THERAPEUTIC INTERVENTION

BEHAVIOR THERAPY
CPSY 514-515
References:
1. Miltenberger, 1997
2. Spiegler & Guevrmont, 1998
 Behavior
Modification
Behavior Modification (Miltenberger, 1997)

• Some uses the terms interchangeably: Behavior Analysis

- Functional
Modification-Cognitive-behavioral therapy
(Spiegler & Guevrmont, 1998) Relationship
- Why of
Behavior

Field of Psychology Modification

.concerned with - Developing &
Implementing
Procedures
- Altering
Environmental
Events
• Originally referred to procedures that:
- change the consequences of behaviors (such as
reinforcement) and
- the stimulus conditions that elicited behaviors (such
as the physical setting).
- sometimes is used as a generic term= any procedure
that modifies behaviors, ranging from lobotomies to
wilderness survival courses

Spiegler & Guevrmont, 1998

Home Task: Read and bring material on Lobotomy and Wilderness
Survival Courses
 So what is Cog Behavior Therapy & Behavior
Therapy
• Main goal is shared with other therapies

• to help clients with psychological problems,

• Psychological problems are:
- personally maladaptive and
- distressing to clients,
- may violate social norms, and
- may be disturbing to other people
 Myths about Behavior Therapy (Spiegler &
Guevrmont, 1998 pg 4)
• Well established laws
• directly changes symptoms
• trusting relationship between client and therapist
is not necessary
• does not deal with problems of feelings, such as
depression and anger.
• little verbal interchange takes place between the
therapist and client
• client’s cooperation is not necessary
Myths continued……
• fewer than five sessions
• not applicable to changing mental processes
• Positive reinforcement works better with children
• painful or aversive treatments
• deals with relatively simple problems
• therapist determines the goals of therapy
• therapist primarily is responsible for therapy success
• Cause is not treated so others will develop the
symptoms
 Characteristics of Behavior Modification
 Focus on Behavior
 Procedures based on behavioral principles
 Emphasis on current environmental events
 Precise description of behavioral modification procedures
 Implemented by persons in everyday life
Measurement of Behavioral Change
De-emphasis on past events as causes of behaviors
Rejection of hypothetical underlying causes of
behavior
1. Focus on Behavior (Miltenberger, 1997)

• De-emphasizes labeling
• Target Behavior

behavioral excess behavioral deficit

2. Procedures based on behavioral principles

• Experimental analysis of behavior, or behavior

analysis (Skinner, 1953b, 1966).
• Behavior modification procedures are based on
research in applied behavior analysis= more than 40
years of practice
 3. Emphasis on current environmental events/Learning

• Events that are functionally related to behavior

• Behavior Events Identification of events
(Behavior Modification)
• Controlling behavioral are identified
• Functional Relationships are altered desired change in
the behavior
• Sometimes label is mistaken for functional relationship----Autism
is causing a child to engage in negative behaviors (screaming,
hitting himself, refusal to follow instructions)
• Label is not cause---rather causes of behavior should be found in
the environment
4. Precise description of behavioral modification procedures

• Procedures to be described precisely

• To ensure that that the procedures will be
used correctly each time
• procedures to be effective each time

• environmental events must occur each time

5. Treatment implemented by people in everyday life

• Used by:
• teachers, parents, job supervisors, or others to help people
change their behavior
• So training and supervision is required (Miltenberger, 1997
- Action therapy
- Home work assignments
- Change agents: can be participants themselves and also other
people serve as change agents for the clients
• self-control approach: personally empowering, maintain the
change, can handle future problems on their own (Spiegler &
Guevrmont, 1998
6. Measurement of behavior change.

• behavior before and after intervention

• ongoing assessment of the behavior is done
• To assess change and its maintenance beyond
intervention
7. De-emphasis on past events as causes of
behavior/Present Focus

• Its important to understand behavior

• Past events are also important
• knowledge of current controlling variables is
most relevant to developing effective behavior
modification
8. Rejection of hypothetical underlying causes of
behavior/scientific

• explanatory fictions
 9. Other Common Characteristics…Spiegler &
Guevrmont, 1998

