Behavioral therapy Behavioral therapy Seminar Series Seminar Series

Winter 2003Winter 2003

Bruce M. Gale, PhDBruce M. Gale, PhDCSMC Dept of PsychiatryCSMC Dept of Psychiatry

Seminar Dates & Times: Feb 6, 13, 20Seminar Dates & Times: Feb 6, 13, 20Office Phone: 310.652.4252Office Phone: 310.652.4252

Educational Learning Educational Learning Objectives:Objectives:

1.1. At the conclusion of this course, the At the conclusion of this course, the residents should be able to:residents should be able to: (recognize, (recognize,

identify, list, summarize, demonstrate, diagnose, treat...identify, list, summarize, demonstrate, diagnose, treat...))

2.2. Understand the behavioral theories Understand the behavioral theories behind this model of treatment.behind this model of treatment.

3.3. Understand and apply the different Understand and apply the different behavioral therapy interventions.behavioral therapy interventions.

Course Description Course Description /Summary:/Summary:

This course will provide residents with an overview This course will provide residents with an overview of basic operant and classical learning theories as of basic operant and classical learning theories as they apply to treatment for common psychiatric they apply to treatment for common psychiatric and behavioral problems. and behavioral problems.

Concepts such as positive reinforcement, Concepts such as positive reinforcement, antecedent-based interventions, effects of antecedent-based interventions, effects of consequences upon behavior, modeling, behavioral consequences upon behavior, modeling, behavioral training, extinction, differential reinforcement, training, extinction, differential reinforcement, behavioral assessment, data collection, and token behavioral assessment, data collection, and token economies will be reviewed. economies will be reviewed.

Attendees will learn how behavioral therapy Attendees will learn how behavioral therapy techniques may be applied to problems related to techniques may be applied to problems related to autism and developmental disabilities; anxiety autism and developmental disabilities; anxiety disorders; depression; and schizophrenia. disorders; depression; and schizophrenia.

HandoutsHandouts

We live in the 21We live in the 21stst Century. Accordingly, Century. Accordingly, instead of paper handouts, you will receive instead of paper handouts, you will receive a copy of this lecture series during the 3a copy of this lecture series during the 3rdrd (final seminar) on CD ROM.(final seminar) on CD ROM.

It will includeIt will include a 40 page summary of behavior modification a 40 page summary of behavior modification

guidelines;guidelines; animation samples of web sites demonstrated animation samples of web sites demonstrated

in this seminar series;in this seminar series; plus selected PDF files.plus selected PDF files.

Course SyllabusCourse Syllabus

#1: Feb 6, 2003#1: Feb 6, 2003 Overview of behavior therapy:Overview of behavior therapy: Discussion Discussion of behavior, history, classical conditioning, of behavior, history, classical conditioning, operant theory.operant theory.

#2: Feb 13, 2003#2: Feb 13, 2003 Basic Assessment and Data Collection Basic Assessment and Data Collection Techniques:Techniques: overview of basic elements overview of basic elements underlying behavior modification techniques. underlying behavior modification techniques.

#3: Feb 20, 2003#3: Feb 20, 2003 Description of behavioral treatments:Description of behavioral treatments: Brief review of Spectrum Anxiety Disorders, Brief review of Spectrum Anxiety Disorders, Depression and psychotic disorders. Depression and psychotic disorders.

Basic Elements of BTBasic Elements of BT

What is meant by “behavior”?What is meant by “behavior”? How are presenting problems How are presenting problems

identified?identified? Is there a specific treatment Is there a specific treatment

approach?approach? How is progress determined?How is progress determined? How is termination handled?How is termination handled?

Behavioral ModelBehavioral Model

Derived from a Scientific Approach to the Derived from a Scientific Approach to the Study of PsychopathologyStudy of Psychopathology

Ivan Pavlov, John B. Watson, and Classical Ivan Pavlov, John B. Watson, and Classical ConditioningConditioning Classical conditioning is a ubiquitous form of Classical conditioning is a ubiquitous form of

learninglearning Conditioning involves a contingency between Conditioning involves a contingency between

neutral and unconditioned stimulineutral and unconditioned stimuli Conditioning was extended to the acquisition of Conditioning was extended to the acquisition of

fear fear

Beginnings of Behavioral Beginnings of Behavioral TherapyTherapy

Reactionary Movement Against Psychoanalysis and Non-Reactionary Movement Against Psychoanalysis and Non-Scientific ApproachesScientific Approaches

