The document discusses classical and operant conditioning principles for modifying maladaptive behaviors. Classical conditioning involves pairing unconditioned stimuli that elicit innate responses with conditioned stimuli to elicit the same responses. Operant conditioning uses reinforcement and punishment to increase or decrease behaviors. Common behavior therapies discussed include shaping, modeling, token economies, systematic desensitization, and their advantages and disadvantages. The role of the nurse is also summarized.

1. By
Amudha.K
M.Sc., (N)

3. INTRODUCTION
• A behavior is considered to be maladaptive
when it is age inappropriate, when it
interferes with adaptive functioning, or when
others misunderstand it in terms of cultural
inappropriateness.

4. • The basic assumption is that problematic
behaviors occur when there has been
inadequate learning and therefore can be
corrected through the provision of
appropriate learning experiences.

5. PRINCIPLES
• Classical conditioning by Pavlov (1927)
• Operant conditioning by Skinner (1938)

6. CLASSICAL CONDITIONING

7. Pavlov’s model of classic conditioning
Sequence of Conditioning Operations:
1. UCS ----------------------------------------------------------------------------- UCR
Unconditioned stimulus Unconditioned response
(eating food) (salivation)
2. UCS ----------------------------------------------------------------------------------- CR
Unconditioned stimulus Conditioned response
(sight of food) (salivation)
3. CS ------------------------------------------------------------------------------------------ NR
Conditioned stimulus No response or
(bell) response unrelated to salivation
4. UCS + CS -------------------------------------------------------------------------------------- CR
Unconditioned + Conditioned stimulus Conditioned response
(food) (bell) (salivation)
5. CS ------------------------------------------------------------------------------------------------- CR
Conditioned stimulus Conditioned response
(bell) (salivation)

8. Classical Conditioning and Stimulus
Generalization
Subject: 6 month old baby
Sequence of Conditioning Operations:
1. CS -------------------------------------------------------------------------------- NR
Conditioned stimulus No response
(Nurse A in white uniform walks into room)
2. UCS ----------------------------------------------------------------------------- UCR
Unconditioned stimulus Unconditioned response
(Nurse A in white uniform gives shot) (cries; clings to mother)
3. CS -------------------------------------------------------------------------------- UCR
Conditioned stimulus Conditioned response
(Nurse A in white uniform walks into room) (cries; clings to mother)
4. CS ----------------------------------------------------------------------------------- CR
Conditioned stimulus Conditioned response
(Nurse B in white uniform walks into room) (cries; clings to mother)
or
(family friend comes to visit wearing a white dress)

9. OPERANT CONDITIONING
• Stimuli may precede or follow a behavior.
• A stimulus that follows a behavior (or
response) is called a reinforcing stimulus or
reinforcer. The function is called
reinforcement.
• When the reinforcing stimulus increases the
probability that the behavior will recur, it is
called a positive reinforcer, and the function is
called positive reinforcement.

10. Contd.,
• Negative reinforcement is increasing the
probability that a behavior will recur by
removal of an undesirable reinforcing
stimulus.
• A stimulus that follows a behavioral response
and decreases the probability that the
behavior will recur is called an aversive
stimulus or punisher. Examples of these
reinforcing stimuli are presented as

11. Examples of Reinforcing Stimuli
Type Stimulus Behavioural response Reinforcing stimulus
Positive Messy room Child cleans her messy
room.
Child gets allowance for
cleaning room.
Negative Messy room Child cleans her messy
room.
Child does not receive
scolding from the
mother.
Aversive Messy room Child does not clean her
messy room.
Child receives scolding
from the mother.

12. MAJOR ASSUMPTIONS
• All behavior is learned (adaptive and
maladaptive).
• Human beings are passive organisms that can be
conditioned or shaped to do anything if correct
responses are rewarded or reinforced.
• Maladaptive behavior can be unlearned and
replaced by adaptive behavior
• Behavioral assessment is focused more on the
current behavior rather than on historical
antecedents.
• Treatment strategies are individually tailored.

13. INDICATIONS

14. INDICATIONS

15. INDICATIONS

16. INDICATIONS

17. INDICATIONS

18. INDICATIONS

20. SHAPING
• Shaping has been shown to be an effective
way of modifying behavior for tasks that a
child has not mastered on command or are
not in the child’s repertoire.

21. MODELING
• Modeling refers to the learning of new
behaviors by imitating the behavior in others.

22. Discriminative
stimulus
(Homework
assignment: to do or
not to do)
R2
(Completion of
homework
assignment)
R1
(Talk to friends on
telephone)
PREMACK PRINCIPLE

23. TOKEN ECONOMY
• With this therapy,
tokens are
awarded when
desired behaviors
are performed and
may be exchanged
for designated
privileges.

24. SYSTEMATIC DESENSITIZATION

25. SYSTEMATIC DESENSITIZATION
• Discuss riding an elevator with the therapist.
• Look at a picture of an elevator.
• Walk into the lobby of a building and see the elevators.
• Push the button for the elevator.
• Walk into an elevator with a trusted person; disembark
before the doors close.
• Walk into an elevator with a trusted person; allow doors to
close; then open the doors and walk out.
• Ride one floor with a trusted person and then walk back
down the stairs.
• Ride one floor with a trusted person and ride the elevator
back down.
• Ride the elevator alone.

26. ADVANTAGES
• Behavioral therapists use empirically tested techniques,
assuring that clients are receiving both effective and brief
treatment
• Evidence-based therapies (EBT) are a hallmark of both
behavior therapy and cognitive behavior therapy
• Most studies show that behavior therapy methods are
more effective than no treatment
• Emphasis on ethical accountability (does not dictate whose
behavior or what behavior should be changed)
• Address ethical issues by stating that therapy is basically an
education process; an essential feature of behavior therapy
involves collaboration between therapist & client

27. DISADVANTAGES
• Behavior therapy may change behaviors, but it
does not change feelings
• Behavior therapy ignores the important
relational factors in therapy
• Behavior therapy does not provide insight
• Behavior therapy treats symptoms rather than
causes
• Behavior therapy involves control &
manipulation by therapist

28. CASE SCENARIO

29. ROLE OF THE NURSE
Nursing diagnoses Outcome criteria
Noncompliance with
therapy
Sammy participates in and cooperates during therapeutic
activities.
Defensive coping Sammy accepts responsibility for own behaviours and
interacts with others without becoming defensive
Impaired social interaction Sammy interacts with staff and peers using age
appropriate, acceptable behaviours.