Behavior therapy


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Behavior therapy

  2. 2. DEFINITION:- “It is a form of psychotherapy which focuses on modifying faculty behavior rather basic changes in the personality. Instead of probing the unconscious or exploring the patient’s thoughts & feelings, behavior therapist tries to eliminate the symptoms & modify ineffective or maladaptive pattern by applying basic learning techniques.” 4/24/2013 2 JAYPATIDAR(M.Sc.NURSING)
  3. 3. BEHAVIOR THERAPY TECHNIQUES 1. Behavioral modification 2. Systematic desensitization 3. Aversion therapy 4. Assertiveness training 5. Cognitive behavior therapy 6. Implosive (flooding) therapy 7. Positive reinforcement a. Response shaping b. Modelling c. Token economy 4/24/2013 3 JAYPATIDAR(M.Sc.NURSING)
  4. 4. 1. BEHAVIOR MODIFICATION It is also called “simple Extinction.” Learned behavior pattern becomes a waste or disappears if it is not reinforced. To eliminated a maladaptive behavior one has to remove the reinforcement for it. It is effective when reinforcement is being used without the knowledge of the affected individual 4/24/2013 4 JAYPATIDAR(M.Sc.NURSING)
  5. 5. COUNT… For Example;  Every time sonu, a nine year old girl bites her nails, her mother gives her an angry look. Sonu understand the mother anger & tries not to repeat the bad habit. A maladaptive behavior is gradually removed. Mother anger is a punishment for sonu .  Reward are also provide to reduce the maladaptive learning. Rishu, 11 year old boy, is told that if he studies one hour regularly on his own in class VI he could be allowed to buy a crocket set of his choice. 4/24/2013 5 JAYPATIDAR(M.Sc.NURSING)
  6. 6. 2. SYSTEMATIC DESENSITIZATION  It is a form of behavior therapy developed by Joseph Wolpe.  The objective of the therapy is to reduce or elimination fear or anxiety in which; I. The patient is trained in deep muscles relaxation. II. He has various anxiety-provoking situation or specific phobia, such as fear of death, fear of animals. These problems are placed from the strongest to the weakest order i.e. the client is anxious about which one is causing anxiety the least. 4/24/2013 6 JAYPATIDAR(M.Sc.NURSING)
  7. 7. COUNT… . Each of these situations is presented in imagination or in reality beginning with the weakest. Once the patient relaxes while imagining, that means the anxiety is getting reduced gradually. For Example; A child is having fear of crossing the road. For a few days the mother can take the child to the road & just stand & talk about other thing. The child keeps observing people crossing the road. Than after 2-3 days mother & child cross the road while they are talking. This may reduce the anxiety in a child as he is allowed to cross the road in a relaxed manner. Therapy is very useful for patient who have developed certain fears specially to domestic animals like dog. 4/24/2013 7 JAYPATIDAR(M.Sc.NURSING)
  8. 8. 3. Aversion Therapy It is a form of behavior therapy in which the patient is conditioned to avoid an undesirable behavior or symptoms by associating them with painful or unpleasant experiences, such as putting a bitter taste on nails or tongue for nail biting, giving drug like apormorphine which cause nausea & vomiting on taking alcohol or an electric shock to treat a child with enuresis. 4/24/2013 8 JAYPATIDAR(M.Sc.NURSING)
  9. 9. COUNT… Aversion therapy has been used for alcoholism, transvestism, compulsive unacceptable social behavior like homosexuality & other sexual deviation. Typically, 20-40 session are given, with each session lasting about 1 hour. After completion of treatment, booster session may be given. 4/24/2013 9 JAYPATIDAR(M.Sc.NURSING)
  10. 10. 4. ASSERTIVENESS TRAINING It is a behavior therapy techniques in which the patient is given training to bring about changes in emotional & other behavioral pattern by asserting himself. One is encouraged not to be afraid of showing an appropriate response, negative or positive, to an idea or suggestion. The assertive behavior training is given by the therapist first by role playing & then by practice in a real life situation. 4/24/2013 10 JAYPATIDAR(M.Sc.NURSING)
