Module 1 - BEHAVIOR THERAPY – I

Behavioral therapy is an umbrella term for types of therapy that treat mental health disorders.
This form of therapy seeks to identify and help change potentially self-destructive or unhealthy
behaviors. It is grounded in the principles of learning.
The focus : current behaviors and the environmental events that sustain them.
Therapy is intended to help people decrease undesirable behaviors and increase desirable ones,
regardless of whether or not they gain insight into the origins of their problems.

HISTORICAL BACKGROUND
Behaviour therapy had its beginnings in the early 1900’s and became established as a
psychological approach in the 1950s and 1960s. At this time, it received much resistance from
the current school of thought, psychoanalysis.

There have been a number of people that that have contributed to the development of
behavioural therapy:

 Ivan Pavlov (1849 — 1936)

In the 1860s, Pavlov’s contributions to behavioural therapy were accidental. He was
originally studying the digestive process of dogs when he discovered that associations
can develop when pairing a stimulus (food) that has a response (dog salivates) with a
stimulus that has no response (bell). The stimulus with no response (bell) eventually
develops the same response (dog salivates) as the stimuli that has the response (food).
This type of learning is known as classical conditioning.
 John B. Watson (1878 — 1958)
Watson has been described as the “father” of behaviourism (McLeod). He used Pavlov’s
principles of classical conditioning as well as emphasizing that all behaviour could be
understood as a result of learning. Watson’s research involved the study of a young child
called “Albert”. “Albert” was initially not scared of rats. However, Watson paired the rat
with a loud noise and this frightened “Albert”. After this was repeated numerous times,
“Albert” developed a fear of rats. He also developed a fear of things similar to a rat such
as men with beards, dogs, and fur coats. This fear was extinguished after a month of not
repeating the experiment (McLeod, n.d.a).
 The first use of the term behaviour modification appears to have been by Edward
Thorndike in 1911. His article Provisional Laws of Acquired Behavior or Learning makes
frequent use of the term “modifying behaviour”.  
 In general, behaviour therapy is seen as having three distinct points of origin:
a) South Africa (Joseph Wolpe’s group) - Joseph Wolpe (1915 — 1977)
Wolpe described a process known as reciprocal inhibition which is when “eliciting a
novel response brings about a decrease in the strength of a concurrent response”
(Seligman, 2006). Wolpe also developed the therapeutic tool of systematic
desensitization which is used in the treatment of phobias.
b) The United States (Skinner) - B.F. Skinner (1904 — 1958)
Skinner developed the theory of operant reinforcement theory which is the notion that
how often a behaviour is executed depends on the events that follow the behaviour
(Seligman, 2006). For example, if the behaviour is reinforced, the behaviour is more
likely to be repeated. He emphasised observable behaviour and rejected the notion of
“inner causes” for behaviour.
 c) and the United Kingdom (Rachman and Eysenck) - Eysenck in particular viewed
behaviour problems as an interplay between personality characteristics, environment,
and behaviour.  
 Skinner’s group in the United States took more of an operant conditioning focus. The
operant focus created a functional approach to assessment and interventions focused
on contingency management such as the token economy and behavioural activation.
 John Dollard (1900 — 1980) & Neal Miller (1909 — 2002)
Dollard and Miller provided more understanding to behavioural theory. They believed
that when a stimulus and response are frequently paired together and rewarded, the
more likely it is for an individual to repeat the behaviour (Seligman, 2006). They
identified this as a habitual response. Dollard and Miller also identified four elements in
behaviour: drive, cue, response, and reinforcement.
 Albert Bandura (1925)
In the late 1960s, Bandura applied the principles of classical and operant conditioning to
social learning. Basically, people learn behaviours through observation of other’s
behaviour, also known as modelling.
 In the early 1970s and its grand success were testament to the famous Indian
psychologist H. Narayan Murthy’s enduring commitment to the principles of behavioural
therapy and biofeedback.
 In the second half of the 20th century, many therapists coupled behaviour therapy with
the cognitive therapy, of Aaron Beck and Albert Ellis, to form cognitive behaviour
therapy.
 Third generation behaviour therapy uses basic principles of operant and respondent
psychology but couples them with functional analysis and a clinical formulation/case
conceptualisation of verbal behaviour more in-line with view of the behaviour analysts.
 Current Focus - The traditional behavioural approach is no longer used as it once was. It
has moved towards a more collaborative treatment with cognitive therapy and as such
this has meant a more applicable approach.

BASIC PRINCIPLES OF BEHAVIOR THERAPY

 Although genetics play a role, individual differences are derived primarily from different
experiences.

  Behaviour is learned and acquired largely through modelling, conditioning, and

reinforcement.

  Behaviour has a purpose.

