BEHAVIORAL THERAPYBEHAVIORAL THERAPY

THERAPEUTIC TECHNIQUETHERAPEUTIC TECHNIQUE Supriti RozarioSupriti Rozario

I. Applied Behavioral I. Applied Behavioral AnalysisAnalysis: : Operant Conditioning Operant Conditioning TechniquesTechniques

• Key Principle:Key Principle:

1. Positive Reinforcement1. Positive Reinforcement- we respond in - we respond in predictable predictable ways because of ways because of

the gains we experiencethe gains we experience- addition of something of value as - addition of something of value as

consequence of certain behaviorconsequence of certain behavior

Goal: decrease or eliminate undesirable behaviors Goal: decrease or eliminate undesirable behaviors to increase frequency of more desirable behaviorto increase frequency of more desirable behavior

2. Negative Reinforcement:2. Negative Reinforcement:

- - escapeescape from or from or avoidance avoidance of aversive or of aversive or unpleasant stimuliunpleasant stimuli

3. Extinction:3. Extinction:

- the process of removing an unwanted - the process of removing an unwanted response by failing to reinforce it.response by failing to reinforce it.

4. Punishment: Aversive control4. Punishment: Aversive control

- consequences of a certain behavior - consequences of a certain behavior result result in the decrease of in the decrease of that behavior. that behavior.

- - Goal: decrease target behavior Goal: decrease target behavior

Positive Punishment – Positive Punishment – an aversive stimulus is added an aversive stimulus is added after the behavior to decrease the frequency of a after the behavior to decrease the frequency of a behaviorbehavior

Negative Punishment – Negative Punishment – reinforcing stimulus is reinforcing stimulus is removed following the behavior to decrease the removed following the behavior to decrease the frequency of a behavior.frequency of a behavior.

* Use the least aversive means possible to change * Use the least aversive means possible to change behavior behavior

Most powerful change agent is Most powerful change agent is Positive Positive ReinforcementReinforcement

II. Relaxation Training and II. Relaxation Training and Related Methods:Related Methods:

• Relaxation exercisesRelaxation exercises

• Aim: Achieve mental and muscular Aim: Achieve mental and muscular relaxationrelaxation

• Most commonly used: progressive Most commonly used: progressive relaxation or muscle relaxationrelaxation or muscle relaxation

III. SYSTEMATIC III. SYSTEMATIC DESENSITIZATION:DESENSITIZATION:

• Developed by Joseph WolpeDeveloped by Joseph Wolpe

• ““exposure therapy”exposure therapy”

• Clients are required to expose Clients are required to expose themselves to anxiety arousing themselves to anxiety arousing images to reduce anxiety gradually / images to reduce anxiety gradually / systematically they become systematically they become desensitized or less sensitive to the desensitized or less sensitive to the anxiety arousing situation.anxiety arousing situation.

• Exposure therapy – a form of Exposure therapy – a form of behavioral therapy in which the behavioral therapy in which the survivor confronts feelings or phobias survivor confronts feelings or phobias or anxieties about a traumatic event or anxieties about a traumatic event & relives it in the therapy session.& relives it in the therapy session.

• The steps involved:The steps involved:– Relaxation trainingRelaxation training– Development of an anxiety hierarchyDevelopment of an anxiety hierarchy– Systematic desensitization properSystematic desensitization proper

IV. IN VIVO EXPOSURE and IV. IN VIVO EXPOSURE and

FLOODINGFLOODING::• In Vivo Exposure – actual exposure of In Vivo Exposure – actual exposure of

the client to the anxiety-evoking eventthe client to the anxiety-evoking event

• Flooding – client is flooded with Flooding – client is flooded with experiences of a particular kind until experiences of a particular kind until becoming either averse to them or becoming either averse to them or numbed to them. (more on imaginary numbed to them. (more on imaginary exposure)exposure)

V.V. EYE MOVEMENT DESENSITIZATION EYE MOVEMENT DESENSITIZATION & & REPROCESSINGREPROCESSING (EMDR): (EMDR):

• Developed by: Francine Shapiro (2001)Developed by: Francine Shapiro (2001)

• A form of exposure therapy that A form of exposure therapy that involves:involves:

- imaginal flooding- imaginal flooding

- cognitive restructuring- cognitive restructuring

- the use of rapid rhythmic eye - the use of rapid rhythmic eye movementsmovements

• For clients with traumatic stressFor clients with traumatic stress

Eight Phases of Treatment:Eight Phases of Treatment:

• First phaseFirst phase – history-taking session where – history-taking session where therapists assesses client’s readiness for therapists assesses client’s readiness for EMDR & develops a treatment plan.EMDR & develops a treatment plan.

• Second PhaseSecond Phase – therapist ensures that the – therapist ensures that the client has adequate methods of handling client has adequate methods of handling emotional distress and coping skills. emotional distress and coping skills.

• Third to sixth phaseThird to sixth phase – a target is identified – a target is identified and processed using EMDR.and processed using EMDR.

• Seventh Phase – closure. Client is asked Seventh Phase – closure. Client is asked to keep a journal during the week to keep a journal during the week

• Eighth Phase – re-evaluation of the Eighth Phase – re-evaluation of the previous work and of progress since the previous work and of progress since the previous sessionprevious session

EMDR treatment ensures processing of EMDR treatment ensures processing of all related historical events, current all related historical events, current incidents that elicit distress, and future incidents that elicit distress, and future scenarios that will require different scenarios that will require different responses.responses.

VI. SOCIAL SKILLS TRAINING:VI. SOCIAL SKILLS TRAINING:

• For individuals with psychosocial For individuals with psychosocial problems.problems.

• Includes: modeling, psychoeducation, Includes: modeling, psychoeducation, reinforcement, behavioral rehearsal, role reinforcement, behavioral rehearsal, role playing, feedbackplaying, feedback

• Anger management training Anger management training

• Assertion training-teaching people to be Assertion training-teaching people to be assertive in a variety of social situationsassertive in a variety of social situations