Treatment Components Behavioral Reconditioning

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Treatment ComponentsBehavioral Reconditioning

• Anna C. Salter

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Behavioral Reconditioning

• Easy to Do Wrong
• Hard to Do Right
• (Steve Jenson, personal communication 11/30/09)

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Behavioral Principles 1

• Dont let person become highly aroused
• Use minimal arousal conditioning
• Being highly aroused is reinforcing
• (Steve Jenson, personal communication 11/30/09)

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Two Components to Deviance

• Sexual urge
• Cognitions that support it
• (Steve Jenson, personal communication 11/30/09)

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Normal and Deviant

• Normal Deviant
• Some urges Intense frequent Controlled by
  urges supported cognition by deviant
• cognitions

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Minimal Arousal Conditioning

• Aversive conditioning
• Minimizing victim contact
• Dealing with spontaneous arousal
• Cognitive restructuring
• Peer relationships

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Minimal Arousal Conditioning

• Punish at first signs of minimal arousal
• Do not wait
• Until full arousal

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Instructions

• We would like you to write a two to three page
  description of one of the most exciting sexual
  encounters you had with your victim. The
  description should include a) where you were,
  b) how you approached your victim, c) how you got
  your victim to cooperate, d) what you did
  sexually, e) how your victim responded, (what did
  they say or do) and f) how the sexual contact
  concluded.
• (Jensen 2002, p. 2)

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1) Aversive Conditioning

• At home
• Every day for 12 weeks
• Ammonia simplest
• Wide mouth jar
• Lid on
• Read scenario to point of first arousal (well
  before sexual behavior)
• Open jar close enough for startle
• Repeat 20 times
• Every day 12 weeks

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If Working

• Dramatic reduction
• 2 weeks
• (Steve Jensen, personal communication, 11/30/09)

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1) Covert Sensitization

• Two to three weeks after starting
• No irrational punishers
• Develop 10 to 20 punishers
• My wife walks in . . .
• Im at work and the police come to arrest
  me. . .

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Where and When

• Aversive Conditioning
• Covert Sensitization
• In the morning
• Place that is private, comfortable
• Rate their arousal as they do it from 1-10

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• Write a two to three page description of any
  other deviant behavior or fantasies not
  previously represented.
• Write a list of at least 10 consequences of your
  sexual behavior to your victim.
• Write a list of at least 10 consequences of your
  sexual behavior to your victim and others.

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• Write a list of at least 10 consequences to you
  if you were to reoffend.
• Write a list of all the reasons that you used to
  make it OK to sexual abuse your victim.
• (Jensen, 2002, p. 2)

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Combining Techniques

• After arousal is controlled by aversive
• 10 repetitions of aversive
• Read 10 different consequences to the victim
• 10 repetitions of aversive
• Read 10 different consequences to self

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Time Line

• Takes 8 to 10 weeks to develop clear lists of
  faulty cognitions (risky thinking)

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1) Covert Sensitization

• After 2 months make a decision working or not?
• If not working, ammonia every other day and
  slowly reduce

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1) Covert Sensitization

• If doesnt work, use maintenance ammonia 10
  repetitions a month
• If fantasies more than once a month, go back to
  aversive

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Behavioral Principles 2

• Aversive conditioning phobic response
• Being around victim ages will desensitize
• (Steve Jenson, personal communication 11/30/09)

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Behavioral Principles 2

• Do not permit nonaversive contact with
• victim ages
• Exit situations with victim ages
• Could not be in home with victims
• (Steve Jenson, personal communication 11/30/09)

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Behavioral Principles 2

• Nonaversive contact is re-enforcing
• Punishment or aversive conditioning
• Only works
• If consistent
• (Steve Jenson, personal communication 11/30/09)

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Behavioral Principle2

• Single arousal or deviant masturbation
• Can undo
• Months of work
• (Steve Jenson, personal communication 11/30/09)

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2) Minimize Contact with Sources of Arousal

• No going to places where victims congregate
• Hanging around kids sports, etc.
• Playing with victims
• Living in home if victims there
• (Steve Jensen, personal communication, 11/30/09)

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3) Dealing with Spontaneous Arousal

• Whenever begins to have inappropriate sexual
  thoughts
• Punish within 10 seconds Ammonia wipes
• Remove from situation
• Before sexual arousal
• Report to support person
• Had this encounter
• Recognized it
• This is how I handled it

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4) Cognitive Restructuring

• Not enough to look at consequences
• Above works for dumb decision
• Doesnt work for deeply held beliefs

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What Does Work

• Deep relaxation (similar to hypnosis) tapes
• Generate as many faulty cognitions as possible
  may have 50 excuses
• Pick 10 to 20
• Identify why they are faulty
• Write out appropriate responses

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Appropriate Responses

• 3 to 6 words
• Faulty Cognition Some children really enjoy sex
  with older kids.
• Counter Its hurtful for young kids to have
  sex with older kids.

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4) Cognitive Restructuring

• Add appropriate response to tape
• There are some thoughts I want to change about
  myself.
• Do not record faulty responses
• Every day play tapes 3 to 4 months

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4) Cognitive Restructuring

• Universal Cognitive Distortions
• I wont get caught.
• It really doesnt do any harm.

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Plethysmograph

• Used to monitor change or no change