COUN Theory Exam 2 - Behavior Therapy

4 common criticisms of behavior therapy

1. behavior therapy may change behaviors, but it does not change feelings 2. behavior therapy does not provide insight 3. behavior therapy treats symptoms rather than causes 4. behavior therapy involves control and social influence by the therapist

Four areas of development in contemporary behavior therapy

1. classical conditioning 2. operant conditioning 3. social-cognitive theory 4. cognitive behavior therapy

4 specific unique characteristics of behavioral group therapy

1. conducting a behavioral assessment 2. precisely spelling out collaborative treatment goals 3. formulating a specific treatment procedure appropriate to a particular problem 4. objectively evaluating the outcomes of therapy

5 core themes of 3rd generation behavior therapy

1. expanded view of psychological health 2. broad view of acceptable outcomes in therapy 3. acceptance 4. mindfulness 5. creating a life worth living

Albert Bandura's 4 areas of research - Behavior Therapy

1. power of psychological modeling in shaping thought, emotion, action 2. mechanisms of human agency, human motivation and choice 3. people's perceptions of their efficacy to exercise influence over the events that affect their lives 4. how stress reactions and depressions are caused

3 step process for desensitization - Behavior Therapy

1. relaxation training (progressive muscle relaxation) 2. development of a graduated anxiety hierarchy 3. systematic desensitization

5 Basic Steps for a Self-Management Program

1. selecting goals 2. translating goals into target behavior 3. self-monitoring - keep a behavioral diary 4. working out a plan for change 5. evaluating an action plan

4 general approaches that can be applied to the practice of behavioral groups

1. social skills training groups 2. psychoeducational groups with specific themes 3. stress management groups 4. mindfulness and acceptance-based behavior therapy groups

Multimodal therapy

Arnold Lazarus grounded in social cognitive learning theory treatment is cognitive behavioral, empirically supported, applies diverse behavioral techniques from a variety of theories to a wide range of problems (technical eclecticism) -breadth over depth

Behavior Therapy in late 1990s

Association for Advancement of Behavior Therapy becomes Association for Behavioral and Cognitive Therapies (ABCT) and claims membership of about 4,500

Albert Bandura's Social Cognitive Theory - Behavior Therapy

(Bandura renamed social learning theory) -how humans function as self-organizing, proactive, self-reflective, and self-regulating beings

Behavior Therapy in the 1960s

-Albert Bandura's social learning theory and focus on cognition -social learning theory combined classical and operant conditioning with observational learning -CBT approaches spring up

Behavior Therapy in the 1970s

-Contemporary behavior therapy emerges and has major impact on education, psychology, psychiatry, psychotherapy, and social work -Behavioral techniques presented as solutions in business, child-rearing, and psychological problems

Key elements of social skills training

-assessment -direct instruction -coaching -modeling -role plays -homework assignments *follow up phase is critical for clients in establishing a range of effective behaviors that can be applied to many social situations

Zen teachings in DBT

-being aware of present moment -seeing reality without distortion -accepting reality without judgment -letting go of attachments that result in suffering -developing greater degree of acceptance of self and others -entering fully into present activities

Client's role in ACT

-commitment to action -make mindful decisions about what they are willing to do to live a valued and meaningful life -completing homework and doing behavioral exercises

General goals of behavior therapy

-increase personal choice -create new conditions for learning

Goals of ACT

-individuals become aware of and examine thoughts -individuals learn to change their relationship to their thoughts -learn to accept yet not identify with thoughts and feelings they have been trying to deny

Mindfulness-Based Cognitive Therapy (MBCT)

Adapted from Kabat-Zinn's MBSR -8 week group treatment program, brief, efficient, cost-effective -skills of mindfulness applied to treating depression -integrates MBSR with cognitive behavioral skills (addressing negative thought patterns)

Social-cognitive approach - Behavior Therapy

Albert Bandura and Richard Walters -triadic reciprocal interaction among the environment, personal factors (beliefs, preferences, expectations, self-perceptions, and interpretations) and individual behavior the environmental events on behavior are mainly determined by cognitive processes governing how environmental influences are perceived and interpreted by an individual

More on self compassion by Neff (2012) - Mindfulness-Based Cognitive Therapy

-self-compassionate people recognize when they are suffering and are kind toward themselves in those moments -self-compassion is associated with greater wisdom and emotional intelligence -self-compassion is associated with feelings of life satisfaction and connection to others -self-compassionate individuals tend to experience increased happiness, optimism, curiosity, and positive emotions -self-compassion engenders compassion toward others

