1. CHAPTER 11: Behavioral and Cognitive-Behavioral Family Therapies
Family Therapy: History, Theory, and Practice
6th Edition
Samuel T. Gladding
Developed by Nathaniel N. Ivers, Wake Forest University
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved

2. Overview Behavioral Family Therapy (BFT) Functional Family Therapy
Cognitive-Behavioral Family Therapy (CFBT)
Major theorists
Premises
Techniques
Roles of the therapist
Processes and Outcomes
Unique Aspects of BFT and CBFT

3. Behavioral Family Therapy (BFT)
Fairly recent treatment methodology
Origins in research on modification of children’s actions by parents
Treatment procedures based on social learning theory
Functional Family Therapy
Cognitive-behavioral family therapy (CBFT)

4. Major Theorists Early Pioneers John B. Watson Mary Cover Jones
Ivan Pavlov
B. F. Skinner
First to use the term, behavioral therapy
Originator and proponent of operant conditioning

5. Gerald Patterson
Credited with being the primary theorist who began the practice of applying behavioral theory to family problems
Instrumental in writing programmed workbooks for parents to employ in helping their children

6. Neil Jacobson
Found that 20% of male batterers, have lower hear rates during times of physical assault
Found that acceptance, or loving one’s partner as a complete person and not focusing on differences, may lead to an ability to overcome fights that continually focus on the same topic
Challenged marriage and family therapy practitioners to be more innovative and reflective in their work

7. Premises of the Theory
Based on the theoretical foundations of behavioral therapy, particularly operant and classical conditioning
Maladaptive behaviors and not underlying causes should be the targets of change
Not everyone in the family has to be treated for change to occur
Emphasizes the major techniques of behavioral theory, such as stimulus, reinforcement, shaping, and modeling
Many behavioral therapists also emphasize cognitive aspects of treatment

8. Types of BFT and CFBT Therapies
Behavioral Parent Training
Authoritative Parenting
Authoritarian Parenting
Permissive Parenting
Neglectful Parenting
One of the main tasks is to define a specific problem behavior
Parents are trained in social learning theory

9. Types of BFT and CFBT Therapies
Functional Family Therapy
All behaviors are adaptive and serve a function
Behaviors represent an effort by the family to meet needs in personal and interpersonal relationships
Relationships help family members achieve one of three interpersonal states
Contact/closeness (merging)
Distance/independence (separating)
A combination of states 1 and 2 (midpointing)

10. Functional Family Therapy Continued
Three-stage process of Functional Family Therapy:
Assessment
Change
Maintenance

11. Types of BFT and CFBT Therapies
Behavioral Treatment of Sexual Dysfunctions
Four phases of sexual responsiveness
Excitement
Plateau
Orgasm
Resolution
Model for Sexuality
PLISSIT

12. PLISSIT P – Permission to talk about sexuality and sexual issues
LI limited information about the prevalence and etiology of problems
SS – specific suggestions
IT – intensive therapy

13. Types of BFT and CFBT Therapies
Heavy emphasis placed on modifying personal or collective core beliefs, or schemas.
Important to help change stable, entrenched, and long-standing beliefs that family members have about family life
Teach families to think for themselves and think differently when it is helpful

14. CBFT Continued
Behavioral component of CBFT focuses on the following actions:
“Excess negative interaction and deficits in pleasing behaviors exchanged by family members
Expressive and listening skills used in communication
Problem solving skills
Negotiation and behavior change skills”
(Dattilio, 2001, p. 11)

15. BFT: Treatment Techniques
General BFT and CBFT techniques:
Education
Communication and problem-solving strategies
Operant conditioning
Contracting

16. BFT Treatment Techniques
Specific behavioral and cognitive-behavioral techniques
Classical conditioning
Coaching
Contingency contracting
Extinction
Positive reinforcement
Quid pro quo
Reciprocity

17. Specific BFT and CBFT Techniques Continued
Reciprocity
Shaping
Systematic desensitization
Timeout
Job Card Grounding
Grounding
Charting
Premack Principle

18. Specific BFT and CBFT Techniques Continued
Disputing irrational thoughts
Thought stopping
Self-instructional training
Modeling and role playing

19. Role of the Therapist Expert Teacher Collaborator Coach
Helps families to set up behavioral and cognitive-behavioral management programs
Behavioral and CBT family therapists must learn to play man roles and to be flexible.
CBT family therapists concentrate on modifying or changing family members’ cognitions as well as their interactions.

20. Process and Outcome If successful:
Family members learn to modify, change, or increase certain behaviors to function better
Family members learn how to eliminate or decrease maladaptive or undesirable behaviors and/or dysfunctional thoughts.
Focuses on increasing parenting skills, facilitating positive family interactions, and improving sexual behaviors
CBFT helps families deal with stress, addiction, and adult sexual dysfunctions

21. Unique Aspects of BFT and CBFT
The theory behind the approaches
The research
Their continued evolution
Their short term treatment
Their rejection of the medical model of abnormal behavior