Theoretical Bases

As originally presented, emotive imagery was regarded as a reciprocal inhibition technique. Wolpe's formulation of the Reciprocal Inhibition Principle stated that If a response antagonistic to anxiety can be made to occur in the presence of anxiety-evoking stimuli so that it is accompanied by a complete or partial suppression of the anxiety responses, the bond between these stimuli and the anxiety responses will be weakened. Whereas Wolpe regarded reciprocal inhibition as a master key to the...

Behavioral Analysis

A behavioral analysis of nocturnal enuresis focuses on the role of environmental conditions and appropriate learning experiences or conditioning. Treatment emphasizes the development of bladder fullness as a discriminative cue enabling the child to inhibit voiding until the appropriate stimulus (bathroom) is present. Additionally, bladder fullness would come to be an adequate stimulus for arousal from sleep. This approach highlights the learned nature of the desired response (nighttime...

Cue Controlled Relaxation

The purpose of cue-controlled relaxation (CR) is for the patient to learn to associate the self-instruction relax with a relaxed state, and further reduce the time it takes to become relaxed. Cue-controlled relaxation may be introduced to patients as follows Most of us have probably been in situations where we or an acquaintance have been very nervous. In that situation we often get the advice to 'take it easy and relax.' This advice very seldom works since it is given when we are already...

Conditioning of Anxiety Relief

In his monograph Psychotherapy by Reciprocal Inhibition published in 1958, which stimulated the widespread introduction of behavioral modification procedures to psychiatry and psychology, Wolpe suggested that anxiety-relief responses might be directly conditioned to convenient stimuli and subsequently used to counter anxiety. He based the suggestion on the observation that if a stimulus was repeatedly presented to an eating animal just before withdrawing its food, that stimulus acquired the...

Intake Session and Inventory Assessments

A friend referred Cindy and Bob to the clinic. They were in their early thirties, had been married for 6 years, and had two daughters, aged 2 and 4. It was the second marriage for Bob, a boiler repairman and mechanical engineer, and the first for Cindy, who was occupied as a housewife and mother. During the initial clinical interview the co-therapist team asked about presenting complaints and the precipitating event leading to the initiation of therapy. When asked, Why are you seeking help now...

Schema Focused Cognitive Therapy

As an extension of Beck's cognitive therapy for personality disorders, Jeffrey Young and his colleagues formulated the concept of an early maladaptive schema, defined as a long-standing and pervasive theme that originates in childhood defines the individual's behaviors, thoughts, feelings, and relationships with other people and leads to maladaptive consequences. Applied specifically to characterological issues, the goal of schema-focused therapy is to help patients to identify cognitive...

Parameters of Exposure in Vivo

Wolpe explained the relative effectiveness of systematic desensitization by the fact that it would be impossible to feel anxious and relaxed at the same time he called this reciprocal inhibition. Research, however, has demonstrated that the addition of relaxation to the exposure element is not essential for improvement. In the eighties, Lars Goran Ost introduced applied relax ation. The purpose of applied relaxation is to teach the patients to monitor and recognize the early signs of tension...

Instruction of Differential Relaxation

The session starts with the patient sitting in the armchair relaxing on their own with the help of CR. When the patient has signaled that they are relaxed, they then follow the instruction to perform certain movements with different parts of the body while at the same time concentrating on being as relaxed as possible in the rest of the body. During the performance of these movements the patient should scan the body often (i.e., think through the different muscle groups) in order to discover...

Didactic Teaching

Behavior therapy relies on didactic teaching to explain behavioral concepts and to instruct clients in how to complete exercises. Individuals are often presented with psychoeducational materials in both verbal and written formats, with the aim of informing them of the various factors that are maintaining maladaptive behaviors. For instance, in presenting information regarding diaphragmatic breathing to individuals with a history of panic attacks, behavior therapists may provide a description of...

Types Of Covert Rehearsal

In general, as the word implies, covert rehearsal involves repetition, or thinking about the material over and over again. However, in a less strict sense, any mental processing engaged in after as well as any extra mental processing engaged in during the occurrence of an event or the presentation of a stimulus item can be considered as covert rehearsal. In those cases, continual repetition per se is not necessary, although the concept of repetition is still there because any further thinking...

Graduated versus Intensive Stimuli Presentation

Clients may be exposed to stimuli in a graduated fashion, beginning with a stimulus that induces little anxiety, or in an intensive fashion, beginning with a stimulus that is maximally anxiety-provoking. The decision on which format to follow should be based on prior research and practical concerns. Research has demonstrated that either format is effective in reducing overall anxiety symptoms, both immediately following treatment and after a short interval. However, one study found that...

Economic Pressures on the Political System

The political system has experienced concerted efforts by providers and other constituencies to more stringently regulate HMOs and managed care. Among the legislation under serious consideration have been parity laws, a Patients' Bill of Rights, and laws to inhibit incentives to providers for cost containment. All of these and others are under active consideration by the Congress and state legislatures, and although some laws have been passed, advocates are expressing disappointment in the...

Description Of Behavioral Case Formulation

Behavioral case formulation is a process in which therapists seek to describe clients, their strengths and resources, stressors, and current concerns in the context of specific, observable, and measurable indicators. Behavioral case formulation has been described as testable hypotheses that connect presenting problems to one another, explains why the problems have developed, and provides predictions of the patients' behavior based on those hypotheses. Other descriptions include references to...

