Behavior Therapy
Behavior Therapy
Behavioural therapy is a term that describes a broad range of techniques used to change
maladaptive behaviours. The goal is to reinforce desirable behaviours and eliminate
unwanted ones.
What is psychotherapy?
An emotionally charged disclosing interaction
Between a trained therapist and someone suffers from psychological problems
Using psychological techniques
Aims:
• change behavior
• Decrease distress
• Increase joy, aspiration, and hope
• Improve resilience
Insight- vs. Action-Oriented Approaches:
Primary medium verbal intervention & processing action with verbal processing
Case # 3:
A boy F was putting lot of weight he joined a weight loss group. At each group
meeting he used to deposit money. Set a goal for daily exercise.
So if he earned specified number of point he used to get back the deposit money otherwise
not.
In these 3 cases you can notice that there is a focused behavior and also a procedure to
change the behavior.
Behavior:
What people do and say.
Examples: running, walking, screaming, slamming the door, head banging etc.
Do you think?
Anger
Sadness
Confusion is a behavior?
Behavior Have one or more dimensions that can be measured.
Physical dimensions:
Frequency
Duration
Intensity
Can be observed and recorded
Have an impact on oneself/environment
Lawful
Systematically influenced by environment events.
May be overt (observed) or covert (private event)
What is that characteristic of behavior?
An autistic child when receives higher attention from the teacher, his disruptive behavior
decreases.
When he receives low attention, disruptive behavior increases.
Which characteristics this??
Ex: 1 A person sits at his computer and types a letter??
Ex: 2 a little child lies in her crib and cries loudly. Her mother then picks her up and feeds
her?
What does mean by? Functional relationship between a disruptive behavior and attention.
OVERT/COVERT behavior:
Thinking is? Expression of anger is? Disruptive behavior?
Areas of Application:
Developmental disabilities
Mental illness
Special Education
Rehabilitation
Community psychology
Clinical psychology
Business and human services
Self-management
Child management
Prevention
Sports psychology
Health related behaviors
Sports psychology
Gerontology (Nursing homes and other care facilities)
Assessment:
Why behavioral assessment/measurement of behavior is important?
Measuring the behavior before treatment provides information that can help you
determine whether treatment is necessary.
Behavioral assessment can provide information that helps you choose the best
treatment.
Measuring the target behavior before and after treatment allows you to determine
whether the behavior changed after the treatment was implemented.
Direct and Indirect Assessment:
Direct involves using interviews, questionnaires, and rating scales to obtain
information on the target behavior from the person exhibiting the behavior or from
others (e.g., parents, teachers, or staff).
Indirect assessment does not occur when the target behavior occurs but relies on an
individual’s recall of the target behavior.
When a school psychologist observes a socially withdrawn child on the playground
and records each social interaction with another child, the psychologist is using direct
assessment.
When the psychologist interviews the student’s teacher and asks the teacher how
many times the child usually interacts with other children on the playground, the
psychologist is using indirect assessment.
Procedures of behavioral analysis:
Defining the target behavior:
When two people independently observe the same behavior and both record that the behavior
occurred, this is called interobserver agreement (IOA) or interobserver reliability determining
the logistics of recording
Choosing a recording method
Choosing a recording instrument
Direct assessment usually is more accurate than indirect assessment.
The Logistics of Recording:
The Observer:
We have defined the target behavior to be recorded for a client, that is, a person who
exhibits the target behavior and with whom the behavior modification program will be
implemented.
The next step is to identify who will observe and record the behavior.
In a behavior modification program, the target behavior typically is observed
and recorded by a person other than the one exhibiting the target behavior (i.e.,
an independent observer).
The observer may be a professional, such as a behavior analyst or a psychologist, or a
person routinely associated with the client in the client’s natural environment, such as
a teacher, parent, staff member, or supervisor.
In some cases, the observer is the person exhibiting the target behavior.
When the client observes and records his or her own target behavior, it is called self-
monitoring.
In addition, the client might be asked to self-monitor the target behavior outside the
therapy sessions.
If self-monitoring is used in a behavior modification program, the client must be
trained to record his or her own behavior in the same way that an observer would be
trained.
When and Where to Record:
The observer records the target behavior in a specific period called the observation
period.
It Observation and recording of behavior take place in natural settings or in analogue
settings.
A natural setting consists of the places in which the target behavior typically occurs.
Observing and recording a target behavior in the classroom is an example of a
natural setting for a student
Observing a target behavior in a clinic playroom is an analogue setting
because being in the clinic is not part of the child’s normal daily routine.
Observation of the target behavior can be structured or unstructured.
