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COGNITIVE BEHAVIORAL PSYCHOTHERAPY LECTUE 8 DEFINING BEHAVIOR • Behavior is what people do and say. Behavior involves a person’s actions, so it is not a static characteristic of the person. It is critical to differentiate between behavior “do and say” and labeling behavior i.e. Angry. • Behaviors have one or more dimensions that can be measured. Frequency, duration, intensity • Behaviors can be observed, described and recorded. • Behaviors have an impact on the environment, including the physical or the social environment. Because behavior is an action that involves movement through space and time, the occurrence of a behavior has some effect on the environment in which it takes place. • Behavior is lawful; that is, its occurrence is systematically influenced by environmental events. Basic behavioral principles describe the functional relationship between out behavior and environmental events. • Behaviors may be overt or covert. An overt behavior is an action that can be observed and recorded by a person other than the one engaging in the behavior. Covert behaviors, also called private events, are not observable to others. For example, thinking is a covert behavior; it cannot be observed and recorded by another person. Thinking can only be observed by the person engaging in the behavior. CHARACTERISTICS OF BEHAVIOR MODIFICATION • Focus on behavior (target behavior: behavioral excess or behavioral deficit) • Procedures based on behavioral principles (research within the laboratory experimental analysis or behavior or applied behavioral analysis) • Emphasis on current environmental events identification of environmental events that are functionally related to the behavior (controlling variable) • Precise description of behavioral modification procedures (specific concrete changes in the environment that are functionally related to the behavior) • Treatment is implemented by people in everyday life. • Measurement or behavior change (empirical validation of effect and the

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application of scientific principles to therapeutic endeavors) • De-emphasis on past events as causes of behavior • Rejection of hypothetical underlying causes of behavior (in particular it rejects the medical model) Behavioral Assessment • Indirect Assessment: interviews questionnaires and rating scales to obtain information on the target behavior from the person or others • Direct Assessment: Observe and record the target behavior as it occurs Defining the Target Behavior • Behavioral definition that includes precisely what the person says or does • Labels for behavior are ambiguous and the label may have different meanings for different observes. • Interobserver Reliability: two people independently observe the same behavior and both record that the behavior occurred Logistics of Recording • Select who will record • Define the observational period • Define the setting (natural settings or contrived settings also called analogue settings) • Recording method o Continuous Recording: observes continuously during the observation period Frequency: record the number of times a behavior occurred Duration: the total amount of time occupied by the behavior Real-time recording: exact time of the onset and offset of the behavior Intensity: the amount of force, energy, or exertion involved in the behavior Latency: time from some stimulus event and the onset of the behavior o Product Recording (Permanent Product Recording): an indirect assessment method that uses the tangible results of a behavior (example: pieces of work produced by a factory worker) o Interval Recording: recording only if the behavior occurred or did not occur during a predefined period (Observation period is subdivided into discrete segments)

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Partial Interval recording (soled record if behavior did or did not occur) Whole Interval Recording (includes frequency, duration or both) o Time Sample Recording: (divide observation period into intervals, but record during only some of the intervals. Example: record behavior of only one minute in each 15 minute interval) • Recording Instrument o Paper and pencil (data sheet) o Counter (example: gold stroke counter) o Stopwatch o Hand-held computer o Transfer coins of chips o Ranger beads o Pedometer • Reactivity: the act of observing an event can alter the event. This effect is called reactivity. • Interobserver Reliability: Two people observe during the same period, then a percent of agreement between the observes is calculated o IOR is calculated differently depending on the recording method used Frequency: IOR=smaller frequency/larger frequency Duration: IOR=smaller duration/larger duration Frequency within Interval: IOR=percentage of agreement of observers or each interval (smaller frequency) sum the percentages for all intervals and divide by the number of intervals. Classification of Behavior Disorders Goldfried, Marvin, Davison, Gerald Clinical Behavior Therapy, Holt Rinehart Winston, New York, New York, 1976 pp. 28-32. Axis I Difficulties in Stimulus Control of Behavior A. Defective Stimulus Control: Person does not recognize the stimulus prompt. For them the SD continues to function as an S Person runs through a red light because they do not understand that a red light means STOP B. Inappropriate Stimulus Control: Person recognizes and responds to the Stimulus Clue, but the Stimulus clue does

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not trigger the behavior you desired. The most common cause for this problem is over-generalization Example: A child who picks only red paint off of a window sill and eats it, may be responding to the red color as a signal indicating that the paint is something to eat. However, this also can occur when there are competing contingencies of reinforcement. Example (Yellow street lights. A yellow street light is supposed to signal CAUTION, however for many people a yellow street light signals (Oh My God, I better hurry up the light is about to turn). Axis II Deficient Behavioral Repertoires: Behavioral problems in which an individual lacks skills needed to cope effectively with situational demands. Aversive Behavioral Repertories: Maladaptive behavioral patterns, which are aversive to other individuals surrounding the client, or aversive to the client themselves as in self-injurious behaviors) Difficulties with Incentive Systems (Reinforcers) A. Defective Incentive System in Individual : This situation applies when a person is attempting to change a behavior within themselves and they have not yet instituted an incentive system sufficient to produce the behavior change. We often categorize this as a “failure of motivation” B. Inappropriate Incentive System in Individual: This situation again occurs when an individual is attempting to change a behavior within themselves, but has chosen a reinforcer that has negative consequences (i.e. getting drunk on alcohol or high on drugs, over eating) or a reinforcer that is aversive to others (violates social norms) (example engaging in deviant sexual behavior as a reward) C. Absence of Incentives in Environment: This situations pertains to situations when you are wanting to change the behavior of another person, but in which reinforcement is lacking in the environment sufficiently to get the other person to change their behavior. D. Conflicting Incentives in Environment: Again this situation pertains to circumstances when you are trying to change the

