Behavior Therapies Essay, Research Paper
The treatment of disorders (can be either mental or physical) by the use of either psychological needs or by the use of medicinal needs is called therapy. Therapy involves talking with a trained professional about things such as symptoms, problems, and understanding one’s self.
Therapists help patients in many ways:
? Help patients understand and cope with their illnesses.
? Empathize with their patients and help them understand why they behave the way they do.
? Help patients make positive changes by discussing their past behavior.
? Help patients discover why they think certain thoughts and how these thoughts affect their feelings.
? Help patients to identify and repair problems with relationships.
There are many different kinds of therapies. The important ones are explained below.
Behavior therapy: this focuses on what you do. This type of therapy works particularly well for problems in which certain maladaptive anxiety-causing behaviors recur such as phobias, anxiety disorders, obsessive compulsive disorders, drug and alcohol abuse and eating disorders.
The therapy is accomplished by reinforcing positive behavior and extinguishing negative ones. Some common types of behavior therapy are:
? Systematic Desensitization- by approaching the situation associated with a great deal of anxiety in steps, the patient can gradually decrease the anxiety related to it. This process usually contained three steps- relaxation techniques (which includes breathing exercises, mental imagery and biofeedback), Creating a Hierarchy (The therapist creates a series of situations in which the feared event occurs more and more intensely) and finally desensitization (where the patient can finally handle the most anxiety causing event in the series. A simple example of this could be a person suffering from the phobia of dogs, the progression can be imagined, (e.g., thinking about a dog barking at you) real, (e.g., having a dog bark at you), or even virtual (e.g., have an animated virtual dog on the computer bark at you.)
? Exposure therapies- involves actual contact with a feared situation. It can be done with a therapist, helper, or alone, and begins with the smallest phobia, gradually working up to more difficult tasks. This is where clients learn to manage their fear firsthand, and we are always aware of the courage it takes for anyone to confront what they fear most – so we are gentle and go slowly. This therapy is especially helpful for driving and flying phobias, as well as fears of heights, bridges, elevators, being alone, and social situations. It is similar to systematic desensitization except without the relaxation techniques.
? Flooding- Instead of going through a hierarchy that works from less traumatic to most traumatic anxiety provoking events, the patient is exposed to the most anxiety-causing event at once. With this technique the patient confronts the feared situation directly.
? Behavior Modification- All behavior therapy attempts to modify behavior but there is also a specific process called behavior modification. This can be used to either increase or decrease a behavior. In this technique, one begins by defining and counting the occurrences of an undesirable behavior the patient would like to decrease, such as biting one’s nails, or a desired behavior the client would like to increase, such as assertive behavior. This is called collecting baseline data. The baseline data is used to compare increases or decreases in behavior, which monitors success of the therapy. For those wanting to decrease a behavior, circumstances that may trigger the undesirable behavior are identified. The person then rearranges his or her environment so that possible triggers of the behavior can be avoided, which, in turn, will hopefully decrease the behavior. For those wanting to increase a behavior, they may identify situations that would be appropriate for the behavior and intentionally put themselves in these circumstances to perform the desirable behavior. Behavior modification may also involve a series of reinforcements and punishments to help increase and decrease specific behaviors.
? GOAL SETTING is important when desensitizing phobias, as well as helping clarify what you want to achieve in your life. Long and short-term goals are carried out during the groups.
? ASSERTIVENESS TRAINING is crucial, because those with anxiety disorders tend to be people pleasers and try to please others at their own expense. In short, they need to learn how to say NO, set limits, maintain boundaries, express both positive and negative emotions openly and easily, and initiate behavior on their own behalf. Assertiveness is not just about getting what you want; it is very much about knowing how you feel and what you want, and then being able to communicate that information to others.
? COMMUNICATION SKILLS allow people to be understood by others, facilitating connection with the world around you. Relationships blossom with good communication skills, wither without them. These skills are taught early in Part I, then practiced routinely to insure permanent learning.
