Behavior Therapy: An Introduction (1978, sound)

for grab a package everybody grab one and let's go for the most part our behaviors are learned behavioral psychologists say that we are conditioned to do the things that we do we come into this world with certain biological Tendencies and predispositions through interaction with our environment and the people in it we acquire the feelings thoughts and attitudes which help us to achieve adaptive responses to our world Mom I'm H we're going to have dinner in 20 minutes I want an ice cream cone you can't have an ice cream cone now we're we learn the activities that are most like to help us fit in with our fellow human beings developing a repertoire of behaviors that are in keeping with the demands of a complex society on occasion we develop maladaptive or inappropriate patterns of behavior even the most supportive and caring individuals unknowingly assist us in acquiring inappropriate behaviors conditioning is often unintentional come me in come me in come me [Music] [Applause] [Music] in no coming in I want now [Applause] [Music] here John's mother is actually rewarding his tantrum behavior when she finally gives in to him in the film you are about to see we will demonstrate several of the more important procedures used in behavior therapy today the processes which affect the development of our behaviors have been identified by the laboratory re resarch of experimental psychologists these psychologists explain the acquisition of behavior in terms of operant classical and observational learning behavior therapy is the process of applying the principles and procedures that have been demonstrated in the laboratory to human situations the three models of learning operant classical and observational are applied by Behavior therapists in treatments designed to eliminate problem behaviors help remove irrational fears and anxieties promote more successful ways of coping and help develop skills to overcome behavioral deficits on occasion the problems that behavior therapists encounter are Inc conducive to the three models of learning as a result Behavior therapists often have to modify their procedures during the course of therapy itself in the opening scene we witnessed the tempered tantrum Little John performed when he didn't get his own way these tantrums took several years to reach that level and developed by the process of operant conditioning the basic procedure of behavior therapy that is used to eliminate these behaviors is also operant conditioning Mrs Stewart has sought the advice of Dr Harry I Kish leading professor of science psychology at the State University of New York at Stonybrook Dr Kish will attempt to modify the problem behaviors of Mrs Stewart's Son by Consulting with her on those aspects of her behavior which encourage and reinforce John's Tantrums as in other types of therapy the most important aspect of behavior therapy is the development of a relationship between the patient and the therapist Dr Caleb has already undertaken the assessment process during which the therapist developed an understanding of the history of the problem and some of the components which instigated it and continued to maintain it now he is preparing to talk to Mrs Stewart about her relationship with her son tell me Mrs Stewart what did you do when John would whine and carry on if you said no well at first I would try to ignore him but then he would cry or scream loudly and I would give in what do you mean give in I would let him stay up late I would let him watch television give him a treat whatever it was that he was yelling for but once in a while I would say no and then he would become hysterical he would scream he would sustain his screaming he would jump up and down I had to physically restrain him and I I couldn't stand seeing him like that so I would let him win and Dr kalish I just can't stand it anymore well you see Mrs Stewart when you gave in to John you rewarded him for his Tantrums his tantrum is what caused you to give him what he wants if he asked for a cookie or a favor or to stay up late you said no but if he screamed and cried you said yes it pays for him to scream and cry right but Dr Kish I don't always let him have his own way no but you do it often enough so that he gets the message if I cry loud enough and long enough she'll give it to me but Dr Kish what can I do about it well it may sound simple but it won't be easy to do you have to say no and mean it you need to be completely consistent tell him no and give him a reasonable explanation for your decision but above all stick to it do you understand yes you're too small I can throw further than you w I beat you Glenn please take these letters to the post office before it closes okay mommy Glen doesn't want to go let me go I can go let me do it let me do it doesn't want to do it no John you cannot ride your bicycle alone on the noce we have done it a few more times together I want to do it now I have work to do no we will do it later joh [Music] Meer thank you I W i w canot done it a few more times I want at first for some time his Tantrums will continue and they may even get worse but it is essential that you remain calm don't show him that you're angry or upset and if need be walk away from him do you understand do you think you can do that I hope I can do that John I work to do I will take you later take me now I will take take me now John said no I will take you later me take [Music] me now there is something else you must remember you must reward Jon when he behaves well and when his Tantrums subside it will take several weeks but I'm confident that if you ignore his Tantrums say no and mean no John will stop his shouting and screaming but remember you must be consistent Johnny you've been so Cooperative lately how about let's taking a bicycle ride to the post office together yeah that's great Ma thanks John's problem was a relatively simple one he was getting rewards for his inappropriate behavior in other words he was being oper conditioned to have his Tantrums John's shouting and screaming would cause his mother to give him what he wanted thereby increasing the likelihood that he would perform the behaviors again and again the job of the therapist in a case like this is to teach the client the procedures for the extinction of the inappropriate behaviors and the replacing of them with more adaptive ones during Extinction