Danger Ideation Reduction Therapy

Menzies I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary cognitive-behavior therapy A therapeutic approach designed to change mental images, thought patterns and behaviors to help sufferers overcome emotional, behavioral, and psychiatric problems. danger ideation reduction therapy (DIRT) Developed by Mairwen K. Jones and Ross G. Menzies in the mid-1990s. DIRT is a cognitive-behavioral treatment package for OCD sufferers who...

Interventions

From its inception, the traditional interventions associated with BMT have included communication and problem-solving skills training and behavioral exchange techniques. Over the years, in many empirical studies, both interventions have been shown to be highly correlated with marital satisfaction. Although communication problem is probably the number one complaint of couples seeking therapy and most therapy approaches work on improving communication between partners in some manner, the hallmark...

The Eight Phases of Treatment

During EMDR, the unprocessed dysfunctionally stored material is linked to more adaptive material, and new associations are made. The client attends to emotionally disturbing material in multiple brief doses while simultaneously focusing on an external stimulus (e.g., therapist-directed eye movements, hand-tapping, bilateral tones). EMDR's three-pronged protocol ensures that all past, present, and future aspects of the problem are thoroughly addressed. Current conditions that elicit distress are...

Empirical Studies A Efficacy of Exposure

Decades of research have established that exposure therapies, particularly graded in vivo exposure and flooding, are the treatments of choice for specific phobias and play an important role in treating other anxiety disorders. These treatments produce clinically significant reductions in fear in about 60 to 80 of cases. Systematic de-sensitization is the least effective of the exposure therapies. Although it is not often used as a stand-alone treatment, this mild, undemanding intervention is a...

Model Presentation

Instruction, model presentation, rehearsal, and coaching can be used when clients lack requisite behaviors in certain situations or when there is a need to refine behaviors. The need to use modeling will be influenced by the complexity of the skill to be acquired and nature of the entering repertoires (available skills) of clients. The greater the complexity of the skill and the more lacking the initial repertoire, the greater the value of model presentation is likely to be. An advantage of...

Using FAP to Improve Cognitive Therapy for Depression

Cognitive-behavior therapy (CBT) for depression, developed in 1979 by Dr. Aaron Beck and his colleagues, has been shown to be an effective treatment for major depression. As with any treatment for depression, however, there is room for improvement. In particular, some clients are resistant to the methods and rationale of cognitive therapy, and outcome is endangered by what is known as a rationale-client mismatch. Examples of mismatches include clients who experience that their feelings rule no...

Empirical Studies

Does Biblical behavior therapy work And if it works, is it effective enough Does it serve its purpose Should a counselor consider its use with his or her Christian clients Because there are few empirical studies on the actual application of behavior modification techniques for spiritual purposes, the answers to the above questions have to be as integrated as the approach itself. Years of research and study have shown the practical and valuable use of respondent and...

Presentation Formats 1 Visual Imagery

In implementing CPR, clients are instructed to imagine a scene in which they are performing the behaviors to be increased. The reinforcing scene should be clearly visualized within 5 seconds after imagining this scene. One pair of target and reinforcing scenes is referred to as a single trial. In 1986, Joseph Cautela and Albert Kearney stated that an intertrial interval of at least 1 minute is recommended in order to avoid inhibition of reinforcement and too rapid a growth of inhibitory...

Case Example

Mary is a 20-year-old African-American female who was seven months pregnant with her third child at the time of the interview. She was referred for psychological treatment by her gynecologist, who described her as difficult, angry, and indifferent. His immediate concern was her drug use. Excerpts from the initial interview with Mary are used to illustrate assessment components in a functional analysis in an outpatient clinic setting. Therapist directly assesses problem behavior Mary, your...

The Match Mismatch Model

Rachman and colleagues have suggested that anxiety expectancies might play a mediating role in exposure therapy. They found that phobics typically overpredict the amount of fear they expect to experience in a threatening situation. A number of researchers investigated the overpre-diction of fear in a series of laboratory studies, in which they asked the subjects to rate their predicted fear before they were exposed to a threatening situation, and to indicate their reported fear just after the...

Awareness Training

The goal of awareness training is to teach the client to identify each occurrence of the habit and to identify the antecedents or warning signs that the habit behavior is about to occur. A number of procedures are used to achieve this goal. First, in the response description procedure, the client is asked to describe the habit behavior. The client describes all the behavioral movements involved in the habit behavior and all of the different ways in which the habit behavior may occur. Next, in...

Assessment Phase

Overlapping with cohesion building and orientation is the assessment phase. This actually begins with the client selecting a given group with a general theme in which she or he is interested or has major concerns (e.g., anxiety management, anger control, dealing with HIV infection). In the group and even in an intake interview, the particulars of the problem begin to be spelled out. Many practitioners make use of such paper and pencil tests as Beck's 1976 depression inventory, the fear survey...

