Behavior Therapy

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Behavior Therapy
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Review

• Psychoanalysis
• Interpersonal Psychotherapy (IPT)
• Client Centered Therapy (Humanistic)
• Behavior Therapy
• Cognitive Behavior Therapy
• Community Psychology
• Ethics

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Behavior Therapies

• Systematic Desensitization
• Exposure therapy
• Invivo desensitization
• Flooding
• Token Economy
• Modeling

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Conditioning Paradigm Terminology

• UCS- Unconditioned stimulus which naturally,
  without learning elicits.
• UCR- Unconditioned response-reflex
• CS- Conditioned stimulus-previously neutral
  stimulus that, through repeated paring with UCS,
  elicits a .
• CR- Conditioned response

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Conditioning Paradigm

• UCS------------------------------?UCR
• Meat
  Salivation
• 
  
• 
  
• CS--------------------------------? CR
• Sound of Experimenter-------? Salivation

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The Dorm and Classical Conditioning

• UCS------------------------------?UCR
• Hot Water Jump
  
• 
  
• 
  
• CS--------------------------------? CR
• Toilet Flush -------? Jump

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Balloon Popping

• Conditioning Paradigm
• UCS------------------------------?UCR
  
• 
  
• 
  
• CS--------------------------------? CR

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Classical Conditioning

• Clinical Applications

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Systematic Desensitization

• Developed by Joseph Wolpe
• Pair relaxation with CS

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Systematic Desensitization Components

• Anxiety hierarchy
• Relaxation training
• Desensitization proper

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Anxiety Hierarchy

• Series of statements about a feared situation
• Ordered from least to most anxiety provoking
• Example
• Item
• The morning of your French exam
• Better Item
• You are in the bathroom brushing your teeth on
  the morning of your French exam

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Types of Hierarchies

• Spatial-temporal- items on the hierarchy get
  physically closer or get closer in terms of time
• Thematic - Items on the hierarchy share a basic
  theme

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Spatial-temporal hierarchy

• A temporal hierarchy for a public speaking
  phobia
• Someone asks you to give a speech in two months
• Writing the speech a month before
• Rehearsing the speech a week before
• The morning of the speech
• Reciting the speech while dressing
• Approaching the auditorium
• Walking up to the podium
• Giving the speech

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A spatial hierarchy for a dog phobia

• Seeing a dog go by in a car
• Seeing a dog in a yard on a leash and behind a
  fence
• Dog poking nose through the fence
• Passing a leashed dog across the street
• Passing a leashed dog on same side of street

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Thematic hierarchies public speaking phobia

• Telling a joke to several friends
• Making an announcement to a group of coworkers
• Speaking at a meeting
• Speaking at company banquet
• Giving the main address at a stockholders
  convention

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Relaxation training

• Progressive relaxation

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Desensitization Proper

• Get client in a relaxed state
• Present first item on hierarchy
• If no anxiety is signaled, present item a second
  time. After two presentations without anxiety
  move to next item
• If anxiety is signaled, return to relaxation.
  Present item again. If anxiety still occurs go
  back to earlier step or reconstruct hierarchy.
• Continue up the hierarchy until all items can be
  imagined without anxiety

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If item raised anxiety

• Present item again
• Present previous item
• Create a new item midway between anxiety item and
  previous item

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Exposure Therapy

• Patients expose themselves to feared objects or
  situations
• Exposure can be real (invivo) or imagined

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Exposure Therapy Necessary Factors

• Long exposure
• Repeated exposure until fear dissipates
• Graduated exposure
• Attention to fear object
• Anxiety must be present

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In-Vivo Desensitization

• Instead of imagining a situation, the client
  actually confronts gradually more anxiety
  producing stimuli

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Flooding or therapeutic extinction

• Abandons the hierarchy
• Person confronts most upsetting situation right
  away

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Disadvantages of Flooding

• Anxiety provoking
• Less room for error

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Sensitization Therapy

• Aversion therapy
• Covert Sensitization

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Aversion Therapy

• Conditioned stimulus is paired with a stimulus
  that elicits a negative response
• CS-------------------------------------? CR
• Small children
  Sexual excite
• UCS----------------------------------? UCR
• Drug
  Nausea

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Covert Sensitization

• Pairing of object or situation with an aversive
  scene that is imagined

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Token Economy
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Token Economy

• Tokens poker chips, coins, tickets, stars,
  points, checkmarks, etc. that function as money
• Exchanged for back-up reinforcers
• Token economy reinforcement system bases on
  token

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Advantages of Tokens

• Maintain behavior at a high level
• Bridge delay between response and reinforcement
• Less subject to satiation
• Easily administered
• Permits administration of a single reinforcer

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Token Economy Achievement Place

• Residents earned redeemable tokens
• Receipt of tokens contingent on good behavior
• Undesirable behavior punished through response
  costs

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Behaviors that Earned Points
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Behaviors that Lost Points
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Back-up Reinforcers

• Variety were available
• Going downtown 1,000 points
• Using woodworking tools 500 points
• Prices were adjusted television more expensive
  in the winter
• One of a kind events rock concert, sport event
  used an auction for highest bidder

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Logistics

• After 4 consecutive weeks of success, privileges
  are free.
• If behavior deteriorates, token economy
  reinstated.

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Observational Learning
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Observational Learning as Therapy

• Modeling forms basis of many therapies
• Animal fears
• Dentist office
• Preparing for non-surgical procedures

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Observational Learning and the Dentists Office

• Melamed et al (1978)
• Video of cooperative child
• Video of demonstration of dental procedure
• Result Viewing child model was associated with
  less disruptive behavior and less fear

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Preparing for Nonsurgical Procedures

• Endoscopy
• Vidotape modeling
• Group 1 Viewed video three times
• Group 2 Viewed video once
• Control Viewed an unrelated tape
• Physicians and Nurses rated patients anxiety
• Results The more preparation the better