the rewards are removed for the inappro apprpriate Behavior here the pigeon is pecking the lighted key and he is rewarded with food when Extinction is applied and rewards are no longer forthcoming it takes the pigeon a short time to learn that this also is the case with John his tantrum Behavior will increase until he becomes aware that his mother will not give in this phenomenon in both humans and animals is known as Extinction bursting operon conditioning procedures are applied in many settings by providing rewards to increase desired behaviors in Mental Hospitals facilities for persons and in School classrooms these procedures are used to encourage people to become more independent and self-sufficient and to work harder in such institutional settings Behavior therapists often resort to providing tangible rewards in the form of food or special privileges they do this by allowing clients to accumulate credits or tokens for appropriate behavior these tokens are later exchangeable for the rewards known as token economies these programs are gaining wider Acceptance in therapeutic communities the second model of learning upon which behavior therapy procedures have been developed is known as classical or pavlovian conditioning in this model A previously neutral stimulus is associated with a reflex a reflex consists of an unconditional stimulus which automatically elicits an unconditional response after a number of associations the neutral stimulus can produce the reflexive response in a famous study by Watson and rer a young child named Albert was shown a white rat the rat was then presented at the same time as a loud frightening noise the noise itself elicited fear in little Albert after repeated conditioning the sight of the rat without the noise came to elicit the fear response in Albert the severe form of this variety of reaction is known as a phobia Behavior therapists suspect that many phobic reactions are conditioned in the same manner that Albert's was other phobic reactions are learned by imitation as for example one might imitate a parent fearful reaction to Heights now let's take a look at a situation for which the next procedure that of counter conditioning would be appropriate hold it everybody for next week the subject of your oral presentations will be short men in power three of you will speak in front of the class on the following fascinating personalities William mfit you're first you'll speak on Napoleon bonapart Marine cats your man is ismad kingdom brunal and Lori Morgan you take Henry Kissinger Dr Joseph W a Pioneer in behavior therapy developed a variety of procedures to counter condition fear and anxiety reactions like the one we have just seen Dr wpe will demonstrate some of the procedures used during a systematic desensitization he spends much time with a painstaking and thorough assessment the assessment phase of the treatment includes development of patient therapist raor a complete physical and psychological history and an evaluation of the problem its intensity and the circumstances surrounding its activation the behavior therapist then designs the techniques for treatment to meet the specific needs of each client throughout the procedures the effects of treatment are carefully evaluated to ensure maximum effective change even after the therapy has been completed Dr wpe will carefully monitor how well the patient's progress has been maintained in the person's natural environment ly what is your problem well I'm petrified of getting up in front of the class I've had to drop out of three courses since I've been in this school just because I can't make an oral presentation I know I'll make a fool out of myself as soon as the Teacher Calls on me I feel my knees buckle and I feel like there's a clamp around my throat I know that if I try and speak nothing's going to come out I don't know what to do how long have you had this fear all my life do you have any other fears during the last five sessions we've been to every aspect of your life you've learned to relax and you really are an excellent relaxer the most important thing that we've found is that you're very sensitive to disapproval you're upset even by the disapproval of unimportant people during the preceding five sessions Dr walp collected a list of graded situations ranging from slightly anxiety provoking to extremely frightening circumstances in Lor's case the items on this list range from she is self-centered to she is unpunctual in the next phase Dr walp will teach Lori deep muscle relaxation as the beginning of a treatment program known as systematic desensitization basically this counter conditioning technique will be used to replace the anxiety response to public speaking with a relaxation response he will also teach her to evaluate the tensions in her body on a graded scale this process will help Lori to tune in to the anxiety states that she experiences he will then have her relax as deeply as she can while he describes a scene which may or may not be frightening to her as soon as she feels the slightest bit of tension she is instructed to indicate that by raising the index finger of her right hand and then Dr Dr W will stop this procedure will continue until Lori can go through all of the items on her hierarchy from least to most frightening without getting tense and anxious the tension response for each of her scenes will be replaced with relaxation and Clara is saying to Joan yes I do like Lori but she tends to be unpunctual now stop imagining that scene by how much did your anxiety level go up while you are imagining that scene five now just relax and imagine the same scene again stop how much did it go up that time not at all okay now keep on relaxing Okay Lori now you've been desensitized to all the items in that hierarchy now open your [Applause] eyes well how do you feel fine well now that you're no longer upset by unimportant disapprovals you're going to find yourself much more comfortable in all public speaking situ situations I do already you know yesterday I was sitting at a meeting and I felt as if I had to say something and I just said it I really couldn't believe it I really feel more comfortable you know talking to people on any level in a matter of weeks Lori like many other phobics will probably be able to face the fearful event calmly systematic desensitization and other counter conditioning techniques have been used successfully in the