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Behavioral and Cognitive-
  Behavioral Therapies
The Behavioral Approaches
๏ฌ Behavior,   Learning, Social Context
๏ฌ Peopleโ€™s unique learning histories
๏ฌ Commonalities in rules, values, and
  learning histories
๏ฌ Principles of learning
๏ฌ Behavioral consistency vs. behavioral
  specificity
Three Main Versions
๏ฌ 1).Classical Conditioning
๏ฌ     (Respondent Learning)
๏ฌ    Joseph Wolpe,
๏ฌ    Hans Eysenck
๏ฌ    emphasize the association of
  conditioned and unconditioned stimuli
๏ฌ 2). Operant Conditioning
๏ฌ     B.F. Skinner
๏ฌ     Functional Analysis : focus on describing
  and explaining functional relationships among
  stimuli, responses, and consequences
๏ฌ 3). Social-Cognitive (Cognitive-Behavioral)
  Theories
๏ฌ     a). Albert Bandura
๏ฌ         Observational Learning
๏ฌ         Self-Efficacy
ABC Functional Analysis

๏ฌ Antecedent
๏ฌ   Event      Behavior      Consequence

๏ฌ          organismic variable
๏ฌ   b). Walter Mischel
๏ฌ       Cognitive Social Learning Person
  Variables(Table 2.2, p.49)
๏ฌ Competencies,   Encoding Strategies and Personal
    Construct, Expectancies, Subjective Value, Self-
    Regulatory Systems and Plans
๏ฌ
๏ฌ       c). Aron Beck
๏ฌ           Cognitive Theory of Depression
๏ฌ    d). Seligman et al.
๏ฌ        Attribution (Habitual explanations)
๏ฌ        Internality, Stability, Globalness

๏ฌ    e). Albert Ellis
๏ฌ        Rational-Emotive Behavioral Therapy
  (REBT)
๏ฌ        Irrational Beliefs : โ€œshouldโ€ statement,
  unrealistically high standards
Behavior Therapy
๏ฌ May  be regarded as the attempt to apply data
 from behavioral science research to the process
 of behavior change for remediation and
 treatment for individuals experiencing
 difficulty in coping with problems of living
 (Walker et al., 1981)

๏ฌ Learning-theory   approach to therapy
Assumptions of behavioral approach
๏ฌ 1). Any behaviors are developing through
  the same law of learning
๏ฌ 2).Therapy methods should be guided by the
  results of research on learning
๏ฌ 3).Aimed at modifying overt, maladaptive
  behaviors, as well as the cognitions, physical
  changes, & emotions that accompany overt
  behavior
๏ฌ 4).Treatment should address clientโ€™s current
  problems by dealing with the contemporary
  environmental forces, learned habits, and
  cognitive factors that maintain them

๏ฌ 5). Commitment to the experimental evaluation
  of treatment

๏ฌ Learning-oriented,   empirical, here and now
The beginnings of behavior therapy
๏ฌ The term behavior therapy first appeared in a
  paper (Lindsley, Skinner, & Solomon, 1953)
๏ฌ Groundwork      1920s
๏ฌ      studying the role of conditioning and
  learning in development of anxiety
๏ฌ      Ivan Pavlov experimental neuroses
๏ฌ      J.B. Watson & Rosalie Rayner(1920)
  little Albert
๏ฌ      Mary Cover Jones(1924)
What is behavior?
๏ฌ 1).   Respondents : antecedent-controlled
๏ฌ       somatic reflexes, emotional reaction, sensations
๏ฌ 2).   Operants : consequence-controlled
๏ฌ       actions, instrumental responses, cognition

