery of conditioning principles was essential to the founding of behavior therapy in the 1950s, and continues to be central to modern behavior therapy. Pavlov's reliance on a physiological model of the nervous system, sensible in the context of an early science of neurology, has had an implication for behavior therapists interested in the study of personality types. However, Pavlov's major legacy to behavior therapy was his discovery of "experimental neuroses," shown by his students Eroféeva and Shenger-Krestovnikova, to be produced and eliminated through the principles of conditioning and counter-conditioning. This discovery laid the foundation for the first empirically-validated behavior therapy procedure, systematic desensitization, pioneered by Wolpe. The Pavlovian origins of behavior therapy are analyzed in this paper, and the relevance of conditioning principles to modern behavior therapy is demonstrated. It is shown that Pavlovian conditioning represents far more than a systematic basic learning paradigm. It is also an essential theoretical foundation for the theory and practice of behavior therapy. Behavior Therapy is the application of experimentally derived learning principles to treat psychological disorders. The concept derives primarily from the work of the Russian psychologist Ivan Pavlov, who published extensively in the 1920s and the 1930s on applying conditioning techniques and theories to abnormal behavior. Behavior therapy was popularized by the U.S. psychologist B.F Skinner, who worked with mental patients in a Massachusetts state hospital. From his work in animal learning, Skinner found that the establishment and extinction (elimination) of responses can be determined by the way reinforcers, or rewards, are given. It can be described as flexible in its behavior techniques, which in general have been empirically validated. Behavior therapy research has resulted in having a good understanding of which specific behavior techniques are most effective for which specific problems. Some limitations to this approach are that behavior therapy does not look at maladaptive behavior within a larger context and empirical research is generally limited to specific behaviors. Today, behavior therapy development means improving existing behavior techniques, developing treatment manuals, and consolidating its gain of three decades of rapid growth. Growth in behavior therapy is expected to continue in the areas of pharmacotherapy, health care, and realistic behavior changes. EFFECTIVE BEHAVIORAL THERAPY TECHNIQUES There is no single type of behavior therapy. In fact, what defines behavior therapy are many different types of specialized therapies, including the following: ● Cognitive behavioral therapy. The therapist helps the person identify unhealthy thought patterns and understand how those thoughts contribute to self-destructive behaviors and beliefs. Once the patterns are known, the therapist works with the person to think more constructively. ● Modeling. The therapist acts out a non-fearful response to a negative situation, and the person’s anxiety may be reduced by imitating the non-fearful response. ● Classroom management. Teachers participate in promoting the student’s positive behaviors, blocking negative behaviors, and focusing the student on academic work. ● Parent training. The child’s parents are taught ways to reinforce positive behaviors, deter negative acts, and enhance the parent-child relationship. Parents are instructed on observing the child, using praise and positive attention to reward good behavior, setting rules, and addressing negative actions. ● Peer intervention. One or more of the student’s peers help them address behavior problems. The peers are taught by a teacher to encourage positive behavior in academic performance and social settings. In addition to proving successful in boosting the student’s health and well-being, the peer assistants benefit from their participation because it reinforces their positive behaviors and enhances their sense of responsibility. TYPES OF BEHAVIORAL THERAPY - Cognitive-Behavioral Therapy (CBT) Focuses on helping individuals change negative thought patterns that contribute to negative emotions. CBT helps people identify those negative thoughts and situations that cause them. Then, clients learn to shift their thoughts and behaviors in a more positive direction, allowing them to be more functional versus dysfunctional. CBT helps clients develop self-awareness and clarity, which allows them to be present in situations. That can let them see things as they are instead of through a veil of negativity. From there, they start learning coping skills to help them handle difficult situations. They also receive education on techniques that show them how to relieve stress. - WHAT CAN COGNITIVE BEHAVIORAL THERAPY TREAT • • • • • • • • Depression Anxiety disorders Phobias Post-traumatic stress disorder (PTSD) Sleep disorders Eating disorders Obsessive-compulsive disorder (OCD) Substance use disorder TYPES OF BEHAVIORAL THERAPY - Dialectical Behavior Therapy (DBT) Rests on psychotherapy foundations. It focuses on helping clients learn how to manage their emotions. They also learn techniques that allow them to navigate conflicts without escalating them to another level. While DBT was initially used to help people with borderline personality disorder, it also proved to be an effective addictive therapy. DBT sessions typically consist of making sure clients are stable before moving on to exploring their past to figure out what led them down the path of addiction. Therapists show a client how to manage emotions that might arise from emotional pain and past trauma without relying on substance use. - DBT CONSISTS OF FOUR ELEMENT, KNOWN AS MODULES Core mindfulness Distress tolerance Emotional regulation Interpersonal effectiveness, which is used to improve relationships with others and yourself WHAT CAN DIALECTICAL BEHAVIORAL THERAPY TREAT • • • • • • • • Depression Suicidal behavior Post-traumatic stress disorder (PTSD) Self-harm Borderline Personality Disorder (BPD) Eating disorders, specifically binge eating and bulimia Obsessive-compulsive disorder (OCD) Substance use disorder TYPES OF BEHAVIORAL THERAPY - Rational Emotive Behavior Therapy (REBT) focuses on helping