When observations are structured, the observer arranges for specific events or
activities to occur during the observation period. For example, when observing
child behavior problems, the observer may ask the parent to make specific
requests of the child during the observation period.
During unstructured observations, no specific
Events or activities are arranged and no instructions are given during the
observation period.
Choosing a Recording Method:
Continuous recording product recording interval recording and time sample recording.
Continuous Recording:
In continuous recording, the observer observes the client continuously throughout the
observation period and records each occurrence of the behavior.
Frequency, duration, intensity, and latency.
How does latency differ from duration?
Latency is the time from some stimulus or event to the onset of the behavior, whereas
duration is the time from the onset of the behavior to its offset. a real-time recording method
in which the exact time of each onset and offset of the target behavior is recorded
Real time recording can be carried out after video recording the target behavior in the
observation period
If you were recording a child’s tantrum behavior (screaming, throwing toys,
slamming doors), which dimension of the behavior would you measure?
The example of a child’s tantrum behavior is less clear. You may be interested in the
number of tantrums per day (frequency), but you may also be interested in how long
each tantrum lasts (duration). Finally, you may be interested in how loud the child
screams or how forcefully the child throws toys or slams doors (intensity).
Unless you measure the right dimension of a behavior, you may not be able to judge
the effectiveness of treatment.
Percentage of Opportunities:
Percentage of trials or percentage correct is one final way in which event recording
may be conducted.
In this method, the observer records the occurrence of a behavior in relation to some
other event, such as a learning trial or a response opportunity, and reports the results
as the percentage of opportunities in which the behavior occurred.
If the teacher made 12 requests and the student complied with the teacher’s requests
11 times, the percentage of compliance is 11/12, or 92%.
However, if the teachers made 25 requests and the student complied 11 times, the
percentage is only 44%, a much less acceptable level of the behavior.
Product Recording:
Another aspect of a behavior that may be recorded is its product. Product recording,
also called permanent product recording (Marholin & Steinman, 1977),
A teacher could record the number of correctly completed homework problems or
workbook pages as a product measure of students’ academic performance (Noel et al.,
2000).
Interval Recording:
Another method for recording behavior is to record whether the behavior occurred during
consecutive time periods. the observer divides the observation period into a number of
smaller time periods or intervals, observes the client throughout each consecutive interval,
and then records whether the behavior occurred in that interval.
There are two types of interval recording:
With partial interval recording, you are not interested in the number of times the behavior
occurs (frequency) or how long it lasts (duration).
You do not have to identify the onset and offset of the behavior; rather, you simply record
whether the behavior occurred during each interval of time.
Suppose that a teacher is recording whether a child disrupts the class during each 15-minute
interval in the class period. The teacher sets a timer to beep every 15 minutes. When the
disruptive behavior occurs, the teacher marks the corresponding interval on a data sheet.
Once an interval is marked, the teacher does not have to observe the child or record the
behavior until the next interval begins. If the behavior does not occur in an interval, presence
or absence of the tic behavior.
In some cases, frequency recording and interval recording can be combined to produce
frequency-within-interval recording. With this method, the observer records the frequency of
the target behavior but does so within consecutive intervals of time in the observation period.
Time Sample Recording:
When using time sample recording, you divide the observation period into intervals of
time, but you observe and record the behavior during only part of each interval.
The observation periods are separated by periods without observation. For
Example, you might record the behavior for only 1 minute during each 15-minute interval, or
you might record the behavior only if it is occurring at the end of the interval.
Consider an observer who is using time sample recording to record a client’s poor posture
(defined as slouching, bending the back forward). The observer sets a timer to beep every 10
minutes and records an instance of bad posture only if the client’s posture is bad when the
timer beeps at the end of the interval. Time sample recording is valuable because the person
does not have to observe thembehavior for the entire interval.
Choosing a Recording Instrument:
What the observer uses to register or make a permanent product of the occurrence of
the behavior.
Paper and pencil
Data sheet prepared in advance for the particular behavior.
The data sheet in Figure 2-5 is used to record the duration of a target behavior.
On each day, there are places to record the times the behavior started (onset) and ended
(offset). By recording the onset and offset of each instance of a behavior, you end up with a
recording of how long the behavior occurred (duration), as well as how often it occurred
(frequency).
Reactivity:
Sometimes the process of recording a behavior causes the behavior to change, even before
any treatment is implemented. This is called reactivity (Foster, Bell-
Dolan, & Burge, 1988; Hartmann & Wood, 1990; Tryon, 1998). Reactivity may
occur when an observer is recording the behavior of another person or when a person
engages in self-monitoring.