๏ฌ a). Behavioral excesses, b). Behavioral deficits,
๏ฌ c). Behavioral anomalies, d). Behavioral assets
๏ฌ Martin  & Pear
๏ฌ     Behavior therapy Behavior modification
๏ฌ 1). Pavlovian-Hullian       Skinnerian tradition
๏ฌ     -Wolpean tradition
๏ฌ 2). Clinical                Nonclinical
๏ฌ 3). Therapeutic setting Natural setting
๏ฌ 4). Experimental foundation Experimental foundation
๏ฌ       based on clinical setting   based on animal or human
๏ฌ                                   operant research
๏ฌ 5).   European tradition          American tradition
Systematic Desensitization
๏ฌ Joseph  Wolpe (1958)
๏ฌ Rationale : Reciprocal Inhibition
๏ฌ responses incompatible with anxiety
๏ฌ 1). deep muscle relaxation, 2). interpersonal
  assertion, 3). sexual arousal
๏ฌ combination of 1). counter-conditioning &
  2). extinction
Procedures of SD
๏ฌ 1).   Diagnosis evaluation
๏ฌ        History Taking, Behavioral Inventoryโ€ฆ
๏ฌ 2).   Hierarchy construction
๏ฌ        Anxiety hierarchy (table 7.2, p.247)
๏ฌ 3).   Teaching anxiety-inhibiting responses
๏ฌ        Progressive relaxation training(Jacobson,
    1938)
๏ฌ 4).   Conducting the therapy session
๏ฌ        Imagery (imagination training)
๏ฌ        In vivo
Exposure Techniques
๏ฌ Exposed   to the most anxiety-provoking
  stimulus for an extended period of time
๏ฌ Rationale : Extinction
๏ฌ Implosion Therapy : Thomas
  Stampfl(1957)
๏ฌ     use of hypothetical construction
๏ฌ Flooding : (Polin, 1959)
๏ฌ     use to objective anxiety-related stimuli
๏ฌ Combine with Response Prevention
Social Skills Training
๏ฌ Social skill deficits
๏ฌ Assertiveness Training
๏ฌ appropriate expression of feeling in ways
  that do not infringe upon the rights of others
๏ฌ 1). Teach clients how to express themselves
  appropriately
๏ฌ 2). Eliminate cognitive obstacles to clear
  self-expression
Modeling
๏ฌ Observational Learning (Bandura, 1969)
๏ฌ 1). Attention process
๏ฌ 2). Retention process
๏ฌ 3). Motor production process
๏ฌ 4). Incentive & motivation process
๏ฌ Model Characteristic : similarity, high status,
  be rewarded for their actions
๏ฌ Participant Modeling
Aversion Therapy
๏ฌA  set of techniques in which painful or
  unpleasant stimuli are used to decrease the
  probability of unwanted behaviors
๏ฌ Rationale :
๏ฌ 1). Punishment
๏ฌ 2). Escape and Avoidance Conditioning
๏ฌ 3). Classical Conditioning
๏ฌ Debate problems
Contingency Management
๏ฌ Behavior modification procedures
๏ฌ Rationale :              Status of   Stimulus
๏ฌ                      present(+)      removed(-)
๏ฌ Nature positive       positive         indirect
๏ฌ of          (+)    reinforcement      punishment
๏ฌ Stimulus negative      direct          negative
๏ฌ              (-)    punishment       reinforcement
Reinforcer
๏ฌ Reinforcer vs. Punisher
๏ฌ Primary vs. Secondary Reinforcer
๏ฌ Social Reinforcer
๏ฌ Choice rules
๏ฌ 1). Personal values & needs
๏ฌ 2). Premack Principle
๏ฌ 3). Trial & error
Schedules of Reinforcement
๏ฌ Continuous   reinforcement(CRF)
๏ฌ Intermittent reinforcement (Partial)
๏ฌ 1). Ratio schedule
๏ฌ     a). Fixed ratio schedule(FR)
๏ฌ     b). Variable ratio schedule(VR)
๏ฌ 2). Interval schedule
๏ฌ     a). Fixed interval schedule(FI)
๏ฌ     b). Fixed variable schedule(VI)
๏ฌ Extinction
๏ฌ Shaping
๏ฌ   successive approximation
๏ฌ Time Out
๏ฌ a special sample of extinction
๏ฌ Contingency Contract
๏ฌ five components: 1). Responsibilities, 2).
  Rewards, 3). Monitoring system, 4).
  Bonuses, 5). Penalties for failure
๏ฌ Response Cost
Token Economies
๏ฌA   system for implementing the principles of
  contingency management to alter a variety
  of behaviors
๏ฌ Four elements
๏ฌ 1). Target behaviors
๏ฌ 2). Token system
๏ฌ 3). Back-up reinforcers
๏ฌ 4). Rules of exchange governing
Biofeedback
๏ฌ Behavioral  methods used to control heart
  rate, blood pressure, muscle tension, &
  physiological responses are known as
  biofeedback
๏ฌ Monitor & feedback apparatus
๏ฌ meter reading, graph, or auditory signal
๏ฌ Used to treat several clinical disorders
Cognitive-Behavioral
             Therapy(CBT)
๏ฌ Cognitive therapy : directed toward changing
  clientsโ€™ maladaptive cognition
๏ฌ The behavioral and cognitive approaches
  have tended to merge, called CBT

