THE SECOND WAVE

The second wave of counseling and psychotherapy approaches came in the 1970’s when some of the
pioneers in counseling and psychotherapy in the Philippines introduced what they had come to value.
Among these pioneers were Brother Justin Lucian and Dr. Alfredo Lagmay, two stalwarts in the field,
who promoted Behavior Modification. Brother Lucian also introduced Rational – Emotive Therapy which
since then become known as Rational – Emotive Behavior Therapy: Reality Therapy which has expanded
to become known as Choice Therapy; and Logotherapy. The Philippine Institute of Applied Behavioral
Sciences (PIABS) then promoted Gestalt Therapy.

BEHAVIOR THERAPY
All behavior is learned and can be unlearned through experimentally established social principles of
learning.
PROPONENTS: Burrhus Frederic Skinner
Carl Thoresen
John D. Krumboltz
Joseph Wolpe
NATURE OF HUMAN BEINGS
(Krumboltz and Thoresen, 1969)

 Not inherently or instinctually good or bad

 Lean to continue performing behaviors that are rewarded and discontinue behaviors that are
punished or ignored
 Can unlearn behaviors
SOURCES OF DIFFICULTIES

 Learn behaviors not adaptive to the situation

 Performed behaviors inimical to one’s own development and/or harmful to other people
GOALS
(Krumboltz and Thoresen, 1969)

 General goal: modify inappropriate or undesirable behavior

 Categories of Goals
o elimination of maladaptive behavior (behavioral excesses)
o development of new behavior (behavioral deficits)
o strengthening new behavior
o maintaining new behavior
o modifying behavior accompanying strong emotions
 Criteria of Goals
 o specifically identified and operationally defined
o pertinent to desired change
o attainable
o measurable and observable progress
o desired by client
o acceptable to the counselor/therapist

MAJOR FOCUS
(Blackham and Silberman, 1971)

 Current maladaptive behavior

o occurring with sufficient frequency
o deterring self – development
o harmful to self or third party
 Environmental situations that may be perpetuating the maladaptive behavior
ROLE OF THE COUNSELOR/THERAPIST

 Act as an expert on a variety of techniques to handle different types of behavioral manifestations

 Prescribed appropriate ways of dealing with the person with maladaptive behavior
 Introduce the practice of behavior therapy by short didactic presentation until fully understood by
the client
 Follow up to ensure that behavior assignments are performed by client and significant others until
the maladaptive behavior is completely eliminated and the desired behavior maintained
COUNSELOR/THERAPIST CHARATERISTICS AND COMPETENCIES
(Krumboltz and Thoresen, 1969)

 In dealing with the client

o objective
o non – judgmental
o firm
o assuring and reinforcing client progress
o patient and encouraging with client failures

 In dealing with the process

o knowledgeable – select the appropriate technique for the client and the concern
o diligent = implementing step by step procedure
o conscientious – keep tab of process
o alert – notice signals when selected strategy is not working
o flexible – change procedures when they don’t work
o daring – experiment with procedures as long as guided by sound theory
o authoritative – convincing significant other to accept responsibility for bringing about change
since he/she may be reinforcing and perpetuating the maladaptive behavior of the identified
client
LEADS AND RESPONSES
(Lucian, 1973)

 Acceptance
 Restatement
 Clarification
 Supposition
 General Leads
 Reassurance
 Interpretation
 Summarization
 Facilitation
 Interpellation
 Rejection
TECHNIQUES
(Krumboltz, 1972; Blackham & Silberman, 1971)

 Goal: To eliminate maladaptive behavior

o Extinction and Positive Reinforcement – ignoring the behavior to extinguish it

o Satiation – pushing for the performance of the behavior until the identified patient is tired or
loses interest since the novelty is gone
o Incompatible Alternative Principle – acknowledging or rewarding the positive behavior that
cannot be performed simultaneously with the target maladaptive behavior
o Negative Reinforcement – terminating the existing undesirable or aversive condition or
situation when the maladaptive behavior stops

 Goal: To develop new behavior

o Social Modeling – presenting a respected person performing the desired behavior and being
rewarded for it to show how it can be manifested under specific circumstances
o Successive Approximation – expressing appreciation for every little effort or movement
toward the goal to increase motivation to change
o Cueing – informing about the contexts in which a behavior is required and giving a signal
when it should or should not be manifested
o Discrimination – helping client to realize that some behaviors are acceptable in some places
and occasions but not in others and helping him/her to make such distinctions

 Goal: To strengthen new behavior

o Positive Reinforcement – giving a reward immediately after performing a behavior to

establish a connection between the positive behavior and the positive outcome and to
motivate the person to keep performing the desired behavior until it becomes part of his/her
habitual activity
  Types of reinforces

