Skinner: Radical Behaviorism Bandura, Ellis, Beck Meicheanbaum Behavior and Cognitive Behavior Therapy Skinner: Radical Behaviorism Bandura, Ellis, Beck Meicheanbaum

Distinct aspects each approach emphasizes Compare -- Contrast Humanistic Theories Person Centered-Existential-Gestalt Common Themes List ways in which the three approaches are similar Distinct aspects each approach emphasizes Central focus of each approach Unique ideas, constructs, and/or techniques each brought to counseling practice

Areas of Major Emphasis Psychoanalytic/Psychodynamic Basic drives and the contribution of early emotional experiences to the person’s presenting concern Humanistic The therapeutic process -- the relationship-- and emotional states in the here and now Behavioral observable behaviors & learning principles; congnitions

Skinner: Radical Behaviorism Placed primary emphasis on the role of the environment in producing behavior Applied learning principles to psychology Experimental psychologist: examined learning principles with rats in the laboratory Books 1948 Walden Two 1953 Science and Human Behavior 1971 Beyond Freedom and Dignity

Behavior/ Cognitive Behavior Theory Classical Conditioning Operant Conditioning Social Learning Approach Cognitive Behavior Therapy

Classical Conditioning If you pair a conditioned stimulus to a natural stimulus, after time, the conditioned stimulus produces the same response as the natural one: Learning by association Pavlov discovery (1900) Meat (us) >> Salivation (ur) Bell (cs)>>Meat (us) >>Salivation (ur) Bell (cs) >> Salivation (cr) Bell (cs) >> Extinguished response

Wolpe: 1950 Exam (us)>>>Anxiety (ur) Applied classical conditioning to treat anxiety by pairing stimuli that cause anxiety (taking an exam) with a state of relaxation, to break the connection between the stimulus and the anxious response Exam (us)>>>Anxiety (ur) Relaxation> Images Exam>Anxiety>Relaxation (cs) (us) (ur) (cr) Images Exam (us) >>> Relaxation (cr) Exam (us) >>> Relaxation (cr)

Behavior Therapy: Learning by Association: Exposure Techniques Systematic Desensitization - anxiety Relaxation training/ Anxiety hierarchy Pairing (+) stimulus with (–) stimulus (shot-lollipop) Aversive Counter Conditioning Exposure Techniques In vivo desensitization Flooding (in vivo, imaginary)

Anxiety: Facilitating and Debilitating

Aversive Counter-Conditioning

Exposure Techniques

Operant Conditioning Behavior is controlled by its consequences Desired Consequences – Increase Behavior Reinforcement No consequences - Decrease Beh. Not-desired consequences - Decrease Beh. Punishment

Environmental Consequences Reinforcement Increase a behavior Positive R Adds a pleasant consequence Negative R Takes away an aversive stimulus Punishment Extinguish a behavior Positive P: Add an aversive consequence Negative P: Takes away a desired stimulus Lack of consequence - Extinguish behavior

Applied Behavioral Analysis: Functional Assessment Model Examine the antecedents and consequences of problem behaviors Conduct a functional assessment using interviews and direct observations (e.g. keeping a diary) to identify Antecedents: conditions that contribute to the behavior of interest Consequences: what happens after specific behavior occurs Behavioral treatments are devised to replace problem behaviors with more adaptive behaviors using reinforcement and extinction strategies

Behavior Modification Program Reinforcement Token economy Extinction Time out, loose privileges, punishment Stimulus control Change environmental antecedents of problem behaviors

Cognitive Behavior Therapy Emphasizes cognitive processes and self-talk as mediators of behavior change Reciprocal Determinism Bandura Rational Emotive Therapy Ellis Cognitive Therapy Beck Cognitive Behavior Modification Meichenbaum

Bandura: Social Learning Approach Psychological functions involve a reciprocal interaction between: Environment <><><> Behavior <> <> <> <> <> Cognitive Process <>

Modeling Vicarious Learning

Cognitive-Behavior Techniques Assertiveness Training Provide Information Examine beliefs and self-talk Role play assertive behaviors Modeling – therapist demonstrates behavior Behavioral rehearsal – client demonstrates behavior

Cognitive-Behavior Techniques 2. Steps: Self-Management Program 1. Identify goal in behavioral terms 2. Behavioral assessment environmental and cognitive contingencies 3. Plan for change 4. Self-Monitoring and Self-Reinforcement Behaviors, thoughts, self-talk 5. Evaluation of action plan - results

Cognitive Behavior Theory Mental disorder- problem with thinking in which a client distorts reality, including: Specific misconceptions Unrealistic expectations Maladaptive attributions Therapy’ aim is to identify and change Faulty patterns of thinking Faulty premises and attitudes Distressing emotions result from maladaptive thinking

Rational Emotive Behavior Therapy: (REBT) Albert Ellis Stresses thinking, judging, deciding, analyzing, and doing Assumes that cognitions, emotions, and behaviors affect ach other Is highly didactic, directive, Emotions stem mainly from our beliefs, evaluations and interpretations

RET: The ABC Theory

RET: Therapy Process Therapy is seen as an educational process Clients learn: To identify and dispute irrational beliefs To replace ineffective ways of thinking with effective and rational cognitions To stop absolutistic thinking, blaming, and repeating false beliefs

RET: Therapy Process Rational Emotive Imagery Homework Imagine being in the worst situation- train to change irrational thoughts/feelings for retional ones Homework REBT Self-Help Form Act as if… to challenge self-limiting Biblio-therapy – Psycho-education

Aaron Beck’s CT: Human Nature Cognitive structures or schemas We all have implicit assumptions or premises that influence what we attend to and how we interpret events Confirmatory bias We tend to electively attend to events that confirm our beliefs Schemas and Disorders Anxiety Threat and Danger Depression Social rejection and failure