๏ฌ 1).   Beckโ€™s Cognitive Therapy
๏ฌ       approach to treatment of depression
๏ฌ 2).   Rational Emotive behavior Therapy(REBT)
๏ฌ       Albert Ellis
๏ฌ       ABC Model
๏ฌ          A             B             C
๏ฌ (Activating event)   (Belief) (emotional
    consequence)


๏ฌ                         D (Dispute)

๏ฌ                         E                  F
๏ฌ                      (Effect)     (new Feeling)
๏ฌ 3). Dialectical Behavior Therapy (DBT)
๏ฌ     Marsha Linehan
๏ฌ     Borderline Personality Disorder
๏ฌ     helps the client confront any traumatic
  experiences
๏ฌ 4). Relapse Prevention
๏ฌ     Alan Marlatt & Judith Gordon
๏ฌ     Alcoholism & Substance Use Disorder
๏ฌ     teach the client to monitor risky cognition
  and to replace them with different thinking
  strategies
๏ฌ 5).   Cognitive Behavior Modification(CBM)
๏ฌ       Meichenbaum, D.
๏ฌ       Self-talk or Self-instruction
๏ฌ       Coping-Skills Programs
๏ฌ       Stress Inoculation Training (SIT)
๏ฌ        a). Conceptualization Phase
๏ฌ        b). Skill Acquisition & Rehearsal Phase
๏ฌ        c). Application Phase

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Behavioral cognitivebehavioraltherapies

