Behaviour therapies
Behavioural (functional) analysis
·uses a subjective account by the patient of antecedents of the problem, the behaviours exhibited, and the consequences (the ABC) ·uses the assumption that immediate consequences are the key determinant of behaviour ·aims to define the problem and identify key variables
·analysis of phobias includes:
·incubation
·stimulus generalization
·analysis of an agoraphobic patient includes:
·fear of closed spaces
·fear of crowds
·does not focus on recent life events or family history
Systematic Desensitization (Joseph Wolpe, 1958)
·based on social learning principles
·involves 3 stages:
1.teaching the patient to relax (progressive relaxation training)
2.a hierarchy of anxiety-arousing situations (desensitization hierarchy)
3.presenting phobic items for the hierarchy in a graded way, while the patient inhibits the anxiety by relaxation
·occurs through classical conditioning of a new calmer response to the fear-provoking stimulus – behaviour is inhibited by relaxation
·reciprocal inhibition – the pairing of an anxiety provoking stimulus with a relaxing one
Flooding
·involves exposing patients to a phobic object in a non-graded manner with no attempt to reduce anxiety beforehand ·can be done in vivo or in imagination (when it is called implosive therapy)
·studies have shown that there is little difference between flooding and systematic desensitisation in the treatment of phobias
Contact desensitization
·combines modelling and guided participation ·the ‘teacher’ models desired behaviour and guides patient through steps in a hierarchy ·does not involve relaxation (c.f. systematic desensitization) ·based on extinction rather than relaxation to inhibit the anxiety ·used in the treatment of phobias
Modelling
·the combination of live modelling with gradual practice is called participant modelling ·modelling is involved in assertiveness and social skills training
Positive Reinforcement
·involves specifying the behaviours to be strengthened through reinforcement
·e.g. token economy
Extinction
·the process of removing the reinforcers that normally follow a particular response
·extinction changes behaviours slowly
·e.g. flooding/ exposure techniques
Aversive Conditioning
·uses classical conditioning
·associates physical or psychological discomfort with behaviours that the client wishes to stop
·e.g. ANTABUSE
·covert sensitization - the client first thinks of the inappropriately attractive stimulus (e.g. obscene phone call) and is then exposed to tape-recorded depictions of frightening or disgusting stimuli (e.g. worst fears/ mother finding out)
Biofeedback
·learning to control autonomic responses by visual/ auditory feedback from one’s functions
·affected by:
·motivation
·feelings
·attitudes
·interpersonal relations
Contingency Management
·controls the contingency between reinforcement and behaviour ·controls the consequences of behaviour with appropriate reinforcement
·e.g. token economy
·improving socially adaptive behaviours, responsibility, and self-reliance
Cognitive restructuring
·based on the work of Albert Ellis ·changes faulty patterns of thinking ·attitudes affect behaviour, and changing behaviour can affect attitudes ·can be used to treat anxiety, and multiple fears in interpersonal situations
Token economies
·utilize Premack’s principle – behaviours of high frequency may be used as reinforcers for those of low frequency ·can make psychotic symptoms worse initially, but they later return to their previous level ·behaviours do not generalize
Negative Practice
·Dunlap (1932)
·used for tics, stammering, thumb-sucking, nail-biting ·relies on the patient deliberately repeating the behaviour – inhibition accumulates during massed practice ·short-term benefit, but no sustained improvement
Cognitive therapy
·emphasis on information processing
Cognitive Distortions
·arbitrary inference = conclusions in absence of evidence
·overgeneralisation = conclusion formed on basis of one incident
·selective abstraction = person abstracts from whole situation and focuses on a single incident
·personalisation = relating external events to oneself
·magnification/ minimization = errors in evaluation
·dichotomous reasoning = ‘all-or-nothing’ thinking
·reasons for abnormal cognitions:
·attend selectively
·errors in logic
·safety behaviours
General Principles
·time limited
·problem oriented
·a-historical
·homework
·openness
·Socratic questioning
Cognitive Formulation
1.Definition of the problem
2.Objective factors – current stresses, past traumatic events, current living situation
3.Internal vulnerability factors – main attitudes and beliefs which the patient holds
4.Mediational cognitive factors – typical automatic thoughts used
5.Current themes – e.g. loss of control, failure, low self-image
6.Coping skills
7.Emotions
Specific techniques
·monitor automatic thoughts
·to recognise connections between cognitions, affect, and behaviour
·to examine evidence for and against distorted automatic thoughts
·to substitute more reality-oriented interpretations
·to learn to identify and alter dysfunctional schemata
Cognitive Analytic Therapy (CAT)
·developed by Anthony Ryle (1990)
·proposes three essential patterns of what he calls neurotic repetitions
1.traps – negative assumptions generate acts which produce consequences which reinforce the assumptions
2.dilemmas
3.snags – appropriate goals are abandoned because of false assumptions
·one of the key concepts is the procedural sequence model (PSM)
·usually takes 10-12 sessions
·a goodbye letter is usually written
