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BEHAVIOURAL THERAPY.pptx

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Madhura Somahekar

The document discusses the principles of classical and operant conditioning and their application to behavioural therapy. It describes Pavlov's classical conditioning experiments with dogs and the concepts of unconditioned response and conditioned response. It then explains Skinner's operant conditioning theory, focusing on how consequences modify voluntary behaviour. The document outlines various behavioural therapy techniques including systematic desensitization, flooding, aversion therapy, positive/negative reinforcement, and punishment procedures. It emphasizes shaping adaptive behaviours and reducing maladaptive behaviours through reinforcement and extinction.

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BEHAVIOURAL THERAPY.pptx
INTRODUCTION Behaviour is considered to be maladaptive when it is age inappropriate, when it interferes with adaptive functioning. The principles of behavioural therapy as we know it today are based on the early studies of classical conditioning by Pavlov (1927), & Operant conditioning by Skinner (1938).
CLASSICAL CONDITIONING Introduced by Russian Physiologist Pavlov. In his experiments with dogs, during which he hoped to learn more about the digestive process. In his trials he found that , as expected that the dog salivated when they began to eat the food that was offered to them. This was the reflective response that Pavlov called as Unconditioned response. However he also noticed that with time, the dogs began to salivate when the food came to the range of view, before it was even presented to them for consumption. Concluding that this response was not reflexive but had been learned. Pavlov called it a conditioned response.
He carried the experiments even further by introducing unrelated stimulus, one that had no previous connection to the animal food. The animal responded with the expected reflexive salivation to the food. After a number of trials with the combined stimuli (food & bell), Pavlov found that the reflexive salivation began to occur when the dog was presented with the sound of the bell in the absence of food. This was an important discovery in terms of how learning can occur. Pavlov found that unconditioned responses (salivation) occur in response to unconditioned stimuli (eating food). He also found that, overtime, an unrelated stimulus (sound of the bell) introduced with the unconditioned stimulus could elicit the same response alone i.e conditioned response
BEHAVIOURAL THERAPY.pptx
OPERANT CONDITIONING It is the use of consequences to modify the occurrence and form of behaviour. Operant conditioning is distinguished from classical conditioning in that operant conditioning deals with the modification of "voluntary behaviour" or operant behaviour. Operant behaviour "operates" on the environment and is maintained by its consequences, while classical conditioning deals with the conditioning of respondent behaviours which are elicited by antecedent conditions. Behaviours conditioned via a classical conditioning procedure are not maintained by consequences.
Operant conditioning (sometimes referred to as instrumental conditioning) is a method of learning that occurs through rewards and punishments for behaviour. Through operant conditioning, an association is made between behaviour and a consequence for that behaviour. Operant conditioning was coined by behaviourist B.F. Skinner, which is why you may occasionally hear it referred to as Skinnerian conditioning. As a behaviourist, Skinner believed that internal thoughts and motivations could not be used to explain behaviour. Instead, he suggested, we should look only at the external, observable causes of human behaviour.
Skinner used the term operant to refer to any "active behaviour that operates upon the environment to generate consequences" (1953). In other words, Skinner's theory explained how we acquire the range of learned behaviours we exhibit each and every day.
Components of Operant Conditioning. REINFORCER: POSITIVE REINFORCERS NEGATIVE REINFORCERS
Punishment PUNISHMENT POSITIVE PUNISHMENT NEGATIVE PUNISHMENT
BEHAVIOURAL THERAPY.pptx
BEHAVIOURAL THERAPY.pptx
BEHAVIOURAL THERAPY It is a form of treatment for problems in which a trained person deliberately establishes professional relationship with the client , with the objective of removing or modifying existing symptoms & promoting positive personality, growth & development.
Major Assumptions of Behavior Therapy Based on the above-mentioned theories, the following are the assumptions of behavior therapy: All behavior is learned (adaptive and maladaptive). Human beings are passive organisms that can be conditioned or shaped to do anything if correct responses are rewarded or reinforced. Maladaptive behavior can be unlearned and replaced by adaptive behavior if the person receives exposure to specific stimuli and reinforcement for the desired adaptive behavior. Behavioral assessment is focused more on the current behavior rather than on historical antecedents.
