How is behaviour therapy different from other realted types of therapy? L1
- very different from psychodynamic therapies, which focus on role of unconscious. behaviourists tend to reject the view that unconscious is very important, have more transparency, have more evidence, are more directive, and less insights into dev history
- closely aligned w cognitive & rational emotive behaviour therapy
How is behaviour thearpy similar to other related types of therapy? (L1) especially Cognitive therapy & CBT
shared characteristics:
- focus on behavioural change/expanding behavioural repertorie and response options
- focus on empiricism, (individual) hypothesis-testing, (continuous) evaluation
- relatedly: supported by scientific research
- behaviour is (largely) “functional” in/function of environment (reinforcement/punishment) and not a patients “fault”
- focus on maintaining factors/current determinants of problem behaviour
- focus on homework in patients real environment
- active, structured, directive, creative
What are the misunderstandings around behaviour therapy?
- denial of (deeper) thoughts & feelings
- superficial and (only) addressing symptoms instead of (real) causes
- exclusive focus on present
- simplistic & manualized
- ignores therapeutic relationship
What is the theory of behavioural psychotherapy?
basic assumption = all behaviour is learned through association, consequences, observation, or learned rules. Therapy tries to provide corrective learning experiences to clients thus leading to behavioral changes.
→ involves active and structured learning and homework
→ clients are expected to apply learned behaviors in external situations
What is the aim of Behaviour Therapy?
aims to change factors in the environment that influence an individual’s behaviour as well as the ways in which individuals respond to their environment
What are the main features of behaviour therapy?
- Focus on changing behavior (decrease maladaptive, increase adaptive and behavioral response repertoire in general)
- Rooted in empiricism (speculation about variables contributing to problem behavior and testing assumptions)
- behaviors assumed to have a function
- emphasizes maintaining factors, not initiating factors
- supported by research
- active (very directive, frequent advice and suggestions are provided by therapist and client has to frequently practice strategies)
- transparent (goal is for the clients to become their own therapists, for which a behavioral model is provided, rationale for strategies, instructions on using behavioral techniques, data collected is shared)
What is the process of behaviour therapy (structure, mechanisms, predictors)? (L4)
- mostly individual, but sometimes partner involved
- therapist usually clinician, but sometimes parent & teacher involved
- duration is often 1h but can vary in length
- session length usually quite short
- treatment length usually 10-20sessions but depends on whats being treated (bpd can range to 1y)
- therapist office but can change
- mechanisms: reinforcement & punishment quadrant, empathetic etc therapeutic relationship, exposure exercises
What are some predictors of worse outcomes?
→ comorbid personality disorder, depression, more severe anxiety symptoms
→ stressful life events
→ poor insight into symptom severity
→ poor motivation
→ negative patterns of communication between family members
→ poor compliance with treatment
What are the problems that can be treated w behaviour therapy (L5)?
helpful for wide range of problems: anxiety, depression, susbtance abuse, schizophrenia, EDs, sexual dysfunction, insomnia, BPD. specifically
- panic disorder: psychoeducation, exposure, cognitive reevaluation
- ocd: exposure + response prevention
- depression: behavioural activation, cognitive reappraisal, problem solving training, social skills training, mindfulness-based treatment
- addictions: contingency managment, community reinforcmene,t behavioural couples & family treatment, CB approaches, MI
- schiz: social skills training, congintency management, behavioural family therapies, CBT -> usually in combination w behavioural therapy
What are the therapeutic techniques used in behaviour therapy? (L6)
- behavioural assessment (including functional analysis, meaning analysis, case conceptualization)
- treatment planning: set specific treatment goals. both FA & clients diagnosis used to select BT treatment
- exposure based strategies (in vivo, imaginal, interoceptive, virtual reality)
- response prevention
- operant conditioning strategies aka applied behaviour analysis (change patterns of rienforcement & punsihment)
- relaxation training
- stimulus control procedures
- modelling
- behavioural activation
- social skills training
- problem solving training
- acceptance based behavioural therapies: minfulness & ACT
- dialectical behavioural therapy: CBT+mindfulness
What are the core steps of problem solving?
- Define the problem
- Identify possible solutions (brainstorming)
- Evaluate the solutions
- Choose the best solution(s)
- Implementation (usually involves a new set of challenges)
How is behavioural activation used to treat depression?
assumes that depression is maintained by constant avoidance of potential positive reinforcers duo to inactivity & withdrawal
core principles:
1. Changing how one feels depends on what one does
2. Unhelpful short-term coping strategies in response to life changes can maintain depression
3. What strategies are most likely to be helpful depends on understanding preceding and consequential factors of the client’s behaviors
What are some operant conditioning strategies?
- reinforcement based procedures: differential reinforcement (reinforcing absence of unwanted & presence of wanted behaviours), token economy (recieving tokens which can be redeemed for rewards for desirable behaviour), contingency management (changing environment so that unwanted behaviours can no longer receive reinforcmeent)
- punishmenet based procedures: aversive conditioning (combining aversive stimuli w initially desired ones (like disulfiram w alcohol)
What is response prevention?
- Inhibiting an unwanted behavior to break association between stimulus and response
- Often used for OCD combined with exposure
- Clients either told to tolerate the discomfort or another competing behavior may be introduced.
What are the 4 main guidelines for effective exposure?
- exposure should be predictable
- exposure should be controllable by client
- should be frequently practiced w longer practices often being more effetive
- modeling through the therapist may help
How is behavioural assessment done in behaviour therapy?
- done before & during to find target behaviours (behaviours to change), assess impact of treamtnent & find most appropriate treatment.
++ methods, ++ informations, ++ situations - ideal target behaviour are those that are distressing, impairing, or dangerous. usually contain behavioural excesses or deficits
through: - functional analysis
- behavioural interviews
- behavioural observations
- monitoring forms & diaries
- self report scales
- psychophysiological assessment
- case conceptualization
- meaning analysis
What is the main aim of the functional analysis in behaviour therapy?
Identify variables responsible for maintaining target behaviors
What is the most significant research related to the outcomes of behaviour therapy? (L7)
- single case experimental designs often used:
clients first assessed before intervention w assessment continuing during therapy & after final session to see long term effects of the treatment
reversal design sometimes reintroduces intervention & sometimes withdraws it
con: cant evaluate effects of treatments that are supposed to last after they have been withdrawn (carryover effects)
What re the pros & cons of manualized treatment?
con: often dont give sufficient info on how to adapt the treatment per client
pro: can be used effectively to yield more new treatments, flexibility can still be present when using
What are the 3 main elements of an empirical approach in therapy?
- Being aware of one’s own biases about clients and treatment
- Collecting data in therapy to test many assumptions about problem-maintaining variables
- Collecting data over the course of treatment to evaluate the effects of the intervention
How can you adapt behaviour therapy for different cultural groups? (L8)
BT not universally effective as it relies on therapeutic relationship, which needs to be adapted per culture. so therapists have to learn about different cultures & be aware of their own biases
What is theory of personality? How does it relate to Behaviour Therapy?
ppl show enduring patterns of behaviour observable in various situations. these behaviours are specific traits that can be high/low in intensity
traditional BT was based on behaviourism which rejected trait view of personality