 Social Reinforcers – a pat on the back, a smile, a nod of the head, handshake, positive
comments
 Material Reinforcers – tangible object or money
 Token Reinforcers – nominal rewards which do not involve expenses, like points or stars
 Activity Reinforcers – activities the client is very much interested in performing which
he/she can be allowed to do after performing desired behavior
 Goal: To maintain new behavior

o Substitution – presenting a previously ineffective reward just before the more effective
reward is presented so that the connection established between the two can make such an
ineffective reward gain status as a positive reinforcement
o Decreasing Reinforcement – lessening the frequency of giving rewards once the behavior
desired shows some stability
o Intermittent Reinforcement – making the schedule of reinforcement sporadic or unpredictable
to maintain the behavior without interval/ration depending on the reward alone
o Interval/Ration Reinforcement – giving the reinforcement only after a stipulated period of
time or number of times the behavior has been performed

 Goal: To modify behavior accompanying strong emotions

o Aversive Therapy – helping the client avoid a desired activity or situation by presenting an
aversive/undesirable condition simultaneously with it
o Assertiveness Training – enabling a person to say what he/she wants to say with no anxiety
by teaching what assertiveness involves; exposing to a model of assertive behavior; and
doing behavior rehearsal until the person is able to face the situation requiring assertiveness
o In – vivo or Contacting Desensitization – eliminating fear by gradually exposing the client to
the feared situation or object hierarchically form the least to the most fear – evoking stimulus
initially with counselor modeling and accompaniment, then gradual distancing until the client
can face by himself/herself what is feared with no fear at all
o Emotional Flooding – eliminating fear by drastically exposing the client to the real
situation/object which is feared until such time that he/she has had enough to realize that
he/she did not encounter the ultimate feared experience
o Systematic Desensitization – gradual exposure to the feared situation hierarchically but using
only the imagination. It involves training in deep muscle relaxation; construction of hierarchy
of anxiety provoking experiences, from least anxiety – provoking to most anxiety provoking
and counterposing relaxation and anxiety provoking situation
o Implosive Therapy – exposing the client to the feared situations through the use of the
imagination and inundating client with images of the anxiety provoking experiences by
presenting the worst possible scenarios the client may be in
STEPS
Operant Conditioning (Lucian, 1973)
  Identify the target behavior in an operational way – specific and concrete manifestation, place
and circumstances of manifestation
 Identify in concrete terms the pertinent, attainable and measurable goal behavior which the client
and the counselor are trying to attain
 Identify the antecedent of the behavior, the circumstance or event which happens before or
which surrounds the manifestation of the maladaptive behavior
 Identify the consequence of the behavior or what happens after the maladaptive behavior is
emitted to determine what could perpetuate it
 State the baseline of the behavior or the pretreatment behavior – frequency (how often), duration
(how long), or intensity (how strong) the manifestation is
 Determine the reinforcers, the consequences of behavior that tend to increase their frequency,
intensity or duration
 Select the appropriate strategy based on the goal and manifestation of the concern
 Reverse strategies by prescribing the opposite of what had been done when treatment was in
progress to determine the stability of the change
HISTORY TAKING