Modifying Clients behavior
It was developed by Joseph Wolpe, based on the behavioral principle of counter conditioning. In this patients attain a state of complete relaxation and are then exposed to the stimulus that elicits the anxiety response. The negative reaction of anxiety is inhibited by the relaxed state, a process called reciprocal inhibition. 1. SYSTEMIC DESENSITIZATION
1 RELAXATION TRAINING 2 HIERARCHY CONSTRUCTION 3 DESENSITIZATION OF THE STIMULUS It consists of three main steps:
Relaxation training: There are many methods which can be used to induce relaxation, some of them are: Jacobson's progressive muscle relaxation Hypnosis Meditation or yoga Mental imagery Biofeedback
Hierarchy construction: Here the patient is asked to list all the conditions which provoke anxiety. Then he is asked to list them in a descending order of anxiety provocation.
Desensitization of the stimulus: This can either be done in reality or through imagination. At first, the lowest item in hierarchy is confronted. The patient is advised to signal whenever anxiety is produced. With each signal he is asked to relax. After a few trials, patient is able to control his anxiety gradually. Indications: Phobias Obsessions Compulsions Certain sexual disorders
2. FLOODING The patient is directly exposed to the phobic stimulus, but escape is made impossible. By prolonged contact with the phobic stimulus, the therapist's guidance and encouragement and his modeling behavior reduce anxiety Sometimes called Implosive therapy, is also used to desensitize individuals to phobic stimuli. Flooding is used to treat agoraphobia and specific phobias
3. AVERSION THERAPY Pairing of pleasant stimulus with an unpleasant response, so that even in the absence of unpleasant response the pleasant stimulus becomes unpleasant by association. Punishment is presented immediately after a specific behavioral response and the response is eventually inhibited. Unpleasant response is produced by electric stimulus, drugs, social disapproval or even fantasy. Indications: Alcohol abuse Paraphilias Homosexuality Transvestism.
4.OPERANT CONDITIONING PROCEDURES FOR INCREASING ADOPTIVE BEHAVIOUR .
Positive reinforcement: When a behavioral response is followed by a generally rewarding event such as food, praise or gifts, it tends to be strengthened and occurs more frequently than before the reward. This technique is used to increase desired behavior. 2. Token economy: This program involves giving token rewards for appropriate or desired target behaviors performed by the patient. The token can later be exchanged for other rewards. For example on inpatient hospital wards, patients receive a reward for performing a desired behavior, such as tokens which they may use to purchase luxury items or certain privileges.
5. OPERANT CONDITIONING PROCEDURES TO TEACH NEW BEHAVIOURS
Modeling: Modeling is a method of teaching by demonstration, wherein the therapist shows how a specific behavior is to be performed. In modeling the patient observes other patients indulging in target behaviors and getting rewards for those behaviors. This will make the patient repeat the same behavior and earn rewards in the same manner.
Shaping: In shaping the components of a particular skill, the behavior is reinforced step by step. The therapist starts shaping by reinforcing the existing behavior. Once it is established he reinforces the responses which are closest to the desired behavior, and ignores the other responses. For example, to establish eye-to-eye contact, the therapist sits opposite the patient and reinforces him even if he moves his upper body towards him. Once this is established, he reinforces the person's head movement in his direction and this procedure continues till eye-to-eye contact is established.
Chaining: Chaining is used when a person fails to perform a complex task. The complex task is broken into a number of small steps and each step is taught to the patient. In forward chaining one starts with the first step, goes on to the second step, then to the third and so on. In backward chaining, one starts with the last step and goes on to the next step in a backward fashion. Backward chaining is found to be more effective in training the mentally disabled.
6. OPERANT CONDITIONING PROCEDURES FOR DECREASING MALADAPTIVE BEHAVIOUR EXTINCTION PUNISHMENT TIME OUT RESTITUTION RESPONSE COST
Extinction/Ignoring: Extinction means removal of attention rewards permanently, following a problem behavior. This includes actions like not looking at the patient, not talking to the patient, or having no physical contact with the patient etc, following the problem behavior. This is commonly used when patient exhibits odd behavior.