? SOCIAL SKILLS training is especially valuable for people struggling with social anxiety. Often, we begin with simple greetings, then graduate to short exchanges, later learning how to express personal opinions, and later yet, displeasure. The training also extends to body language, movement, gestures, and personal presentation. Learning to be the center of attention and speak in front of a group are other areas addressed.
Some theorists combine behavioral techniques with cognitive therapy techniques such as thought restructuring. The two theories work well together especially when treating depression and anxiety disorders.
Cognitive Therapy believes that negative thoughts are the cause of mental suffering. It focuses on identifying and changing negative thinking patterns. Often people with clinical depression make negative assumptions about their world. These assumptions lead them to have negative thoughts about themselves, their situation, and their future (cognitive triad). These negative thoughts create depressive feelings. This therapy’s goals are to help clients become aware of what their thoughts are, be able to identify irrational or distorted thinking, and then substitute more balanced, functional thoughts. In short, what we think about and believe with certainty becomes our reality.
Since thoughts and feelings are believed to be linked together, the way you think can affect how you feel. Since thoughts sometimes happens so quickly, people often don’t realize what they are thinking in certain situations. What they notice is how they feel. Thus, cognitive psychotherapists view these thoughts as “automatic.” They believe that the way to change these negative feelings is to change the thoughts that occur in stressful situations.
For example, if you were placed in front of hundreds of people to give a talk, you may be scared to death and your stomach may do somersaults. You may only notice that you feel nervous and not realize you thought, “I ‘m going to mess up and everyone’s going to laugh!” One way to feel better in this situation is to change how you think about public speaking. A cognitive psychotherapist would help you identify and your specific thoughts and assumptions about giving a speech.
Catastrophic Thinking and the Anticipatory Response are central to maintaining anxiety disorders. “Time Magazine” called agoraphobia “the dreaded disease of the What ifs”, because every thought that begins ‘What if’ is a catastrophic thought.
Because your body and mind are intimately connected as one bodymind, you start the panic feedback loop of escalating anxiety when you think catastrophic thoughts. Just thinking those upsetting thoughts will cause you to have scary physical symptoms and panic attacks; then you really begin to believe you’re going crazy . . . losing control . . . having a heart attack . . . making a fool of yourself . . .going to crash the car, whatever your worst fear is, and your symptoms escalate to the panic level.
Cognitive psychotherapists are actively involved and focus on specific problems in the present. Cognitive therapists teach depressed people how to examine and recognize negative thinking patterns and negative automatic thoughts. By identifying these thought distortions, depressed patients can learn how to modify them and thus alter their depressed mood. Patients often keep a log of their thoughts and feelings that they use with their therapist to identify dysfunctional thinking patterns. Patients practice their new cognitive strategies in real life, discuss the outcomes with their therapist, and modify their approaches.
Many therapists classify themselves as Cognitive-Behavioral therapists. They combine behavior therapy techniques, such as relaxation training, and cognitive techniques, such as thought restructuring.
Expressive therapies are often used to treat patients diagnosed with schizophrenia. Expressive therapies include art, music, movement, drama, and creative writing. Sometimes, patients have a difficult time expressing themselves, especially when they try to talk about emotions. By using creative media, patients can express anger, frustration, and other emotions that they may otherwise keep inside. Therapists often use expressive therapy in conjunction with individual or group therapy to enhance treatment.
Family therapy often helps families that have difficulties communicating and handling conflict with each other. One viewpoint is that a family operates as a system; when one member acts, that action affects all the others. When one person changes how he or she interacts with another member, it will affect the rest of the family. One way to explain this idea is to use a sports team as an analogy. A team works as a unit but each member has his or her own job that he or she must perform in order for the team to function. When one person changes how he or she does their job, the rest of the team has to adjust accordingly even when the change is a good one.
