BEHAVIOR

THERAPY

MR. JAYESH PATIDAR

www.drjayeshpatidar.blogspot.com

DEFINITION:-

“It is a form of psychotherapy which

focuses on modifying faculty behavior

rather basic changes in the personality.

Instead of probing the unconscious or

exploring the patient’s thoughts &

feelings, behavior therapist tries to

eliminate the symptoms & modify

ineffective or maladaptive pattern by

applying basic learning techniques.”

4/2

4/2

013

2

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

BEHAVIOR THERAPY TECHNIQUES

1. Behavioral modification

2. Systematic desensitization

3. Aversion therapy

4. Assertiveness training

5. Cognitive behavior therapy

6. Implosive (flooding) therapy

7. Positive reinforcement

a. Response shaping

b. Modelling

c. Token economy

4/2

4/2

013

3

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

1. BEHAVIOR MODIFICATION

It is also called “simple Extinction.”

Learned behavior pattern becomes a

waste or disappears if it is not reinforced.

To eliminated a maladaptive behavior one

has to remove the reinforcement for it.

It is effective when reinforcement is being

used without the knowledge of the

affected individual

4/2

4/2

013

4

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

For Example;

Every time sonu, a nine year old girl bites her

nails, her mother gives her an angry look. Sonu

understand the mother anger & tries not to

repeat the bad habit. A maladaptive behavior

is gradually removed. Mother anger is a

punishment for sonu .

Reward are also provide to reduce the

maladaptive learning. Rishu, 11 year old boy,

is told that if he studies one hour regularly on

his own in class VI he could be allowed to buy a

crocket set of his choice.

4/2

4/2

013

5

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

2. SYSTEMATIC DESENSITIZATION

It is a form of behavior therapy developed by

Joseph Wolpe.

The objective of the therapy is to reduce or

elimination fear or anxiety in which;

I. The patient is trained in deep muscles

relaxation.

II. He has various anxiety-provoking situation or

specific phobia, such as fear of death, fear of

animals. These problems are placed from the

strongest to the weakest order i.e. the client is

anxious about which one is causing anxiety the

least.

4/2

4/2

013

6

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

. Each of these situations is presented in imagination

or in reality beginning with the weakest. Once the

patient relaxes while imagining, that means the

anxiety is getting reduced gradually.

For Example; A child is having fear of crossing the

road. For a few days the mother can take the child

to the road & just stand & talk about other thing.

The child keeps observing people crossing the road.

Than after 2-3 days mother & child cross the road

while they are talking. This may reduce the anxiety

in a child as he is allowed to cross the road in a

relaxed manner. Therapy is very useful for patient

who have developed certain fears specially to

domestic animals like dog.

4/2

4/2

013

7

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

3. Aversion Therapy

It is a form of behavior therapy in which

the patient is conditioned to avoid an

undesirable behavior or symptoms by

associating them with painful or

unpleasant experiences, such as putting

a bitter taste on nails or tongue for nail

biting, giving drug like apormorphine

which cause nausea & vomiting on

taking alcohol or an electric shock to

treat a child with enuresis.

4/2

4/2

013

8

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

Aversion therapy has been used for

alcoholism, transvestism, compulsive

unacceptable social behavior like

homosexuality & other sexual deviation.

Typically, 20-40 session are given, with

each session lasting about 1 hour. After

completion of treatment, booster session

may be given.

4/2

4/2

013

9

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

4. ASSERTIVENESS TRAINING

It is a behavior therapy techniques in which the patient is given training to bring about changes in emotional & other behavioral pattern by asserting himself.

One is encouraged not to be afraid of showing an appropriate response, negative or positive, to an idea or suggestion.

The assertive behavior training is given by the therapist first by role playing & then by practice in a real life situation.

4/2

4/2

013

10

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…Attention is focus on more effective

interpersonal-skill.

The most techniques used in assertiveness training is behavioral rehearsal, in which the patient act out problematic interpersonal interactions with the nurse or therapist. After this role-playing specific maladaptive behavior are identified & the client behavior can be adapted.

This training can be used for client with bulimia nervosa & major depression, mentally healthy & mentally ill persons.

4/2

4/2

013

11

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

5. COGNITIVE BEHAVIOR THERAPY

It is a psychotherapeutic approach based on the

idea that emotional problems in an individual

arise due to faulty ways of thinking & distorted

attitude towards oneself & others.

The therapist takes the role of a guide who helps

the patient to correct & revise his perceptions &

thoughts.

This helps the patient to change his thoughts,

feelings & behavior about himself.

Cognitive behavior therapy is considered effective

in the treatment of depression & adjustment

difficulties.

4/2

4/2

013

12

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

6. IMPLOSIVE THERAPY (FLOODING)

It is a behavior therapy techniques

opposite to systematic desensitization, no

prior relaxation techniques are taught to

the patient.

In this therapy, an individual is exposed

directly to a maximum intensity fear-

producing situation either in imagination

or in real life. The patient gradually feels

no actual danger in the situation.

4/2

4/2

013

13

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

For Examples; He has developed

intense phobia of a lizard. During

psychotherapy session suddenly the

therapist puts a rubberized lizard on

the table. For a minute the patient may

get scared but gradually may start

handling a rubberized lizard while

taking.

4/2

4/2

013

14

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

7. POSITIVE REINFORCEMENT

It is a stimulus or stimulus situation

which is given to a patient or individual

after the response.

When the stimulus is given after the

response it is on the basis that the

strength of the response is increased &

that the response will appear again.

Examples; as soon as the infants gets up

& walks, the mother claps & gives the

infant a piece of chocolate to enjoy.

4/2

4/2

013

15

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

Positive Reinforcement can be done by:

a. Responsive shaping

b. Modelling

c. Token Economy

4/2

4/2

013

16

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

a. Response Shaping:

Positive reinforcement is used in

response shaping or incorporating or

establishing a response which is not

existing in an individual’s behavior.

This technique is used in a behavior

problem or mental retardation.

4/2

4/2

013

17

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

For example; Shubam, 14, has an intelligence level of a five years old child. He had never done any of this activities such as washing after defecation, wearing shoes & socks. The therapist trained the family member to encourage Shubam to wear his socks & shoes. When he wears them he should be taken for a ride (car) which he enjoys the maximum. In this way he can be encourage to learn those behaviors which he has never learnt.

4/2

4/2

013

18

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

b. Modelling:

Modelling is a behavior therapy technique in which learning occurs through observation.

The client watches someone else perform a particular action such as answering telephone.

Models are often parents or other adults & children

Modelling is a form of social learning & is often called observation learning.

4/2

4/2

013

19

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

COUNT…

c. Token Economy:

It is a behavioral therapy programme usually

conducted in a hospital or classroom setting.

In token economy the desired behavior is reinforced

by offering tokens that can be exchanged for special

food, games, comics or other rewards.

For example; a patient with schizophrenia does not

maintain personal hygiene. The day he maintains he

gets a token as reinforcer that he can watch T.V.

when he desire. Like this he is able to collect many

tokens & adapt behavior which is socially acceptable.

Like maintaining personal hygiene. Sometimes in

return of tokens the patient may exchange then by

asking for PAROLE.

4/2

4/2

013

20

JA

Y P

AT

IDA

R (M

.Sc. N

UR

SIN

G)

THANK

YOU

21

JAY PATIDAR (M.Sc. NURSING)