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BEHAVIOR

THERAPY
MR. JAYESH PATIDAR
www.drjayeshpatidar.blogspot.com
DEFINITION:-
It is a form of psychotherapy which
focuses on modifying faculty behavior
rather basic changes in the personality.
Instead of probing the unconscious or
exploring the patients thoughts &
feelings, behavior therapist tries to
eliminate the symptoms & modify
ineffective or maladaptive pattern by
applying basic learning techniques.
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BEHAVIOR THERAPY TECHNIQUES
1. Behavioral modification
2. Systematic desensitization
3. Aversion therapy
4. Assertiveness training
5. Cognitive behavior therapy
6. Implosive (flooding) therapy
7. Positive reinforcement
a. Response shaping
b. Modelling
c. Token economy
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1. BEHAVIOR MODIFICATION
It is also called simple Extinction.
Learned behavior pattern becomes a
waste or disappears if it is not reinforced.
To eliminated a maladaptive behavior one
has to remove the reinforcement for it.
It is effective when reinforcement is being
used without the knowledge of the
affected individual
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For Example;
Every time sonu, a nine year old girl bites her
nails, her mother gives her an angry look. Sonu
understand the mother anger & tries not to
repeat the bad habit. A maladaptive behavior
is gradually removed. Mother anger is a
punishment for sonu .
Reward are also provide to reduce the
maladaptive learning. Rishu, 11 year old boy,
is told that if he studies one hour regularly on
his own in class VI he could be allowed to buy a
crocket set of his choice.
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2. SYSTEMATIC DESENSITIZATION
It is a form of behavior therapy developed by
Joseph Wolpe.
The objective of the therapy is to reduce or
elimination fear or anxiety in which;
I. The patient is trained in deep muscles
relaxation.
II. He has various anxiety-provoking situation or
specific phobia, such as fear of death, fear of
animals. These problems are placed from the
strongest to the weakest order i.e. the client is
anxious about which one is causing anxiety the
least.
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. Each of these situations is presented in imagination
or in reality beginning with the weakest. Once the
patient relaxes while imagining, that means the
anxiety is getting reduced gradually.
For Example; A child is having fear of crossing the
road. For a few days the mother can take the child
to the road & just stand & talk about other thing.
The child keeps observing people crossing the road.
Than after 2-3 days mother & child cross the road
while they are talking. This may reduce the anxiety
in a child as he is allowed to cross the road in a
relaxed manner. Therapy is very useful for patient
who have developed certain fears specially to
domestic animals like dog.
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3. Aversion Therapy
It is a form of behavior therapy in which
the patient is conditioned to avoid an
undesirable behavior or symptoms by
associating them with painful or
unpleasant experiences, such as putting
a bitter taste on nails or tongue for nail
biting, giving drug like apormorphine
which cause nausea & vomiting on
taking alcohol or an electric shock to
treat a child with enuresis.
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Aversion therapy has been used for
alcoholism, transvestism, compulsive
unacceptable social behavior like
homosexuality & other sexual deviation.
Typically, 20-40 session are given, with
each session lasting about 1 hour. After
completion of treatment, booster session
may be given.
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4. ASSERTIVENESS TRAINING
It is a behavior therapy techniques in
which the patient is given training to
bring about changes in emotional & other
behavioral pattern by asserting himself.
One is encouraged not to be afraid of
showing an appropriate response,
negative or positive, to an idea or
suggestion.
The assertive behavior training is given
by the therapist first by role playing &
then by practice in a real life situation.
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Attention is focus on more effective
interpersonal-skill.
The most techniques used in assertiveness
training is behavioral rehearsal, in which
the patient act out problematic
interpersonal interactions with the nurse or
therapist. After this role-playing specific
maladaptive behavior are identified & the
client behavior can be adapted.
This training can be used for client with
bulimia nervosa & major depression,
mentally healthy & mentally ill persons.
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5. COGNITIVE BEHAVIOR THERAPY
It is a psychotherapeutic approach based on the
idea that emotional problems in an individual
arise due to faulty ways of thinking & distorted
attitude towards oneself & others.
The therapist takes the role of a guide who helps
the patient to correct & revise his perceptions &
thoughts.
This helps the patient to change his thoughts,
feelings & behavior about himself.
Cognitive behavior therapy is considered effective
in the treatment of depression & adjustment
difficulties.
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6. IMPLOSIVE THERAPY (FLOODING)
It is a behavior therapy techniques
opposite to systematic desensitization, no
prior relaxation techniques are taught to
the patient.
In this therapy, an individual is exposed
directly to a maximum intensity fear-
producing situation either in imagination
or in real life. The patient gradually feels
no actual danger in the situation.
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For Examples; He has developed
intense phobia of a lizard. During
psychotherapy session suddenly the
therapist puts a rubberized lizard on
the table. For a minute the patient may
get scared but gradually may start
handling a rubberized lizard while
taking.
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7. POSITIVE REINFORCEMENT
It is a stimulus or stimulus situation
which is given to a patient or individual
after the response.
When the stimulus is given after the
response it is on the basis that the
strength of the response is increased &
that the response will appear again.
Examples; as soon as the infants gets up
& walks, the mother claps & gives the
infant a piece of chocolate to enjoy.
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Positive Reinforcement can be done by:
a. Responsive shaping
b. Modelling
c. Token Economy
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a. Response Shaping:
Positive reinforcement is used in
response shaping or incorporating or
establishing a response which is not
existing in an individuals behavior.
This technique is used in a behavior
problem or mental retardation.
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For example; Shubam, 14, has an
intelligence level of a five years old
child. He had never done any of this
activities such as washing after
defecation, wearing shoes & socks. The
therapist trained the family member to
encourage Shubam to wear his socks &
shoes. When he wears them he should
be taken for a ride (car) which he enjoys
the maximum. In this way he can be
encourage to learn those behaviors
which he has never learnt.
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b. Modelling:
Modelling is a behavior therapy technique
in which learning occurs through
observation.
The client watches someone else perform a
particular action such as answering
telephone.
Models are often parents or other adults &
children
Modelling is a form of social learning & is
often called observation learning.
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c. Token Economy:
It is a behavioral therapy programme usually
conducted in a hospital or classroom setting.
In token economy the desired behavior is reinforced
by offering tokens that can be exchanged for special
food, games, comics or other rewards.
For example; a patient with schizophrenia does not
maintain personal hygiene. The day he maintains he
gets a token as reinforcer that he can watch T.V.
when he desire. Like this he is able to collect many
tokens & adapt behavior which is socially acceptable.
Like maintaining personal hygiene. Sometimes in
return of tokens the patient may exchange then by
asking for PAROLE.
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THANK
YOU
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JAY PATIDAR (M.Sc. NURSING)