In family therapy, the therapist may moderate how the family interacts and help the family to change maladaptive ways of interacting while trying to maintain the balance within the family. Sometimes, when a family first comes to therapy, one person has been identified as the “patient.” Even though one person is the patient, the entire family may learn how the rest of the their actions, feelings, and beliefs contribute to that person ’s problems. They may also learn how the family works as a whole. Sometimes families meet with other families and a therapist for group therapy. This type of therapy allows families to learn and get support from other families with similar circumstances.
Group therapy involves a group moderator and other people who share a common interest or problem. The group moderator is either a professional therapist or someone with similar issues as the rest of the group and who has been chosen by them to lead the group. The group could have different therapeutic approaches such as cognitive, interpersonal, or psychodynamic. In a helpful group, the moderator guides the discussion in productive directions and makes sure that conversations are meaningful for everyone. A good group moderator will not force individuals to speak or share personal information if they do not want to. Many moderators will not even request that silent participants speak, although silent participants usually find themselves becoming more involved as time progresses. The moderator of a group is different than a mediator in couples or family therapy. A group moderator poses questions and encourages involvement of group members. A therapy mediator acts as a communication facilitator to the couple or family. The mediator helps family members to understand one another and work through their conflicts. Conflicts are typically not as much of an issue in group therapy.
Usually, the group develops quickly to a comfortable level at which sharing experiences does not feel awkward. Group members may comment that they feel close to other members because they share the same difficulties.
Interpersonal therapy (IPT) was developed for the treatment of depression. IPT has been empirically studied and has been shown, when used in conjunction with medication, to be superior to no active treatment and to medication alone.
Interpersonal therapy focuses on interpersonal relationships and improving interpersonal and communication skills and one ’s self-concept. The emphasis is on the here and now and on specific problems that the patient may be experiencing. To deal with these problems, the patient is taught new adaptive behavior that improve their interpersonal and communication skills. Treatment can be either short-term or long-term. An IPT therapist often focuses on these four areas:
Grief–The way one deals with grief can have a significant impact on interpersonal relationships.
Role transition–Changes in roles may be a source of stress for many people and may affect one’s interpersonal relationships. Examples of role transition are becoming a parent or starting a new job.
Interpersonal disputes–Unresolved fights or constant disputes can also be disruptive to your mental well being and may be the underlying cause of other problems you are experiencing.
Interpersonal deficits–Communication skills affect one’s interpersonal relationships. If you are always negative and are constantly belittling your friends, families, or co-workers, your relationships with these people will certainly suffer.
Psychoanalysis was developed by Sigmund Freud in the early twentieth century. While it was the most common type of therapy for the first half of the century, many other types of therapy exist today.
In psychoanalysis, the therapist helps the patient be more aware of unconscious influences of childhood experiences. By identifying early conflicts or traumas, the therapist can integrate aspects of the past that the patient has not dealt with.
A key element of psychoanalysis is defense mechanisms. Traditionally, psychoanalysis is not accompanied by medication therapy.
Techniques: In free association, a person talks about anything that comes to mind. The different associations that people make may give insight to a person ’s own conflicts and usual defense mechanisms.
Freud believed that dreams were keys that could help unlock the doors of unconsciousness. By analyzing dreams, patients can better understand what their repressed wishes are and how these wishes affect their personality.
Psychodynamic therapy grew out of psychoanalysis. Instead of focusing on past events and long repressed feelings, it integrates an understanding of past experiences and early relationships into the patient’s current life. In order to deal with stressful situations more positively, therapists work with patients to develop insight into the reasons or causes behind their problems, which can help them, develop more adaptive behavior to cope with them. It is geared toward shorter-term treatment.
Gelfand, D. M., Jenson, W. R. & Drew, C. J. (1988). Understanding child behavior Disorders. (2nd ed.). Chicago: Holt, Rinehart and Winston, Inc.
Whalen, C. K., Henker, B. & Hinshaw, S. P. (1985). Cognitive-behavior therapies for hyperactive children: Premises, problems, and prospects. Journal of Abnormal Child Psychology, 13, 391-410.
Theories of Behavior Therapy- Exploring Behavior Change; edited by William O’Donohue and Leonard Krasner