clients identify destructive or negative feelings and therapies. Once clients have identified these challenging feelings, they can work on challenging them. In the best-case scenarios, they can then replace the adverse feelings and emotions using more rational or realistic ideas. Focuses on identifying negative or destructive thoughts and feelings. People then actively challenge those thoughts and replace them with more rational, realistic ones. - WHAT CAN RATIONAL EMOTIVE BEHAVIOR THERAPY TREAT • • • • • • • • • Addictive behaviors Aggression Anxiety Depression Disordered eating habits Overwhelming feelings of anger, guilt, or rage Phobia Procrastination Sleeping problems TECHNIQUES In order to understand how behavioral therapy works, it is important to know more about the basic principles that contribute to behavioral therapy. The techniques used in this type of treatment are based on the theories of classical conditioning and operant conditioning. Classical conditioning Aversion therapy Flooding Systematic desensitization Operant conditioning Behavior modeling Contingency Extinction Token economies CLASSICAL CONDITIONING Involves forming associations between stimuli. Previously neutral stimuli are paired with a stimulus that naturally and automatically evokes a response. After repeated pairings, an association is formed, and the previously neutral stimulus will come to evoke the response on its own. Classical conditioning is one way to alter behavior. Several different techniques and strategies are used in this approach to therapy. •• • Aversion therapy. Flooding. Systematic desensitization. Aversion therapy This process involves pairing an undesirable behavior with an aversive stimulus in the hope that the unwanted behavior will eventually be reduced. For example, someone with an alcohol use disorder might take Antabuse (disulfiram), a drug that causes severe symptoms (such as headaches, nausea, anxiety, and vomiting) when combined with alcohol. Flooding This process involves exposing people to fear-invoking objects or situations intensely and rapidly. It is often used to treat phobias. During the process, the individual is prevented from escaping or avoiding the situation. Systematic desensitization In this technique, people make a list of fears and then learn to relax while concentrating on these fears. Starting with the least fear-inducing item and working their way to the most fear-inducing item, people systematically confront these fears under the guidance of a therapist. Systematic desensitization is often used to treat phobias and other anxiety disorders. OPERANT CONDITIONING Focuses on how reinforcement and punishment can be utilized to either increase or decrease the frequency of a behavior. Behaviors followed by desirable consequences are more likely to occur again in the future, while those followed by negative consequences become less likely to occur. Behavioral therapy techniques use reinforcement, punishment, shaping, modeling, and related techniques to alter behavior. These methods have the benefit of being highly focused, which means they can produce fast and effective results. Contingency management This approach uses a formal written contract between a client and a therapist (or parent or teacher) that outlines behavior-change goals, reinforcements, rewards, and penalties. Contingency contracts can be very effective in producing behavior changes since the rules are spelled out clearly, preventing both parties from backing down on their promises. Extinction Another way to produce behavior change is to stop reinforcing behavior in order to eliminate the response. Time-outs are a perfect example of the extinction process. During a time-out, a person is removed from a situation that provides reinforcement. By taking away what the person found rewarding, unwanted behavior is eventually extinguished. Behavior modeling This technique involves learning through observation and modeling the behavior of others. Rather than relying simply on reinforcement or punishment, modeling allows individuals to learn new skills or acceptable behaviors by watching someone else perform those desired skills. Token economies This strategy relies on reinforcement to modify behavior. Parents and teachers often use token economies, allowing kids to earn tokens for engaging in preferred behaviors and lose tokens for undesirable behaviors. These tokens can then be traded for rewards such as candy, toys, or extra time playing with a favorite toy. EXPERIMENTAL NEUROSIS • A pathological condition induced in a nonhuman animal during conditioning experiments requiring discrimination between nearly indistinguishable stimuli or involving punishment for necessary activities. • An abnormal behavioral condition produced in an artificial laboratory setting. The subject is typically placed in a problem-solving or discernment scenario they cannot solve because it is too difficult or impossible. This can result in erratic altered behavior that mimics a mental disorder. Experimental neurosis is essentially a psychosis that is produced artificially. The stress of not being able to solve the experimental problem causes the behavior to appear. THE GOALS OF BEHAVIOR THERAPY • In an effort to achieve equality through affirmative action, this results in social class inequality. Affirmative action may help those who have experienced past racial or ethnic discrimination. But giving them the upper hand over those who haven't exacerbated social unfairness. There are more effective approaches to achieving equality for all. EFFECTIVENESS • How well behavioral therapy works depends on factors such as the specific • • type of treatment used as well as the condition that is being treated. This does not mean that CBT or other behavioral approaches are the only types of therapy that can treat mental illness. It also doesn't mean that behavior therapy is the right choice for every situation. Anxiety disorders, including post-traumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), and phobias, for example, often respond well to behavioral treatments. However, researchers found that the effectiveness of behavioral therapy, specifically CBT, in the treatment of substance use disorders can vary depending on the substance being misused. Thank you CMCian.
