Chapters 28 and 27 handouts

Chapters 28 and 27 handouts - Today’s Objectives...

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Unformatted text preview: Today’s Objectives Today’s Any questions? Chapters 27 and 28 – Clinical Interventions with B-mod – Desensitization – Cognitive Behavior Modification Questions/Thoughts/Comments? Clinical Interventions Clinical Behavioral treatments are the treatment of Behavioral choice for phobic reactions choice – Classical conditioning and operant conditioning Specific Phobias – In vivo exposure – Imaginal exposer – Flooding Flooding (flood with the thing that scares them until the fear (flood habituates) habituates) – Modeling Specific Phobias – Types Open spaces Closed spaces Heights Lightening and thunder Certain animals Illnesses/germs Exposure therapies Exposure Two-factor theory of conditioning (Mowrer, 1960) In-vivo exposure Imaginal exposure Flooding Modeling Systematic Desensitization Self-sensitization More Clinical Applications of B-mod of Panic Disorder – Acute physiological experience that is un expected Acute – Symptoms – Common co –occurrence : agoraphobia – Treatment Treatment Panic control treatment – Therapist and client work together to expose the pt to the Therapist symptoms , and showing that they can experience the emotions and nothing bad will happen (they wont die, pass out, gor crazy…etc..) crazy…etc..) Alcohol abuse/dependence – Symptoms – Treatment: BT Designed to look at the varying consequences that Designed have resulted from the abuse have More applications More Marital distress – Conditioned aversive stimuli for one another (the Conditioned presence of their spouse is an adversive stim.) presence Get them more in contact with reinforcing things and Get their spouse their – Behavioral Marital Therapy Habit Disorders – Symptoms ( Caused by some type of nervous…) Treatment of Choice: Habit Reversal Cognitive Behavior Therapy Cognitive Traditionally, there has been a rift between Traditionally, cognitive and behavior therapists cognitive Cognition = thought, attitude, perception, Cognition expectancy expectancy How would you conceptualize a cognition How from a behavioral perspective? from Cognitive Behavior Therapy Cognitive The idea behind Cognitive behavior therapy The (CBT) is that a persons thoughts and behaviors contribute to psychological difficulties difficulties Treatment, then is designed to modify these Treatment, thoughts and behaviors thoughts – A method is to reherse things method How do we “think” about this from a behavioral perspective? behavioral Client has developed inaccurate or faulty Client rules that lead to either external or internal punishment or have not been supported by the natural consequences in the environment environment Goal is to alter maladaptive or followed by Goal reinforcement in the natural environment reinforcement Systems of CBT Systems Rational Emotive Behavior Therapy (REBT) – Developed by Albert Ellis – Clinician actively disputes cognitions Beck’s Cognitive Therapy – Identify, evaluate and replace negative automatic Identify, thoughts thoughts – Negative cognitive triad Techniques of CBT Techniques Cognitive restructuring – Fundamental assumption that changes in Fundamental thinking lead to changes in feeling and acting thinking – Identification of distorted thought patterns, Identification followed by systematic testing and modification followed Behavioral activation – Increase contact with positive reinforcers – Decrease avoidance behavior – Identify maladaptive reinforcement paradigms Identify Major Depressive Disorder Major Major Depressive Disorder – Symptoms – Treatment of choice: CBT and BT – Treatment consists of: Cognitive restructuring – seeking to id dispute and Cognitive midify thoughts that are inaccurate midify Behavioral activation – ID places where they have Behavioral stopped recieveing reinforment, or have engaged in avoidance, etc.. avoidance, Empirical support for Cognitive Behavior Therapy Cognitive Depression: More than 80 controlled studies Depression: (cf, Hollon, Thase, & Markowitz, 2002) (cf, – “Well established” treatment for depression – Cognitive therapy has better efficacy in Cognitive preventing future episodes of depression than medications (Hollon et al. 2006) medications (Beck’s) Cognitive Therapy (Beck’s) Beck’s Cognitive Therapy has been pretty Beck’s extensively evaluated, particularly related to its application to depression its – More recent research has focused on : Is cognitive therapy more effective than other Is treatments,( particularly sever depression) and what seem to be the “active” ingredients seem Does cognitive theory descriptively and causally account for depressive disorders? causally Haaga et al. (1991) – Examines the validity of cognitive theory Examines theory – Examines both: – Central findings: Is cognitive therapy more effective than other treatments, and what seem to be the “active” ingredients? “active” Dimidjian et al. (2006) – Replicated (and extended) a large, NIMH controlled Replicated treatment trial (Elkin et al., 1995) which showed that CT less effective than medications and was no more effective than placebo for severe depression effective – Active ingredient of CBT may be behavioral activation , Active not cognitive components (Jacobson et al. 1996) not – This study sought to combine and extend both of these – Results from Dimidjian et al. (2006) Take home messages about the research… research… Cognitive treatment , IS effective in Cognitive improving symptoms. It is not necessarily a linear change. It is likely that the REASON for CT’s effectiveness is the behavioral components components Class activity Class A mom brings her 12 yr old daughter to you mom because of generalized non compliance, particularly in completing her daily homework. You conduct a function assessment and determine that this non contingent access to reinforcement , Mom has become an SD for punishment, the homework environment has become conditioned aversive stimulus , and insufficient consequences for completion. Wrap-up Wrap-up Questions/thoughts/comments? Next Time: Finish up residual topics, talk Next about real life applications! about ...
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