Behavior therapy is a type of psychotherapy which is based on theories of learning and aims at changing maladaptive behavior and substituting it with adaptive behavior.

1. Behavior Therapy

2. Introduction
• It is a form of treatment for problems in which
a trained person deliberately establishes a
professional relationship with patient, with
the objective of removing or modifying
existing symptoms and promoting positive
personality, growth and development.

3. Definition
• Behavior therapy is a type of psychotherapy
which is based on theories of learning and
aims at changing maladaptive behavior and
substituting it with adaptive behavior.

4. Goal of behavior therapy
• The main goal or aim of the behavior therapy
is to remove the maladaptive behavior and
substitute it with the adaptive or positive and
desirable behavior.

5. Assumption of behavior therapy
• All the behavior is learned.
• Human beings are passive organism that can
be conditioned or shaped to do anything if
correct responses are rewarded or reinforced.
• Maladaptive behavior can be unlearned and
can be replaced by adaptive behavior if the
person receives exposure to specific stimuli
and reinforcement for the desired adaptive
behavior.

6. Cont..
• Behavioral assessment is focused more on the
current behavior rather than on historical
antecedents.
• Treatment strategies are individually tailored.

7. Advantages of behavior therapy
• Behavior therapists use empirically tested
techniques, assuring that the clients are
receiving both effective and brief technique.
• Reduce incidence of self harm.
• Improve social skill.
• Better functioning in unfamiliar situation.

8. Cont..
• It is a short duration therapy. The total
duration of therapy is 6-8 weeks.
• Therapies are easy to train and is cost
effective.

9. Limitations of behavior therapy
• Behavior therapy may change the behavior
but does not change the feelings.
• Behavior therapy ignores the important
relational factors in therapy.
• It does not provide insight.
• Treats symptoms rather than causes.
• Involves control and manipulation by
therapist.

10. Indications of behavior therapy
• Phobias
• Social anxiety
• Nocturnal enuresis
• Sexual dysfunctions
• Tension headache
• Maladaptive habits
• Smoking
• Anorexia nervosa
• Psychosomatic reactions
• alcoholism

11. Cont…
• Eating disorders
• Post traumatic distress
• Bipolar disorder
• Attention deficit/ hyperactivity disorder
• Obsessive compulsive disorder
• Self harm
• Panic disorder
• Anger issues

12. Techniques of behavior therapy
• Systemic desensitization
• Flooding or explosion therapy
• Aversion therapy
• Operant conditioning procedures for increasing
adaptive behavior
• Operant conditioning procedures to teach new
behavior
• Operant conditioning procedure to decrease
maladaptive behavior

13. Cont..
• Assertiveness or social skill training
• Classical conditional conditioning

14. Systemic desensitization
• It was developed by Joseph Wolpe. In this
patient attain a state of complete relaxation
and are then exposed to the stimulus that
elicits the anxiety response.
• It consists of 3 main steps
1) relaxation training
2) hierarchy construction
3)desensitization of the stimulus

15. Relaxation Training
 Progressive muscle relaxation
 Hypnosis
 Yoga and meditation
 Guided imagery
 Biofeedback training

16. Hierarchy construction
In such technique the patient is asked to list out
all the conditions or stimulus that provoke the
fear and anxiety and make its hierarchy from
higher provoking to least provoking factors
and the sensitization is done accordingly.

17. Desensitization of the stimulus
This can either be done in reality or in
imagination. First of all the lower item in
hierarchy is confronted.
In this technique the patient is able to control
his anxiety gradually.
Example of this technique done for the fear of
lizard.

18. Cont…
• Looking at a picture of lizard.
• Looking at a real lizard in a jar.
• Holding the jar.
• Touching a small or dead lizard.
• Touching a real and large lizard.

19. Flooding or Implosion Therapy
It is an alternative way of treating the phobic
disorder by exposing the anxiety provoking
stimulus in full intensity, not gradually. It is
repeated until the client no longer feels
anxious.
Eg. Fear of lizard treated by putting rubberized
lizard suddenly on the table. For a minute the
patient may get scared but gradually may start
handling a rubberized lizard while talking.

20. Aversion Therapy/Classical
Conditioning procedure
Aversion therapy is used for treatment of conditions
which are pleasant but undesirable, e.g. alcohol
dependence homosexuality, nail biting, and other
sexual deviations. In this the patient is
conditioned to avoid an undesirable behavior or
symptoms by associating them with painful or
unpleasant experiences. Eg. Putting bitter taste
on nails for nail biting, giving drugs like disulfiram
which cause nausea and vomiting on taking
alcohol. Etc.

21. Operant Conditioning Procedure for
Increasing Adaptive Behavior
Positive reinforcement
When the behavioral response is followed by a
generally rewarding event such as food ,
praise or gift. It tends to strengthen the
adaptive behavior before rewarding.

22. Cont..
Token economy
This program includes giving token rewards for
appropriate or desired target behaviors
performed by the patient. The token can later
be exchanged for other rewards which they
purchase luxury items or certain privileges.

23. Operant conditioning procedure for
decreasing the maladaptive behavior
• Ignoring
• Punishment
• Timeout
• Restitution or over correction
• Response cost

24. Operant conditioning behavior to
teach new behavior
• Modeling
This is the method of teaching by demonstration . Where, the
therapist show how a specific behavior is performed. The
patient learns the model behavior from others.
• Shaping
In shaping the components of a particular behavior is
reinforced step by step. Eg. To establish eye to eye contact,
the therapist sits opposite of the client and reinforces him
even if he moves his upper body parts towards him. Once
this is established, he reinforces the person’s head
movement in his direction and this procedure is continued
till eye to eye contact is established.

25. Cont…
• Chaining
Chaining is used when the person fails to
perform a complex task, the complex task is
broken into the small steps and each step is
taught to the patient.
This is most effective training for mentally
disabled person.

26. Assertiveness or social skill therapy
• Assertiveness training is a behavior therapy
technique in which the patient is given
training to bring about change in emotional
and other behavior pattern by being assertive.
Patient is encouraged not to be afraid of
showing an appropriate response, negative or
positive to an idea or suggestion.
• Social skill training helps to improve social
manners like encouraging eye contact,
speaking appropriately and relating to people.

27. Role of Nurse in Behavior Therapy
The nurse plays role in behavior therapy according
to different techniques chosen by
psychotherapist and client parties.
The main role of nurse is to ease the therapy
There are some vital roles that nurse plays before
during and after procedure of behavior therapy.
Nurses role before therapy
• The nurses role is primarily facilitator, provide a
safe, comfortable environment for the therapy.

28. Cont…
• Select the correct patient.
• Maintain good rapport with patient.
• Collect necessary information regarding
clients.
• Assess degree of maladaptive behavior.
• Obtain verbal informed consent for therapy.
• Explain about the time duration or process of
therapy to the patient parties.

29. During procedure
• Make patient to sit in comfortable position.
• Encourage the patient to explore the feelings and emotion.
• Check the judgment and insight of the patient.
• Encourage the patient to perform activities in correct
manner.
• Provide reward for desired target behavior.
• Encourage the patient to be relaxed in any situation over
the period of the therapy.
• In this phase, the nurse acts as an assistant, an observer, a
motivator, a teacher, a listener, collaborator, and a well
wisher for the desire behavior of the patient.

30. After procedure
• Make patient comfortable.
• Record and report the outcome of therapy.
• Advice the patient about next date and time
of therapy if needed.