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Chapter 2

Psychotherapy - Chapter 2.docx

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Amanda A Uliaszek

Chapter 2 Behaviour Therapy - Central feature of behavior therapy is that it involves the application of the laws of learning theory to the modification of problematic behavior - Another key feature was distinguishing etiological factors from maintain ones THEORETICAL CONCEPTS OF BEHAVIOUR ThERApy - Key concepts are classical conditioning, instrumental conditioning, generalization, extinction, and functional assessment - Also gave rise to a key methodological concept: the single case design - Discriminative stimuli signal when different contingencies involving a given response are in effect o those that signal reward are reward cues and elicit hope o those that signal punishment are passive avoidance cues and elicit anxiety o those that signal omission of a reward are omission cues and elicit frustration o those that signal a response will lead to the omission of an otherwise expected punishment are called active avoidance cues and are thought to elicit anxiety (on early trials) and relief on later trials - generalization Similar stimuli will elicit a response there is a generalization radient with those most similar eliciting the greatest response - Functional assessment - the attempt to determine the contingencies that maintain problematic behavior and the discriminate stimuli that signal when those contingencies are in effect and thus serve to elicit the problem behaviours - Single case designs - involve the systematic assessment of problem behaviours or treatment targets across both baseline conditions,and conditions in which an intervention or therapeutic contingency is actively implement o most common is A/B, or ABA HISTORY OF BEHAVIOUR THERAPY - closely linked to learning theory Ivan Pavlov - the discovery with the most profound impact was extinction John Watson - father of behaviourism - influenced by Loeb, who believed that behavior could be explained by tropisms , that, were instinctual chains of responses that involved the whole organism responding to environmental stimuli o thus behavior could be explained in mechanistic terms by observin how organisms responded to environmental input - insisted we measure OVERT behavior Skinner -operationalism posits that concepts should be defined in terms of objective measurements - atheoretical approach, believed we should avoid seeking internal explanations of behavior but rather describe relationships between environmental consequences and emitted responses Focused on response and outcome operant behavior Created the functional analysis - in which reinforcers are identified for various behaviours, especially problematic behaviours - by identifying variables that control certain behaviours, treatment can be taiolored to change these behaviours Pavlov/Watson focused primarily on stimulus/response relationships while skinner focused on response.outcome Modern behaviourists usually seek a 3 part contingency Stimulus response- outcome A B C Orval Hobart Mowrer - an early behaviourist that studied avoidance behavior - his main influence lies in avoidance o was of interest because it was tempting to explaina voidance behavior in terms of expectances (responses were emitted to prevent expected negative outcomes) - he sought to explain avoidance without reference to mental constructs, and formulated a 2 factor theory of avoidance o animals learn relationships between stimuli and fear responses responses that lead to the removal of the elicitng stimulu were reinforced by the reduction of fear o thus he combined classical conditioning and instrumental learning in his two factor theory o some stimuli became conditioned stimuli for fear responding, and operant behavior was reinforced by the removal of the conditioned stimulu - he influenced exposure therapy which has the goal to extinguish the relationship between certain stimuli and fear responses CONTEMPORARY VARIATIONS OF BEHAVIOUR THERAPY - the term behavior therapy often refers to a perspective on how assessment and therapy are done, as opposed to specific techniques Systematic Desensitization - Wolpe showed that anxiety could be treated by pairing previously anxiety-elicting stimuli with a state of relaxation - Used relaxation and systematic desensitization - The theoretical basis ffo systematic desensitization is recriprocal inhibiton - the notion that opposite emotional states cannot be experienced simultaneously o Sometimes referred to as counterconditioning because it involves changing the valence of an unconditioned stimulus - According to Wolpes theory, if a patient can learn to relax in particular situations, then the state of relaxation will supersede feelings of anxietyo Other mechanisms, such as extinction and habituation are also involved in systematic desensitization o Can be done with real shit, but often done with imagination - Goldfriend and Davidson describe the basic steps of systematic desensitization o First patient is trained to relax using behavioural and imagery techniques This involves contracting and relaxing muscles while imagining calming scenes Must learn to induce state of relaxation, and report this and anxiety on a scale of 0 100 (SUDS) o If imagined exposure is planned, the patient is furthered trained in the use of imagery so that anxiety-evoking scenes can be vivdly imagined The therapist and patient would create a fear hierarchy SUD would organize it o The exposure component of systematic desensitization begins with exposure to the first item in the hierarchy The patient is first asked to relax, then the first item in the hierarchy is I magined or presented in vivo According to wolpe, relaxation will inhibit the anxiety, thus anxiety associated with a feared stimulu will dcrease with repeated pairings of relaxation and the feared stimulus While exposed to the items, the patient signals to the therapist when he or she begins to feel anxious, the therapist then
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