Behaviour therapy techniques
This is a series of posts about popular types of therapy used with psychotherapists today, my last post on Behaviour Therapy can be found here. This is a follow up post which expands more on the techniques employed in behaviour therapy. This post will cover operant conditioning techniques, relaxation training, systematic desensitization, In vivo exposure, social skills training and assertion training.
Operant Conditioning Techniques
In applied behaviour analysis, operant conditioning techniques and methods of assessment and evaluation are applied to a wide range of problems in many different settings. Behaviourists believe we respond in predictable ways because of the gains we experience (positive reinforcement) or because of the need to escape or avoid unpleasant consequences (negative reinforcement). Once the client’s goals have been assessed, specific behaviours are targeted. The goal of reinforcement, whether positive or negative is to increase the targeted behaviour, positive reinforcement involves the addition of something (money, attention etc) whilst negative reinforcement involves the escape or removal of an unpleasant stimuli.
Another operant method of changing behaviour is extinction, which refers to withholding reinforcement from previously reinforced responses. In applied settings, extinction can be used for behaviours that have been maintained by reinforcement. Another way to control behaviour is through punishment or aversive control, in which the consequence of the behaviour is to decrease the targeted behaviour. In positive punishment an aversive stimulus is added, in contract negative punishment involves the removal of a reinforcing stimulus. However according to Skinner punishment has limited value in changing behaviour and was often an undesirable way to modify behaviour.
Relaxation training involves several components that typically require multiple hours of instruction. Clients are given a set of instructions that teach them how to relax, they assume a passive relaxed position in a quiet environment while alternatively contracting and relaxing muscles. Deep and regular breathing is also associated with producing relaxation, at the same time clients learn to mentally “let go” which is often done by focusing on pleasant thoughts or feelings. Clients are instructed to actually feel and experience the tension building up, it also a useful technique for teaching clients the difference between a tense and relaxed state. The client is then taught how to relax all the muscles while visualising the various parts of the body with emphasis on the facial muscles. Relaxation becomes a well learned response which can become a habitual pattern if practiced daily.
Systematic Desensitization and In Vivo Exposure
Systematic desensitization which is based on the principles of classical conditioning is a basic behavioural procedure in which clients imagine successively more anxiety-arousing situations at the same time that they engage in a behaviour that competes with anxiety (relaxation training for instance). Gradually clients become less sensitive to the anxiety arousing situation. This procedure can be considered to be a form of exposure therapy because clients are required to expose themselves to anxiety-arousing images as a way to progressively reduce their anxiety.
Exposure therapies are designed to treat fears and other negative emotional responses by introducing clients, under carefully controlled conditions, to the situation that contributed to such problems. Exposure is a key process in treating a wide range of problems associated with fear and anxiety. In vivo exposure involves client exposure to the actual anxiety provoking event rather than simply imagining these situations. Together, the client and therapist generate a hierarchy of situations for the client to encounter in ascending order of difficult, also known as an anxiety hierarchy with the most anxiety provoking events at the top. Client then engage in brief and graduated series of exposures to the feared events.
Social Skills Training and Assertion Training
Social skills training is a broad category that deals with an individual’s ability to interact effectively with others in various social situations; it is used to correct deficits clients have in their interpersonal competencies. Social skills involves being able to communicate with other in a way that is both appropriate and effective. Social skills training includes; psychoeducation, modelling, reinforcement, behaviour rehearsal, role playing and feedback. Another popular variation of social skills training is anger management training.
One specialised form of social skills training that has gained increasing popularity is teaching people how to be assertive in a variety of social situations. Many people have difficulty feeling that it is appropriate or right or assert themselves. People who lack social skills frequently experience interpersonal difficulties at home, at work, at school, and during leisure time. Assertion training can be useful for those who have difficulty expressing anger or irritation, who have difficulty saying no and who are overly polite and allow others to take advantage of them. Assertion training can also be helpful for individuals who find it difficult to express affection, who feel they do not have a right to express their thoughts, feelings and beliefs or who have social phobias. The basic assumption of underlying assertion training is that people have a right but not the obligation to express themselves. One goal of assertion training is to increase people’s behavioural repertoire so that they can make the choice of whether to behave assertively in situations.
