A history and comparison.

1. Existential and Behavioral
Therapy
By: Jacqueline Heler and Siofra
Sharpe

2. The case of Miriam…

3. Miriam (Pg. 361)
• Abused as a child “…terrifying and degrading
childhood abuse,” (Corsini, 361)
• Speaks in a flat voice seemingly disconnected
from her feelings
• Self-critical
• Terrified of other people/relationships
• Can’t “feel”
• When she dared to move into contact with
therapist, she would suddenly shrink back in
shame

4. EXISTENTIAL THERAPY

5. Key Theorists
• Kierkegaard (1813–55): believed that truth
could ultimately only be discovered
subjectively by the individual in action
• Nietzsche (1844–1900): encouraged people to
choose their own standards and live by their
own free will
• Heidegger (1889–1976): interpretation seeks
to understand how the person himself
subjectively experiences something

6. Key Points
• there is no such thing as psychological dysfunction or
being ill, every way of being is merely an expression of
how one chooses to live one's life
• accepting feelings rather than trying to change them
• generally not concerned with the client's past; instead,
the emphasis is on the choices to be made in the
present and future
• 4 “givens” of human existence: death, freedom,
isolation, and meaningless
• depending on how we confront these themes, we
determine the design and quality of our lives

7. 4 Dimensions “Worlds”

8. In an Existential Psychotherapy
Session…
• Authentic the therapeutic relationship
• Encourage clients to personalize their dialogue
• Providing examples, speaking in the first
person, taking responsibility for perceptions
about self and world
• Grounding exercise: “embodied meditation”

9. Role of the Therapist
• Psychotherapist functions as a guide,
accompanist, and symbol… “wisdom teacher”
• Provides clear, humble demonstration of what
is possible
• Provides support and guidance, but the search
is the CLIENT’S
• Authentic relationship…awakening to what is
real, immediate, and personal. HERE AND
NOW

10. Pros and Cons
• Cross-cultural applications; both Eastern and
Western civilizations can relate
• There is no system or design to existential
therapy
• Handling mental illness?
• Present and future oriented
• Emphasizes personal responsibility

11. Existential References (beyond the
Corsini textbook)
• Yalom, Irvin D.; Existential Psychotherapy;
Basic Books, 1980.
• Yalom, Irvin D.; The Gift of Therapy; Piatkus
Books, 2001.
• Ryckman, Richard M.; Theories of Personality;
Wadsworth Publishing Company, 1999.

13. BEHAVIOR THERAPY
“What is causing this person to behave in this
way right now, and what can we do right now
to change that behavior?”

14. Approach
• A primary focus of both cognitive and behavioral
techniques is to change the cognitive processes
viewed as essential to therapeutic success
• Both cognitive and behavioral methods are used to
modify faulty perceptions and interpretations of
important life events
• For this reason, it is now common to refer to
“Cognitive Behavior Therapy”(CBT), instead of
Behavior Therapy

15. History
•Emerged in the late 1950’s as a systematic approach to the
assessment and treatment of psychological disorders
•In its early stages, Behavior therapy was defined as the
application of modern learning theory to the treatment of
clinical problems
•Modern learning theory referred to the principles and
procedures of classical and operant conditioning
•Behavior therapy was seen as the logical extension of
behaviorism to complex forms of human activities
•Key theorists: Pavlov, Skinner,Wolpe, Bandura

16. Key Theorists
• Pavlov (1849-1936): Established the foundations of classical conditioning
• Skinner (1904-1990): Radical behaviorism has had significant impact on
BT as well as on psychology in general
• Wolpe (1915-1997): anxiety as causal agent in all neurotic reactions,
defined as a persistent response of the automatic nervous system,
acquired through classical conditioning
• developed specific techniques such as systematic desensitization, one of
the most widely used methods of BT
• Bandura (1925-present) His Social Cognitive theory has influenced
many areas of inquiry: Education, Health Sciences, Social Policy and
Psychotherapy among others
• Concepts: analysis of personal efficacy and social roots of moral
behavior

17. Basic concepts
Three main approaches have been identified:
1. Applied Behavior Analysis - focuses exclusively on observable behavior
rejects all cognitive mediating processes
2. Neobehavioristic Mediational Stimulus-Response (S-R) Model
3. Social-Cognitive Theory - relies heavily on cognitive theories
These approaches differ in the extent to which they use
cognitive concepts and procedures.

18. Common Core of Basic Concepts:
• Many types of abnormal behavior formerly regarded as illnesses
are now construed as nonpathalogical “problems of living”
• Most abnormal behavior is assumed to be acquired and
maintained in the same way as normal behavior
• Assessment focuses on current determinants rather than on
analysis of possible historical antecedents
• Specificity the hallmark of behavioral assessment and treatment
(person best understood and described by what the person does in
a particular situation)
• Understanding the origins of a psychological problem not essential
for producing behavior change
• Behavior therapy involves a commitment to the scientific method.
This includes an explicit, testable conceptual framework.

19. Techniques used in psychotherapy
• Imagery-based techniques
• Cognitive Restructuring
• Assertiveness and Social Skills Training
• Self-Control Procedures
• Real-Life Performance-Based Techniques

20. Current Developments
• Most recent developments, emerging in the 1990s and gaining
momentum, have been labeled the “third wave” (Hayes, Follette
and Linehan)
• First wave: focused on modifying overt behavior
• Second wave: emphasis on cognitive factors, resulting in what is
known as CBT
• The Third wave: A group of therapeutic approaches with overlapping
conceptual and technical foundations. The two most prominent forms
of these developments are Dialectical Behavior Therapy (DBT) and
Acceptance and Commitment Therapy (ACT)
• Cognitive defusion - seperating thoughts from their referents and
differentiating the thinker from the thoughts
• Mindfulness is taught in both systems and the goal of acceptance is
essentially the same in ACT as in DBT

21. Dialectical Behavior Therapy (DBT)
• Defining feature: its focus on balancing the traditional
emphasis on behavior change with the value of acceptance,
and the importance of the relationship between the two
• Mindfulness: DBT uses typical BT techniques and
strategies but a distinctive and seminal therapeutic strategy
in DBT is to use mindfulness training

22. Acceptance and Commitment Therapy (ACT)
• Designed to help clients learn that experiential avoidance
does not work and that it is part of the problem and not the
solution
• Patients need to accept the thoughts and feelings they have
been trying to get rid of
• Commitment - ACT is all about action. Making mindful
decisions about what is important in life and what you are
going to do in order to live a valued life
•The goal of acceptance is essentially the same in ACT as DBT,
and mindfulness is taught in both systems

23. • Today, there is increasing recognition of the
importance of biological factors and brain
mechanisms in many of the disorders commonly
treated with behavioral methods
(Example: D Cycloserine, combined with behavior
treatment such as exposure has proven to be very
effective in the extinction of fear responses located in the
brain)