  Behaviour is the major determinant of habits, thoughts, emotions, and other aspects of
personality.

  Behaviour therapy seeks to understand and change behavior.

  Therapy should be based on the scientific method and be systematic, empirical, and
experimental. Goals should be stated in behavioral, specific, and measurable terms, with
progress assessed regularly.
   The focus of treatment should generally be on the present. Even if behaviours are
longstanding, they are maintained by factors in the current environment.

  However, behaviours must be viewed in context, and some exploration of the past is
appropriate to provides that context and help people feel understood.

  Education, promoting new learning and transfer of learning, is an important aspect of

behavior therapy.

  Strategies of behavior therapy need to be individualized to the particular person and

problem.

  Clients have primary responsibility for defining their goals and completing homework
tasks. The treatment plan is formulated collaboratively, with both client and clinician
participating actively in that process.

 A concentration on behavioural processes i.e., processes closely associated with overt

behaviour.

 A rejection of the idea that the human personality is composed of traits.

FUNCTIONAL BEHAVIORAL ANALYSIS/ASSESSMENT

Historically, functional analysis entered psychology through the influence of B. F. Skinner, who in
turn was influenced by Ernst Mach’s conceptualizations of functional relationships. When
behaviour occurs there will always be two features present, the form and the function of the
behaviour. The form of a behaviour is most easily identified. The form of a behaviour is what is
observed. The function of a behaviour is less easily identified. Functional Behaviour Analysis
(FBA) can be defined as the analysis of the function of behaviour. The purpose of FBA is to
identify antecedents or consequences that maintain behaviour with a view to introducing
adjustments that will produce an alternate behaviour or set of behaviours. More specifically,
functional analysis is a set of procedures that attempts to identify important environmental
variables that develop and maintain behavior.

A target behavior may be “Johnny is off task 80% of the time during seat work.” This target
behavior may include several “off task” actions (e.g. Johnny talks to other students, leaves his
desk, and drums his pencil on his desk instead of following directions). This process leads to
development of intervention plans to teach acceptable alternative behavior. The resulting
intervention plan focuses on teaching new behavior and social skills but usually also requires
modification of the school or classroom environment and activities, adaptation of curriculum
and instructional delivery, and changes in the teacher/student relationship that maintain the
undesirable behavior.
Procedure
Functional analysis is derived from basic behavioral principles. It attends to the antecedents,
stimuli, responses, consequences, and contingencies that produce and maintain effective or
ineffective behaviors.

The basic form of a functional analysis is :

(1) identify aspects of the client and his or her environment or history that may be relevant to
the problem;
(2) organize information about potentially relevant variables according to behavioral principles
in order to identify possible causal relationships among variables;
(3) collect additional detailed information about potential causal variables in order to complete
the analysis;
(4) identify or create a treatment hypothesized to produce a desired increase in the frequency
or intensity of the causal variables based on the case conceptualization of how the variable
functions for the individual;
(5) implement the intervention for one variable at a time and observe any changes in the
problem;
(6) if there is no change in the target behavior, remove the original intervention, move to the
next suspected causal variable, and implement and evaluate the treatment of that variable;
(7) if the problem is not alleviated, return to the case conceptualization to identify alternative
variables that may be pertinent or alternative casual relationships and continue with the steps
of the functional analysis; and
(8) continue to revise the conceptualizations and interventions until the problem is solved.

TECHNIQUES
1 Stimulus Control
Stimulus control is a term used to describe situations in which a behavior is triggered by
the presence or absence of some stimulus. If a person always eats when watching TV, then (in
the operant conditioning use of the term) eating behavior is controlled by the stimulus of
watching TV.

A student might be talkative with friends but silent in class, the social environment is exerting
stimulus control over talking. Stimulus control can either promote or inhibit a behavior.

What is stimulus control? What is the difference between consequences and antecedents?

Teachers of operant conditioning sometimes say behavior is controlled by its consequences.

That sums up contingency management, but it is an incomplete description of operant
conditioning. In situations of stimulus control, it is antecedents, not consequences, that control
behavior.

Antecedents (ant-a-SEED-ince) are things that come before. In operant conditioning, antecedent

stimuli are those occurring before a behavior.

Stimulus control is the basic value in conditioning. It allows the trainer to give commands that
are obeyed. It also increases attention of the subject when they know they need to watch for
cues and then complete the action in order to get the reinforcing reward.

The principle of increasing probability is not always appreciated when absolute control is
required. This becomes a matter of definition of objectives, of what stimulus control is required.
When how a subject behaves is affected by a stimulus, then there is a degree of control,
although it is not absolute.  When there is a desire for high reliability in obedience, such as in
the military, then training will need to continue until the desired degree of stimulus control is
achieved.
Stimulus control can be mutual and two-way, for example when a parent hugs a child and the
child smiles, each is conditioned by the other's action. The parent hugs the child in order to get
the reward of the smile, while the child predictably smiles when the parent hugs them.