treatment of phobias obsessive compulsive disorders sexual fetishes and a variety of other problems Masters and Johnson's treatments for sexual dysfunctions is a variation on these counter conditioning procedures first developed by Dr wpe the last category of therapeutic procedures developed by behaviorists is the category applying the principles of observational learning or modeling these principles first elucidated by Dr Albert bandora demonstrate that people learn to behave by observing the actions of others the behavior and its consequences determine whether a behavioral pattern will be learned this learning process applies to both appropriate and inappropriate activity in this final segment we will see observational learning procedures applied in the therapeutic [Applause] meu you okay F hi hi say is your instrument case okay I saw that guy go barrel and by and I thought maybe he knocked Oh I thought like maybe he hurt your instrument or something listen um I don't suppose you'd like to have lunch or something cuz you know I was um I was thinking of going down to the cafeteria you know and I thought um you know if you're not doing anything or like if you are you know we could do it some other time or something okay another time oh oh okay yeah okay see you later I guess you wanted to go and have some lunch the young man has entered therapy with Dr Virginia a Roswell supervising psychologist at the State University of New York at Stonybrook away is that all that happened Jim yeah that's it let's role play okay okay you said you were in a corridor right all right why don't we turn the chairs around and that'll make the room look like it's a corridor does this look about right yeah and she was she was standing against the wall okay all right right I'll play the girl and why don't you pretty much say and do what you did the other day Okay um hi is your instrument case okay I saw that guy go baring by once Dr Roswell has observed Jim's Behavior she will reverse their roles all right Jim now I'm going to imitate your behavior okay ready mhm oh hi uh I notic Dr Roswell is showing Jim what he looked like when he approached her right she is imitating his behavior avior when she is finished she will ask Jim to comment on the pros and cons of his technique Dr Roswell assumes that Jim will see some of the errors he made but she will have to point out directly others that he might not have noticed the next procedure she will use will demonstrate or model the procedures that might be more appropriate notice that she will only work with the initial meeting the first exchange she wants to be sure that Jim will feel comfortable with it before they go any further okay Jim what sort of criticisms can you level against my imitation of your behavior well it started out okay I think and then you got more and more nervous um there was less eye contact when you asked me to go to lunch and and your speech patterns became more hesitant I think anything else uh I don't know anything good well it it seemed like a good way to start out the conversation to ask her how she was in addition to which your voice was very friendly when you went over to her now I'm going to model for you an improved version of the same scene all right okay hi I saw that guy jled your B your instrument case is everything all right oh it's fine yes it's fine oh God he gave you quite a knock I'm all right everything all right mhm good my name is Jim uh it's lunch time would you like to uh join me in the cafeteria for some lunch well all right I was going down to the cafeteria good good the food's not great but the treat's on me okay very good what's your name uh my name's Jenny Super okay Jim what was different about that well you were a lot more at ease there was good eye contact and you fac me straight on and you spoke without hesitation mhm mhm in addition to which the phrase I used was was put in a positive rather than a negative way yes okay now let's reverse roles again and I'd like you to rehearse the Behavior I've just modeled okay ready mhm the process now is a general shaping of the pattern that will best suit Jim without the self-defeating style that he originally used it's okay it will take a while before Jim can imitate a whole initial meeting but he's catching on in this case the client didn't have a problem Behavior he had a skill deficit he needed to learn how to perform a needed social behavior Dr roswell's approach was to allow Jim to pick out his own mistakes and then show him a better way she then helped him to try it himself the procedures demonstrated by Jim and Dr Roswell were based primarily on the observational learning model these procedures have been applied to skill deficit problems antisocial behaviors phobias and interpersonal problems in this film we have seen the three basic procedures used by Behavior therapists those based on operant classical and observational learning these procedures are an outgrowth of experimental research and learning research done with laboratory animals but the procedures of behavior therapy have also been built up from empirical studies with human beings themselves behavior therapy begins with the establishment of a warm and personal relationship between therapist and client it includes well planned and carefully executed assessment procedures to evaluate the problem and what the effects of removing the difficulty might be for the client and those with whom the client interacts the behavior therapist must be able to see the client within the context of his or her environment how does the client fit into their network of friends relatives and acquaintances behavior therapy is a way of objectively viewing individuals and their worlds behavioral psychologists undertake a systematic careful analysis of the procedures and processes of behavior therapy in direct relation to the individuals to whom it will be applied the techniques and procedures of behavior therapy are ones that can be tested and retested for revision and Improvement hi hi um is this SE taken no no um my name is Jim I'm Alice hi Alice um what are you studying well I'm not stud in our introduction to behavior therapy we have had only a brief time to demonstrate the very basics of this method of treatment there is much more we hope you will take the time to explore for yourselves the Elegance Simplicity and Effectiveness that is behavior [Music] therapy [Music] n [Music]