• Individualized Therapy
• Stepwise Progression
• Treatment Package: but research varies
- exposure therapy for obsessive compulsive disorder
and social phobia is as effective as combining
exposure therapy with cognitive-behavioral
therapies
- Other anxiety disorders: Combined treatment is
more effective as compared to specific treatments
• Brevity
 AREAS OF APPLICATION (Miltenberger,
1997)
• Developmental Disabilities
- self-injurious behaviors,
- aggressive behaviors, and
- destructive behaviors
• Mental Illness
chronic mental illness: to modify such behaviors as:
- daily living skills,
- social behavior,
- aggressive behavior,
- treatment compliance,
- psychotic behaviors, and
- work skills
• Education and Special Education
- student–teacher interactions in the classroom,
- improved teaching methods, and
- higher education to improve instructional
techniques, and
- thus improve student learning
- developmental disabilities
• Rehabilitation
- head injury from an accident or brain damage from
a stroke
- head injury from an accident or brain damage from
a stroke
- to promote compliance with rehabilitation
routines such as physical therapy,
- to teach new skills that can replace skills lost
through the injury or trauma,
- to decrease problem behaviors, to help manage
chronic pain, and to improve memory
performance
• Community Psychology
- behavior of large numbers of people in ways that
benefit everybody
- reducing littering,
- increasing recycling,
- reducing energy consumption,
- reducing unsafe driving,
- reducing illegal drug use,
- Increasing
- the use of seat belts,
- decreasing illegal parking in spaces for the disabled, and
• reducing speeding
• Clinical Psychology
- individual or group therapy
- In clinical psychology behavior modification=behavior
therapy
• Self-Management
- to control personal habits,
- health-related behaviors,
- professional behaviors, and personal problems
• Child Management
- to help children overcome bedwetting,
- nail-biting, temper tantrums, noncompliance, aggressive
behaviors, bad manners,
- stuttering, and other common problems
• Prevention
- child sexual abuse,
- child abduction,
- accidents in the home,
- child abuse and neglect, and
- sexually transmitted diseases
• Business, Industry, and Human Services
• organizational behavior modification or organizational behavior
management
• (Frederickson, 1982).
• to improve work performance and job safety and to decrease
tardiness, absenteeism, and accidents on the job
• to improve supervisors’ performances
• increased productivity
• and profits for organizations and increased job satisfaction for workers
• Sports Psychology
- to improve athletic performance in a wide variety of sports
during practice and in competition (Brobst & Ward, 2002)
- to result in better athletic performance than do traditional
coaching procedures
• Health-Related Behaviors
- to promote health-related behaviors by
- increasing healthy lifestyle behaviors (such as exercise and proper
nutrition) and
- decreasing unhealthy behaviors (such as smoking, drinking, and
overeating).
- to promote behaviors that have a positive influence on physical
or medical problems—such as decreasing frequency and intensity
of headaches, lowering blood pressure, and reducing
gastrointestinal disturbances (Blumenthal & McKee, 1987;
Gentry, 1984
• Gerontology
- applied in nursing homes and other care facilities
- declining physical abilities,
- to help them adjust
- to nursing home environments,
- to promote health-related behaviors and
appropriate social interactions, and
- to decrease problem behaviors that may arise
from Alzheimer’s disease,
- other types of dementia, or institutional
demands
 THERAPIST–CLIENT RELATIONSHIP IN BEHAVIOR
THERAPY (Spiegler & Guevrmont, 1998)
• relationship between the therapist and the client is
important in all forms of psychotherapy
• However in some psychotherapies it is the most critical
factor
• considered a necessary but not a sufficient condition for
successful treatment
• clients are helped primarily by the specific change
techniques
• Clients may attribute their improvement more to the
therapist–client relationship than to the therapy procedures
• Its analogous to surgery
• Collaboration between the therapist and client
is a hallmark of behavior therapy
• Sharing of expertise to the clients
• Decisions about therapy goals and
• treatment procedures
 MANY VARIATIONS OF BEHAVIOR THERAPY

• Self-Instructional Training
• Modeling and Behavior Rehearsal
• Response Cost
• Positive Reinforcement
• Stress Inoculation Training
• Extinction and Differential Reinforcement of Other Behaviors
• Systematic Desensitization
• Token Economy and Shaping
• Cognitive-Behavioral Couple Therapy
• Cognitive Restructuring
• Acceptance and Commitment Therapy
Discussion on History of Behavior
Modification
CLASS DISUSSION