Reactivity may be undesirable, especially for research purposes, because the behavior
recorded during the observation period is not representative of the level of the
behavior occurring.
Usually this change in behavior is only temporary, and the behavior returns to its
original level once the child becomes accustomed to the observer’s presence.
One way to reduce reactivity is to wait until the people who are being observed
become accustomed to the observer.
Another is to have the observer record the behavior without the people knowing that
they are being observed.
This may be accomplished with the use of one-way observation windows or with
participant observers. A participant observer is a person who is normally in the setting
where the target behavior occurs, such as a teacher’s aide in a classroom.
Likewise, when a person starts to record his or her own behavior as part of a self-
management project, the behavior often changes in the desired direction as a result of
the self-monitoring (Epstein, 1996). For this reason, self-monitoring sometimes is
used as a treatment to change a target behavior.
Inter observer Agreement:
You assess IOA to determine whether the target behavior is being recorded
consistently.
To evaluate IOA, two people independently observe and record the same target
behavior of the same subject during the same observation period. The recordings of
the two observers are then compared, and a percentage of agreement between
observers is calculated.
When the percentage of agreement is high, it indicates that there is consistency in the scoring
by the two observers. This suggests that the definition of the target behavior is clear and
objective, and that the observers are using the recording system correctly. When high IOA is
reported in a research study, it suggests that the observers in the study recorded the target
behavior consistently.
Examples for Data Collection:
Intervention is warranted when behaviors are harmful to the self or others unsafe or
destructive distressing to the individual/family disruptive to learning disruptive to social
functioning hindering participation in daily living or occupational activities.
Evaluate Priorities:
Set realistic goals
Start with small steps that can build on each other
First:
Target behaviors that are dangerous
Target skills that would help to improve situations across several behavioral scenarios.
Features across Intervention Strategies:
Clear—understood by family/caregivers/supervisors
Consistent—family/caregivers are on the same page with the interventions, expectations,
response, and rewards
Successive Approximation:
In the process of shaping, a successive approximation is a behavior that more closely
resembles the target behavior.
Target Behavior:
Is the behavior one want to see demonstrated; the end goal.
Reinforces:
Is a stimulus or event that increases the future probability of a behavior when it occurs. It is
contingent on the occurrence of the behavior.
What is shaping??
• having a target (goal) behavior in mind
• Establishing steps that work toward that target behavior
• positively reinforcing only a specific behavior at a time while ignoring all other
behaviors
• once one step has been accomplished, shaping requires moving on to the next step,
only ever reinforcing the current step until the target behavior is reached
There are five aspects or dimensions of behavior that can be shaped:
• topography,
• frequency,
• duration,
• latency,
• And intensity.
DIMENSIONS OF BEHAVIOR THAT CAN BE SHAPED
Dimension Definition Example
Latency Time between the controlling stimulus Time between time and exercising
and the behavior
(Reaction time)
Steps to shaping:
1. Define the behavior
2. Determine whether shaping is the most appropriate procedure
3. Identify the starting behavior
4. Choose the shaping steps
5. Choose the reinforces
6. Differentially reinforce successive approximations
7. Move through the steps at a proper pace
1. Define the behavior:
The first stage in shaping is to identify clearly the final desired behavior, which
is often referred to as the terminal behavior.
A precise statement of the final desired behavior increases the chances of
consistent reinforcement of successive approximations of that behavior.
The final desired behavior should be stated in such a way that all the relevant
characteristics of the behavior (its topography, amount, latency, and intensity)
are identified.
The conditions under which behavior is or is not to occur should be stated, and
any other guidelines that appear to be necessary for consistency should be
provided.
Types of chaining:
Forward chaining
Backward chaining
Rules for chaining:
Define the target behavior
As a chain! – You must know in advance what sequence you will be
dealing with
Reinforce successive elements of the chain
Monitor results
Prompting and Fading:
A prompt can be defined as a cue or hint meant to induce a person to perform
desired behaviour. Prompting is an act of helping a behaviour to occur. A coach
help a small child hold a baseball bat to teach a proper swing.
Fading:
Fading is when the trainer gradually withdraws the prompt
Eg: Learning to drive a vehicle
Types of prompting:
Verbal
Physical
Gestural
Modeling
Environmental
Rules for prompting and fading:
Define the target behavior
Identify the suitable prompts
Prompt reinforce and fade
Monitor results
Systematic Desensitisation:
Is a behavioural treatment that is used to treat anxiety causing behaviour
such as phobias and fears?
