Behavior therapy is a form of treatment that establishes a professional relationship between a trained person and a patient to modify or remove symptoms and promote growth. It is based on assumptions that all behavior is learned, maladaptive behavior can be unlearned and replaced, and treatment strategies are individually tailored. Common behavior techniques include systematic desensitization, flooding, aversion therapy, operant conditioning using reinforcement or punishment, and assertiveness/social skills training.

1. BEHAVIOR THERAPY
Rojina poudel
Roll no:25
Bsc nursing 3rd year

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

3. MAJOR ASSUMPTIONS OF
BEHAVIOUR THERAPY
The following are the assumptions of behavior
therapy.
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 if the person
recieves exposure to specific stimuli and
reinforcement for the desired adaptive behavior.

4. Behavior assessment is focused more on the
current behavior rather than on historical
antecedents.
Treatment strategies are individually tailored.

5. BEHAVIOR TECHNIQUES
Systemic desensitization
It was developed by joseph wolpe,based on
the behavioral principle of counter
conditioning. In this, patient attain a state of
complete ralaxation and are then exposed to
the stimulus that elicits the anxiety
response.The negative reaction of anxiety is
inhibited by the relaxed state, a process called
reciprocal inhibition.

6. It consists of three main steps:
 Relaxation training
 Hierachy construction
 Desensitization of the stimulus

7. a)Relaxation training
There are many methods which can be used
to induce relaxation. Some of them are:
 jacobson’s progressive muscle relaxation
 Hypnosis
 Meditation or yoga
 Mental imagery
 biofeedback

9. b)Hierachy construction
Here the patient is asked to list all the
conditions which provoke anxiety. Then he is
asked to list them in a descending order of
anxiety provocation.
c)Desensitization of the stimulus
This can either be done in reality or though
imagination.At first, the lowest item in hierachy is
confronted.The patient is advised to signal
whenever anxiety is produced. After a few trails,
patient is able to control his anxiety gradually.

10. INDICATION
• Phobias
• Obessions
• Compulsions
• Certain sexual disorders

11. FLOODING
The patient is directly exposed to the phobic
stimulus, but escape is made impossible.By
prolonged contact with the phobic stimulus,
the therapist guidance and encouragement
and his modeling behavior reduce anxiety.
Indication: specific phobias

12. AVERSION THERAPY:
Pairing of the pleasant with an unpleasant
response, so that even in absence of the
unpleasant response the pleasant stimulus
becomes unpleasant . Unpleasant response is
produced by electric stimulus,drugs,social
disapproval or even fantasy.

13. INDICATIONS
 Alcohol abuse
 Paraphilias
 Homosexuality
 Transvestism

14. OPERANT CONDITIONING PROCEDURE
FOR INCREASING ADAPTIVE BEHAVIOUR
a)Positive reinforcement
When a behavioral response is followed by a
generally rewarding event such as food, praise or
gifts, it tends to be strengthed and occur more
frequently than before reward. This techniques is
used to increase desired behavior.
b)Token economy
This program involves giving token rewards for
appropriate or desired target behaviours
performed by the patient.

15. OPERANT CONDITIONING PROCEDURE
TO TEACH NEW BEHAVIOUR
a)Modeling
modeling is a method of teaching by
demonstration where the therapist shows
how a specific behavior is to be performed.In
modeling the patient obsreves other patient in
delging in target behaviors and getting
rewards for those behaviors.This will make the
patient repeat the same behavior and earn
rewards in the same manner.

16. b)Shaping
In shaping the components of a particular skill,
the behaviour is reinforced step by step. The
therapist starts shaping by reinforcing, the
existing behavior.

17. C)Chaining
Chaining is used when a person fails to perform a
complex task. The complex task is broken in to a
number of small step and each step is taught to
the patient. In forward chaining one start with
the first steps, goes on to the second step, then
to the third and so on. In backward chaining, one
starts with the last step and goes on to the next
step in a backward fashion.

18. 0PERANT CONDITIONING PROCEDURES FOR DECREASING
MALADAPTIVE BEHAVIOR
a)Extinction/Ignoring
Extinction mean removal of attention
rewards parmanently, following a problem
behavior. This includes actions like not looking
at the patient, not talking to the patient, or
having no physical contact with the
patient.This is used when patients exhibit odd
behaviour.
.

19. b)Punishment
The punishment procedure should be
administerd immediately and consistenty
following the undesirable behavior with clear
explanation. Desirable punishment should
always be added when a punishment is being
used for decreasing an undesirable behavior

20. c)Time out
Timeout method includes removing the patient
from the reward or the reward from the
patient for a particular period of time
following a problem behavior.This is often
used in the treatment of childhood disorders.
for eg the child is not allowed to go out of the
ward to play if he fails to complete the given
work.

21. d)Restitution (over correction)
Restitution means restoring the disturbed
situation to a state that is much better than
what it was before the occurrence of the
problem behavior. for eg if a patient passes
urine in the ward he would be required to not
only clean the dirty area but also map the
entire area of the floor in the ward.

22. ASSERTIVENESS AND SOCIAL SKILL
TRAINING
Assertive traning is a behavior therapy technique in
which the patient is given training to bring about
change in emotional and other behavioral pattern by
being assertive. Patient is encouraged not to be afraid
of showing an appropriate response, negative or
positive, to an idea or suggestion. Assertive behavior
training is given by the therapist, first by role play and
then by practice in a real life situation. Social skills
training helps to improve social manners like
encouraging eye contact, speaking appropriately,
observing simple etiquette and relating to people.