Front | Back |
Nine Issues to Consider in
Implementing a Behavior Mod Program:
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1.
Was the problem referred primarily for the client’s benefit or for someone
else’s?
2.
Can the problem and goal be specified so you can target specific, measurable
behaviors?
3.
Is the problem important to the client or to others?
4.
Has the counselor eliminated the possibility of confounding variables that
could best be handled by some other discipline?
5.
How deeply embedded is the behavior?
6.
How might the new behavior be generalized and maintained?
7.
Are there persons in the natural environment who will assist in the maintenance
of the new behavior?
8.
What is the impact of saboteurs (co-dependents, enablers, people threatened by
client’s new competence)?
9. Is your training adequate to implement a behavioral treatment
program?
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Seven Assumptions of Behavioral Therapy
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1.
Many abnormal behaviors, rather than being illnesses or symptomatic of illness,
are “problems of living.”
2.
Most abnormal behavior is acquired and maintained through learning (just like
normal behavior)
3.
Assessment of behavior deals with present causes rather than with origins in
the past.
4.
Analysis of the problems requires dividing it into constituent parts, so that
treatment procedures may be targeted at specific components.
5.
Treatment strategies are tailored to different problems in different individuals.
6.
Successful treatment of a psychological problem does not require understanding
its origins.
7. Behavior therapy requires a commitment to the testable,
scientific approach.
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Assessment of baseline is critical: where is client starting
from?
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1) Assessment of goal attainment must also be measurable.
2)Overt behavior vs. covert behavior (attitudes, feelings, thoughts) |
Behavioral Contract
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Client states in advance
the kind of behavior she wants to change, and then commit to that change by
preparing the contract with the counselor. Both client and counselor sign
the contract, and it is referred to whenever it is fears, by either party, that
client may relapse. Should be simple, nonjudgmental. Clients tend
to take more seriously than verbal contracts.
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Behavioral Techniques
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1.
Activity scheduling
2.
Assertion training
3.
Behavior modeling/vicarious learning
4.
Behavior rehearsal (practiced in simulated real-world context)
5.
Bibliotherapy
6.
Cognitive modeling (counselor using self-talk while modeling a task, to teach
client)
7.
Contingency contracts
* Describes specific behaviors to be performed
* Specifications of immediate reinforcement
* Describes how goals will be observed, measured, recorded
8.
Counter-conditioning (reducing anxiety by practicing a counter-emotion, such as
by
whistling or relaxation techniques)
9.
Encouragement (may be verbal or active)
10.
Extinction: elimination of unwanted behavior by removing the stimulus/reward
for
that behavior
11.
Feedback (positive and suggestive)
12.
Graduated exposure (“in vivo” training)
13.
Graduated task assignment
14.
Guided imagery
15.
Multimodel therapy assessment
16.
Play therapy
17.
Reinforcement, punishment, and omission
18.
Response generalization (demonstrating a learned behavior in an environment
other
than the one in which it was learned)
19.
Self-management and self-reinforcement
* Specify desired changes
* Translate goals into target behaviors
* Practice self-monitoring
* Form a plan
* Practice self-reinforcement
* Do self-contracting
* Evaluate the plan for change
20.
Shaping (forward, i.e., taking step closer to approximation of desired
behavior, like learning to swim; and backward, i.e., starting from target
behavior and working back, such as teaching child to put on own pants)
21.
Stress-inoculation training
* Education (thinking, physiological response, consequences)
* Rehearsal (coping techniques)
* Application training (performing new behavior
in under conditions that
formerly caused stress)
22.
Systemic desensitization (moving from low anxiety to high anxiety items, while
remaining calm, from graduated list.
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Reciprocal Inhibition/Counter-conditioning:
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Reducing or
eliminating client’s anxiety by having client practice or experience an
opposite emotion, such as whistling or using relaxation techniques (such as
progressive stretching, deep breathing, or other relaxation)
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Vicarious Learning:
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learning from observing the behaviors of
others. The counselor may model behavior for the client, such as self-talk,
specific tasks, etc.
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Assertion Training
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A set of techniques designed to teach
alternatives to passive or aggressive behaviors. Assertiveness is ability
to express one’s needs and thoughts confidently, without muting or hiding them,
on one hand, or forcing them on others. Focuses on self-talk
(modification of thoughts about self and/or others). Includes behavior
rehearsal, exposure, modeling, and reinforcement. Goals are empowerment
to behave assertively, ability to express themselves with sensitivity towards
others, and provide realistic opportunities for facing challenges in a safe
environment. Help’s client see her negative self-statements and beliefs,
faulty thinking patterns.
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Graduated Task Assignment:
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assigned task, often homework, begins simply,
proceeds in steps that are more difficult, complex, potentially
anxiety-producing. Steps done one at a time, no progression until client
proceeds successfully with current step:
Example:
Greet one new person
Greet two new people, consecutively
Greet several people in one location
Greet someone and make comment about weather
Greet someone and introduce oneself
Introduce yourself and ask if you can help
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BASIC ID
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Lazarus, multimodel therapy assessment; tool for assessing in
which component of her life the client is experiencing difficulty:
Behavior
– refers to typical behaviors; acts that can be observed and recorded
Affect
– refers to how client feels (how emotional he/she is)
Sensation
– refers to the five senses
Imagery
– refers to how client sees the self; includes dreams, fantasy, memory
Cognition
– refers to self-talk, values, beliefs, and opinions
Interpersonal
Relationships – refers to interactions with others
Drug/Biology
– refers to drug use, diet, exercise, overall health
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Shaping:
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Two types—forward and backward (see above). Shaping
is a form of operant conditioning. Purpose of shaping is to reach a
desired behavior by using reinforcement of successive approximations to the
required response, with gradual cessation of reinforcement of earlier
responses. At beginning, reinforcement must occur with each time behavior
occurs. Praise is one kind of reinforcement. Gradually,
reinforcement for the learned behavior is withdrawn, and we move to the nest
step.
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Stress Inoculation
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Three-phase process:
1.
Education: exploring and discussing the origin of emotions and how the person
responds to stress (including cognition, somatic responses, and consequences of
behavior)
2.
Rehearsal: exploring ways to cope and rehearsing new coping skills (might be
somatic, like relaxation or breathing; cognitive, like self-talk, etc.)
3.
Application training: in a controlled setting, client is gradually exposed to
stressor to test new coping skills and to think of ways she might apply the
skills in real-life situations.
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