Punishment: Aversive stimulus (punishment) is presented contingent upon the undesirable response. The punishment procedure should be administered immediately and consistently following the undesirable behavior with clear explanation. Differential reinforcement of an adaptive or desirable behavior should always be added when a punishment is being used for decreasing an undesirable behavior. Otherwise the problem behaviors tend to get maintained because of the lack of adaptive behaviors and skill defect
Timeout: Timeout method includes removing the patient from the reward or the reward from the patient for a particular period of time following a problem behavior. This is often used in the treatment of childhood disorders. For example, the child is not allowed to go out of the ward to play if he fails to complete the given work.
Restitution (Over-correction): Restitution means restoring the disturbed situation to a state that is much better than what it was before the occurrence of the problem behavior. For example, if a patient passes urine in the ward he would be required to not only clean the dirty area but also mop the entire/ larger area of the floor in the ward.
Response cost: This procedure is used with individuals who are on token programs for teaching adaptive behavior. When undesirable behavior occurs, a fixed number of tokens or points are deducted from what the individual has already earned.
7. CONTINGENCY CONTRACTING A contract is drawn up among all parties involved .The behaviour change that is desired is stated explicitly in writing. The contract specifies the behaviour change desired & the reinforcers to be given for performing desired behaviours. The negative consequences or punishers that will be rendered for not fulfilling the terms of the contract are also delineated. The contract is specific about how reinforcers & the punishment will be presented.
8. Assertiveness & Social skills training: Assertiveness training is a behaviour therapy technique in which the patient is given training to bring about change in the emotional & other behavioural pattern by being assertive. Social skills training helps to improve social manners like encouraging eye contact, speaking appropriately, observing simple etiquette, & relating to people.
ROLE OF A NURSE 1. Providing direct patient care 2. Planning treatment programmes 3. Teaching others the use of behavioural techniques
Application to nursing Nurses commonly use behavioural techniques in a wide variety of mental health settings. Additionally nurses who work with clients having physical disability, chronic pain, chemical dependency and rehabilitation centres also apply these techniques. she should provide direct care to the patient and also teach others the use of behavior technique and also implement in her professional life.
BEHAVIOURAL THERAPY.pptx

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BEHAVIOURAL THERAPY.pptx

  • 2. INTRODUCTION Behaviour is considered to be maladaptive when it is age inappropriate, when it interferes with adaptive functioning. The principles of behavioural therapy as we know it today are based on the early studies of classical conditioning by Pavlov (1927), & Operant conditioning by Skinner (1938).
  • 3. CLASSICAL CONDITIONING Introduced by Russian Physiologist Pavlov. In his experiments with dogs, during which he hoped to learn more about the digestive process. In his trials he found that , as expected that the dog salivated when they began to eat the food that was offered to them. This was the reflective response that Pavlov called as Unconditioned response. However he also noticed that with time, the dogs began to salivate when the food came to the range of view, before it was even presented to them for consumption. Concluding that this response was not reflexive but had been learned. Pavlov called it a conditioned response.
  • 4. He carried the experiments even further by introducing unrelated stimulus, one that had no previous connection to the animal food. The animal responded with the expected reflexive salivation to the food. After a number of trials with the combined stimuli (food & bell), Pavlov found that the reflexive salivation began to occur when the dog was presented with the sound of the bell in the absence of food. This was an important discovery in terms of how learning can occur. Pavlov found that unconditioned responses (salivation) occur in response to unconditioned stimuli (eating food). He also found that, overtime, an unrelated stimulus (sound of the bell) introduced with the unconditioned stimulus could elicit the same response alone i.e conditioned response
  • 6. OPERANT CONDITIONING It is the use of consequences to modify the occurrence and form of behaviour. Operant conditioning is distinguished from classical conditioning in that operant conditioning deals with the modification of "voluntary behaviour" or operant behaviour. Operant behaviour "operates" on the environment and is maintained by its consequences, while classical conditioning deals with the conditioning of respondent behaviours which are elicited by antecedent conditions. Behaviours conditioned via a classical conditioning procedure are not maintained by consequences.
