BEHAVIOR AND COGNITIVE

THERAPYTopic 5

VIEW OF HUMAN NATUREthe person is the producer and the product of his or her environment

SIX KEY CHARACTERISTICS OF BT: 1. BT is based on the principles

and procedures of the scientific method.

2. BT deals with the client’s current problems and the factors influencing them, as opposed to an analysis of possible historical determinants.

CONT’D 3. Clients involved in BT are

expected to assume an active role by engaging in specific actions to deal with their problems.

4. BT assumes an approach that change can take place without insight into underlying dynamics.

CONT’D 5. BT focuses on assessing overt

and covert behavior directly, identifying the problem, and evaluating changes.

6. Behavioral treatment interventions are individually tailored to specific problems experienced by clients.

THERAPEUTIC PROCESS General Goal:

 To increase personal choice and to create new conditions of learning.

* The client, with the help of the Thist, defines specific treatment goals at the outset of the therapeutic process.

* Goals must be clear, concrete, understood, and agreed on by the client and the Thist.

THERAPIST’S FUNCTION AND ROLE:

  1. Thist formulates initial treatment goals and designs and implements a treatment plan to accomplish these goals.

2. Thist uses strategies that have research support for use with a particular kind of problem

CONT’D 3. Thist evaluates the success of the change plan by measuring progress toward the goals throughout the duration of the treatment.

4. Thist conduct follow-up assessments to see whether the changes are durable over time.

CLIENT’S EXPERIENCE IN THERAPY 1. The client engages in

behavioral rehearsal with feedback until skills are well-learned and generally receives active homework assignments.

2. Changes clients have in therapy are translated into their daily lives.

CONT’D 3. Clients are motivated to

change and are expected to cooperate in carrying out therapeutic activities, both during therapy sessions and in everyday life.

4. If clients are not motivated, they undergo motivated interviewing.

CONT’D 5. Clients are encouraged to experiment for the purpose of enlarging their repertoire of adaptive behavior.

6. Clients are aware when the goals have been meet.

RELATIONSHIP BET. THIST AND CLIENT 1. BT stress the value of

establishing a collaborative working relationship.

2. BT contends that factors such as warmth, empathy, authenticity, permissiveness, and acceptance are necessary, but not sufficient, for behavior change to occur

APPLICATION: THERAPEUTIC TECHNIQUES AND PROCEDURES ABA: Operant conditioning techniques

- use of the following principles: positive reinforcement, negative reinforcement, extinction, positive punishment, and negative punishment

CONT’D Relaxation training and related methods - method of teaching people to cope with stresses produced by daily living.

CONT’D Systematic desensitization - based on the principle of classical conditioning where clients imagine successively more anxiety-arousing situations at the same time that they engage in a behavior that competes with anxiety.

CONT’D In vivo exposure - involves client's exposure to the actual anxiety-evoking events rather than simply imagining these situations.

CONT’DFlooding - consists of intense and prolonged exposure to the actual anxiety-producing stimuli.

CONT’D Social skills training - deals with an individual's ability to interact effectively with others in various social situations; it is used to correct deficits clients have in interpersonal competencies. (i.e. assertion training)

CONT’D Self-modification programs and sel-directed behavior - includes self-monitoring, self-reward, self-contracting, stimulus control and self-as-model.

CONT’D Basic steps in SMPs: 1. Selecting goals 2. Translating goals into target behaviors.

3. Self-monitoring. 4. Working out a plan for change,

5. Evaluating an action plan.

CLASS ACTIVITY Instructions: 1. Select one behavior that you

want to work on. 2. Describe those behaviors so

that they can be observed and counted.

3. Identify rewards that will help provide motivation to do well. Utilize a reinforcing-event menu.

CONT’D . (let your partner) Keep track of

your behavior and give out reward when the desired behavior is exhibited or met.

5. Write a contract. 6. Collect data. 7. Rewrite the contract if the

goal is not achieved.

SAMPLE CONTRACT Effective dates: From 26 August 2009- 2 September2009     We, the undersigned parties, agree to perform the

following behaviors:   If Mark will not utter swear words each day then Dr. Phil

will allow Mark  to watch a movie of his own choice at the University theater.

  Bonus: If Mark expresses what he feels calmly and directly he

will be given food when he watches a movie.                                 Signed  ____________________(Mark)                                 Signed  ____________________ (Dr

Phil)