3 Steps of Systematic Desensitisation
Training to relax:
Hierarchy of Anxiety:
Desensitisation process:
Training to Relax:
Training to relax: Progressive relaxation, one first tightens and then relaxes
various muscle groups in the body.
Hierarchy of Anxiety:
Hierarchy of Anxiety: a catalogue of anxiety provoking situations or stimuli
arranged in order from least to most distressing.
Desensitisation Process:
Desensitisation process: Direct confrontation of the situation.
Systematic Desensitisation:
The patient is taught to relax through various relaxation techniques like
Learning how to relax the muscles and applying various deep breathing
relaxation techniques.
The patient is asked to think about only red rose. Of course this may generate
the feeling of anxiety but only in a limited amount as the object of fear is only
imaginary and not real.
Slowly a picture of rose is presented to the person in a pleasant situation. For
instance a picture of a boy offering a red rose to a girl as a symbol of love will
be shown to the person. This will help him to associate pleasant feeling to rose.
Then the person is presented a funny drawing, representing a person or scene
that includes a rose. If this generates anxiety the person will be asked to close
his eyes, relax his mind, and once relaxed presented with the picture again.
Now the person has to see a real rose in a vase, from a distance. This will be
done with a constant reassurance that it can possibly cause no harm.
The person will slowly be made to approach the red rose and look at it
From a shorter distance. The person will go close to the rose placed in a vase
and be asked just to touch the vase. The to touch the rose real.
Holds the red rose in his hands.
Finally he will be able to hold the entire bouquet of red roses without
Experiencing any anxiety of fear. Thus works the Systemic Desensitisation
Aversion Therapy:
A behaviour therapy in which an aversive (causing a strong feeling of dislike or
disgust) stimuli is paired with an undesirable behaviour in order to reduce or
eliminate that behaviour.
Aversion Therapy is used in:
Alcohol abuse, drug abuse, gambling, sexual deviations, smoking or behaviour
problems.
Examples Aversion Therapy:
Electric Shock, drugs, disturbing media such as graphic images or loud and
painful noises, unappealing scenes or sensations.
Drugs used Aversion Therapy:
Pungent smelling chemicals, strong emetics, noxious and irritating chemicals,
irritating ophthalmic applications, capsicum aerosols etc.
Precautions of Aversion Therapy:
The chemicals and medicaments generate very unpleasant and often physically
painful responses. This type of aversive stimulation may be risky for persons
with heart or lung problems. Behavioural contract to be executed. Worsening of
the present medical conditions.
Extinction:
Extinction is used to stop an undesirable behaviour. Like punishment, an
extinction behaviour is used when you need to get your subject to stop some
behaviours.
Parents can create behaviour “extinction” by carefully observing their child’s
behaviour and noticing what reward the child receives for that inappropriate
behaviour. High magnitude of reinforcement of the undesired behaviour makes
it hard to remove by extinction.
Associative Loss theory in Extinction:
The simplest explanation of extinction is that as the CS is presented without the
aversive US, the animal gradually “unlearns” the CS-US association.
Behaviour Contracting:
It’s a therapeutic approach in which an agreement is reached with a client
usually in the form of a written contract.
This would make clear the consequences that would follow certain identified
behaviours.
Eg: A contract may be drawn up with a child specifying their reward for bed-
wetting. These agreement make clear the schedule of reinforcement being
applied and in signing up to the agreement it’s understood that this might
motivate the client to cooperate with the programme.
Is applied to stopping of smoking, drinking etc.
Procedure of Behaviour Contracting:
Plan the contract, set up a meeting, communicate the laid out conditions,
benefits and deadlines. Schedule follow ups.
Token Economy:
Is a system of behaviour modification based on the systematic positive
reinforcement of target behaviour?
The reinforcement symbols or tokens that can be exchanged for other
reinforces. It’s based on the conditions of operant conditioning.
Are applied with children and adults. Give the reward whenever the behaviour
occur.
Steps of Token Economy:
Step 1: Select target behaviour for change.
Step 2: Develop a method for recording or token or points.
Step 3: Identify powerful rewards.
Step 4: Establish Goals- number of tokens or points to be won for obtaining the
rewards.
Step 5: Detail the programme to the child.
Step 6: Provide thefeedback.
Step 7: Finally present the reward.
Step 8: Change the programme. When the desired result is obtained too you
should change the programme ingredients.
Time Out:
Temporarily changing or separating the child from the environment where
Inappropriate behaviour has occurred. It’s intended to remove a positive
reinforcement of the undesired behaviour.
It’s an educational and parenting technique recommended by some
paediatricians and developmental psychologists as an effective measure to
ensure child discipline.