Cognitive Therapy (CT) Insight-focused therapy Emphasizes changing negative thoughts and maladaptive beliefs Theoretical Assumptions People’s internal communication is accessible to introspection Clients’ beliefs have highly personal meanings These meanings can be discovered by the client rather than taught by the therapist

CT’s Cognitive Distortions Arbitrary inferences Selective abstraction Overgeneralization Magnification and minimization Personalization Labeling and mislabeling Polarized thinking

CT’s Cognitive Distortions Arbitrary inferences Gloria: relationships with the eligible men do not work out because she feels anxious and acts flippantly Selective abstraction Focuses on only on one aspect of a situation: typically a negative aspect- Overgeneralization This relationship did not work, no relationship will ever work Magnification and minimization Emphasize negatives and minimize positives

CT’s Cognitive Distortions Presonalization A mother blames herself for child’s problems A man blames himself for partner's lack of interest in the relationship Labeling and mislabeling Type of generalization: I made a mistake vs. I am a looser Polarized thinking Either co-workers praise me or they hate me Gloria: Men are either eligible or “icky”

Therapy Process Teach clients to recognize, observe and monitor negative "automatic" thoughts & Subject their automatic thoughts to reality testing: examine evidence for and against them Clients learn to substitute realistic and accurate interpretations for biased cognitions Process is collaborative an interactive: Socratic dialogue

Beck’s Approach to Depression: Cognitive Triad Have a negative view of themselves; attribute setbacks to themselves w/o looking at the environment Tend to interpret experiences in a negative manner. Screen out positive experiences not consistent with negative view of themselves (selective abstraction) Gloomy vision and projections about the future

Ellis Vs. Beck Ellis is more directional and confrontational in pointing out and refuting irrational thoughts Beck helps clients discover their distorted patterns of thinking Collaborative empiricism Guided discovery client and therapist examine and evaluate beliefs and modify and correct client’s misconceptions

Contributions Beh- Cog Beh Focus on short-term behavioral goals Emphasis on evaluation of therapy outcome Empirical evidence of positive results

Limitations May lead to symptom substitution Too much therapist power and control Lack of attention to relationship issues No processing of emotions and feelings Focus only on cognitive issues

Meichenbaum: Cognitive Behavior Modification Is primarily a self-instructional therapy that Focuses on helping clients become aware of their self-talk, - cognitive restructuring - and acquire practical coping skills to deal with problems and behaviors Process of Change Self observation Start a new internal dialogue Learn new behaviors

Phase 1: Self-Observation Observe thoughts, feelings, actions, Realize how client contributes to own problems Leads to new cognitive structures – see problems in a new light

Phase 2: Start New Internal Dialogue Identify maladaptive behaviors Recognize more adaptive options Develop adaptive internal dialogue to guide behaviors New behaviors impact cognitive structures

Phase 3: New Skills Teaches more effective coping skills Practice in real- life situations Continue monitoring/changing internal dialogue Observe behaviors Assess outcomes

Coping Skills Program: Stress Inoculation Stress management techniques for present and future problems Three phases: Conceptual phase Skills acquisition and rehearsal Application and follow-through

Conceptual Phase Collaborative relationship (Rogers) Didactic presentation of the role cognitions and emotions play in stress (Ellis) Guided discovery to identify own self-talk and how it creates stress (Beck) Systematic observation and monitoring of maladaptive behaviors and their related self-talk (Behavioral) New cognitive structures = see problems in a new light (Beck)

Skills Acquisition and Rehearsal Give clients behavioral and cognitive coping techniques to apply to stressful situations Rehearse new self-statements Relaxation training Social skills training Time management instruction Making changes in everyday life

Application and Follow-Through Arrange for transfer and maintenance of change from therapy to the real world Homework assignments of increasing complexity Results of assignments are carefully evaluated Follow-up and booster sessions are scheduled in 3-, 6-, and 12 months intervals

Contributions Focus on short-term behavioral goals Emphasis on evaluation of therapy outcome Empirical evidence of positive results

Limitations May lead to symptom substitution Too much therapist power and control Lack of attention to relationship issues No processing of emotions and feelings Focus only on cognitive issues

Multimodal Therapy: Lazarus Holistic approach to behavior modification Technical eclecticism Human experience interplay of genetics, environment and social learning can be accounted by examining the BASIC ID

BASIC ID Framework for assessment and therapy B – behavior A – affective processes S – sensation- five senses I – imagery C – cognition I – interpersonal relations D – physiological aspects - health

Therapy Process Therapy is guided by what is best for the client Starts with a thorough assessment of the BASIC ID profile BASIC ID determines the tone or quality of the person’s functioning Therapist functions as trainer, educators, consultant, role model Emphasize skill learning

New Applications and Integrations (end of Behavior Chapter #9) Mindfulness and Acceptance- Based Cognitive Therapies: Emotional Regulation Dialectical – Behavior Therapy (DBT) Combines CBT and Psychodynamic Highly structured- requires training - Borderline PD Minimum 1-year of frequent outpatient treatment Mindfulness-Based Stress Reduction (MBSR) Mindfulness-Based Cognitive Therapy (MBCT) Acceptance and Commitment Therapy (ACT)

Mindfulness and Acceptance How to live more fully in the present (Ext) Interventions: yoga, meditation Experiential learning and self-discovery (Ext- Gestalt -Rogers) Practice – In session and home-work Acceptance (rather than challenge cognitions) change awareness of and relation to negative thoughts (Ext) acceptance (nonjudgmental awareness) of cognitions (Rogers)