1. Behavior TherapyTechniques Lesson 18

2. Clarifying the clients problem Formulating initial goals for therapy Designing a target behavior Identifying the maintaining conditions Designing a treatment plan Implementing the treatment plan Evaluating the success of treatment Conducting follow-up assessment ~ Goal setting Behavioral Definitions Functional Analysis Objective measurement Data collection Evaluation ~ Behavior Therapy Behavior Modification

3. Changing Behavior • Acceleration Target Behaviors • Increase behavioral deficits • Primarily positive reinforcement • Deceleration Target Behaviors • Punishment   behavior • “Dead” person rule • Include acceleration behaviors ~

4. Deceleration Techniques • Differential RFT (DRO & DRI) • Direct Deceleration Therapy • Consequential deceleration • Aversion therapy • Token Economies • Pos RFT & response cost • Exposure therapies • Brief / graduated • Prolonged / intense ~

5. Counter-Conditioning: Joseph Wolpe • Reciprocal inhibition • Buzzer sounded when cat was eating • Buzzer (CS) : eating (US)  pos CER • Buzzer (CS) : shock (US)  fear • Substitution of competing responses • Respondent Learning • Can also replace fear with pos CER ~

6. Mary Cover Jones & “Peter” • Treatment of phobias • Peter fearful of white rabbit • Counterconditioning • Pairing favorite food & rabbit • Exposure therapy • Gradually moved rabbit closer • Peter watched another child play with rabbit ~

7. Inhibitory learning • Conditioned Inhibition • Learning to withhold conditional response • CS-: US will not occur • no US for period of time • US must be a significant event • Occurs only if there is an excitatory context ~

8. Standard Procedure • Some trials: CS+ --- US • Other trials: CS+ / CS- --- No US • Example: traffic light • CS+ (red)  CR? • CS- (police officer) / CS+  CR? • Respond differently under different circumstances ~

9. Negative CS-US Contingency • Similar to standard procedure • Some trials: CS+ & US • Other trials: CS- & no US • CS-  no response • Example: Traffic light • Red (CS+) – Danger (US) • Green (CS-) – no Danger (no US) ~

10. Inhibitory Conditioning & Stress • Panic attacks  extreme stress • Carter, Hollon, Carson, & Shelton (1995) • triggered by CS+ for aversive stimuli • Panic attack experimentally induced • accompanied by trusted friend • or alone ~ • Friend acted as CS- for stress •  stress compared the alone group • trusted friend was a safety signal ~

11. Exposure Therapies • For fear/anxiety & other negative CERs • Intense, maladaptive, or inappropriate • Some strong fears adaptive • Based on Extinction • Fear-provoking events (CS+) • Safe environment (no US) ~

12. Exposure Therapies Models • Brief/graduated exposure therapy • Short exposure periods • Gradually increase intensity of CS • Prolonged/intense • Lengthy exposure periods • Immediate exposure to intense CS • Mode of exposure on continuum • Imaginal ---------------------- in vivo ~

13. Systematic Desensitization • Brief/Graduated Exposure Therapy • Relaxation Training • Tense then relax muscle groups • Fear Hierarchy • Rank fear-provoking situations • Graded Pairing • CS for fear with muscle relaxation • Thru hierarchy: lowest highest ~

14. Systematic Desensitization: Theoretical Explanations • Counterconditioning • Substitution of competing response • Reciprocal inhibition • Neurophysiological processes • Parasympathetic vs Sympathetic • Extinction • Cues present but no danger (US) ~

15. Flooding • Prolonged/Intense Exposure Therapy • Also called implosive therapy • In vivo or imaginal • Treatment for • Phobias • Obsessive-compulsive disorder • Post-traumatic stress disorder • Agoraphobia ~

16. Flooding • Aversive CS  escape/avoidance • Limits opportunity for extinction • Confront individual w/ fear-provoking situations/ images • No relaxation • Not graded • Extinction process • Potential for intensifying fear ~

17. Aversive Therapy • Punishment of target behaviors • Instrumental conditioning • Raversive stimulus • E.g., chronic vomiting  shock • Problems • Avoidance of therapy (drop out) • Disruptive CERs •  punishment of others • Ethics concerns ~

18. Snap rubber band on wrist Cigarette smoke Bitter substance Water mist sprayed in face Loud noise Mild mouthwash Trichotillomania (Pulling out hair) Compulsive eating Nail biting Face slapping Bruxism Biting other children “More Acceptable” Punishers Punisher Target Behavior

19. Aversive Therapy: Covert Sensitization • Classical & instrumental conditioning • Use of imaging • Therapist describes behavior • & aversive outcome • Advantages • Safe & more acceptable to clients • Clients can self-administer in vivo • Effectiveness equivocal ~