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Clinical Psychology-I

Hadiqa Asif

Roll # 14 Evening

BS (Hons) 2020-2024

Semester VI

Clinical Psychology Assignment

Mam Rabia Dasti

August 10, 2023

Centre for Clinical Psychology

University of the Punjab
Lahore
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Clinical Examples

Classical or Respondent or Pavlovian Conditioning

Example #1

A warm and nurturing teacher (US) makes students feel connected (UR). Students associate

going to school (CS) with the teacher. Therefore, students learn to enjoy going to school (CR).

Key terms: US= Unconditioned stimulus, UR= Unconditioned response, CS= Conditioned

stimulus, CR= Conditioned response

US (warm and nurturing UR (students feel

teacher) connected)

CR (students feel good

CS (going to school)
going to school)

First Order Conditioning

It is the initial pairing of a neutral stimulus with an unconditioned stimulus, leading to a

conditioned response.

For example, a bust of dust particles (unconditioned stimulus) produces sneezing (unconditioned

response). Now if we pair US with a conditioned stimulus bell, then it will elicit sneezing

(conditioned response).

Process

US (bust of dust particles) UR (sneezing)

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US is paired with CS.

Outcome

CS (Bell) UR (sneezing)

Second Order Conditioning

It occurs when a previously conditioned stimulus is used to condition a new stimulus. From the

previous first order conditioning example, now if we pair the bell sound with word DUST

repeatedly, it will eventually cause the person to sneeze every time the word DUST is said to the

person.

1st CS (bell sound) +

CR (sneezing)
2nd CS (word DUST)

Outcome CS (word DUST) CR (sneezing)

Higher Order Conditioning

Higher-order conditioning occurs when an NS is paired with an already established CS and the

NS becomes a CS.

Example

First Order Conditioning

Nurse (NS) + Chemotherapy (US) UR (nausea)
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Nurse (CS) CR (nausea)

Second Order Conditioning

Waiting Area (NS) + Nurse (CS) CR (nausea)

Waiting Area (CS) CR (nausea)

Higher Order Conditioning

Hallway (NS) + Waiting Area (CS) CR (nausea)

Hallway (CS) CR (nausea)

As the flow chart shows, chemotherapy (US) causes nausea (UR). Now if a conditioned stimulus

nurse is paired, then with repetition, nurse will cause nausea alone (first order conditioning).

Likewise, if another CS (waiting area) is paired with nurse, it will alone eventually after

repeatedly being paired, will cause nausea (second order conditioning). Then if another CS

(hallway) is paired, it will also eventually cause nausea alone (higher order conditioning).

Operant Conditioning

In operant conditioning, behavior is followed by rewards or punishments as consequences. When

a behavior is paired with a consequence repeatedly, an association is formed to create new

behavior.
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Example

A dog trainer gives his dog a treat every time the dog raises its left paw. The dog learns that

raising its left paw can earn him a food reward. It will raise its paw again and again for more

treats.

Response (dog raising is immediately Consequence (food

left paw) followed by award)

Positive Punishment

The child will get a new chore such as cleaning the wardrobe (adding a new stimulus) every

time he disobeys his mother.

Response (child is immediately followed Consequence/Punisher

disobeying his mother) by (cleaning the wardrobe)

Negative Punishment

The child will not get his toys he plays with daily (removing an old stimulus) every time he does

not do his homework.

Response (child not is immediately followed by

Consequence/Punisher (he
doing homework) will not be given his toys)

Differential Reinforcement
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Differential reinforcement is reinforcing a target behavior while withholding reinforcement from

an unwanted behavior.
Types
Differential Reinforcement of Alternate Behavior

Antecedant (teacher Response (child cries to Consequence (teacher

present) call teacher) pays attention)

Outcome: Child’s behavior of crying is reinforced.

The teacher wants to reinforce his assertive behavior by not crying while calling him. He decides

not to pay attention when he cries.

Reinforcement

Antecedant (teacher Response (child calls Consequence (teacher

present) teacher without crying) pays attention)

Outcome: In the future, the child is more likely to call his teacher without crying
Extinction

Antecedant (teacher Response (child calls Consequence (teacher does

present) teacher with crying) not pay his attention)

Outcome: Future probability of crying behavior is more likely to reduce.

