Lecture 2 - Behaviour therapy (BT)

Question 1

There is a common misunderstanding about behavioural therapy that it only constitutes motor behaviours, what are also considered behaviours within this therapeutic approach? (3)

Answer 1

• Physiological responses
• Emotions
• Cognitions

Question 2

What is, very simply and straightforward, the main “attacking” point for behavioural therapy?

thus what does it mainly focus on

Answer 2

The behaviour that forms the main obstacle in the present (e.g., trouble sleeping) and changing it

Question 3

How is behavioural therapy traditionally defined?

Answer 3

As the empirical cycle or an experiment with a single participant (i.e., scientific thinking in the treatment)

RQ > Observation/theory > Hypothesis > Procedure > Evaluation

Question 4

In what 3 ways is behavioural therapy linked with scientific research (i.e., how does this show in the therapy itself)?

Answer 4

• Experimental method/attitude (see classical definition)
• Outcome/evaluation and mechanisms/explanations
• Individual level, but also group level

Question 5

What is meant with there not being unmanualized treatment and that thus this distinction is rudimentary?

obvs within psych

Answer 5

If treatment was fully unmanualized you’d literally just be doing random shit (and it would also not be possible to teach about it, write books, etc.)

Question 6

Behavioural therapy can take many shapes, but what are 3 shared characteristics between them?

6 total, 3 important

Answer 6

• Focus on behavioural change/expanding repertoire and response options
• Focus on empiricism, hypothesis-testing and evaluation
• Supported by scientific research
• Behaviour is (largely) “functional” in/function of environment (reinforcement/punishment) and not a patient’s fault
• Focus on maintaining factors/current determinants of problem behaviour
• Focus on “homework” in patients’ real environment
  Active, structured, directive and creative

Focus on bold

Question 7

Misunderstandings of behavioural therapy? (5)

Answer 7

• Denial of (deeper) thoughts and feelings (i.e., the first flashcard)
• Superficial and only addressing symptoms instead of real causes
• Exclusive focus on present (although it is seen as very important)
• Simplistic and manualized
• Ignores therapeutic relationship

Question 8

What is meant by the “three waves of behaviour therapy”?

Answer 8

Combine behavioural with other therapies- seems to be mostly like historically how this developed:
- Behavioural wave
- Behavioural + cognitive wave
- Behavioural + cognitive + acceptance wave

Question 9

Learning theory is often the basal theory for behavioural therapy (not always), what four main types of learning are there within this theory?

Answer 9

• Classical conditioning
• Operant conditioning
• Vicarious/observational learning
• Rule-governed/instructional learning

Question 10

A distinction is usually made between adaptive and problem behaviours, how does the learning theory look at the acquirement of these?

Answer 10

The learning processes/acquirement of both behaviours are the same- that also means previously adaptive behaviour can become problematic (and vice versa)

The latter; adaptive > problem, not uncommon

Question 11

What is the central construct/mechanism for encompassing a client case in behavioural therapy?

Answer 11

Case conceptualization (wooo)

Question 12

Five criteria are mentioned for treatment planning in the lecture on behavioural therapy, which are these?

i.e., determinants for what is treated

Answer 12

• Probability value (likelihood)
• Problematic value
• Treatability
• Centrality (vs. “end problem”) aka most important/does treating this central problem = dissapating of other problems
• Patient’s reason for therapy

these are possible, not necessary

Question 13

Functional analysis (FA) is another central construct for behavioural therapy, what does this look like in this approach?

considered the most important construct

Answer 13

A scheme to explain/understand and then treat complaints
- S-R > positive/negative consequences (this is the base model)

Question 14

Within FA for behavioural therapy, the stimulus constitutes the situation/trigger for the response (i.e., a cause), what do the negative and positive consequences constitute?

Answer 14

• Negative = reason for therapy
• Positive = maintaining factor

Question 15

What is it that these negative vs. positive consequences represent in the client (on an internal level)?

hint, concept in MI

Answer 15

Ambivalence

Question 16

What is the meaning analysis (another central construct)?

Answer 16

It is similar to FA, but from a pavlovian standpoint
- CS > CR (because of US/UR)

Question 17

What is the most common treatment (within BT) for CS/CR aka meaning analysis?

Answer 17

Basically unlearning (thus, inhibitory learning, cuz you can’t unlearn)
- Exposure that leads to new learning

Question 18

What are the most central/important techniques for BT? (6)

Answer 18

• Exposure
• Response prevention
• Stimulus-control
• Operant-conditioning strategies (reinforcement/punishment)
• Modeling
• Behavioural activation

also social skills, but is more general

Question 19

Why is reinforcement more often used than punishment?

Answer 19

Because reinforcement is more effective; with punishment behaviour often returns (as people learn to avoid punishment, etc.)

Question 20

Answer the four questions for the Karaman case in the context of behavioural therapy:
- Case conceptualization
- Resistance
- Approach
- First step

Answer 20

• Case conceptualization can have different conclusions, but the underlying method is that of FA (thus, consequences, stimulus, etc.) and the five criteria for treating (e.g., central problem)
• Resistance would be explained through the environment; work, therapy (as he has trouble asking for help)
• Approach can differ depending on what exactly comes to be from the CC; exposure exercises for asking for help, burnout manualized treatment, etc.
• First step depends on the above, of course