Bearable Electrical Aversion in Treatment of Homosexuality

Throughout the 1960s the assumption persisted that the milder form of electrical aversion was a conditioning procedure resulting in an aversion to the stimulus or behavior that preceded administration of the electric shock. This assumption was first questioned in 1969 in relation to its use in the modification of homosexual interest or behaviors. As pointed out in a 1977 review by McConaghy, it was this use that was most subjected to empirical investigation, both in relation to its efficacy and...

Henry T Stein and Martha E Edwards

Alfred Adler Institute of San Francisco and Ackerman Institute for the Family III. Applications and Exclusions V Case Illustration VI. Summary antithetical scheme of apperception The sharply divided way of interpreting people and situations with an either or, black and white restriction of qualities no grey area is acknowledged. compensation A tendency to make up for underdevelopment of physical or mental functioning through interest and training, usually within a relatively normal range of...

Description Of Treatment Processes

Comprehensive treatment for eating disorders generally requires attention to four distinct features of these disorders (1) biological aspects, particularly nutritional status and the deleterious consequences of semistarva-tion and undernutrition on the one hand, or serious obesity on the other (2) eating disorders related behaviors including restrictive and idiosyncratic eating patterns, eating binges, purging, ordinarily by means of vomiting or use of laxatives, and excessive, compulsive...

Theoretical Basis For Applied Relaxation

So far there are no developed theoretical models to explain the mechanism of AR. However, it is possible to use a modification of the type of vicious circle explanation that has been developed for cognitive therapy in panic disorder. This model assumes that independently of what kind of a eliciting stimulus or what type of initial reaction follows there is an interaction between physiological and cognitive reactions, culminating in a panic attack. The purpose of AR is to break the vicious...

Introduction To The Theory

Control-mastery theory is a theory of the mind, psy-chopathology, and psychotherapy. It was introduced by Joseph Weiss, and was investigated empirically and developed by Weiss, Harold Sampson, and the San Francisco Psychotherapy Research Group (formerly the Mount Zion Psychotherapy Research Group). Control-mastery theory assumes that patients are highly motivated, both consciously and unconsciously, to solve their problems, to rid themselves of symptoms, and to seek highly adaptive and...

In Vivo versus Imaginal Flooding

Clients may be exposed to actual feared stimuli (in vivo flooding) or may be asked to picture feared stimuli (imaginal flooding). Deciding which procedure to employ requires clinicians to consider practical matters as well as prior research. Overall, studies have found that in vivo exposure is superior to imaginal exposure in reducing anxiety symptoms. In particular, for simple phobias, anxiety reduction is clearly enhanced with in vivo exposure. However, in vivo stimuli presentation has been...

Covert Modeling

In this procedure, clients are asked to imagine observing a model performing the target behavior and then to imagine either a reinforcing or punishing consequence applied to the model's behavior. For example, a client with a fear of authority figures may imagine a model acting assertively with her boss and being reinforced by the boss's change of mind. This should result in an increase in the probability of assertive responses in the future. Or, an overly aggressive client may be asked to...

Binge Eating Disorder

Psychotherapy research involving binge eating disorder has been largely based on treatments for bulimia nervosa and, because substantial numbers of binge eating disorder patients are overweight or obese, on psychotherapy treatment research for obesity. Because obesity is a common comorbid condition, researchers have been concerned with how to relate treatments designed to reduce binge eating behavior with those designed to enhance weight loss. Based on available studies, most experts agree that...

Arnold A Lazarus

Rutgers University and Center for Multimodal Psychological Services I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary cognitive-behavior therapy This therapy involves a set of principles and techniques that stress the reciprocal relationship between thoughts and feelings. Its underpinnings rest on experimental psychology, particularly social learning theory. Most normal and abnormal behaviors are considered to be maintained and modified by environmental events....

Marita P McCabe

Deakin University, Burwood, Australia I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary classical conditioning The main feature of this form of conditioning is that the originally neutral conditioned stimulus, through repeated pairing with the unconditioned stimulus, acquires the responses originally given to the unconditioned stimulus. operant conditioning This type of conditioning involves the strengthening of an operant response by presenting a reinforcing...

Reactions to the CEE

Several problems with the CEE concept have discouraged its use over the decades. Four specific problems will be discussed Alexander's use of medications in the sessions, the lack of applicability of the CEE to all kinds of patients, the use of role-playing to create the CEE in the therapy, and the history of a disdainful attitude toward supportive techniques, as the CEE has generally although erroneously been described. Alexander suggested that drug-induced states of mind could be ideal for the...

Computers And Behavioral Assessment

In the future, behavioral assessment will be increasingly augmented by the use of computer technology. Already, researchers have developed computer programs that help the behavioral assessor efficiently collect, store, and analyze data. Programs are now available that ease data collection and analysis across all the major methods of behavioral assessment. For example, software for event recording has replaced earlier electromechanical devices and paper-pencil recording formats. Tapp, Wehby, and...

Very Low Calorie Diets and Meal Planning

One way of improving weight loss is to incorporate a very low calorie diet (VLCD), defined as less than 800 kcal day, into the treatment protocol. Most behavioral weight control programs have used low calorie diets (LCD), which usually consist of approximately 1200 to 1500 kcal day. Thomas A. Wadden and Albert J. Stunkard's initial study, which was conducted in 1986, and studies that followed, consistently found that a VLCD combined with behavior therapy was more successful than a LCD combined...