Axis III

Axis IV

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behavior in another person, but your efforts are unsuccessful because you reward and punish the same behavior/ Situations where there are conflicts between environmental consequences, example children whose maladaptive behavior appears to pay off where there is contradiction between what has been labeled by the environment as maladaptive and what, in fact, the environment is inadvertently reinforcing. (Examples include negative attention seeking in children, or when a mother punishes a child for a tantrum, but then tries to soothe the child after inflecting the punishment) Axis V Aversive Self-Reinforcing Systems Cognitive processes capable of maintaining various forms of behavior are unrealistically high and self-reinforcement is withheld regardless of how adequate the behavior may be according to external criteria. (You withhold reinforcement from yourself until you have achieved some truly spectacular, heroic goal (i.e. I am not going to buy myself another stitch of cloths until I lose 100 pounds).

Research Design • Although assessment is necessary to evaluation process itself is insufficient. • Not only wish to achieve change, but also need to understand the reasons for that change • The investigator must arrange a situation so that a casual relation can be demonstrated between certain conditions, such as treatment and behavior change. • Independent variable is the treatment intervention • Dependent variable is the behavior assessed (changed) • Two major classes of designs are Control Group and Single Case Designs Group Experimental Design • Use groups exposed to or receive different conditions • Groups must be similar to begin with (most typically achieved through either random assignment or matching)

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Basic Control Group Designs • Two groups minimum one receiving treatment the other not • Control for maturational difference • May be expanded to several groups at the same time to explore further comparisons that will elaborate the basis for group differences (However, in a basic control group design comparisons are always drawn between two groups at a time so the addition of groups is in essence running several studies simultaneously) • The addition of groups helps to answer different questions and account for various events that may account for the behavior change or to exclude rival interpretations of the results Factorial Designs • Control group design in which two or more variables are examined simultaneously (typically minimum of four groups) • The main advantage of this method is that it allows you to determine not only a main effect for each independent variable but also interaction effects. (Book example is 5 session versus 20 session, mundane topics versus emotional topics psychotherapy) • Strengths of Factorial design Economy because different variable can be studied with fewer subjects Combined effects of independent variables (interactions) Factorial designs can address more complex and sophisticated questions than do single-variable experiments Single-Case Experimental Designs • Also called intrasubject-replication design and N=1 research • In single-case research, inferences are usually made about the effects of the intervention by comparing different conditions presented to the same subject over time. Reversal or ABAB Design • Observations are usually made for several days prior to any treatment, this data is referred to as baseline or operant rate. • Baseline is also referred to as Phase A • The phase during which treatment intervention is implemented is referred to as the treatment phase or Phase B • Behavior change due to implementation of treatment does not necessarily mean that the treatment is responsible for the change (maturational effect)

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• After treatment a third phase referred to as reversal phase is usually reintroduction of conditions that were in effect during the initial baseline phase • If behavior reverts to baseline levels this is strongly suggests that the program was responsible for the change. • To increase the plausibility of this conclusion the treatment program is reinstated in the final phase of the experiment. (Reinstalling treatment is also viewed as the ethical thing is treatment effect is evident) • ABAB design is used extensively in behavioral modification research • Limitations o Behaviors sometimes do not reverse when the program is temporarily withdrawn o Changes in the behavior may change the environment in some way that supports and maintains the behavior change o Reversal designs is often undesirable or even unethical to show reversal in behavior (ex extremely aggressive behavior) o Reversal period only needs to be established for enough time to show return to baseline or approximating a return to baseline before reinstating treatment. Multiple-Baseline Designs • A causal relationship is established by showing that behavior changes when treatment is introduced at several different points in time. This is accomplished without a reversal procedure • Three versions Multiple-baseline design across individuals • Baseline data gathered for two or more individuals • Treatment intervention provided to one individual • After treatment behavior of one individual shows a stable pattern, treatment intervention is applied to another individual • In this design treatment intervention is applied to all individuals at different points in time, until everyone is included in the program Multiple-baseline design across behaviors • Baseline data gathered on two or more behaviors within a given individual • Treatment intervention for the first behavior while baseline data continues to be gathered on other behaviors • The first behavior should change while the other behaviors should not • Treatment intervention then introduced for second behavior • In this design treatment effect demonstrated when each behavior changes only when the treatment intervention is introduced.

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• Generalization of treatment effect (although usually highly desirable in real life, is a serious problem for this research design) Multiple-baseline design across situations • Baseline data is gathered for a given behavior across two or more situations • After baseline data is gathered treatment intervention introduced in one situation (environment) baseline data continues to be gathered in other situations • This research design is often used in educational settings (treatment intervention introduced in one class setting at a time.) Evaluation of Multiple-baseline Design • Demonstrate effect of an intervention without using a reversal procedure • Greatest weakness is associated with generalization of treatment effect Changing-Criterion Design • Begins with a baseline phase with data gathered on a single behavior • Following baseline treatment is introduced (reward if a particular behavior) • In this design the reward is program so that it is relatively easy to meet in the beginning of treatment • As behavior changes the criterion for earning the reward is changed • If behavior changes as the criterion for reward is altered one may conclude that the program is responsible for the change. • Example Joe’s smoking cessation program Evaluation of Changing-Criterion Design • Provides fairly clear demonstration of a causal relationship • Suited to situations in which performance can be changed gradually and the final goal is reached in a series of steps • Dramatic treatment effects for this approach are actually a problem • Less clear in its ability to establish causal relationship between treatment and behavior

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