Behavioural (functional) analysis
·uses a subjective account by the patient of antecedents of the problem, the behaviours exhibited, and the consequences (the ABC) ·uses the assumption that immediate consequences are the key determinant of behaviour ·aims to define the problem and identify key variables
·analysis of phobias includes:
·incubation
·stimulus generalization
·analysis of an agoraphobic patient includes:
·fear of closed spaces
·fear of crowds
·does not focus on recent life events or family history
Systematic Desensitization (Joseph Wolpe, 1958)
·based on social learning principles
·involves 3 stages:
1.teaching the patient to relax (progressive relaxation training)
2.a hierarchy of anxiety-arousing situations (desensitization hierarchy)
3.presenting phobic items for the hierarchy in a graded way, while the patient inhibits the anxiety by relaxation
·occurs through classical conditioning of a new calmer response to the fear-provoking stimulus – behaviour is inhibited by relaxation
·reciprocal inhibition – the pairing of an anxiety provoking stimulus with a relaxing one
Flooding
·involves exposing patients to a phobic object in a non-graded manner with no attempt to reduce anxiety beforehand ·can be done in vivo or in imagination (when it is called implosive therapy)
·studies have shown that there is little difference between flooding and systematic desensitisation in the treatment of phobias
Contact desensitization
·combines modelling and guided participation ·the ‘teacher’ models desired behaviour and guides patient through steps in a hierarchy ·does not involve relaxation (c.f. systematic desensitization) ·based on extinction rather than relaxation to inhibit the anxiety ·used in the treatment of phobias
Modelling
·the combination of live modelling with gradual practice is called participant modelling ·modelling is involved in assertiveness and social skills training
Positive Reinforcement
·involves specifying the behaviours to be strengthened through reinforcement
·e.g. token economy
Extinction
·the process of removing the reinforcers that normally follow a particular response
·extinction changes behaviours slowly
·e.g. flooding/ exposure techniques
Aversive Conditioning
·uses classical conditioning
·associates physical or psychological discomfort with behaviours that the client wishes to stop
·e.g. ANTABUSE
·covert sensitization - the client first thinks of the inappropriately attractive stimulus (e.g. obscene phone call) and is then exposed to tape-recorded depictions of frightening or disgusting stimuli (e.g. worst fears/ mother finding out)
Biofeedback
·learning to control autonomic responses by visual/ auditory feedback from one’s functions
·affected by:
·motivation
·feelings
·attitudes
·interpersonal relations
Contingency Management
·controls the contingency between reinforcement and behaviour ·controls the consequences of behaviour with appropriate reinforcement
·e.g. token economy
·improving socially adaptive behaviours, responsibility, and self-reliance
Cognitive restructuring
·based on the work of Albert Ellis ·changes faulty patterns of thinking ·attitudes affect behaviour, and changing behaviour can affect attitudes ·can be used to treat anxiety, and multiple fears in interpersonal situations
Token economies
·utilize Premack’s principle – behaviours of high frequency may be used as reinforcers for those of low frequency ·can make psychotic symptoms worse initially, but they later return to their previous level ·behaviours do not generalize
Negative Practice
·Dunlap (1932)
·used for tics, stammering, thumb-sucking, nail-biting ·relies on the patient deliberately repeating the behaviour – inhibition accumulates during massed practice ·short-term benefit, but no sustained improvement
Cognitive therapy
·emphasis on information processing
Cognitive Distortions
·arbitrary inference = conclusions in absence of evidence
·overgeneralisation = conclusion formed on basis of one incident
·selective abstraction = person abstracts from whole situation and focuses on a single incident
·personalisation = relating external events to oneself
·magnification/ minimization = errors in evaluation
·dichotomous reasoning = ‘all-or-nothing’ thinking
·reasons for abnormal cognitions:
·attend selectively
·errors in logic
·safety behaviours
General Principles
·time limited
·problem oriented
·a-historical
·homework
·openness
·Socratic questioning
Cognitive Formulation
1.Definition of the problem
2.Objective factors – current stresses, past traumatic events, current living situation
3.Internal vulnerability factors – main attitudes and beliefs which the patient holds
4.Mediational cognitive factors – typical automatic thoughts used
5.Current themes – e.g. loss of control, failure, low self-image
6.Coping skills
7.Emotions
Specific techniques
·monitor automatic thoughts
·to recognise connections between cognitions, affect, and behaviour
·to examine evidence for and against distorted automatic thoughts
·to substitute more reality-oriented interpretations
·to learn to identify and alter dysfunctional schemata
Cognitive Analytic Therapy (CAT)
·developed by Anthony Ryle (1990)
·proposes three essential patterns of what he calls neurotic repetitions
1.traps – negative assumptions generate acts which produce consequences which reinforce the assumptions
2.dilemmas
3.snags – appropriate goals are abandoned because of false assumptions
·one of the key concepts is the procedural sequence model (PSM)
·usually takes 10-12 sessions
·a goodbye letter is usually written
No comments:
Post a Comment