Challenging Unrealistic Alcohol Outcome Expectancies

Alcohol expectancies are the beliefs one holds about the positive desirable and negative undesirable outcomes of drinking. For example, some people believe that drinking alcohol will make it easier for them to meet new people that drinking helps them perform better sexually that drinking will result in difficulty thinking clearly or speaking clearly. Such beliefs result from observing the outcomes of drinking by others (both in vivo and portrayed in popular culture) and by recalling (and...

Joel Yager

University of New Mexico School of Medicine I. Description of Treatment Processes II. Case Examples III. Summary anorexia nervosa A psychological and physical condition of semistarvation in which individuals weigh 85 or less of what would ordinarily be their healthy body weight, resulting in physical impairments and, in the 90 of patients who are female, cessation of menses. This condition is due to highly restricted food intake, often accompanied by excessive exercise and sometime purging by...

Observation of Early Signs of Anxiety

In order for applied relaxation to work optimally patients must use the relaxation technique as early as possible in the response to an anxiety reaction or a panic attack. Reacting quickly to the first signs of anxiety greatly increases the patients' ability to employ AR effectively. In order to increase the patient's awareness of the initial signs of anxiety, homework assignments involve observing and recording these reactions. In the panic diary the patient records the situation, the symptoms...

Exposure in Vivo Therapy versus Cognitive Therapy

One of the theoretical problems in the comparison of the effectiveness of exposure in vivo therapy and cognitive therapy is that cognitive restructuring without any form of exposure is rare in cognitive therapy. The use of exposure exercises called behavioral experiments or hypothesis testing is seen as clinically important aspects to test the validity of the beliefs. In specific phobias, cognitive therapy was generally less effective than in vivo exposure. Several studies found cognitive...

Fading Response Prompts

When a new response is taught through the use of response prompts, fading is accomplished through one of three procedures time delay, least-to-most prompts, and most-to-least prompts. Time delay involves allowing the natural cue to occur, and then waiting several seconds before prompting. For example, when teaching deep breathing to an individual with anxiety, the natural cue to use deep breathing would be the occurrence of any anxiety producing stimuli, perhaps the approach of an individual of...

The Nullification of the Supply and Demand Relationship

It has long been recognized that the laws of supply and demand have not operated in the health care sector as they do in the general economy. This is because the physicians (and therefore the hospitals and other providers) have traditionally controlled both the supply and demand sides of health care. It is the doctor who determines what treatment the patient needs, what procedures should be rendered, and how long the treatment should last. On the supply side the government subsidized the...

Rostyslaw W Robak

Meaning Reconstruction with Grieving Persons III. Theoretical Bases Most people experience the loss of a loved one as a painful, confusing, and disruptive event. Several approaches to therapy with grieving persons have been widely applied. The two most well-known models of grief therapy are J. William Worden's tasks of mourning and Robert Neimeyer's meaning reconstruction. Both of these approaches offer valuable specific therapeutic interventions. When applied well, they allow for the...

Norman Andrew Clemens

Why Confidentiality Is Fundamental to Psychotherapy III. Ethical Foundations of Confidentiality IV Legal Protections of Confidentiality in Psychotherapy V Exceptions to the Privilege of Confidentiality VI. Case Illustrations VII. Electronic Communications and Confidentiality VIII. Legislative and Regulatory Developments Affecting Confidentiality IX. Summary confidentiality Characterizes an understanding between parties in a defined relationship the necessary ingredient is trust that one...

Nature And Significance Of Insomnia

Insomnia, characterized by difficulty initiating, maintaining, or obtaining qualitatively satisfying sleep is a widespread health complaint. Like the common cold, most individuals have experienced at least transient bouts of nocturnal sleep difficulty due either to an impending stressful (e.g., final exam) or exciting (e.g., a long-awaited vacation trip) event or due to acute medical or environmental factors. However, slightly over one-third of the adult population complains of recurring,...

Classical Conditioning

Exposure Therapies Applications and Exclusions V Case Illustration VI. Summary classical conditioning A form of associative learning in which a neutral stimulus is paired with an unconditioned stimulus. After a sufficient number of trials the neutral stimulus comes to elicit responses similar to those originally evoked by the unconditioned stimulus. counter-conditioning A classical conditioning procedure in which a stimulus that formerly elicited one response (e.g., pleasure) is...

David Reitman and Nichole Jurbergs

Theoretical Bases III. Empirical Studies IV Summary feedback Information provided to an individual following a response that is intended to promote the acquisition of behavior. modeling Action performed by a therapist or coach to illustrate important elements of a response requiring imitation by clients or patients. Feedback and instructions are also used to shape the behavioral repertoire to approximate more closely the actions of the model. Communication skills...

Post Watson Era of the 1930s and 1940s Enter the Neobehaviorists

Few of Watson's ideas had survived intact in the 1930s, and many of his neobehaviorist contemporaries began to take psychology and behaviorism in new and quite different directions. Psychology as a science of behavior was retained during this period, and behaviorism flourished in academic departments around the United States. New theories of learning and conditioning revolved around major neobehav-iorist figureheads, such as Clark Hull, Edwin Guthrie, Edward Thorndike, B. F Skinner, and Edward...