ACT and values

-work of ACT depends on what an individual wants and values -therapy involves assisting clients to choose values they want to live by, designing specific goals, and taking steps to achieve goals

Behavior Therapy in the 1980s

Increased attention to role of emotions in therapeutic change, as well as to the role of biological factors in psychological disorders 2 significant developments in the field (1) continued emergence of CBT (2) application of behavioral techniques to prevention and treatment of health-related disorders

Progressive muscle relaxation was initially developed by

Jacobson

Mindfulness-Based Stress Reduction (MBSR)

Jon Kabat-Zinn meant to relieve medical patients of stress, pain, illness, suffering designed to help people increase their responsibility for their own wellbeing and actively develop inner resources for treating physical health concerns -eight week structured group program -training in mindfulness and meditation *not a form of psychotherapy per se

Systematic Desensitization

Joseph Wolpe -based on principle of classical conditioning Clients imagine successively more anxiety-arousing situations at the same time that they engage in a behavior that competes with anxiety. Gradually they become less sensitive to the anxiety-arousing situation. -often used to treat phobias

Mindfulness-Based Stress Reduction and cognition

MBSR does not actively teach cognitive modification techniques, nor does it label certain cognitions as "dysfunctional" because this is not consistent with the nonjudgmental attitude one cultivates with mindfulness

Dialectical Behavior Therapy (DBT)

Marsha Linehan -originally developed to treat chronically suicidal individuals with Borderline -blend of behavioral, cognitive-behavioral and psychoanalytic techniques -acceptance and change-oriented strategies -mindfulness -one year treatment, includes both individual and group skills training

This approach serves as a major link between some behavioral principles and the cognitive behavioral approach

Multimodal therapy

Behavior therapy and insight

This approach assumes that change can take place without insight into underlying dynamic and without understanding the origins of a psychological problem

Eye Movement Desensitization and Reprocessing (EMDR)

a form of exposure therapy -entails assessment and preparation, imaginal flooding, cognitive restructuring in the treatment of individuals with traumatic memories -involves use of rapid, rhythmic eye movements and other bilateral stimulation

self compassion - Mindfulness-Based Cognitive Therapy

a form of self-care when facing difficult situations -mindfulness is a way of developing self-compassion -self compassion is positively associated with mental wellbeing and decreased levels of anxiety and depression

Acceptance and Commitment Therapy (ACT)

a mindfulness-based approach -uses acceptance, mindfulness, commitment, and behavior change strategies to increase psychological flexibility -involves fully accepting present experience and mindfully letting go of obstacles -little emphasis on changing the content of a client's thoughts, clients are meant to accept cognitions

Acceptance

a process involving receiving one's present experience without judgment or preference, but with curiosity and kindness, and striving for full awareness of the present moment

Operant conditioning

a type of learning in which behaviors are influenced mainly by the consequences that follow them -if the environmental changes brought about by the behavior are reinforcing, the chances are increased that the behavior will occur again

How does ACT define acceptance?

acceptance is not merely tolerance, it is the active nonjudgmental embracing of experience in the here and now

kindness - Mindfulness-Based Cognitive Therapy

acknowledging our shortcomings without critical judgment

By replacing judgment, criticism, and avoidance with acceptance, you increase

adaptive functioning

Behavior therapy has been used to successfully treat...

anxiety disorders, depression, PTSD, substance abuse, eating and weight disorders, sexual problems, pain management, hypertension

Behavior therapy and assessment

assessment is an ongoing process of observation and self-monitoring that focuses on current determinants of behavior, including identifying the problem and evaluating the change

punishment is also known as - Behavior Therapy

aversive control consequences of a certain behavior result in a decrease of that behavior

Underlying assumption of multimodal therapy

because individuals are troubled by a variety of specific problems it is appropriate that a multitude of treatment strategies be used in bringing about change -multimodal therapists aim to determine precisely what relationship and what treatment strategies will work best with each client and under which particular circumstances

functional assessment - Behavior Therapy

behavior therapists look to the current environmental events that maintain problem behaviors and help clients produce behavior change by changing environmental events Wolpe refers to this as a behavioral analysis *goal is to understand ABC sequence