 Considered irrelevant
PSYCHOLOGICAL ASSESSMENT

 Standardized tests considered unimportant

 Non – psychometric assessment ongoing throughout the relationship to determine maladaptive
behavior, antecedents and reinforcers
COUNSELING SESSION
Jewel, 16, is a college freshwoman. Towards the middle of the second semester, her grades began to
suffer.
Clor I have not seen you in a quite a while. How have you been?
Clee Not so good. That’s why I am here.
Clor There is something that bothers you at this point.
Clee I think I am going to lose my financial grant.
Clor This means you are not meeting the grade requirements, am I right?
Clee Yes. I am so scared. My parents cannot afford to send me to school and they have high
hopes for me. In fact, they are depending on me since I am the eldest.
Clor You are disturbed because the maintenance of the financial grant means so much to you
and your family not only for now but for the future.
Clee Yes. I am so stupid… so stupid…
Clor You mean to say you cannot understand your lessons?
Clee No. I can… Easy naman …
Clor What made tou call yourself stupid then?
Clee I’m stupid because I cannot say ‘no’ to my friends when they want to skip classes. Ayun
… I miss quizzes. Sometimes I can’t do my assignments because we stay out till late at
night.
Clor It seems like you would like to be able to say ‘no’ to them. Am I right?
Clee I like naman going with them. And I enjoy the thing that we do. But it’s not right to set
aside my studies. I know I need to graduate as soon as I can.
Clor It’s very clear to you then that while you like having activities with them, you should be
able to say ‘no’ because you should prioritize your studies.
Clee Yes. But it’s so hard ti say ‘no’ to them. I don’t want to lose their friendship. And they
are very persuasive. They won’t stop until I say ‘yes’.
Clor How many friends are involved?
Clee Three
Clor Let’s do a little bit of a role play here. You pretend to be your friend asking Jewel to go.
Clee ‘Hey Jewel. There’s this movie that everyone is talking about. Let’s go. Then we can
have merienda in this newly – opened restaurants. I’ll treat.’
Clor ‘But we still have classes.’
Clee ‘Oh… That’s so boring naman. Everything he talks about is found in our textbook. You
just read on your own.’
Clor ‘But we need to be in class.’
Clee ‘He does not naman check attendance. Naku, sayang lang the time we spend in class.
You sit there not learning anything. Buti pa this movie. You get entertained na, you learn
pa.’
Clor ‘But…’
Clee ‘Malay mo. In our other classes, the professor might ask us if we have watched this
movie. Di ba, in Theo, our Prof always asks us?’
Clor So how does Jewel now respond to all these?
Clee ‘Baka may quiz tayo.’
Clor And your classmates would say?
Clee ‘Never pa naman nagbigay ng quiz si Sir na unannounced.’
‘So far naman your grades are okay. At saka ten percent lang of the total grade would
come from quizzes. One quiz won’t hurt.’
‘Hay, naku. Sige, if you don’t want to go, ikaw rin. Pag nagkuwentuhan kami wala kang
maiintindihan.’
 ‘At saka, siempre, we do not naman enjoy without you.’
‘Nauubos na naman ang oras. Kung ayaw ni Jewel, huwag na nating pilitin. Let’s go na,
girls…’
Clor And what does Jewel do now?
Clee ‘O, sige na nga. Bahala na.’
Clor The last few things said make you give in.
Clee Kasi parang they make me feel guilty. And the ‘yung last one, si Janelle ‘yun. She shows
na parang annoyed na siya.
Clor Okay. Reviewing those, what do you really want to say?
Clee ‘I really cannot join you because of my grade are already suffering.’
Clor And what do you think they will say to that?
Clee ‘You are passing naman in this subject.’
Clor And what would you want to be able to say?
Clee ‘I really want to go with you. My grade in this subject is passing but I need to make it
higher to compensate for the low grades in my other subject. You know naman that I
have to maintain an average to keep my financial grant.’
Clor What do you think will the response be?
Clee ‘Last time na’
Clor And what would Jewel say?
Clee ‘If I have to start, I need to start now. I will go with you in all the other times I can when
my grades are okay.’
Clor What do you think will happen?
Clee I think they will understand na. Pero bahala na sila. I really need to recover. Kaya lang,
in the real situation it is very difficult.
Clor Let’s do some behavior rehearsal. Imagine that they are in front of you now and they are
trying to convince you to go. You are hearing them say the words that usually make you
feel guilty. I represent them. Respond to them.
Clee ‘I can’t join you because my grades are already suffering.’
Clor Your tone seems to be afraid and you don’t seem to make any eye contact. You see, if
you really want to assert, you have to show firmness in your behavior and voice. Okay,
let me show you how. I am you now. And you are Jewel’s friends. You try to respond to
me in the way you think they would. But observe me when I am responding – the words I
use, the way I say them, my facial expression, my movements.
Clee Okay.
Clor ‘I really enjoy your company and would like to join you all the time. But at this time I
cannot allow, my grades to continually suffer.’ What do you think of that?
Clee I think that will work.
Clor What did you notice about how I said it?
Clee You looked into the eyes but very naturally – not wide-eyed or glaring. Your voice was
firm but not threatening – you still sounded friendly. Your words expressed the priority I
have but still showed caring and interest in them.
Clor Okay, try to say those words the way I did. See those friends in me now.
Clee ‘I really enjoy your company and would like to join you all the time. But at this time I
cannot allow my grades to continually suffer.’
Clor Getting there. Your voice seems to be a bit uncertain, though. Try again, please.
Clee ‘I really enjoy your company and would like to join you all the time. But at this time I
cannot allow my grades to continually suffer.’
Clor Very good. What if in the real situation they say all those ‘guilt – provoking’ words that
get you?
Clee ‘As I have said, I really want to join you but I cannot allow my grades to continually
suffer.’ I will just repeat those words. I think I am also clear that in the long run I will be
to one to suffer. If they don’t understand, that will be sad. But I have to think of the future
rather than the immediate present. Thank you.’
Assertiveness Training was used for Jewel since the stated problem of losing her financial grant stemmed
from her inability to say “no” to her friends. While she was very much aware of her priorities and what
she would need to do to maintain her financial grant, her friends’ subtle attack on her pakikisama and the
hint of annoyance were always successful weapons to persuade her.
At the start, the counselor used paraphrase, clarification, general leads. The she moved toward role
playing/role reversal to get to understand the context where non – assertiveness occurred and how it was
manifested. The client was asked for her preferred behavior in the situation and how the other might
respond to such. This was to ensure that the situation would be replicated appropriately during the
training for assertiveness.
Social Modeling was used to show in detail how the client could respond appropriately to her classmates.
The counselor spoke the proper words and asked the client to observe her behavior as she gave the
response.
Behavior rehearsal was then done to hear the client responding to the persuasion of her classmates.
Feedback was given and rehearsal was repeated until such time that the client responded appropriately
and felt convinced that she could transfer the learning to actual situations.