Covert Positive Reinforcement

The Groden Center, Inc. and Brown University I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary analogue studies Studies similar to clinical studies but not using clinical patients or clinical level problems. antecedent A preceding event, condition, or cause. baseline Measures taken on a behavior before initiating a treatment program. This is used to evaluate the effect of a behavior treatment program. cognitive restructuring A cognitive-behavioral procedure in...

Behavioral Observation 1 Naturalistic Behavioral Observation

Naturalistic behavioral observation is a behavioral assessment method in which an individual is observed in his or her natural environment (e.g., home, school, work), usually in a context that is most associated with a problem behavior. Typically, observations are made on a predetermined schedule by one or more observers. A time sampling interval is determined a priori (e.g., 20-second periods, 5-minute periods) and the observer records the occurrences of the target behavior and or other...

Development Of Continence

The ability to go through the night without wetting the bed, whether by postponing voiding until the morning or awakening and voiding during the night, is referred to as nocturnal (nighttime) continence. There are four stages or steps in the acquisition of mature bladder functioning necessary for nocturnal continence. These include (1) demonstrated awareness of bladder fullness (1 to 2 years) (2) ability to retain urine voluntarily (3 years) (3) capacity to start and stop the flow of urine in...

Electrical Aversion in the Treatment of Alcoholism

As compared with its use in homosexuality, empirical studies of electrical aversive therapy for alcoholism were limited in number and methodological adequacy. A probable contributing factor was the report by Garcia and Koelling in 1966 that in animals aversions to tastes were much more easily established to malaise produced by ionizing radiation than to electrical shock, whereas the reverse was true for aversions to visual and auditory stimuli. In his 1977 review pointing out the lack of...

Tian P S Oei and Genevieve Dingle

Development and Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary brief intensive group cognitive behavior therapy (BIGCBT) A version of cognitive behavior therapy conducted in full-day sessions over a short time period (e.g., 3 consecutive days). Brief intensive group cognitive behavior therapy (BIGCBT) is a version of cognitive behavior therapy conducted in full-day sessions over a short time period, for example, 3 consecutive days. This article presents the...

Richard M Suinn and Jerry L Deffenbacher

Applications and Exclusions V Empirical Studies AMT Acronym for anxiety management training. anxiety management training A self-control intervention using relaxation as a coping skill to prevent or reduce anxiety arousal. anxiety scene A concrete event from the client's actual experience associated with anxiety being aroused. biofeedback Methods for relaxation training that employ equipment to monitor and provide feedback on physiological responses, such as changes in muscle tension or...

Habituation and Extinction Models

Processes often cited as explanation for the effects of exposure are habituation and extinction. Habituation refers to a decline in fear responses, particularly the physiological responses, over repeated exposures to fear-provoking stimuli. Habituation is regarded as an unlearned temporary reaction. Habitua-tion is supposed not to be affected by cognitions. The classical habituation theory predicts that habituation would not occur if (baseline) arousal were high. Then, arousal would further...

Empirical Questions And Studies

Compared to the abundance of self-help books and manuals available, the evaluation of these materials is skimpy in terms of whether they do more good than harm. For example, do they really help people achieve what they promise Self-help books differ in the clarity with which hoped-for outcomes are described. Promising self-fulfillment is vague compared to helping readers lose weight, get better grades, or make friends. Self-help books differ in the evidentiary base of their views about how...

Bulimia Nervosa

Initial assessment of the patient with bulimia nervosa for psychotherapeutic readiness, to assess comor-bid psychiatric states and attend to them, and to determine what approaches are likely to be most helpful for the given individual is of critical importance to maximize the likelihood of successful treatment. Eor patients with comorbid substance abuse or dependence disorder, successful treatment of bulimia nervosa ordinarily requires that the substance abuse disorder be attended to first, or...

Case Examples A Anorexia Nervosa

Patsy was a 17-year-old high school student who had been suffering from anorexia nervosa since the age of 13. She was characterized by her family as a tenacious and diligent student, and she had been an excellent athlete in middle school and earlier in high school. Starting at ages 9 and 10 she clearly excelled in track and appeared to be headed for the State championship team. However, at age 13, shortly after she first started to menstruate, she started to diet severely in response to a...

Winnie Eng and Richard G Heimberg

Adult Anxiety Clinic of Temple University I. Description II. Theoretical Bases III. Empirical Studies IV Summary automatic thoughts The self-critical or exaggerated negative self-statements that go through a person's mind and are accepted as true by the person without testing their accuracy. cognitive restructuring A treatment technique that attempts to identify and modify negative or unrealistic thoughts or attributions. cognitive triad A person's view of him- or herself, of the world, and the...

S Mark Kopta Jenny L Lowry

Session Therapeutic Curve

University of Evansville Loyola College in Maryland I. Psychotherapy Is Beneficial II. The Dosage Model Determining How Much Is Enough III. Different Methodologies of the Dosage Model IV Summary dose Number of psychotherapy sessions. dose-outcome An extension of the dose-effect methodology that tracks psychotherapeutic progress across sessions for an individual patient. effect Percentage of patients improved or probability of improvement for one patient. HLM Hierarchical linear modeling. A...

