INTRODUCTION Any manifestation of life is activity’ says woods worth (1948) and behavior is a collective name for these activities. Therefore, the term, Behavior includes all the conative activities ( walking, swimming, dancing ), cognitive activities( thinking, reasoning, imagining ) and affective activities( feeling, happiness, sadness and angriness etc ).
It not only includes the conscious behavior and activities but also the subconscious and unconscious aspect of human mind and also covers both overt and covert behavior. A behavior is considered to be maladaptive, -when it is age inappropriate -when it interferes with adaptive functioning -when others misunderstands it in terms of cultural inappropriateness.
BEHAVIORISTIC THEORY RELEVANT TO MENTAL HEALTH Behavioral theory is based on the concept that all behavior adaptive or maladaptive is a product of learning. problematic behaviors occur when there is an inadequate learning and therefore it can be corrected through the provision of appropriate learning experiences
ASSUMPTIONS OF BEHAVIOR THEORY All human behavior is a response to a stimulus from the environment Human beings can control or determine the behavior of others The human personality is a mere pattern of stimulus-response chains or habits Both adaptive and maladaptive behaviors are learned and strengthened through reinforcements
Maladaptive can be unlearned and replaced by adaptive behavior, if the person receives exposure to specific stimuli and reinforcements for the desired adaptive behavior
FEATURES OF THE BEHAVIORAL APPROACH The behavioral approach to therapy is that, people have become what they are through learning processes or through the interaction of the environment with their genetic endowment. Therefore, It focuses on the maladaptive behavior rather than on disease process, impaired personality structure or unconscious conflict
Preference is given for observable and measurable aspects of behavior such as phobic avoidance, compulsive hand washing etc Attention is paid to the cognitive processes, imagery and subjective affect when they are relevant to the analysis or modification of symptoms
Operational definitions are used for the internal events Treatment goals are defined specifically after frank discussion and negotiation with the patient and his family Specification of the target behavior to be modified and with what they should be replaced must be determined by discussing with the patient
It analyses problem behavior behavior and understands its development in terms of its initiating and maintaining variables
BEHAVIORAL THERAPY: It is a type of psychotherapy which aims at changing maladaptive behavior and substituting it with adaptive behavior It is based on theories of learning such as operant conditioning ( B.F.Skinner ) and classical conditioning ( Ivan pavlov )
ASSUMPTIONS OF BEHAVIOR THERAPY Abnormal behavior can be favorably influenced by therapeutic arrangements of an individuals interaction with his or her environment Principles of learning govern the maintenance of abnormal and normal behavior and thus can be utilized for therapeutic gain
Behavioral assessment focuses more on the current determinants of behavior rather than the post-hoc analysis of the possible historical antecedents Specificity is the hallmark of behavioral assessment and treatment; thus it is assumed that patients are best understood by what they do in a situation rather than by what they say about themselves
Treatment strategies are individually tailored to meet the varied needs, resources and assets of the different patients Instrumental and interpersonal behaviors are more readily changed than cognitive and affective levels of behavior. Thus treatment usually begins with interventions aimed at changing the overt behavior with the expectation that cognitive and affective changes will follow
Therapeutic interventions may result in unintended side effects Behavior therapy reflects an applied sciences approach to the clinical problems and rests on experimental evaluation of the treatment methods Behavior therapy focuses on behavior in its broad multimodal phenomenology; hence, affects cognitions, imagery and biological processes ( eg; heart rate or muscle tension )
Behavior therapy yields to patients learning of new skills, adaptive coping styles or ways of strengthening existing assets
THERAPEUTIC PROCESSES IN BEHAVIORAL MODEL Reciprocal inhibition: This is based on the premise that the observable behavior or symptom is a learned response to anxiety. The symptom is reinforced because it leads to a reduction of anxiety even though it is not a productive behavior. Reciprocal inhibition substitutes a more adaptive behavior for the symptom through learning an alternative means of reducing the anxiety Eg; desensitization and relaxation therapy
Assertive training: Assertiveness implies the ability to stand up for one’s own rights while not infringing on the rights of others. It is provided to alleviate anxiety when the patient’s anxiety is arising from interpersonal relationships. In assertiveness training the patient identifies his usual mode of behavior. Through role-play and practice, he modifies his behavior toward increased assertiveness, this increases self-esteem and the sense of self-control. Thus, interpersonally based anxiety is reduced
Aversion therapy: It refers to the use of a painful stimulus usually an electric shock of very low voltage to create an aversion to a stimulus. This approach attempts to change homosexual behavior. Patients consider that their emotional pain is so intense that physical pain is accepted to alleviate it
Token economy systems: These are positive reinforcements programs. It encourages socially acceptable behavior in chronically hospitalized patients. The person is rewarded with a token generally an eatable or a cigarette when the desirable behavior occurs, where as he is penalized by removal of tokens when undesirable behavior takes place. When enough tokens are accumulated they may be spent for snacks, out passes, to watch a cinema or whatever is meaningful to the patient. This pleasurable experience reinforces the future repetition of the desired behavior and the reward must be highly desirable to the client
Shaping: It is a behavioral modification technique used to condition close approximations of some desired adaptive behavior.
FUNCTIONS OF THE NURSE Devises behavioral objectives with the client Identifies the behavior that is to be changed and breaks them down into small and manageable segments Advocates clients for identifying the behaviors that are appropriate, constructive and amenable to change whatever the treatment setting
Observes documents and outlines behaviors targeted for change Teaches and reinforces cognitive behavior techniques particularly in inpatient or community setting with a behavioral orientation Teaches progressive relaxation to the client with anxiety; models, shapes and reinforces appropriate behavior
Initiates and leads group that focus on developing social skills and assertive behaviors Refers the clients for cognitive behavior therapy As a member of the interdisciplinary team, conducts 6-20 sessions for effective outcome
CONCLUSION The behavioral model views people as being capable of exercising control over their own behavior. They select, organize and transform incoming stimuli. The concept of reinforcement is crucial in this model. Interactions between human and environment strengthen the persons behavior, little or no rewarding interaction with the environment causes the person to feel sad