  • 7. Operant conditioning (sometimes referred to as instrumental conditioning) is a method of learning that occurs through rewards and punishments for behaviour. Through operant conditioning, an association is made between behaviour and a consequence for that behaviour. Operant conditioning was coined by behaviourist B.F. Skinner, which is why you may occasionally hear it referred to as Skinnerian conditioning. As a behaviourist, Skinner believed that internal thoughts and motivations could not be used to explain behaviour. Instead, he suggested, we should look only at the external, observable causes of human behaviour.
  • 8. Skinner used the term operant to refer to any "active behaviour that operates upon the environment to generate consequences" (1953). In other words, Skinner's theory explained how we acquire the range of learned behaviours we exhibit each and every day.
  • 13. BEHAVIOURAL THERAPY It is a form of treatment for problems in which a trained person deliberately establishes professional relationship with the client , with the objective of removing or modifying existing symptoms & promoting positive personality, growth & development.
  • 14. Major Assumptions of Behavior Therapy Based on the above-mentioned theories, the following are the assumptions of behavior therapy: All behavior is learned (adaptive and maladaptive). Human beings are passive organisms that can be conditioned or shaped to do anything if correct responses are rewarded or reinforced. Maladaptive behavior can be unlearned and replaced by adaptive behavior if the person receives exposure to specific stimuli and reinforcement for the desired adaptive behavior. Behavioral assessment is focused more on the current behavior rather than on historical antecedents.
  • 16. It was developed by Joseph Wolpe, based on the behavioral principle of counter conditioning. In this patients attain a state of complete relaxation and are then exposed to the stimulus that elicits the anxiety response. The negative reaction of anxiety is inhibited by the relaxed state, a process called reciprocal inhibition. 1. SYSTEMIC DESENSITIZATION
  • 17. 1 RELAXATION TRAINING 2 HIERARCHY CONSTRUCTION 3 DESENSITIZATION OF THE STIMULUS It consists of three main steps:
  • 18. Relaxation training: There are many methods which can be used to induce relaxation, some of them are: Jacobson's progressive muscle relaxation Hypnosis Meditation or yoga Mental imagery Biofeedback
  • 19. Hierarchy construction: Here the patient is asked to list all the conditions which provoke anxiety. Then he is asked to list them in a descending order of anxiety provocation.
  • 20. Desensitization of the stimulus: This can either be done in reality or through imagination. At first, the lowest item in hierarchy is confronted. The patient is advised to signal whenever anxiety is produced. With each signal he is asked to relax. After a few trials, patient is able to control his anxiety gradually. Indications: Phobias Obsessions Compulsions Certain sexual disorders
  • 21. 2. FLOODING The patient is directly exposed to the phobic stimulus, but escape is made impossible. By prolonged contact with the phobic stimulus, the therapist's guidance and encouragement and his modeling behavior reduce anxiety Sometimes called Implosive therapy, is also used to desensitize individuals to phobic stimuli. Flooding is used to treat agoraphobia and specific phobias
  • 22. 3. AVERSION THERAPY Pairing of pleasant stimulus with an unpleasant response, so that even in the absence of unpleasant response the pleasant stimulus becomes unpleasant by association. Punishment is presented immediately after a specific behavioral response and the response is eventually inhibited. Unpleasant response is produced by electric stimulus, drugs, social disapproval or even fantasy. Indications: Alcohol abuse Paraphilias Homosexuality Transvestism.
  • 23. 4.OPERANT CONDITIONING PROCEDURES FOR INCREASING ADOPTIVE BEHAVIOUR .
  • 24. Positive reinforcement: When a behavioral response is followed by a generally rewarding event such as food, praise or gifts, it tends to be strengthened and occurs more frequently than before the reward. This technique is used to increase desired behavior. 2. Token economy: This program involves giving token rewards for appropriate or desired target behaviors performed by the patient. The token can later be exchanged for other rewards. For example on inpatient hospital wards, patients receive a reward for performing a desired behavior, such as tokens which they may use to purchase luxury items or certain privileges.