Behavior Therapy in early 2000s

behavior tradition has broadened considerably, involved enlarging scope of research and practice "third generation" or "third wave" of behavior therapy includes DBT, Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and ACT

Therapeutic relationship - Behavior Therapy

behavioral practitioners have increasingly recognized the role of the therapeutic relationship as a critical factor related to outcome of treatment -empathy, warmth, etc are necessary but not sufficient for behavior change to occur

informal mindfulness practice - Mindfulness-Based Stress Reduction

being mindful while standing, walking, eating, doing chores

Self-Management Programs and Self-Directed Behavior

change can be brought about by teaching people to use coping skills in problematic situations -strategies include teaching clients how to select realistic goals, translate goals into target behaviors, create an action plan for change, and ways to self-monitor and evaluate their actions

Mindfulness-Based Cognitive Therapy primary aim

change clients' awareness of and relation to their negative thoughts

Progressive Muscle Relaxation

client assumes a passive and relaxed position in a quiet environment while alternately contracting and relaxing muscles deep and regular breathing, possibly focusing on pleasant thoughts or images useful for clients to experience the difference between a tense and a relaxed state

Second session of MBCT

clients learn reactions they have to life experiences, learn more about mindfulness, learn importance of kindness and compassion towards self and others

Flooding

consists of intense and prolonged exposure to the actual anxiety-producing stimuli

Clients and goals - Behavior Therapy

contemporary behavior therapy stresses clients' active role in formulating specific measurable goals goals must be clear, concrete, understood, and agreed upon by the client and counselor - results in a contract that guides therapy *behavior therapists and clients alter goals as needed

Where does most distress/suffering originate - Mindfulness-Based Stress Reduction (MBSR)

continually wanting things to be different from how they actually are -MBSR assists people in learning how to live more fully in the present rather than ruminating about the past or worrying about the future

The current trend in behavior therapy is toward developing procedures that give...

control to clients and thus increase their range of freedom -aims to increase people's skills so they have more options for responding

The functional analysis in Behavior Therapy incorporates the client's... (making it appropriate for diverse clients)

cultural context!

Sixth session of MBCT

describing thoughts as "merely thoughts", clients learn they do not have to act on thoughts "I am not my thoughts" "Thoughts are not facts"

Consequences - Behavior Therapy

events that maintain a behavior in some way, either by increasing it or decreasing it

Systematic desensitization can be considered a form of _____________ therapy

exposure

BF Skinner - Behavior Therapy

father of behavioral approach to psychology -radical behaviorism -determinist -paid attention to environmental factors that can be observed and changed -concept of reinforcement

Those in the Mindfulness-Based Stress Reduction program are encouraged to practice...

formal mindfulness meditation for 45 minutes daily

Third session of MBCT

gathering the scattered mind, breathing techniques, focusing on present experience, anchoring thoughts with a focus on the breath

by the mid-1970s, CBT...

had replaced behavior therapy as the accepted designation the field began emphasizing interaction among affective, behavioral, and cognitive dimensions

BF Skinner's deterministic view - Behavior Therapy

he did not believe humans had free choice -feelings and thoughts exist, but they do not cause our actions -cause-and-effect links between objective environmental conditions and behavior

Goals of DBT

helping clients make changes in their behavior and environment while communicating acceptance of their current state -learn to integrate the opposing notions of acceptance and change -regulating emotions and behaviors

Distress tolerance - DBT

helping individuals calmly recognize emotions associated with negative situations without becoming overwhelmed by situations learn how to tolerate pain and discomfort

Fifth session of MBCT

how to accept experiences without holding on; value of allowing and letting be

Emotional Regulation - DBT

identifying emotions, identifying obstacles to changing emotions, reducing vulnerability, increasing positive emotions learning the benefits of regulating emotions such as anger, depression, and anxiety

First session of MBCT

identifying negative automatic thinking associated with depression, introducing basic mindfulness practices

Two variations of traditional systematic desensitization

in vivo exposure flooding

Essential components of Mindfulness-Based Cognitive Therapy

kindness and self compassion

The major reason many people do not attain their goal - Self Management Programs

lack of certain skills or unrealistic expectations of change hope can be a therapeutic factor that leads to change, but unrealistic hope can lead to failure

Seventh session of MBCT

learning how to take care of oneself, develop an action plan in case of relapse

Fourth session of MBCT

learning to experience the moment without becoming attached to outcomes, sitting meditation and mindful walking

the core of therapy - Behavior Therapy

learning!