Generalized Stimulus Control occurs where the subject understands the idea of cue, action and
reward, and so becomes easier to train.

2 Shaping

The process of establishing a behavior that is not learned or performed by an individual at

present is referred to as Shaping. The concept was first developed and used by B.F Skinner, who
is known for his theories that involve learning behaviors through reinforcement.

Shaping is the process of reinforcing successively closer and closer approximations to a desired

terminal behavior. The shaping of behavior starts at an early age. For example, a child learns to
pull itself up, to stand, to walk and to finally move about through reinforcement of slightly
exceptional instances of behaviors. Walking doesn't necessarily come naturally to a child, but
through subtle reinforcements of being able to reach a toy or move more independently, the
child's behavior is shaped.
Ex: Skinner experiment with rat
Steps involved in the process of Shaping:

 For starters, reinforce any behavior that is even remotely close to the desired, target
behavior.
 Next step, reinforce the behavior that is closer to the target behavior. Also, you
shouldn’t reinforce the previous behavior.
 Keep reinforcing the responses/behaviors that resembles the target behavior even more
closely. Continue reinforcing the successive approximations until the target behavior is
achieved.
 Once the target behavior is achieved, only reinforce the final response.

Applications

Shaping can also be defined as a conditioning paradigm used primarily in the experimental
analysis of behavior. The method of reinforcing successive approximations in order to teach a
behavior has been found affective in humans and animals alike. So, it’s widely in use when it
comes to training and teaching new behaviors.
Example: Let’s say a teacher is trying to teach Johnny to speak in front of the whole classroom.
Given that Johnny is a shy kid, he wouldn’t be able to give a speech right away. So, instead of
promising Johnny some reward for giving a speech, rewards should be given to behaviors that
come close. Like, giving him a reward when he stands in front of the class. Next, when he goes in
front of the class and say hello. Then, when he can read a passage from a book. And, finally
when he can give a speech. The whole point is for rewards to be successive and it’s not possible
to retain rewards with previous responses. In this way, shaping of behavior can be done.

3 Prompting
Prompting is extensively used in behavior shaping and skill acquisition. It provides learners with
assistance to increase the probability that a desired behavior will occur. Successful performance
of a desired behavior elicits positive reinforcement, therefore reinforcing learning. Prompting is
a means to induce an individual with added stimuli (prompts) to perform a desired behavior. A
prompt is like a cue or support to encourage a desired behavior that otherwise does not occur.
In other words, a prompt is an antecedent that is provided when an ordinary antecedent is
ineffective. Prompts are often categorized into a hierarchy from most intrusive to least intrusive.
Types of prompts (from most intrusive to least intrusive), their descriptions, and examples are
as follows:

 Full physical assistance. The teacher uses “hand‐over‐hand” support to aid the child in
completing a task (e.g., when teaching the child to pick up a cup, the teacher takes the
child’s hand and guides him to pick it up).

 Partial physical assistance. The teacher provides partial physical assistance to help the
child complete a task (e.g., when teaching the child to pick up the cup, the teacher
guides the child’s hand to the cup by tapping his elbow).

 Full model. The teacher models the desired behavior (e.g., when teaching the child how
to clap, the teacher claps while telling the child to clap).

 Partial model. The teacher models only part of the desired behavior (e.g., when teaching
the child how to clap, the teacher puts his hands in front of himself, but does not
actually clap).

 Full verbal prompts. The teacher verbally modelsthe desired behavior (e.g., when
teaching the child to expressively label “car,” the teacher asks, “What isit? Say car.”).

 Partial verbal model. The teacher verbally models only part of the desired behavior
(e.g.,when teaching the child to expressively label “car,” the teacher asks, “What is it?
Say c___”).

 Gestural prompt. The teacher utilizes a physical gesture to encourage the desired
behaviour (e.g., when teaching the function of an object, the teacher says, “What do you
drink with?” while holding his hand to his mouth shaping it like a cup).

 Positional prompt. The teacher places the target item in a location that is closer to the
child (e.g., when teaching the child to label “toy,” the teacher places the toy closest to
the child).

Steps

1. Identify the least intrusive prompt. Choose a prompt that is necessary for a correct
response to occur.
 2. Give differential reinforcement. After a correct response, give appropriate
reinforcement that is equivalent to the level of performance independency.

