1. Discuss modern behavior therapy. Behavior therapy is a relationship between two (or more) people in the roles of therapist and client in which the therapist uses constructs developed in experimental psychology, namely conditioning and learning metaphors, to explain the causes of the client's problems and to intervene to help the client choose ways to effectively change his behaviors (including mental behaviors) and environments.

Some common misconceptions about behavior therapy (BT) are: (a) BT tries to condition the client (they treat clients like other therapies), (b) BT is mechanical in applying technique (BT therapists are human, flexible, and apply the necessary techniques), (c) BT relies primarily on reinforcement and punishment within the therapy session (very little BT rewards during the session), (d) BT does not believe in cognition (not true. They believe people are cognitive but they do not rely on it), (e) BT is impersonal, and (f) one must be behavioristic in philosophy to be a behavior therapist (not true. BT is well substantiated as a philosophy of change).

2. Discuss personality to the behavioral therapist. First, people are complex organisms who live in social and physical environments. Second, behavior is controlled mostly through consequences and stimulus situations, such that the most probabilistic way of helping people is by changing those consequences and situations. Modern BT does not believe in determinism, and they do not know what causes behavior.

3. Discuss the causes of problems. First, behavior is not in itself abnormal. It is abnormal in relation to social situations. Second, the causes of problems are: (a) when a person does not have the appropriate repertoire of behaviors, (b) previous learning history makes them behave inappropriately, and (c) stimulus variables may respond to the wrong cues in problem situations.

4. Discuss the theory of therapy. First, determine who the client is. This is the first task in BT, and the client is person sitting in front of you. Second, establish a caring, sharing relationship because this is necessary for change. Third, assess the situation. Pinpoint specific behaviors and tie them to specific situations and consequences. Perform functional analyses to determine how the behavior is maintained (ABC - anticedent/behaviors/consequences). Explore historical causes of problems. Develop a conceptualization of causes and cures. Present the conceptualization to the client. Develop and agree with the client on specific performance goals and behavior goals. Performance goals are things that cannot be reinforced, like losing weight. Behavioral goals are things that can be reinforced, like reduce calorie intake and exercise more. Break goals into subgoals. Fourth, develop a treatment plan with the client. Jointly develop a plan, tailored to the client. The therapist may suggest a "smorgasbord" of techniques from which the client chooses. Fifth, carry out the plan. Secure a commitment from the client to perform the plan. Follow-up to determine the success of the plan. The plan is continually evaluated by using data that the client collects. Modify the plan as needed (clients do not fail, plans fail). Sixth, plan for generalization and maintenance. Seventh, the therapist maintains some general philosophical stances. Maladaptive behaviors that are learned cannot be unlearned. Maladaptive behaviors are currently maintained by environmental and self variables. Therapy is teaching rather than self-discovery. Therapists are not trying to facilitate learning, but they teach. Therapy is consulting, and the consultant is the expert. Eighth, some key concepts are to change the environment, client self-control, tailoring to the client, pinpointing rather thang general conceptualization, problem solving rather than goal setting, empirical, planful (always have a plan), and personal.

5. Discuss behavioral self-control. The philosophy is that the client is taught to be his or her own therapist. The general conceptualization of problems in terms of self-control problems is that they are behaviors with short-term (ST) and long-term (LT) consequences that are in conflict with each other. When ST of doing A is greater than ST of not doing A, but LT of doing A is less than LT of not doing A, then this is the basis for a self-control problem. Smoking is an example. The ST of smoking is preferred to the ST of not smoking. However, the LT of not smoking is perferred to the LT of smoking. Problems occur when there are tensions between the two behaviors, and time erodes the value of a reinforcer. When this happens, the person becomes controlled by ST. The solution is to modify ST. A self-controlling behavior is a way of regulating self. Therapy begins with assessment.

For the assessment, (a) define and pinpoint the problem, (b) collect the data (how frequent is problem before the person attempts to change), (c) analyze the behavioral ecology to allow realistic goal setting (accelerating behaviors are behaviors to increase and practice more. Deceleratng behaviors are behaviors that should decrease. Accelerating behaviors usually involve setting goals. Decelerating behaviors involve giving things up), (d) set performance goals, and (e) set behavioral goals.

Intervention involves environmental planning (change the environment so that the client can do the self-controlling behavior) and behavioral programming (arranging the consequences for doing self-control behavior). Environmental planning consists of stimulus control to keep the client on track, self-instructions so the client can tell self what to do, making a contract with self, incorporating the help of others, preprogramming consequences (setting up negative consequences for failure or positive consequences for success), and self-regulated stimulus exposure. Behavioral programming consists of self-reward, self-punishment, shaping (gradually approaching the client's goals, also having a plan for failure to prevent relapsing back to the beginning), and tokens and token menus to stand for a reinforcer or a symbol.

				Tom of Bethany

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