  • 1. Behavioral and Cognitive- Behavioral Therapies
  • 2. The Behavioral Approaches ๏ฌ Behavior, Learning, Social Context ๏ฌ Peopleโ€™s unique learning histories ๏ฌ Commonalities in rules, values, and learning histories ๏ฌ Principles of learning ๏ฌ Behavioral consistency vs. behavioral specificity
  • 3. Three Main Versions ๏ฌ 1).Classical Conditioning ๏ฌ (Respondent Learning) ๏ฌ Joseph Wolpe, ๏ฌ Hans Eysenck ๏ฌ emphasize the association of conditioned and unconditioned stimuli
  • 4. ๏ฌ 2). Operant Conditioning ๏ฌ B.F. Skinner ๏ฌ Functional Analysis : focus on describing and explaining functional relationships among stimuli, responses, and consequences ๏ฌ 3). Social-Cognitive (Cognitive-Behavioral) Theories ๏ฌ a). Albert Bandura ๏ฌ Observational Learning ๏ฌ Self-Efficacy
  • 5. ABC Functional Analysis ๏ฌ Antecedent ๏ฌ Event Behavior Consequence ๏ฌ organismic variable
  • 6. ๏ฌ b). Walter Mischel ๏ฌ Cognitive Social Learning Person Variables(Table 2.2, p.49) ๏ฌ Competencies, Encoding Strategies and Personal Construct, Expectancies, Subjective Value, Self- Regulatory Systems and Plans ๏ฌ ๏ฌ c). Aron Beck ๏ฌ Cognitive Theory of Depression
  • 7. ๏ฌ d). Seligman et al. ๏ฌ Attribution (Habitual explanations) ๏ฌ Internality, Stability, Globalness ๏ฌ e). Albert Ellis ๏ฌ Rational-Emotive Behavioral Therapy (REBT) ๏ฌ Irrational Beliefs : โ€œshouldโ€ statement, unrealistically high standards
  • 8. Behavior Therapy ๏ฌ May be regarded as the attempt to apply data from behavioral science research to the process of behavior change for remediation and treatment for individuals experiencing difficulty in coping with problems of living (Walker et al., 1981) ๏ฌ Learning-theory approach to therapy
  • 9. Assumptions of behavioral approach ๏ฌ 1). Any behaviors are developing through the same law of learning ๏ฌ 2).Therapy methods should be guided by the results of research on learning ๏ฌ 3).Aimed at modifying overt, maladaptive behaviors, as well as the cognitions, physical changes, & emotions that accompany overt behavior
  • 10. ๏ฌ 4).Treatment should address clientโ€™s current problems by dealing with the contemporary environmental forces, learned habits, and cognitive factors that maintain them ๏ฌ 5). Commitment to the experimental evaluation of treatment ๏ฌ Learning-oriented, empirical, here and now
  • 11. The beginnings of behavior therapy ๏ฌ The term behavior therapy first appeared in a paper (Lindsley, Skinner, & Solomon, 1953) ๏ฌ Groundwork 1920s ๏ฌ studying the role of conditioning and learning in development of anxiety ๏ฌ Ivan Pavlov experimental neuroses ๏ฌ J.B. Watson & Rosalie Rayner(1920) little Albert ๏ฌ Mary Cover Jones(1924)
  • 12. What is behavior? ๏ฌ 1). Respondents : antecedent-controlled ๏ฌ somatic reflexes, emotional reaction, sensations ๏ฌ 2). Operants : consequence-controlled ๏ฌ actions, instrumental responses, cognition ๏ฌ a). Behavioral excesses, b). Behavioral deficits, ๏ฌ c). Behavioral anomalies, d). Behavioral assets
  • 13. ๏ฌ Martin & Pear ๏ฌ Behavior therapy Behavior modification ๏ฌ 1). Pavlovian-Hullian Skinnerian tradition ๏ฌ -Wolpean tradition ๏ฌ 2). Clinical Nonclinical ๏ฌ 3). Therapeutic setting Natural setting ๏ฌ 4). Experimental foundation Experimental foundation ๏ฌ based on clinical setting based on animal or human ๏ฌ operant research ๏ฌ 5). European tradition American tradition
  • 14. Systematic Desensitization ๏ฌ Joseph Wolpe (1958) ๏ฌ Rationale : Reciprocal Inhibition ๏ฌ responses incompatible with anxiety ๏ฌ 1). deep muscle relaxation, 2). interpersonal assertion, 3). sexual arousal ๏ฌ combination of 1). counter-conditioning & 2). extinction
  • 15. Procedures of SD ๏ฌ 1). Diagnosis evaluation ๏ฌ History Taking, Behavioral Inventoryโ€ฆ ๏ฌ 2). Hierarchy construction ๏ฌ Anxiety hierarchy (table 7.2, p.247) ๏ฌ 3). Teaching anxiety-inhibiting responses ๏ฌ Progressive relaxation training(Jacobson, 1938) ๏ฌ 4). Conducting the therapy session ๏ฌ Imagery (imagination training) ๏ฌ In vivo
