DEFNITION OF BEHAVIORAL THERAPY
It is a form of treatment for problem in which a trained person deliberately
establishes a professional relationship with the patient, with objective of
removing or modifying existing symptoms and promoting positive personality
growth and development.
COVER JONES
He is often referred as ” The Mother of Behavior therapy “ for her research
work and developing testing techniques to eliminate or to reduce phobias in
children Her best known case was of a three year old boy, Peter.
Behavioral treatment for mental disorders has been found since the early
1900’s Key proponents like Skinner , Pavlov and Watson developed theories of
change and behavioral treatments.
CONCEPT OF BEHAVIOUR
The concept of behavior in psychology states the term behavior as “ the
activity of an organism interacting with its environment. It is a response to things
that are happening internally –thoughts and feelings.
Externally – environment including other people
MAJOR ASSUMPTONS OF BEHAVIORAL THERAPY
The following are the assumptions of behavior therapy
(1). All behavior is learned. (adaptive and maladaptive).
(2). Human biengs are passive organisms that ca n be conditioned or shaped to do
anything, if correct responses are reinforced.
(3). Maladaptive behavior can be unlearned and replaced by adaptive behavior , if
the person receives exposure to specific stimuli and reinforcement for the desired
adaptive behavior.
(4). Behavior assessment is focused more on the current behavior rather than on
historical antecedents.
(5). Treatment strategies are individually tailored.
BEHAVIOUR TECHNIQUES
SYSTEMIC DESENSITIZATION
It was developed by Joseph wolpe , based on the behavioral principle of counter
conditioning
In this , patient attain a state of complete relaxation and are then exposed to the
stimulus that elicits the anxiety response. The negative reaction of anxiety is
inhibited by the relaxed state, a process called reciprocal inhibition.
It consists of three main steps.
(1) Relaxation training.
(2) Hierarchy construction.
(3) Desensitization of stimulus.
RELAXATION TRAINING
There are many methods which can be used to induce relaxation. Some of them
are
(1) Hypnosis.
(2) Meditation.
(3) Mental imagery.
(4) Biofeedback.
HIERACHY CONSTRUCTION
Here the patient is asked to list all the conditions which provoke anxiety, then he
is asked to list them in descending order of anxiety provocation.
DESENSITIZATION OF STIMULUS
This can either be done in reality or through imagination. At first, the
lowest item in hierarchy is confronted. The patient is advised to signal whenever
anxiety is produced. After a few trials , patient is able to control his anxiety
gradually.
PRINCIPLES OF BEHAVIOURAL THERAPIES
THEORY OF OPERANT CONDITIONING
It involves learning of reinforcement
Example : rewards and punishment and can explain abnormal behavior should as
eating disorders.
THEORY OF CLASSICAL CONDITIONING
It involves learning by association and is usually the cause many phobias.
INDICATIONS OF BEHAVIOURAL THERAPY
(1) Obsessive compulsive disorder.
(2) Post traumatic and stress disorder’
(3) Depression and substance abuse.
(4) Social phobia and eating disorder.
(5) Bipolar disorder and chronic pain.
(6) Autism , generalized anxiety disorder.
(7) Personality disorder.
(8) Specific phobia , schizophrenia.
OPERANT CONDITIONING PROCEDURE TO TEACH NEW BEHAVIOUR
MODELING
It is a method teaching by demonstration where a therapist shows how a specific
behavior is to be performed. In modeling the patient observes other patient
indulging in target behavior and getting rewards for those behaviors. This will
make the patient repeat the same behavior and earn reward in the same manner.
SHAPING
In shaping the components of a particular skill, the behavior is reinforced step by
step .The therapist starts shaping by reinforcing , the existing behavior.
CHAINING
CHAINING
Chaining is used when a person fails to perform a complex task. The complete
task is broken into a number of small steps and each step is taught to the patient.
In forward chaining one start with first steps, goes on to the second step then to
the third and so on. In backward chaining one starts with last step and goes on to
the next step in a backward fashion.
OPERANT CONDITIONING PROCEDURE FOR DECREASING
MALADAPTIVE BEHAVIOUR
MALADAPTIVE BEHAVIOUR
EXTINCTION / IGNORING
It means removal of attention rewards permanently following a problem
behavior. This includes actions like not looking at the patient, not talking to the
patient or having no physical contact with the patient. This is used when patients
exhibit odd behavior.
PUNISHMENT
This procedure should be administered immediately and consistently following
the undesirable behavior with clear explanation. Desirable punishment should
always be added when a punishment is being used for decreasing an undesirable
behavior.
TIME OUT
This method includes removing the patient from reward or reward from the
patient for a particular period of time following a problem behavior. This is often
used in the treatment of childhood [Link] example , child is not allowed to
go out of the ward to pay, if he fails to complete the given work.
RESTITUTION ( OVER CORRECTION )
It means restoring the disturbed suituation to a state that is much
better than what it was before the occurrence of the problem behavior.
For example, if a patient passes urine in the ward, he would be required
to not only clean the dirty area but also map the entire area of the floor
in the ward.
ASSERTIVENESS AND SOCIAL SKILL TRAINING
ASSERTIVE TRAINING
It is behavior therapy technique in which patient is given training to
bring about change in emotional and other behavioral pattern by being
assertive. Patient is encouraged not to be afraid of showing an
appropriate response , negative or positive to an idea or suggestion.
Assertive behavior training is given by the therapist, first by role play
and then by practice in a real life situation.
SOCIAL SKILL TRAINING
Social skill training helps to improve social manners like encouraging eye
contact, communication skill, observing simple etiquette and relating to
people.