Differential Reinforcement of Incompatible Behavior

DRI reinforces a physically incompatible behavior to replace the unwanted behavior.

Example
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If you’re trying to teach a child to remain seated in class, you’re going to provide reinforcement

when they are in their seat and withhold reinforcement when they are out of their seat. A child

cannot have in and out of seat behavior at the same time, and so the positive and negative

behaviors are physically incompatible.

Differential Reinforcement of Other Behavior

Antecedant (Caretaker Response (child sucks Consequence (caretaker

present) her thumb) does not read the story)

Antecedant (Caretaker Response (child does not Consequence (caretaker

present) suck her thumb) reads the story)

Outcome: The absence of thumb sucking behavior reinforces.

The child’s thumb sucking behavior isn’t reinforced. The absence of behavior reinforces positive
behavior.
Differential Reinforcement of Low Rates of Responding
It is used to get a behavior to occur less (not necessarily to eliminate the behavior).

Example

A third-grade student raises their hand frequently to answer questions, but the teacher wants to

lower frequency. DRL is an ideal procedure, instructing them to raise their hand only five times

per class period, and if they do, they will read first in the reading group. If they raise their hand

more than three times, they will read last. The teacher can track their behavior on paper or on

board.
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Reinforcement

Antecedant (teacher Response (student raises Consequence (reads first in

present) hand five times per period) the reading group)

Antecedant (teacher Response (student raises hand Consequence (reads last in the
present) more than five times per period) reading group)

Outcome: The student’s hand raising behavior of more than five times is likely to be reduced.
Full-Session DRL

Full session DRL involves implementer providing reinforcement at the end of a session if

undesired behavior incidents fall at or below a predetermined criterion level.

Example

If an individual rocks back and forth an average of 10 times per half hour, a psychologist could

provide a positive reinforcer contingent upon that individual rocking 8 or fewer times per half

hour.

Response (individual rocks

Antecedant (psychologist Consequence (no reinforcer
back and forth 10 times per
present) provided)
half hour)

Response (individual rocks

Antecedant (psychologist Consequence (reinforcer
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Alternatively, the psychologist could provide a reinforcer following a rocking incident if there

Response (individual rocks

Antecedant (psychologist Consequence (reinforcer
back and forth 5 times per half
present) provided)
hour)

had been a minimum amount of time (e.g., 5 min) since the previous rocking episode.

Spaced-Responding DRL
In this, the reinforcer is delivered for a response when it is separated from the previous response

by a specified interval of time. In this, the timing of responses is important.

Example

Treating a patient with a poor diet is an example of applying spaced responding DRL. We utilize

a spaced-response system of 4 hours in order to prevent kids from overeating. This means that

they can only have one meal after 4 hours have passed since their last meal, which will be

reinforced with dessert at their final meal of the day.

Response (eating one meal Consequence (reinforced with

Antecedant (psychologist after 4 hours from previous
present) the dessert at final meal of the
meal) day)

Outcome: 4 hours scheduled eating plan is reinforced.

Antecedant (psychologist Consequence (not reinforced with

Response (eating one meal before
the dessert at final meal of the
present) 4 hours from previous meal)
day)
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Outcome: The future probability of overeating behavior is likely to be reduced

Extinction

Extinction occurs when a behavior that has been previously reinforced no longer results in

reinforcing consequences and, therefore, the behavior stops occurring in the future.

Example

The child’s shouting behavior to gain her parents attention can be eliminated by parents not

giving her attention every time she does that so. If her shouting behavior is reinforced, the

present behavior will be negatively reinforced and more likely to occur in future.

Consequence (she receives

Response (child shouting)
attention from parents)

Reinforcement

Outcome: The child’s shouting behavior is negatively reinforced.

If her shouting behavior is not reinforced by her parents, the present behavior will become

extinct and less likely to occur in future.

Consequence (she receives

Response (child shouting)
no attention from parents)

Extinction
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Outcome: The child is less likely to shout because the behavior is no longer reinforced by her

parents.

Covert Sensitization

It is a behavior therapy technique that involves clients imagining undesirable behavior and its

unpleasant consequences, reducing undesired behavior.

Example

One imagines himself gambling, then feeling vomiting and nauseous or different negative

consequences.

A person used slot machine gambling (just imagines) with fear of snakes and get them to

imagine the payout wasn’t money but snakes pouring out.