Early PioneersEarly Pioneers Joseph Wolpe – Systematic desensitizationJoseph Wolpe – Systematic desensitization Edward Thorndike, B. F. Skinner, and Operant ConditioningEdward Thorndike, B. F. Skinner, and Operant Conditioning

Another ubiquitous form of learningAnother ubiquitous form of learning Most voluntary behavior is controlled by the consequences that Most voluntary behavior is controlled by the consequences that

follow behaviorfollow behavior Learning Traditions Greatly Influenced the Development of Learning Traditions Greatly Influenced the Development of

Behavior TherapyBehavior Therapy Behavior therapy tends to be time-limited and directBehavior therapy tends to be time-limited and direct Strong evidence supporting the efficacy of behavior Strong evidence supporting the efficacy of behavior

therapiestherapies

Efficacy of Behavior TherapyEfficacy of Behavior Therapy(Behavior Online)(Behavior Online)

Multidimensional Models Multidimensional Models of Abnormal Behaviorof Abnormal Behavior

Biological Influences Biological Influences Behavioral Influences Behavioral Influences Emotional InfluencesEmotional Influences Social InfluencesSocial Influences Developmental InfluencesDevelopmental Influences

Multidimensional Models of Abnormal Behavior Multidimensional Models of Abnormal Behavior (cont.)(cont.)

Implications of Implications of Neuroscience for Behavior Neuroscience for Behavior Therapy Therapy (and other effective treatments)(and other effective treatments)

Relations Between Brain and Relations Between Brain and Abnormal BehaviorAbnormal Behavior Example: Obsessive compulsive disorder Example: Obsessive compulsive disorder

(OCD)(OCD)

Experience Can Change Brain Experience Can Change Brain Structure and FunctionStructure and Function

Therapy Can Change Brain Structure Therapy Can Change Brain Structure and Functionand Function Medications and psychotherapyMedications and psychotherapy

Role of Emotion and Behavior Role of Emotion and Behavior TherapyTherapy

Domains of Assessment: The Domains of Assessment: The Clinical Interview and Physical Clinical Interview and Physical

ExamExam Clinical InterviewClinical Interview

Most common clinical assessment methodMost common clinical assessment method

Structured or semi-structuredStructured or semi-structured

Mental Status ExamMental Status Exam Appearance and behaviorAppearance and behavior

Thought processesThought processes

Mood and affectMood and affect

Intellectual functioningIntellectual functioning

SensoriumSensorium

Physical ExamPhysical Exam

Domains of Assessment:Domains of Assessment:The Clinical Interview and The Clinical Interview and

Physical Exam (cont.)Physical Exam (cont.)

Efficacy of Behavior TherapyEfficacy of Behavior Therapy(Clinician’s Research Digest)(Clinician’s Research Digest)

Domains of Assessment: Behavioral Domains of Assessment: Behavioral Assessment and ObservationAssessment and Observation

Behavioral Assessment Focus on the present – Here and now Focus on direct observation of behavior-

environment relations Purpose is to identify problematic

behaviors and situations Identify antecedents, behaviors, and

consequences

Domains of Assessment: Behavioral Domains of Assessment: Behavioral Assessment and ObservationAssessment and Observation

Behavioral Observation and Behavioral Assessment Can be either formal or informal

Self-monitoring vs. others observing

Problem of reactivity using direct observation methods

Domains of Assessment:Domains of Assessment:Behavioral Assessment and Observation (cont.)Behavioral Assessment and Observation (cont.)

Efficacy of Behavior TherapyEfficacy of Behavior Therapy(Review PDF Files)(Review PDF Files)

Course SyllabusCourse Syllabus

#1: Feb 6, 2003#1: Feb 6, 2003 Overview of behavior therapy:Overview of behavior therapy: Discussion Discussion of behavior, history, classical conditioning, of behavior, history, classical conditioning, operant theory.operant theory.

#2: Feb 13, 2003#2: Feb 13, 2003 Basic Assessment and Data Collection Basic Assessment and Data Collection Techniques:Techniques: overview of basic elements overview of basic elements underlying behavior modification techniques. underlying behavior modification techniques.

#3: Feb 20, 2003#3: Feb 20, 2003 Description of behavioral treatments:Description of behavioral treatments: Brief review of Spectrum Anxiety Disorders, Brief review of Spectrum Anxiety Disorders, Depression and psychotic disorders. Depression and psychotic disorders.