  • 16. Exposure Techniques ๏ฌ Exposed to the most anxiety-provoking stimulus for an extended period of time ๏ฌ Rationale : Extinction ๏ฌ Implosion Therapy : Thomas Stampfl(1957) ๏ฌ use of hypothetical construction ๏ฌ Flooding : (Polin, 1959) ๏ฌ use to objective anxiety-related stimuli ๏ฌ Combine with Response Prevention
  • 17. Social Skills Training ๏ฌ Social skill deficits ๏ฌ Assertiveness Training ๏ฌ appropriate expression of feeling in ways that do not infringe upon the rights of others ๏ฌ 1). Teach clients how to express themselves appropriately ๏ฌ 2). Eliminate cognitive obstacles to clear self-expression
  • 18. Modeling ๏ฌ Observational Learning (Bandura, 1969) ๏ฌ 1). Attention process ๏ฌ 2). Retention process ๏ฌ 3). Motor production process ๏ฌ 4). Incentive & motivation process ๏ฌ Model Characteristic : similarity, high status, be rewarded for their actions ๏ฌ Participant Modeling
  • 19. Aversion Therapy ๏ฌA set of techniques in which painful or unpleasant stimuli are used to decrease the probability of unwanted behaviors ๏ฌ Rationale : ๏ฌ 1). Punishment ๏ฌ 2). Escape and Avoidance Conditioning ๏ฌ 3). Classical Conditioning ๏ฌ Debate problems
  • 20. Contingency Management ๏ฌ Behavior modification procedures ๏ฌ Rationale : Status of Stimulus ๏ฌ present(+) removed(-) ๏ฌ Nature positive positive indirect ๏ฌ of (+) reinforcement punishment ๏ฌ Stimulus negative direct negative ๏ฌ (-) punishment reinforcement
  • 21. Reinforcer ๏ฌ Reinforcer vs. Punisher ๏ฌ Primary vs. Secondary Reinforcer ๏ฌ Social Reinforcer ๏ฌ Choice rules ๏ฌ 1). Personal values & needs ๏ฌ 2). Premack Principle ๏ฌ 3). Trial & error
  • 22. Schedules of Reinforcement ๏ฌ Continuous reinforcement(CRF) ๏ฌ Intermittent reinforcement (Partial) ๏ฌ 1). Ratio schedule ๏ฌ a). Fixed ratio schedule(FR) ๏ฌ b). Variable ratio schedule(VR) ๏ฌ 2). Interval schedule ๏ฌ a). Fixed interval schedule(FI) ๏ฌ b). Fixed variable schedule(VI) ๏ฌ Extinction
  • 23. ๏ฌ Shaping ๏ฌ successive approximation ๏ฌ Time Out ๏ฌ a special sample of extinction ๏ฌ Contingency Contract ๏ฌ five components: 1). Responsibilities, 2). Rewards, 3). Monitoring system, 4). Bonuses, 5). Penalties for failure ๏ฌ Response Cost
  • 24. Token Economies ๏ฌA system for implementing the principles of contingency management to alter a variety of behaviors ๏ฌ Four elements ๏ฌ 1). Target behaviors ๏ฌ 2). Token system ๏ฌ 3). Back-up reinforcers ๏ฌ 4). Rules of exchange governing
  • 25. Biofeedback ๏ฌ Behavioral methods used to control heart rate, blood pressure, muscle tension, & physiological responses are known as biofeedback ๏ฌ Monitor & feedback apparatus ๏ฌ meter reading, graph, or auditory signal ๏ฌ Used to treat several clinical disorders
  • 26. Cognitive-Behavioral Therapy(CBT) ๏ฌ Cognitive therapy : directed toward changing clientsโ€™ maladaptive cognition ๏ฌ The behavioral and cognitive approaches have tended to merge, called CBT ๏ฌ 1). Beckโ€™s Cognitive Therapy ๏ฌ approach to treatment of depression
  • 27. ๏ฌ 2). Rational Emotive behavior Therapy(REBT) ๏ฌ Albert Ellis ๏ฌ ABC Model ๏ฌ A B C ๏ฌ (Activating event) (Belief) (emotional consequence) ๏ฌ D (Dispute) ๏ฌ E F ๏ฌ (Effect) (new Feeling)
  • 28. ๏ฌ 3). Dialectical Behavior Therapy (DBT) ๏ฌ Marsha Linehan ๏ฌ Borderline Personality Disorder ๏ฌ helps the client confront any traumatic experiences ๏ฌ 4). Relapse Prevention ๏ฌ Alan Marlatt & Judith Gordon ๏ฌ Alcoholism & Substance Use Disorder ๏ฌ teach the client to monitor risky cognition and to replace them with different thinking strategies
  • 29. ๏ฌ 5). Cognitive Behavior Modification(CBM) ๏ฌ Meichenbaum, D. ๏ฌ Self-talk or Self-instruction ๏ฌ Coping-Skills Programs ๏ฌ Stress Inoculation Training (SIT) ๏ฌ a). Conceptualization Phase ๏ฌ b). Skill Acquisition & Rehearsal Phase ๏ฌ c). Application Phase