Eighth session of MBCT

maintaining and extending new learning, generalizing mindfulness practices to daily life

The third wave (or third generation) of behavior therapy emphasizes things that were considered off limits for behavior therapists until recently...

mindfulness, acceptance, the therapeutic relationship, spirituality, values, meditation, being in the present moment, emotional expression

Four modules of DBT

mindfulness, interpersonal effectiveness, emotional regulation, distress tolerance

Albert Bandura's Social Modeling - Behavior Therapy

modeling is a powerful process that explains diverse forms of learning

What does behavior include? - Behavior Therapy

not limited to overt actions that we can observe, includes internal processes such as cognitions, images, beliefs, and emotions

Most of the significant responses we make in everyday life are examples of _________________

operant behaviors

The key characteristic of a behavior is that it is something that can be __________________

operationally defined

Basic assumption of social-cognitive approach - behavior therapy

people are capable of self-directed behavior change and that the person is the agent of change

BF Skinner's radical behaviorism - Behavior Therapy

places primary emphasis on effects of environment on behavior

Most powerful change agent in Behavior Therapy

positive reinforcement! some behavioral practitioners are opposed to using aversive control or punishment and recommend substituting positive reinforcement -key principle is to use least aversive means possible

Albert Bandura's Social Learning Theory - Behavior Therapy

prominent role of observational learning and social modeling in human motivation, thought, and action

Classical conditioning (respondent conditioning)

refers to what happens prior to learning that creates a response through pairing

behavior therapy is based on principles and procedures of the ___________________

scientific method -evaluation methods are used to discern the effectiveness of both assessment and treatment procedures -therapeutic techniques employed must have demonstrated effectiveness

Albert Bandura's Self Efficacy - Behavior Therapy

self efficacy is the individual's belief or expectation that he or she can master a situation and bring about desired change people need a sense of self-efficacy and resilience to create a successful life and to meet the inevitable obstacles and adversities they encounter

formal mindfulness practice - Mindfulness-Based Stress Reduction

sitting meditation, mindful yoga, body scan meditation

Albert Bandura - Behavior Therapy

social modeling, social learning theory, social cognitive theory, self-efficacy -humans are not simply reactive organisms shaped by the environment -humans are not simply driven by inner impulses -inner cognitive-affective forces that motivate human behavior

Shortcomings from a Diversity Perspective - Behavioral Therapy

some counselors focus on using techniques to narrowly treat specific behavioral problems instead of viewing clients in sociocultural context (focusing too much on problems within the individual)

Strengths from a diversity perspective - Behavior Therapy

specificity, task orientation, focus on objectivity, focus on cognition and behavior, action orientation, focus on present rather than past, emphasis on brief interventions, coping strategies, problem-solving orientation, *focus on environmental conditions that contribute to client's problems* and gives special attention to culture

behavioral concepts and procedures are... (3 things)

stated explicitly, tested empirically within a conceptual framework, and revised continually

Relaxation procedures are often applied to problems related to

stress and anxiety also helpful for preparing patients for surgery, coping with chronic pain, asthma, headache, hypertension, insomnia, IBS, and panic disorder

The DBT environment is...

structured and predictable

Some techniques used by behavior therapists that are common to other approaches

summarizing, reflection, clarification, and open-ended questioning

Interpersonal effectiveness - DBT

teaches clients to ask for what they need, how to say "no", increases chances that client's goals will be met without damaging relationships

Exposure therapy used in DBT

teaches clients to learn to tolerate painful emotions without enacting self-destructive behaviors

Role of therapist - Multimodal therapy

tend to be very active, trainers, educators, coaches, role models provide feedback, information, instruction, and model assertive behaviors offer suggestions, positive reinforcement, and are appropriately self-disclosing

Mindfulness

the awareness that emerges through having attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment by moment -clients train themselves to focus on present experience with acceptance, and develop an attitude of curiosity and compassion

Behavioral Assessment Interview

therapist's task is to identify the particular antecedent and consequent events that influence, or are functionally related to, an individual's behavior

The therapeutic relationship - Multimodal Therapy

therapists recognize that a good working alliance is a cornerstone of the foundation of effective therapeutic practice

Contemporary behavior therapy is no longer limited to... and it increasingly overlaps with...

treatments based on traditional learning theory; other theoretical approaches

extinction - Behavior Therapy

withholding reinforcement from a previously reinforced response