1. Discuss some uses of behavior therapy. Most behavior psychoanalysis is behavioral self-control, but it is not so dependent on an outpatient point of view. Behavior therapy always begins with assessment.

2. Discuss some methods of behavioral assessment. This is a very involved process. Assessment begins the therapy, but it occurs throughout. Therapists are concerned with what the data shows. Assessment is concerned with the causes of underlying problems, but symptoms are the problem. Still, they do want to look at the historical causes. The methods of behavioral assessment are: (a) actual in vivo observation (observe them in the midst of their difficulty, in their natural habitat. This gets away from the counseling room where the therapist can observe unobtrusively. Of course, the therapist may have difficulty knowing what to look for. They need to be able to count things (such as behaviors) as part of their observations.), (b) direct measurement by significant others (with minimal training, parents or caregivers can watch their children’s behavior), (c) having a behaviorally-oriented interview (try to propose specific behaviors in certain situations. The questions to answer are how, what, and where. Behavior therapists strives for complete cooperation from patient, which is not like Freud), (d) keeping a behavioral log or behavioral diary (therapist wants to do an ABC (affect before content) functional analysis), (e) having the client do self-monitoring, (f) role playing, (g) using situations created in imagery by client, (h) the judicious use of physiological devices (the therapist can hook people up to a machine and measure a number of factors, but this is only done with great care.), and (i) systematic cross-situational observations to determine current cues, behaviors, and consequences and to suggest ways to intervene.

3. Discuss some methods (interventions) of behavioral change. Therapy should be individually tailored to the client because behavioral therapy is the most individualized approach to therapy. Interventions must be based on assessments and presented to the client in the context of a rationale.

First is modeling, which is a form of social learning. This is when the therapist has the client demonstrate an appropriate behavior. Modeling can be used to teach new behaviors. The five types are: (1) live (the in vivo process), (2) guided participant modeling (done with client and therapist), (3) videos to express behavior, and (4) symbolic (stories or have client imagine how they want to be). A problem with modeling is that it may not teach the client how to behave but it does help them with the performance of a behavior. It can also help them stop a particular behavior. They can learn to not be afraid in certain situations. Some conditions can enhance the modeling process, such as closely matching the modeling situation to the target situation. Modeling can be progressive, can involve multiple models, can be guided participant, and can be good if objectives are clearly spelled out beforehand. The client can then pay attention to what they are supposed to learn, and the therapist should review the process once it is completed. Lastly, modeling works well with role playing.

Second is role playing (behavioral rehearsal). If they learn from modeling, then have them show you. Try to set up the right environment and let them know what they are supposed to be doing. Worthington says to not use the words "role playing" because the clients probably will not want to do it.

Third is contingency management, which is learning to manage the consequences. The therapist can even control the consequences even though they do not like to. This teaches the client to administer their own consequences.

Fourth is aversive control, which is doing things people do not like. Punishment does not teach, but it stops negative behavior. Try to punish effectively. Hit hard, hit often. Punish based on principles and rules. Extinction is the process of removing rewards. A kid throwing a temper tantrum usually is choosing the reward of attention over the consequences of punishment. Remove the reward of attention, and the child will stop throwing the tantrum. Time out from reinforcement is removing the person from the situation that may have been reinforcing the behavior (isolating the child from peers temporarily). Covert sensitization is having the client imagine engaging in the inappropriate behavior, immediately followed by imagining a personally-aversive consequence. Aversion relief is removing an aversive stimulus as soon as the client discontinues the inappropriate behavor. Response prevention is preventing a client from completing a compulsive behavior until the desire to do so declines.

4. Discuss the methods to promote generalization and maintenance. For generalization, (a) plan explicitly to promote the transfer of effects to other situations, (b) bring other situations into therapy, (c) take therapy to other situations, (d) move the work of therapy into other situations (homework), (e) assign homework to keep the client involved and current with things that are being learned, and (f) comply with the homework and make sure that the client is doing it.

				Tom of Bethany

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