  • 25. 5. OPERANT CONDITIONING PROCEDURES TO TEACH NEW BEHAVIOURS
  • 26. Modeling: Modeling is a method of teaching by demonstration, wherein the therapist shows how a specific behavior is to be performed. In modeling the patient observes other patients indulging in target behaviors and getting rewards for those behaviors. This will make the patient repeat the same behavior and earn rewards in the same manner.
  • 27. Shaping: In shaping the components of a particular skill, the behavior is reinforced step by step. The therapist starts shaping by reinforcing the existing behavior. Once it is established he reinforces the responses which are closest to the desired behavior, and ignores the other responses. For example, to establish eye-to-eye contact, the therapist sits opposite the patient and reinforces him even if he moves his upper body towards him. Once this is established, he reinforces the person's head movement in his direction and this procedure continues till eye-to-eye contact is established.
  • 28. Chaining: Chaining is used when a person fails to perform a complex task. The complex task is broken into a number of small steps and each step is taught to the patient. In forward chaining one starts with the first step, goes on to the second step, then to the third and so on. In backward chaining, one starts with the last step and goes on to the next step in a backward fashion. Backward chaining is found to be more effective in training the mentally disabled.
  • 29. 6. OPERANT CONDITIONING PROCEDURES FOR DECREASING MALADAPTIVE BEHAVIOUR EXTINCTION PUNISHMENT TIME OUT RESTITUTION RESPONSE COST
  • 30. Extinction/Ignoring: Extinction means removal of attention rewards permanently, following a problem behavior. This includes actions like not looking at the patient, not talking to the patient, or having no physical contact with the patient etc, following the problem behavior. This is commonly used when patient exhibits odd behavior.
  • 31. Punishment: Aversive stimulus (punishment) is presented contingent upon the undesirable response. The punishment procedure should be administered immediately and consistently following the undesirable behavior with clear explanation. Differential reinforcement of an adaptive or desirable behavior should always be added when a punishment is being used for decreasing an undesirable behavior. Otherwise the problem behaviors tend to get maintained because of the lack of adaptive behaviors and skill defect
  • 32. Timeout: Timeout method includes removing the patient from the reward or the reward from the patient for a particular period of time following a problem behavior. This is often used in the treatment of childhood disorders. For example, the child is not allowed to go out of the ward to play if he fails to complete the given work.
  • 33. Restitution (Over-correction): Restitution means restoring the disturbed situation to a state that is much better than what it was before the occurrence of the problem behavior. For example, if a patient passes urine in the ward he would be required to not only clean the dirty area but also mop the entire/ larger area of the floor in the ward.
  • 34. Response cost: This procedure is used with individuals who are on token programs for teaching adaptive behavior. When undesirable behavior occurs, a fixed number of tokens or points are deducted from what the individual has already earned.
  • 35. 7. CONTINGENCY CONTRACTING A contract is drawn up among all parties involved .The behaviour change that is desired is stated explicitly in writing. The contract specifies the behaviour change desired & the reinforcers to be given for performing desired behaviours. The negative consequences or punishers that will be rendered for not fulfilling the terms of the contract are also delineated. The contract is specific about how reinforcers & the punishment will be presented.
  • 36. 8. Assertiveness & Social skills training: Assertiveness training is a behaviour therapy technique in which the patient is given training to bring about change in the emotional & other behavioural pattern by being assertive. Social skills training helps to improve social manners like encouraging eye contact, speaking appropriately, observing simple etiquette, & relating to people.
  • 37. ROLE OF A NURSE 1. Providing direct patient care 2. Planning treatment programmes 3. Teaching others the use of behavioural techniques
  • 38. Application to nursing Nurses commonly use behavioural techniques in a wide variety of mental health settings. Additionally nurses who work with clients having physical disability, chronic pain, chemical dependency and rehabilitation centres also apply these techniques. she should provide direct care to the patient and also teach others the use of behavior technique and also implement in her professional life.

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