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Introduction to Behaviorism & Cognitive Behavior Therapies. Anne Farrell, Ph.D. New York Medical College. Introduction and goals. Background Knowledge and experience Goals Familiarize participants with tenets of behaviorism and basis for cognitive behavior therapies - PowerPoint PPT Presentation
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Introduction to Behaviorism & Cognitive Behavior TherapiesAnne Farrell, Ph.D.New York Medical College
Introduction and goals Background Knowledge and experience Goals
– Familiarize participants with tenets of behaviorism and basis for cognitive behavior therapies
– Background and interrelationships– Common adult and pediatric
applications– References and resources
Behavior Therapy Commonly used to treat
– anxiety, mood, eating disorders, parasuicidality
– impulse, anger control disorders, disruptive behavior
– sexual dysfunction, substance abuse– behavioral medicine and compliance
Two models of conditioning– Classical (Pavlovian) conditioning model– Operant (Skinnerian) conditioning model
Classical conditioning “Pavlovian” conditioning model
– unconditioned reflexes (UCR)• salivation, eye blink
– Contingency: pair with neutral stimulus (UCS)• bell, tone, bang, ash
– Conditioning (CS)• Previously neutral stimulus becomes
conditioned stimulus
– Conditioned response (CR)• Reflex now occurs in response to CS
Common examples?
Classical conditioning Relation to specific disorders
– Post-traumatic stress– Specific phobias (Little Albert)
• Panic disorder with agoraphobia
Related principles– Contingency, extinction,
generalization, discrimination– Schedules of reinforcement and
resistance Background
– First applied as BT by Wolpe, Lazarus
Skinnerian conditioning (“B-mod”) consequences of a behavior change
future probability of occurrence key influence
– association between response and consequences
Thorndike’s Law of Effect– positive outcomes strengthen
behaviors– negative outcomes weaken them
Operant Conditioning
Positive reinforcement Probability of response when it is
followed by a rewarding stimulus examplesNegative reinforcement Probability of response when it is
followed by removal of an unpleasant stimulus
examplesPunishment frequency of response due to
consequence
Operant Conditioning (Skinner)
Operant Conditioning Principles timing
– learning is more efficient under immediate rather than delayed circumstances
shaping– reward successive approximations of
desired behavior primary reinforcement
– reinforcer is innately satisfying secondary reinforcement
– reinforcer acquires its value through experience
Schedules of Reinforcement Continuous reinforcement– response is reinforced every time it
occurs. Partial reinforcement
– a response is reinforced only part of the time.
Schedules: rules for partial reinforcement– fixed ratio: after set # target responses– variable ratio*: after average
(unpredictable) # of responses– fixed interval: after a fixed amount of time– variable interval: after an unpredictable
amount of time
Resistance to extinction
Operant Conditioning
extinction a response is not reinforced and it
decreasesspontaneous recovery occurs in operant conditioning (and CC)discrimination learning to repeat only reinforced responsesgeneralization giving the learned response to similar
stimuliApplied behavioral analysis (ABA): operant conditioning principles to change
behavior
BT and disorders Assumptions about etiology? Anxiety disorders
– Acquired – classical conditioning– Maintained – operant conditioning
Role of avoidance– Highly reinforcing
Manualized treatments– Barlow: panic disorder, GAD
• Stress innoculation, panic induction, biological challenge
– Foa: OCD, PTSD• Exposure with response prevention• Relaxation strategies and retelling
– Frequently combined with meds, cog therapies
Basics of CBTs Assessment and intervention Empirical support for practice Characteristics of treatment
– Active, structured, focused– Past v. present v. future– Brief therapies– Change is achieved by
• Altering connections between troublesome situations and habitual reactions to them
• Challenging and changing distorted beliefs and thoughts that relate to dysfunction
Applications Operant conditioning
– Applied behavior analysis (ABA)• Single case designs• Children with autism, challenging
behavior
– Educational interventions• Functional behavioral assessment (FBA)
and behavior intervention plans (BIP)– Mandated under IDEA
– Generic parenting strategies• Reinforcement and punishment
ABCs– Antecedent – behavior - consequence
Single case design (ABA)
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Baseline 1 Alternate 1 Baseline 2 Alternate 2
Cognitive therapies Emerge from behavioral models
– Use BT techniques– Assume interrelationship among
cognition, affect, behavior Beck, Ellis, Young Situation, thoughts, feelings,
behavior Common elements:
– Ellis (RET): core irrational ideas– Beck (CT): maladaptive beliefs– Young: Early maladaptive schemas
CBT techniques Relaxation and imagery Self monitoring (mood monitoring,
impulse control, self-mutilation) Exposure Response prevention Flooding Behavioral rehearsal Thought stopping Coping statements Cognitive disputation
Outcomes Empirical support evidenced via
– Single case design (A-B-A-B)– Controlled studies
• Comparison to no treatment, wait-list, placebo-controls; comparison to other therapies and combinations of therapies
– Meta-analyses• Group differences expressed in sds
Resources Association for the Advancement
of Behavior Therapy (AABT.org) American Institute for Cognitive
Therapy (AICT.com) Ellis Institute, Beck Institute National Institutes of Mental Health
–– Web site – Facts about…
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