3. Fade prompt. After the child masters a skill, gradually move prompt away or replace
with least intrusive prompt.

BRIEF EXAMPLE: Josh was learning to match objects with names. The teacher started with verbal
and gestural prompts. She said, “It is time for drawing, and we need some crayons to draw
with.” She looked at the crayons on the table and pointed at them, saying, “These are crayons.”
Then she pointed at the crayons and asked Josh, “What are these?” After Josh responded
“Crayons,” the teacher nodded her head and said, “These are crayons! Good job, Josh!” To fade
prompts, the teacher gradually moved from verbal and gestural prompts to only positional
prompts. For example, the next time the teacher placed the crayons on the table near Josh, she
said, “We need some crayons to draw with. Josh, show me the crayons.” Josh pointed to the
crayons correctly and received a point on his token board.

4 Chaining 

Chaining is an instructional procedure used in behavioral psychology, It

involves reinforcing individual responses occurring in a sequence to form a complex behavior.

Procedure

a. The chain of responses is broken down into small steps using task analysis.

b. Parts of a chain are referred to as links.

c. The learner’s skill level is assessed by an appropriate professional and is then:

 either taught one step at a time while being assisted through the other
steps forward or backwards.

 or if the learner already can complete a certain percentage of the steps

independently, the remaining steps are all worked on during each trial total task.

d. A verbal stimulus or prompt is used at the beginning of the teaching trial.

e. The stimulus change that occurs between each response becomes the reinforcer for that
response as well as the prompt/stimulus for the next response without requiring
assistance from the teacher. For example, in purchasing a soda you pull the money out
of your pocket and see the money in your hand and then put the money in the machine.
Seeing the money in your hand both was the reinforcer for the first response (getting
money out of pocket) and was what prompted you to do the next response (putting
money in machine).

Behaviour chain: A consistent sequence of stimuli and responses that occur closely to each
other in time and in which the last response is typically followed by reinforcement.
What Chaining should look like : SD1-> R1-> SD2-> R2-> SD3-> R3

Example of Chaining : Brushing Teeth= get brush-> toothpaste-> brush-> rinse-> spit

Types

In utilizing chaining, the teacher must (a) analyze the desired behavior, (b) break it into steps,
and (c) plan for the teaching. There are two type of chaining techniques:

1. Forward chaining.

The forward chaining technique moves a child from the first part of the task to the end.
In short, each step must be mastered before the next step in the skill series is added.

The steps in forward chaining:

 The teacher teaches the child the first step in the chain.

 When the first step is learned, the teacher adds the second step. The child is
learning the second step in the routine and attaching it to the first step.

 The third step is taught in conjunction with the first two steps once the child is
able to demonstrate the first two steps.

2. Backward chaining.

The backward chaining technique involves the same process as forward chaining, except
in reverse. That is, the teaching process moves from the last part of the task to the
beginning. This technique is used when it is easier to teach a child a task from the last
step than from the beginning.

The steps in backward chaining: mirror those of forward chaining except they occur in reverse.
The teacher provides the child assistance throughout the process until the last step.

 The child is encouraged to complete the last step independently.

 When the last step is mastered, the teacher provides assistance until the child is able to
perform the step before the last one.

 The child completes more and more ending steps independently until he masters all
steps and is able to complete the task without assistance.

BRIEF EXAMPLE : One of 6‐year‐old Tommy’s goals was to learn to brush his teeth. In order to
teach Tommy this skill, his teacher decided to use backward chaining. First, the teacher
conducted a task analysis to identify all the steps of tooth‐brushing. In the beginning, the
teacher guided and prompted. Tommy to perform all steps except the last one: looking at the
mirror and wiping his mouth with a towel. Tommy learned to perform this last step first with
prompts and reinforcement. After mastering this last step, the next teaching target was the
second‐to‐the‐last step, turning off the faucet. With backward chaining, Tommy learned to
brush his teeth by working on the last step first.

Behavioral Skills training

BST teaches a person what to do — that is, what behaviors to engage in under a particular
circumstance.  It allows for practice within the program so that the person can become fluent
with the skills.  It is an effective train-the-trainer procedure. And perhaps most importantly, can
be individualized to each person.
 Instruction – Provide a description of the skill, its importance or rationale, and when and
when not to use the skill. Repeat this step as necessary. 
 Modeling – Show your participant how to perform the skill. In-vivo modeling is
recommended. 
 Rehearsal – Practice, practice, and practice! Allow the participant opportunities to
practice the skill. Recent research suggests that participants should be able to practice
in-situ. The trainer should record data on correct and incorrect responding during this
step. 
 Feedback – The trainer should provide positive praise for correct responding and some
form of corrective feedback for incorrect responses. 
Some requirements before you can implement a BST program include: the person receiving the
training must have the pre-requisite skills required for the behaviors you are teaching, the skill
must include a chain of behaviors (a number of skills), and you must be able to role-play or
video model the skills.