Description Of Behavioral Insomnia Therapies

Formal applications of behavioral interventions to insomnia were first reported in the 1950s but such treatments did not gain much popularity until the 1970s. Over the past 30 years, various behavioral insomnia therapies have been developed, tested, and, at times, modified. The nature and specific focus of these treatments has varied significantly in that some are composed of fairly formalized exercises designed primarily to address sleep-related performance anxiety and excessive bedtime...

Description Of Treatment

Configurational analysis is a method of psychological formulation that focuses on cognitive-emotional conflicts and the dynamics of identity and relationship roles. It combines concepts derived from psychody-namic, interpersonal, cognitive-behavioral, and family systems theories. It also integrates ego-psychology, object relations, and self-psychology methods of formulation. Configurational analysis is a simplified, practical, and teachable system based on agreements reached in clinical...

Functional Analytic Clinical Case Modeling

Another case formulation model has been developed by Stephen Haynes and his colleagues. A functional analytic clinical case model (FACCM) is a means of schematically representing a functional analysis2 using vector graphic diagrams, as discussed by Haynes, Leisen, and Blaine in 1997. FACCM variables include original causal variables, causal variables, moderating variables, client behavior problems, and effects of client problems. Original causal variables are variables that affect client...

Cognitive Behavioral Case Formulation

Jacqueline Persons is one of several cognitive-behavioral (CB) therapists who have developed case formulation methods, but hers may be the best known. The method draws extensively from Aaron Beck's cognitive therapy, which holds that psychological symptoms and problems result from the activation of maladaptive core beliefs under conditions of stressful life events. The CB case formulation approach also draws from behavior therapy, which emphasizes measurement to track change and the...

Meal Planning

Goals related to nutrient intake may take many forms e.g., calories, fat grams, or dietary exchanges . In general, research has shown that explicit meal plans are most effective for compliance. An explicit meal plan might include an actual menu to be followed each day. The use of portion-controlled foods that are prepackaged for use in diets can be quite useful for persons who have difficulty following a more general meal plan. Ideally, a dietitian should manage this aspect of the program.

History

Freud had coined the term countertransference gegenubertragung and referenced it only on several occasions during his writing, and never treated it systematically. Freud seemed to conceptualize counter-transference as the analyst's transference toward the patient. Consequently, for Freud the notion of counter-transference was a part of therapy that needed to be managed and kept in check. Several early analysts conceptualized the relationship between analysand and analyst differently from Freud...

Further Reading

J., Taylor, A. E., Loos, W. R., amp Gerardi, R. J. 1994 . The psychophysiology of motor vehicle accident related posttraumatic stress disorder. Behavior Therapy, 25, 453-467. Boyce, T. E., amp Geller, E. S. 2001 . A technology to measure multiple driving behaviors without self-report or participant reactivity. Journal of Applied Behavior Analysis, 34, 39-55. Carr, E. G., Langdon, N. A., amp Yarbrough, S. C. 1999 . Hypothesis-based intervention for severe problem...

Negative Effects Of Psychotherapy

Findings from study of the progress and outcome of patients undergoing psychotherapy have resulted in both expected and unexpected conclusions. Most patients receiving treatment improve, a minority of patients remain unchanged, and contrary to the intent of psychotherapy, a small percentage of patients actually worsen as a result of, or at least during, treatment. Independent reviews of the literature suggest that some patients fail to achieve beneficial gains from treatment. Although accurate...

Panic Disorder

A number of different techniques have been employed to bring under control somatic responses that are related to panic. The most frequently used technique is respiratory training. David H. Barlow and his associates have termed this approach panic control training. Eleven sessions of a combination of cognitive restructuring with breathing retraining und interoceptive exposure constitute a highly effective treatment in panic disorder. This treatment worked equally well with and without...

Emotive Imagery

Rutgers University and Center for Multimodal Psychological Services I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary in vivo desensitization Instead of just imagining feared situations, in vivo desensitization gradually and systematically presents the actual feared stimuli or events. For example, a client who fears dogs would be encouraged to approach the animal closer and closer, and eventually be willing to touch it and pet it and thus conquer the fear....

The Cognitive Revolution

The Cognitive Revolution

Following a period of extensive research on basic behavioral processes, and how various forms of psy-chopathology may be acquired through environmental FIGURE 3 Modified behavioral theory. In this revised view of behavior-environment relations, cognitions are considered a mediator between behavior and consequences. FIGURE 3 Modified behavioral theory. In this revised view of behavior-environment relations, cognitions are considered a mediator between behavior and consequences. circumstances...

Contextual Therapies

The contextual therapies owe their genesis to the pioneering work of Milton Erickson and the subsequent elaboration of his therapy in strategic-systems and solution-focused therapies. These are among the briefest of the brief therapies, sometimes addressing change in a single session. Common to the contextual brief therapies is the notion that problems are constructed and not intrinsic to the individual. Once people construe a set of life outcomes as problems, they typically attempt solutions...

Analogue Behavioral Observation

Analogue behavioral observation is a behavioral assessment method in which a clinician observes a client's behavior in a contrived environment e.g., a waiting room, play room, clinical setting to assess variables hypothesized to influence behavior. Although analogue assessment is a direct measure of behavior, the target behavior is observed outside of the individual's natural environment. A special section of the journal Psychological Assessment Vol. 13, No. 1 is devoted to a discussion of...

