Theory and Practice of Counseling and Psychotherapy TENTH EDITION Gerald Corey Cengage Learning

Chapter 9 Behavior Therapy

Four Areas of Development (slide 1 of 2) 1. Classical (or Respondent) Conditioning Refers to what happens prior to learning that creates a response through pairing 2. Operant Conditioning Focuses on a type of learning in which behaviors are influenced mainly by the consequences that follow them Theory and Practice of Counseling and Psychotherapy - Chapter 9 (1)

Four Areas of Development (slide 2 of 2) 3. Social-Learning (or Social-Cognitive) Approach Gives prominence to the triadic reciprocal interaction between an individual’s behavior, personal factors, and the environment 4. Cognitive Behavior Therapy Social skills training, cognitive therapy, stress management training, mindfulness, and acceptance-based practices all represent the cognitive behavioral tradition Theory and Practice of Counseling and Psychotherapy - Chapter 9 (2)

Behavior Therapy (slide 1 of 3) A set of clinical procedures relying on experimental findings of psychological research Based on principles of learning that are systematically applied Focus is on the client’s current problems and on assessing behavior through observation or self-monitoring Theory and Practice of Counseling and Psychotherapy - Chapter 9 (3)

Behavior Therapy (slide 2 of 3) Largely action-oriented and educational – therapist teaches clients skills of self-management Behavior is something that can be operationally defined; it includes overt actions as well as internal processes Change can take place without insight into underlying dynamics and the origins of a psychological problem Theory and Practice of Counseling and Psychotherapy - Chapter 9 (4)

Behavior Therapy (slide 3 of 3) Behaviorists ask: “What treatment, by whom, is the most effective for this individual with that specific problem and under which set of circumstances?” The general goals of behavior therapy are to increase personal choice and to create new conditions for learning Theory and Practice of Counseling and Psychotherapy - Chapter 9 (5)

Functional Assessment of Behavior A-B-C model Antecedent(s) Behavior(s) Consequence(s) A B BehaBvior C Consequence Theory and Practice of Counseling and Psychotherapy - Chapter 9 (6)

Operant Conditioning Positive and negative reinforcement Goal: to increase target behavior Extinction Goal: to decrease or eliminate a behavior by withholding reinforcement from a previously reinforced response Positive and negative punishment Goal: to decrease target behavior Theory and Practice of Counseling and Psychotherapy - Chapter 9 (7)

Progressive Muscle Relaxation Progressive muscle relaxation is a popular method of teaching people to cope with the stresses produced by daily living Relaxation becomes a well-learned response, which can become a habitual pattern if practiced daily Relaxation procedures have been applied to a variety of clinical problems ranging from chronic pain to panic disorder Theory and Practice of Counseling and Psychotherapy - Chapter 9 (8)

Systematic Desensitization Based on classical conditioning, SD was developed by Joseph Wolpe SD is effective in reducing maladaptive anxiety and treating anxiety-related disorders, particularly specific phobias SD entails relaxation training, development of a graduated anxiety hierarchy, and presentation of hierarchy items while client is deeply relaxed Theory and Practice of Counseling and Psychotherapy - Chapter 9 (9)

Exposure Therapies (slide 1 of 2) In Vivo Desensitization Involves client exposure to the actual anxiety-evoking events rather than simply imagining these situations Flooding In vivo or imaginal exposure to anxiety-evoking stimuli for a prolonged period of time without the feared consequences Theory and Practice of Counseling and Psychotherapy - Chapter 9 (10)

Exposure Therapies (slide 2 of 2) Eye Movement Desensitization and Reprocessing (EMDR) An exposure-based therapy Involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders Extensive research has validated EMDR Theory and Practice of Counseling and Psychotherapy - Chapter 9 (11)

Social Skills Training Helps clients develop and achieve skills in interpersonal competence May involve behavioral procedures (e.g., psychoeducation, modeling, behavior rehearsal, and feedback) If clients can correct their problematic behaviors in practice situations, they can then apply these new skills in daily life Theory and Practice of Counseling and Psychotherapy - Chapter 9 (12)

Self-Management Programs In S-M programs people make decisions concerning specific behaviors they want to control or change The process includes selecting goals, translating goals into target behaviors, self-monitoring, working out a plan for change, and evaluating an action plan S-M strategies have been successfully applied to many populations and problems Theory and Practice of Counseling and Psychotherapy - Chapter 9 (13)