Recommended for younger children. The purpose is to isolate or separate the
child for a short period of time (usually 5 to 15 minutes) in order to allow the
child to calm down as well as to discourage inappropriate behaviour.
May on chair, steps, corner or any other locations where there is no distractions.
Temporarily changing or separating the child from the environment where
Inappropriate behaviour has occurred. It’s intended to remove a positive
reinforcement of the undesired behaviour.
Type of a behaviour control method based on removing positive reinforcements
Overcorrection:
A type of Positive practice which involves performing an action repeatedly until
it’s performed correctly. If you have trouble in producing the exact musical note
in a song you overcorrect it by practicing singing until you reach the desired
level of performance.
Stimulus satiation:
This response of elimination procedure involves the repeated presentation of the
desired stimulus for the purpose of reducing its attractiveness. Excessive
presentation of desired stimulus to reach levels or satiation (to get cloyed with).
Flooding:
A form of desensitisation for treating phobias and anxieties by repeated
exposure to highly distressing stimuli until the lack of reinforcement of the
Anxiety response causes its extinction. A form of desensitisation used in
behaviour therapy in which the person imagines or is actually exposed to
anxiety-producing stimuli.
Assertiveness Training:
A form of behaviour therapy designed to help people stand up for themselves-
to empower themselves.
Assertiveness is a response that seeks to maintain an appropriate balance
between passivity and aggression.
Assertiveness response that promotes fairness and equality in human
interaction, based on positive sense of respect for self and others.
The purpose of assertiveness training is to teach persons appropriate
Strategies for identifying and acting on their desires, needs and opinions while
remaining.
Bio-feedback:
Applied Psychological feedback- is a patient guided treatment that teaches an
individual to control muscle tension, pain, body temperature, brain waves and
other bodily functions and processes through relaxation, visualisation and other
cognitive control techniques.
Temperature Bio-feedback GSR Galvanic Skin Response EEG Bio-feedback
Bio-Life Feedback-Return Applied Psychological feedback- is a patient guided
treatment that teaches an individual to control muscle tension, pain, body
temperature, brain waves and other bodily functions and processes through
relaxation, visualisation and other cognitive control techniques.
Relaxation Methods:
Relaxation is not just zoning our before a TV at the end of a stressful day.
To effectively combat stress, we need to activate the body’s natural
Relaxation response. We can do this by practicing relaxation techniques such as
deep breathing, mindful meditation, rhythmic exercises and YOGA.
Self-Management:
Self-management Problems:
Self-management problems include behavioral excesses and behavioral deficits
Self-management problems involve a conflict between short term contingencies
and long term consequences.
Short term contingencies control the behavior
Short term Long term
Contingencies consequences
-----------------------------------------------------------
(Excess) Pos. reinforcing Negative
Less resp. effort
(Alt. beh.) Less reinforcing Positive
Or punishing
More resp. effort
------------------------------------------------------------
(Deficit) Punishing or Positive
Less reinforcing
(Alt. beh.) More reinforcing Negative
Less resp. effort
Self-management process:
Must analyze the target behavior and alternative behaviors (behavioral excess
and deficit) in self-management.
In self-management you engage in a controlling behavior in the present to
influence the controlled behavior in the future
Controlling behavior = self-management strategy
Controlled behavior = target behavior to be changed in a self-management
program.
Self-Management Strategies:
1. Goal setting and self-monitoring
2. Antecedent manipulations to influence the target behavior or alternative
behaviors (ch 16)
- Manipulate SDs, EOs, or response effort
3. Arranging rein forcers and punishers
4. Behavioral contracting (chapter 23)
5. Social support
6. Self-instructions (rules) and self-praise
Steps in Self-Management:
1. Make the decision to do it (commitment).
2. Define target behaviors and competing behaviors.
3. Set a goal.
4. Develop a self-monitoring plan and begin self-monitoring.
5. Conduct a functional assessment of the antecedents and consequences of the
target behavior and alternative behaviors.
6. Implement appropriate self-management strategies based on functional
assessment information
7. Evaluate change from baseline once self-management strategies are
implemented
8. Modify self-management strategies if necessary
9. Implement maintenance strategies to keep the change going over time
Common Problems in Self-Management Projects:
Unclear descriptions of antecedents and consequences in the functional
assessment unclear descriptions of intervention procedures
Examples: “I’ll just make myself do it.”
“I’ll work harder to stop it.”
“I’ll talk myself into doing it.”
Procedures aren’t practical - too much $$, time, or effort
Procedures aren’t based on functional assessment information
Consequences are too delayed to be effective
Consequences are too weak or easily short-circuited