Principles of Behavior Modification (PSY333)

Gary L. Cates, Ph.D., N.C.S.P

Clinical Behavior Therapy

Cognitive Behavior Modification

Cognition: belief, thought, expectancy, attitude, or perception

• Assumption 1: People respond to events in terms of their perceived significance.

• Assumption 2: Cognitive deficiencies cause emotional disorders.

• √ Goal: Change cognition to make better adjusted person

Method 1: Cognitive Restructuring

• Substituting rational thoughts and appraisal of information for irrational or dysfunctional thinking.

• Ellis: Rational Emotive Therapy (Later REBT)• Beck: Cognitive Therapy

– Dichotomous Thinking: Absolute terms– Arbitrary Inference: Faulty conclusions – Overgeneralization: One failure means failure in

general– Magnification: Exaggeration

Method 2: Self-instructional Coping methods

• Identify internal stimuli that are stress related

• Use them as SD’s to engage in appropriate self talk

• Appropriate self talk through a set of things to do to relax

• Positive self reinforcing statements after positive self talk

Method 3: Problem-Solving Methods

• General orientation: Be systematic not impulsive

• Problem Definition: Be specific• Generation of alternatives: Brainstorm

solutions• Decision making: Evaluate the pros and

cons to each alternative and pick the best one.

• Verification: Keep track of progress (data)

Empirical Evaluation of Ellis

• Reducing self talk: 46%

• Reducing emotional distress: 27%

• Gossette and O’Brien (1992)

√ Effects probably due to homework assignments, not the challenge of cognition.

Let’s Add Cognitive Restructuring!

• Let’s not!– 83% of research suggests it adds nothing!– Helpful for social anxiety only

Empirical Evaluation of Beck

• No better than a placebo (placebo may be effective!) [NIMH, 1989]

• - 55% BT, 52% IPT, 46% CT, 34% BDPT (Agency for health care policy and research, 1994)

Behavioral vs. Cognitive

• 83% of pure cognitive had no added benefit.

√ Cognitive good for social-anxiety and phobia

Two Points

• Cognitive techniques rely on rule-governed behavior

• Rules control behavior only when linked to environmental contingencies

Areas of Clinical Behavior Therapy

• Agoraphobia: In vivo exposure (group or individual)– Cognitive restructuring does not add anything

• OCD: In vivo exposure (65-75%)– Cognitive (imagining) led by therapist adds to

effectiveness.

• Stress: Relaxation techniques and exercise• Depression: Exercise is gaining a lot of

momentum• placebo > no Tx and = to cognitive therapy• 30-60 minutes 3 times per week

Areas of Clinical Behavior Therapy

• Alcohol Problems:– Most successful programs use behavioral components such as:– Decreasing reinforcing properties of alcohol– Teaching new skills– Strategies to prevent relapse– Contingency management– SOCIAL SUPPORT IMPORTANT! DRA?

√ Tx good for problem drinkers not as effective for alcoholics

• Obesity– Self-monitoring, stimulus control, changing eating behavior,

behavioral contracts

Areas of Clinical Behavior Therapy

• Marital Distress– Instigation of positive exchanges– Communication Training– Problem Solving Training

• Habit Disorders– Habit reversal (Azrin & Nunn, 1973)

History

Respondent Conditioning

• 1904 Pavlov wins Noble Prize in Medicine

• 1913 J.B. Watson writes Behaviorists Manifesto

• 1916 Little Albert

• 19 43 Clark Hull: Operant & Respondent

• 1958 Wolpe: reciprocal inhibition

Operant Conditioning

• 1938 Behavior of Organisms

• 1950 Keller & Schoenfield: Principles of Psychology

• 1953 Science of Human Behavior– Testing out: Sugar-milk, mmm-hmmm,

Jellybeans – Allyn & Michael (1959).

• 1965 Ullmann & Krasner: 1st bmod book

• 1982 Iwata (Functional Analysis)

Terms

• Behavior Modification: The large over arching term to describe behavior principles being used to modify behavior

• Behavior Therapy: Pavlov-wople orientation with cognitive focus

• Behavior analysis: Operant orientation (Function)

Ethics in Behavior Modification

Ethical Issues for Human Services

• Have goals of treatment been adequately considered?

• Has choice of treatment methods been adequately considered?

• Clients participation voluntary?• Subordinate client interests considered?• Adequacy of treatment been evaluated?• Confidentiality protected?• Referrals when necessary?• Therapist Qualified?

Careers in Behavior Modification

So you want to be a behavior modifier/analyst huh?

Schools in behavior analysis

• http://programs.gradschools.com/usa/applied_behavior_analysis.html

• http://www.abainternational.org/sub/behaviorfield/education/accreditation/index.asp

• Behavioral School Psychology– Syracuse, MSU, USM, UN-L, UO, ISU?

Interesting Jobs

• Most you need a masters degree– Certified as behavior analyst & Collect 3rd

party pay

• B.S. Marcus Institute, Kennedy Krieger,

• Ph.D.– Licensed Psychologist