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PSYC 4060 Study Guide - Midterm Guide: Cognitive Therapy, Exposure Therapy, Progressive Muscle Relaxation

Course Code
PSYC 4060
Gary Turner
Study Guide

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Mini Exam 2 Study Notes
Chapter 6: Behaviour Therapy
Chapter 7: Cognitive Therapy
Chapter 9: Gestalt Therapy
Chapter 12: Contemplative Therapy
Evidence for Psychotherapy
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Behaviour Therapy
The theoretical perspective
1) How is human nature described?
- behaviour: motor behaviours, physiological responses, emotions, cognitions; have a function, make sense for the context they occur in
- behaviour influenced by env (reinforce/punish, classical conditioning); behave diff across situations BUT indv temperaments influenced by learning, genetics
- Conditioning experiences  components associated so that elements makes it more likely other components also activated. Exposure to feared situations works by activating fear network AND
incorporating new, corrective info
2) Psychotherapeutic problem described?
- rooted in env/ways indv/env interact – not blamed for behaviour/problem b/c problem behaviours understandable given context
- fearful associations stored as fear network: S, R, meaning  need correcting info
The Intervention
1) overall strategy/elements, to address psychotherapeutic issue? Strategy goal?
- change env factors that influence indv’s behaviour and ways indvs respond to env
- many behaviour therapists today CBT: blend of 2 methods!
- decrease maladaptive behaviours, increase adaptive/helpful
- increase flexibility in behavioural repertoire
- speculate about variables that contribute to problem behaviour, test assumptions through behavioural assessment, collect data through treatment, revise hypotheses
- change current determinants of behaviour (env contingencies, maladaptive behaviour); not early dev events that caused this problem behaviour
- client actively engaged (practice behaviour strategies w/in and b/w sessions). Clients as own therapists, provided w/ behavioural model to understand problems, rationale for strategy, instructions to use
- client receives all data collected during treatment
- client determines treatment goals *BUT helpful if client/therapist share goals
2) What are the most commonly used specific techniques? their specific goals?
- shaping
- classical conditioning: CS signal UCS that signals UCR  eventually CR to CS alone
- extinction: present CS w/o UCS so CR stops  reinstatement: re-pair UCS and CS
- stim control: correct if under control of inappropriate stimulus
- bell and pad
- modelling: learn to behave from watching others
- behavioural activation: schedule specific activities to complete in daily life, increase diverse, stable, personally meaningful sources of +ve reinforcement
- operant conditioning: change reinforcement/punishment  change behaviour
Reinforcement: +ve = follow w/ rewarding S, -ve = followed by remove bad S
Punishment: +ve = add bad consequence, -ve = remove good stimulus
Extinction: stop behaviour, b/c not followed by good stimulus
Discrimination: response reinforced in specific situations
Generalization: apply behaviour in more than original situation
- vicarious learning: learn by watching other’s behaviour consequences
- rule-governed behaviour: learn w/o experiencing contingencies 1st hand
- systematic desensitization: gradually confront feared situations, while relaxing
- token economy: manage behaviour problems via reinforcement of desirable behaviours by providing tokens that can be exchanged for rewards
- treatment planning: set treatment goals (specific, measurable, realistic, timelines).
- progressive muscle relaxation: tense/relax muscle group  meditate  relax
- exposure therapy: confront feared stimuli directly. gradual (hierarchy). Effective when: predictable, controllable, frequent, longer, along side modeling. In vivo: exposure to feared situations in real-life;
Imaginal: exposure to feared mental imagery; Interoceptive: exp frightening physical sensations until not scary
- relaxation training: diaphragm breath, guided mental imagery, progressive relax
- mindfulness meditation: facilitate acceptance; attend to worries, accept them
- complete dairies to monitor behaviour
- behavioural assessment: before/throughout treatment. To identify target behaviour (distressing, impairment), determine appropriate treatment (behavioural deficit excess, env issues), assess impact of
therapy, final outcome. Relies on many methods, informants, situations. Treatment behaviours selected to increase flexibility
- Functional analysis: identify variables responsible for maintain target behaviours (manipulate env, measure impact on target behaviours). Inferred ABC (antecedent, behaviour, consequence); 1)
behaviour interviews (behaviour form/function, establish A and C, direct samples), 2) behaviour observation (client assess ABC; naturalistic, analog, indirect. Reactivity: behaviour affected by assessment
procedure), 3) monitoring forms/diaries (baseline, measure change; record overt and other AC), 4) self-report scales 5) psychophysiological assessment
- response prevention: inhibit unwanted behaviour to break association b/w S/R (encouraged to tolerate discomfort until subsides, introduce competing behaviour)
- acceptance based therapies: ACT (foster acceptance, aware of values so behaviour matches), DBT (CBT and mindfulness for acceptance, tolerate distress)
- social skills training: function socially effective is core to success/well-being
- problem solving training: define problem specifically, identify possible solutions, evaluate cost-benefit of solutions, choose best solution(s), implement
The Therapist
1) Therapist’s role?
- some say process should be automated as possible!
- frequent advice/suggestions (directive)
- be aware of power to influence client, only recommend what can benefit them
- clear professional boundaries; client understand why activities practiced in therapy
- maintain confidentiality
- keep client motivated to be fully engaged in treatment
2) What qualities and skills of the therapist are emphasised?
- client-therapist relationship NOT emphasized BUT is important
- empathy, +ve regard, congruence, genuineness, self-disclosure  +ve outcomes  immediate social reinforcement for desired behaviours, model interpersonal skills, promote engagement, HW compliance,
collaboration toward treatment goals
Making Comparisons to Other Systems
- closely aligned w/ other psychotherapies
- directive/brief: cognitive, REBT  CBT therapists, strategies from all 3 approaches (ex/ behaviour: exposure to fear, cognitive: examine –ve thought patterns)
modern behaviourists: thoughts/emotions have role in person’s R to env
time limited, directive, transparent, evidence-based, active, focus on changing factors that maintain psychological problems (not initial factors)
- Gestalt: behavioural strategies (role play, exp emotion/feeling rather than control)
- family therapy: treatments also given in a family context
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