Premacks Principle

Premack's principle or the differential probability hypothesis refers to reinforcing a target behavior by awarding some privilege to engage in a more desired behavior afterward. For example, a child may be told that he or she can have dessert after eating his or her vegetables, or be told that he or she can play baseball after completing a certain chore. The more highly desirable behavior is used to entice a person to engage in a usually productive, albeit less enjoyable, activity. Typically,...

Acceptance of Controlled Drinking

As noted earlier, controlled drinking training is controversial in some countries and its application may be limited by institutional treatment philosophy and setting. For example, abstinence is the predominant outcome goal prescribed for alcoholics and problem drinkers in American alcoholism treatment programs. A survey of American alcohol treatment agencies found that controlled drinking was considered unacceptable for clients in almost every responding residential program including inpatient...

Definition Prevalence And Stability Of Controlled Drinking

The term controlled drinking is used to describe non-abstinence outcomes that is, moderate or non-problem drinking by persons who have abused or have been dependent on alcohol. Definitions of controlled drinking typically include some limit on the quantity of alcohol consumed per day for example, consumption of no more than 3 to 5 standard drinks per day 1 standard drink 0.5 ounce of ethanol . Similarly, the British Department of Health recommends that men limit their consumption to no more...

Raymond G Miltenberger

Applications and Exclusions awareness training A component of competing response training in which the therapist teaches the client to identify each occurrence of the habit behavior or antecedents to the habit behavior. competing response An incompatible behavior that the client engages in contingent on the occurrence of the habit behavior as part of competing response training. habit disorder A repetitive behavior that does not typically serve any social function but occurs with...

Implosion

Implosion involves exposing the person to intensely fear-evoking imagined stimuli, which lie at the top of the fear hierarchy. Often exposure is embellished by having the patient imagine extremely terrifying forms of the stimuli. Implosion is often used in the treatment of posttraumatic stress disorder, where the goal is to reduce the fear and associated distress associated with traumatic memories. More often, however, the feared stimuli are simply imagined in great detail, with the person...

Corrective Emotional Experience

Definition, History, and Contemporary Uses of the Corrective Emotional Experience III. Therapeutic Alliance, Corrective Emotional Experience, and the Outcome of Psychotherapy IV Summary defenses A person's habitual ways of protecting herself or himself against uncomfortable thoughts and feelings. expressive therapy Therapy aiming to uncover unconscious thoughts, beliefs, and feelings often stirring up anxiety as new mental content is discovered. intrapsychic Within one person's mind, not...

Tranquilizer Withdrawal

Elsesser et al. compared the effect of complaints management training with that of anxiety management training, the treatment that had previously been shown to be effective in facilitating benzodiazepine withdrawal. Immediately after treatment, the abstinence rate was higher in the complaints than in the anxiety management group Fig. 2a , and patients in the former were also less anxious and depressed Fig. 2b . At followup, there was no longer a significant difference between groups in terms of...

The Focus The Bible

When Christians have a question about what their behavior should be, they go to the Bible, which they consider the word of God, for guidance. They may go to other sources as well e.g., ministers and counselors , but the Good Book is their primary source for answers. That is now the place to go for examples of Biblical behavior modification. Although they are not always immediately evident, the Bible is replete with examples of respondent conditioning. In fact, Christians are to associate all...

Targeted Behaviors

Among persons who are typically developing, backward chaining has been effective in treating children with specific speech problems such as misarticulation. In 1987, Edna Carter Young used backward chaining as part of a procedure to retrain the speech of two toddlers who frequently omitted weak syllables or consonants. Essentially, the procedure involved teaching the child to say the last part of a word first and then incorporating that part into the word. For example, to learn to say the word...

Competing Response Practice

The goal of competing response practice is to teach the client to engage in a competing response each time the habit behavior occurs or when an antecedent to the habit behavior occurs. The therapist implements competing response practice after awareness training is completed, and the client can identify each occurrence of the habit or antecedents to the habit. To begin competing response practice, the client with the aid of the therapist chooses one or more competing responses that can be used...

Definitions of Behavior Modification and Therapy

Kazdin has written the most comprehensive and authoritative history of behavior modification and behavior therapy currently available. The terms behavior therapy and behavior modification denoted differences that were perhaps once more vigorously defended than they are today. Kazdin's preface states Behavior modification can be defined as the application of basic research and theory from experimental psychology to influence behavior for purposes of resolving personal and social problems and...

M Tension and Migraine Headaches

There is a wealth of outcome research demonstrating that these two disorders can be effectively treated with biofeedback techniques. For tension headaches, BFRT, with placements of the EMG sensors in the frontal location, combined with general relaxation techniques, such as PMR has been shown to be effective. Utilization of specific muscle feedback of the muscles of the face, neck, and cervical area has also proven effective. This author recommends the combination of frontal EMG feedback, PMR,...

Paradoxical Intention

As the name implies this treatment strategy employs a form of reverse psychology to address sleep difficulties. Designed mainly to address the excessive performance anxiety that contributes to sleep onset difficulties, this treatment instructs the insomnia sufferer to remain awake as long as possible after retiring to bed. In essence, the insomnia sufferer is placed in the paradoxical position of having to perform the activity of not sleeping when in bed. If the individual complies and...