  11. 11. COUNT… Attention is focus on more effective interpersonal-skill. The most techniques used in assertiveness training is behavioral rehearsal, in which the patient act out problematic interpersonal interactions with the nurse or therapist. After this role-playing specific maladaptive behavior are identified & the client behavior can be adapted. This training can be used for client with bulimia nervosa & major depression, mentally healthy & mentally ill persons. 4/24/2013 11 JAYPATIDAR(M.Sc.NURSING)
  12. 12. 5. COGNITIVE BEHAVIOR THERAPY  It is a psychotherapeutic approach based on the idea that emotional problems in an individual arise due to faulty ways of thinking & distorted attitude towards oneself & others.  The therapist takes the role of a guide who helps the patient to correct & revise his perceptions & thoughts.  This helps the patient to change his thoughts, feelings & behavior about himself.  Cognitive behavior therapy is considered effective in the treatment of depression & adjustment difficulties. 4/24/2013 12 JAYPATIDAR(M.Sc.NURSING)
  13. 13. 6. IMPLOSIVE THERAPY (FLOODING) It is a behavior therapy techniques opposite to systematic desensitization, no prior relaxation techniques are taught to the patient. In this therapy, an individual is exposed directly to a maximum intensity fear- producing situation either in imagination or in real life. The patient gradually feels no actual danger in the situation. 4/24/2013 13 JAYPATIDAR(M.Sc.NURSING)
  14. 14. COUNT… For Examples; He has developed intense phobia of a lizard. During psychotherapy session suddenly the therapist puts a rubberized lizard on the table. For a minute the patient may get scared but gradually may start handling a rubberized lizard while taking. 4/24/2013 14 JAYPATIDAR(M.Sc.NURSING)
  15. 15. 7. POSITIVE REINFORCEMENT It is a stimulus or stimulus situation which is given to a patient or individual after the response. When the stimulus is given after the response it is on the basis that the strength of the response is increased & that the response will appear again. Examples; as soon as the infants gets up & walks, the mother claps & gives the infant a piece of chocolate to enjoy. 4/24/2013 15 JAYPATIDAR(M.Sc.NURSING)
  16. 16. COUNT… Positive Reinforcement can be done by: a. Responsive shaping b. Modelling c. Token Economy 4/24/2013 16 JAYPATIDAR(M.Sc.NURSING)
  17. 17. COUNT… a. Response Shaping:  Positive reinforcement is used in response shaping or incorporating or establishing a response which is not existing in an individual’s behavior.  This technique is used in a behavior problem or mental retardation. 4/24/2013 17 JAYPATIDAR(M.Sc.NURSING)
  18. 18. COUNT… For example; Shubam, 14, has an intelligence level of a five years old child. He had never done any of this activities such as washing after defecation, wearing shoes & socks. The therapist trained the family member to encourage Shubam to wear his socks & shoes. When he wears them he should be taken for a ride (car) which he enjoys the maximum. In this way he can be encourage to learn those behaviors which he has never learnt. 4/24/2013 18 JAYPATIDAR(M.Sc.NURSING)
  19. 19. COUNT… b. Modelling: Modelling is a behavior therapy technique in which learning occurs through observation. The client watches someone else perform a particular action such as answering telephone. Models are often parents or other adults & children Modelling is a form of social learning & is often called observation learning. 4/24/2013 19 JAYPATIDAR(M.Sc.NURSING)
  20. 20. COUNT… c. Token Economy:  It is a behavioral therapy programme usually conducted in a hospital or classroom setting.  In token economy the desired behavior is reinforced by offering tokens that can be exchanged for special food, games, comics or other rewards.  For example; a patient with schizophrenia does not maintain personal hygiene. The day he maintains he gets a token as reinforcer that he can watch T.V. when he desire. Like this he is able to collect many tokens & adapt behavior which is socially acceptable. Like maintaining personal hygiene. Sometimes in return of tokens the patient may exchange then by asking for PAROLE. 4/24/2013 20 JAYPATIDAR(M.Sc.NURSING)