UCS (imagined bad consequences;

something disturbing, e.g., snakes) UCR (fear)

UCS (imagined snakes) + NS (slot

gambling machine) UCR (fear)

CS (slot gambling machine/gambling) CR (fear)

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Shaping Steps

Shaping develops target behavior (that person does not currently exhibits) through differential

reinforcement of successive approximations until the person exhibits the desired behavior.

To teach a child how to ride a bicycle for the first time, the caretaker can use shaping steps in

successive approximations.

Sitting on bicycle seat and place your left foot on the left pedal and right foot
Step 1 on the right pedal and hold the handlebars.

Step 1 plus maintain balance by placing your legs on pedals and maintain a
Step 2 standing position long enough to drink 1 tablespoon of milk.

Steps 1 and 2 plus push your left foot forward and then push your right foot
Step 3 forward and start riding and cover 1m distance before getting the reinforcer.

Step 4 Same as step 3 except cover 3m distance before getting the

reinforcer.

Step 5 Same as step 3 except cover 6m distance before getting the

reinforcer.

Step 6
Same as step 3 except cover 15m distance before getting
the reinforcer.

Step 7
Same as step 3 except cover 30m distance before getting
the reinforcer.
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Cognitive Conceptualization Diagram

Cross-Sectional Core Belief

Situation
Teacher asks, “How are you doing?”

Automatic Thoughts and Images

She must think I’m not preparing for the upcoming exam.

Reaction

Behavioral Physiological
Emotional
Anxious; thinking of that Nauseous, stomachache,
Anxiety, fear, inferiority
same situation again and headache.
complex feelings
again. Not getting back for
study.
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Longitudinal Cross Belief

Relevant History
During childhood faced a lot of parental conflicts. During childhood and adulthood,
interference of paternal family. As a middle child of her parents faced ignoring behavior from
parents compared to other siblings. Faced a lot of familial pressure after F Sc to secure
admission in MBBS amidst a lot of interference of paternal family in her personal life. As a
student, she always performed excellent and remained a topper until university, she always
faced a lack of emotional support. After failing to come up her parents’ expectations, she loses
confidence in her academic achievements; she is an average student of her class in university.
Her father was very strict towards religion and rules. She was made guilty for not being able
to secure admission in MBBS. Because of a lack of emotional support and too much paternal
interference in her personal life, she started avoiding interacting with her family as much as
she could and started spending less time with them to avoid any further conflicts. She was
confident but eventually different kinds of complexes developed in her life. She started feeling
incapable of doing things properly as other do. A lot of emotional vulnerabilities aroused in
her personality.

Core Beliefs
I’m not good enough (in terms of achievement).
I’m incompetent.
I’m uncared.
I can’t do anything right.

Conditional Assumptions/Attitudes/Rules
If I do not start preparing for my exam, I’m ok; If I start preparing for exam, my anxious and
complexed thoughts will spiral out.
If I don’t tell my mother I want a new outfit, I am ok; If I share with my mother I want a new
outfit, I will be sad.
If I don’t start a new project, I’m ok; If I start my new project, I’ll be occupied by anxiety and
sad feelings.
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Coping/Compensatory Strategies
Avoidance, keeping feelings to self.
Does not prepare for exam.
Does not tell her mother that she wants a new outfit.
Does not start the project.

Situation #1 Situation #2 Situation #3

Thinking that I should Talking to her mother and Thinking to start a
start preparation for thinking I should tell her I new project.
want a new outfit for the
the upcoming exams. upcoming event.

Automatic Thought(s) Automatic Thought(s) Automatic Thought(s)

I will not be able to She will not buy me a I will not be able to do
secure good marks as new outfit as she does this as I’m not
I’m not capable and not care for me. competent enough and I
incompetent. will not do it rightly.

Meaning of A.T. Meaning of A.T. Meaning of A.T.

I’m incompetent; I’m I’m uncared. I’m incompetent; I can’t
not good enough. do anything right; I’m
not good enough.

Emotion(s) Emotion(s) Emotion(s)

Anxiety, complexed Sad Anxiety, sad, hopeless
thoughts

Behavior Behavior Behavior

Avoids preparing for Does not tell her mother Avoids starting her
the exam. that she wants a new outfit. project.