Preface

When we began this project, it would have been beyond our most radical beliefs to think that we would be seeing a nation fraught with intense worry, anxiety, acute stress disorder, post-traumatic stress disorder, grief, and depression less than three years later. So now, as we put our finishing touches on this work, and following the terrorist incursions, we regrettably have been forced to see the graphic proof of the inherent value of psychotherapy. The critical contributions and the value of...

Aversion Relief

Kamphuis I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary aversion relief A therapeutic procedure in which the occurrence of desired behavior leads to the cessation of an aver-sive stimulus. aversion therapy A variety of specific techniques based on both classical and operant conditioning paradigms intended to change maladaptive behavior. covert sensitization The pairing in imagination of undesired behavior with covert negative...

Assisted Covert Sensitization

Cambridge Center for Behavioral Studies, New School for the Learning Sciences, and Brown University I. Description of Treatment II. Theoretical Basis III. Empirical Studies assisted covert sensitization A behavioral strategy in which standardized scripts are employed to guide the client through clinically relevant scenarios in which ultimately aversive imaginal consequences are presented. covert conditioning A family of behavior therapy procedures which combine the use of imagery with the...

Assertion Training

University of California at Berkeley III. Applications and Exclusions V Case Example VI. Summary behavior rehearsal Practicing behaviors of interest. coaching Providing corrective feedback to develop a skill. cognitive restructuring Helping clients to increase self-statements that contribute to attaining valued outcomes and to decrease self-statements that have the opposite effect. discrimination training Reinforcing a behavior in one situation and not in others in order to increase the rate of...

Backward Chaining

Theoretical Basis III. Empirical Studies IV Summary chaining Process by which an organism learns an ordered sequence of behaviors. discriminative stimulus A stimulus in the presence of which a particular behavior is reinforced. reinforcement A process in which a behavior is followed by the presentation of a stimulus and as a result, produces an increase in the future probability of that behavior. target behavior The behavior of interest, or the behavior to be...

Beck Therapy Approach

Cognitive Conceptualization Diagram

Beck Institute for Cognitive Therapy and Research, University of Pennsylvania I. Description of Treatment II. Theoretical Basis III. Efficacy IV Summary automatic thought An idea that seems to arise in one's mind spontaneously, in verbal or imaginal from. belief One's basic understandings of oneself, one's world, and other people. cognition A thought, image, rule, attitude, assumption, or belief. cognitive distortion A type of thinking error. schema A relatively stable and enduring mental...

Kirk Strosahl

Description of ACT Treatment III. Empirical Studies of ACT IV Summary cognitive fusion The act of perceiving private experiences such as thoughts and feelings from the perspective structured by the private event itself rather than the perspective of an observer of that event as a process. Reducing fusion is a key target of meditation, mindfulness, and deliteraliza-tion interventions in ACT. cultural change agenda The culturally sanctioned model most clients bring...

Info

Note Pages of Volume 2 have prefix 'b' b1, b2, . Implosive Therapy Donald J. Levis 1-6 Individual Psychotherapy Larry E. Beutler and T. Mark Harwood 7-15 Informed Consent Catherine Miller 17-24 Integrative Approaches to Psychotherapy Jerry Gold 25-35 Interpersonal Psychotherapy Scott Stuart and Michael Robertson 37-47 Interpretation T. Wayne Downey 49-56 Intrapsychic Conflict Alan Sugarman 57-62 Job Club Method Nathan H. Azrin 63-67 Jungian Psychotherapy Jeffrey Satinover 69-81 Language in...

The Therapeutic Environment Animals as an Aspect of Milieu Therapy

One of the most valued aspects of having animals as part of a therapeutic alliance appears to be related to their impact on altering the therapeutic environment. This assumption has been strongly advocated by this writer in numerous previous publications. The assumption has also been supported by Alan Beck who also believed that animals seemed to have the capacity to modify a person's environment. In most cases, presence of an animal appears to modify the perceived environment and make it more...

Raymond W Novaco

Applications and Exclusions V Case Illustration VI. Summary aggression Behavior intended to cause psychological or physical harm to someone or to a surrogate target. The behavior many be verbal or physical, direct or indirect. anger A negatively toned emotion, subjectively experienced as an aroused state of antagonism toward someone or something perceived to be the source of an aversive event. anger control The regulation of anger activation and its intensity, duration, and mode of...

Robert Ostroff

Theoretical Basis III. Historical Overview IV Summary adjunctive therapy Two or more therapies used in an integrative fashion to treat an individual with mental illness. conjoint therapy Therapy consisting of two distinct treatment models 1 The treatment of two or more related individuals in the same setting, for example, couples treated in a group therapy or family therapy groups and 2 treatment used interchangeably with adjunctive therapy. In this chapter,...

Paul R Stasiewicz and Kellie E Smith

Racial Ethnic Minorities III. Women IV Summary cultural competence The belief that treatment providers should recognize and respect other cultural groups and be able to effectively work with them in a clinical setting. special populations People with special treatment needs related to age, gender, ethnic background, or health status that are underserved by alcohol and drug treatment resources. The origin of the term special population can be attributed to several U.S....