Multimodal Therapy A comprehensive, systematic, holistic approach to behavior therapy developed by Arnold Lazarus Grounded in social-cognitive theory Applies diverse behavioral techniques to a wide range of problems; it encourages technical eclecticism Theory and Practice of Counseling and Psychotherapy - Chapter 9 (14)

Multimodal Therapy: BASIC ID The complex personality of human beings can be divided into seven major areas of functioning: B = behavior A = affective responses S = sensations I = images C = cognitions I = interpersonal relationships D = drugs, biological functions, nutrition, and exercise Theory and Practice of Counseling and Psychotherapy - Chapter 9 (15)

Dialectical Behavior Therapy A promising blend of behavioral and psychoanalytic techniques for treating borderline personality disorders and other issues Includes both acceptance-oriented and change-oriented strategies Skills are taught in four modules: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance Theory and Practice of Counseling and Psychotherapy - Chapter 9 (16)

Mindfulness-Based Stress Reduction Assists people in learning to live more fully in the present The skills taught in MBSR include sitting meditation and mindful yoga, aimed at cultivating mindfulness Didactic instruction is minimized and experiential learning and self-discovery are emphasized MBSR is not a form of psychotherapy per se, but it can be an adjunct to therapy Theory and Practice of Counseling and Psychotherapy - Chapter 9 (17)

Mindfulness-Based Cognitive Therapy An 8-week group treatment program adapted from MBSR that includes components of CBT Clients learn to respond in skillful and intentional ways to their automatic negative thought patterns Kindness and self-compassion are essential components of MBCT Theory and Practice of Counseling and Psychotherapy - Chapter 9 (18)

Acceptance and Commitment Therapy ACT involves fully accepting present experience and mindfully letting go of obstacles There is little emphasis on changing the content of a client’s thoughts. Instead, the emphasis is on acceptance (nonjudgmental awareness) of cognitions The goal of ACT is to allow for increased psychological flexibility Theory and Practice of Counseling and Psychotherapy - Chapter 9 (19)

Application to Group Counseling (slide 1 of 2) Treatments Rely on empirical support and tend to be brief Emphasize self-management skills and thought restructuring Leaders Use a brief, directive, psychoeducational approach Conduct behavioral assessments Theory and Practice of Counseling and Psychotherapy - Chapter 9 (20)

Application to Group Counseling (slide 2 of 2) Leaders and members Create collaborative, precise treatment goals Devise a specific treatment plan to help each member meet goals Objectively measure treatment outcome Theory and Practice of Counseling and Psychotherapy - Chapter 9 (21)

Strengths from a Diversity Perspective Behavior therapy may appeal to culturally diverse clients for many reasons (e.g., it emphasizes objectivity, tasks, cognition, behavior, action, coping, problem-solving, etc.) Behavior therapy focuses on environmental, social, and political conditions that contribute to a client’s problems Theory and Practice of Counseling and Psychotherapy - Chapter 9 (22)

Limitations from a Diversity Perspective Some counselors may use a variety of techniques in narrowly treating specific behavioral problems Therapists who do not assess the interpersonal and cultural dimensions of the client’s problem may not adequately prepare him/her for the consequences of newly acquired social skills Theory and Practice of Counseling and Psychotherapy - Chapter 9 (23)

Contributions of Behavior Therapy The specificity of the behavioral approaches helps clients translate unclear goals into concrete plans of action A wide variety of specific behavioral techniques have been developed Behavioral interventions have been subjected to more rigorous evaluation than other approaches Behavior therapy emphasizes ethical accountability Theory and Practice of Counseling and Psychotherapy - Chapter 9 (24)

Limitations of Behavior Therapy (slide 1 of 2) Heavy focus on behavioral change may detract from client’s experience of emotions Some counselors believe the therapist’s role as a teacher deemphasizes the important relational factors in the client-therapist relationship Behavior therapy does not place emphasis on insight Theory and Practice of Counseling and Psychotherapy - Chapter 9 (25)

Limitations of Behavior Therapy (slide 2 of 2) Behavior therapy tends to focus on symptoms rather than underlying causes of maladaptive behaviors There is potential for the therapist to manipulate the client using this approach Some clients may find the directive approach imposing or too mechanistic Theory and Practice of Counseling and Psychotherapy - Chapter 9 (26)