Behaviour therapy

description on behaviour therapy

1. BEHAVIOR THERAPY Rojina poudel Roll no:25 Bsc nursing 3 rd year

2. BEHAVIOR THERAPY It is a form of treatment for problem in which a trained person deliberately establishes a professional relationship with the patient,with the objective of removing or modifying existing symptoms and promoting positive personality, growth and development.

3. MAJOR ASSUMPTIONS OF BEHAVIOUR THERAPY 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 recieves exposure to specific stimuli and reinforcement for the desired adaptive behavior.

4. Behavior assessment is focused more on the current behavior rather than on historical antecedents. Treatment strategies are individually tailored.

5. BEHAVIOR TECHNIQUES Systemic desensitization It was developed by joseph wolpe,based on the behavioral principle of counter conditioning. In this, patient attain a state of complete ralaxation 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.

6. It consists of three main steps: Relaxation training Hierachy construction Desensitization of the stimulus

7. a)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

8. b) Hierachy 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. c)Desensitization of the stimulus This can either be done in reality or though imagination.At first, the lowest item in hierachy is confronted.The patient is advised to signal whenever anxiety is produced. After a few trails, patient is able to control his anxiety gradually.

9. INDICATION Phobias Obessions Compulsions Certain sexual disorders

10. FLOODING The patient is directly exposed to the phobic stimulus, but escape is made impossible.By prolonged contact with the phobic stimulus, the therapist guidance and encouragement and his modeling behavior reduce anxiety. Indication: specific phobias

11. AVERSION THERAPY: Pairing of the pleasant with an unpleasant response, so that even in absence of the unpleasant response the pleasant stimulus becomes unpleasant . Unpleasant response is produced by electric stimulus,drugs,social disapproval or even fantasy.

12. INDICATIONS Alcohol abuse Paraphilias Homosexuality Transvestism

13. OPERANT CONDITIONING PROCEDURE FOR INCREASING ADAPTIVE BEHAVIOUR a)Positive reinforcement When a behavioral response is followed by a generally rewarding event such as food, praise or gifts, it tends to be strengthed and occur more frequently than before reward. This techniques is used to increase desired behavior. b)Token economy This program involves giving token rewards for appropriate or desired target behaviours performed by the patient.

14. OPERANT CONDITIONING PROCEDURE TO TEACH NEW BEHAVIOUR a)Modeling modeling is a method of teaching by demonstration where the therapist shows how a specific behavior is to be performed.In modeling the patient obsreves other patient in delging 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.

15. b)Shaping In shaping the components of a particular skill, the behaviour is reinforced step by step. The therapist starts shaping by reinforcing, the existing behavior.

16. C)Chaining Chaining is used when a person fails to perform a complex task. The complex task is broken in to a number of small step and each step is taught to the patient. In forward chaining one start with the first steps, 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.

17. 0PERANT CONDITIONING PROCEDURES FOR DECREASING MALADAPTIVE BEHAVIOR a)Extinction/Ignoring Extinction mean removal of attention rewards parmanently , 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.This is used when patients exhibit odd behaviour . .

18. b)Punishment The punishment procedure should be administerd immediately and consistenty following the undesirable behavior with clear explanation. Desirable punishment should always be added when a punishment is being used for decreasing an undesirable behavior

19. c)Time out 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 eg the child is not allowed to go out of the ward to play if he fails to complete the given work.

20. d)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 eg if a patient passes urine in the ward he would be required to not only clean the dirty area but also map the entire area of the floor in the ward.

21. ASSERTIVENESS AND SOCIAL SKILL TRAINING Assertive traning is a behavior therapy technique in which the patient is given training to bring about change in emotional and other behavioral pattern by being assertive. Patient is encouraged not to be afraid of showing an appropriate response, negative or positive, to an idea or suggestion. Assertive behavior training is given by the therapist, first by role play and then by practice in a real life situation. Social skills training helps to improve social manners like encouraging eye contact, speaking appropriately, observing simple etiquette and relating to people.