Frequency and Duration of Cognitive Behavioral Family Therapy
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Cerebral-Behavioral Family Therapy
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Cognitive-Behavioral Family Therapy
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Cerebral-Behavioral Family Therapy Nichols, Grand. P. & Schwartz, R. C. (2001). Cognitive-behavioral family therapy. In Thou. P. Nichols & R. C. Schwartz, Family therapy: Concepts and methods (fifth ed., pp. 265-305). Boston: Allyn and Bacon.
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Sketches of Leading Figures • Gerald Patterson at the Oregon Social Learning Institute has been a pioneer in the development of behavioral parent training. • Robert Liberman described an operant learning framework for couple and family therapy. It included • contingency direction • role rehearsal • modeling Dr. Ronald Werner-Wilson
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Sketches of Leading Figures • Richard Stuart introduced contingency contracting that featured reciprocal reinforcement. Couples were taught to • listing behaviors that they desired from each other • record frequency of behavior demonstrated past partner • identify exchanges for desired behaviors. • John Gottman: leading effigy in research on marriage. Dr. Ronald Werner-Wilson
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Theoretical Formulations • Central Premise: beliefs is maintained past its consequences. • Reinforcements: consequences that affect charge per unit of beliefs. • Positive reinforcement: rewarding consequences. • Negative reinforcement: aversive consequences. • Reinforcement Schedule: describes intervals associated with reinforcement. • Punishment: not the same equally negative reinforcement. • aversive control (e.k., yelling, spanking) • withdrawl of positive consequences Dr. Ronald Werner-Wilson
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Theoretical Formulations (cont). • Extinction: behavior ends because of lack of reinforcement. "Inattention … is often the best response to behavior you lot don't like" (p. 269). • Teaching Complex Behavior • Shaping: process of rewarding behaviors in successive approximations. • Modeling: people larn by emulating others. Dr. Ronald Werner-Wilson
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Normal Family Development • Satisfying relationships: balance between giving and getting. At that place is "a high ratio of benefits relative to costs" (p. 271). • Critical influences on relationship satisfaction: • affection • communication • kid care • Conflict resolution seems to be one of the about critical skills associated with family unit harmony. Dr. Ronald Werner-Wilson
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Development of Behavior Disorders • Symptoms are idea of "every bit learned responses, involuntarily acquired and reinforced" (p. 272). • People may inadvertently reinforce problematic behavior. • Punishments oftentimes have the contrary effect of their intention. Attention (even from someone who is angry) is a powerful social reinforcer. • Behavior problems may be maintained considering of inconsistent responses. Dr. Ronald Werner-Wilson
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Development of Behavior Disorders (cont.) • Crusade of Marital Discord (based on Azrin, Naster, & Jones, 1973; listed on p. 274 of text): • Receiving also little reinforcement from the marriage. • Two few needs given marital reinforcement. • Marital reinforcement no longer provides satisfaction. • New behaviors are non reinforced. • One spouse gives more reinforcement than he or she receives. • Matrimony interferes with extramarital sources of satisfaction. • Communication about potential sources of satisfaction is non adequate. • Aversive control (nagging, crying, withdrawing, or threatening) predominates over positive reinforcement. Dr. Ronald Werner-Wilson
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Development of Behavior Disorders (cont.) • Distressed marriages include fewer rewarding exchanges and more than punishing exchanges. "Spouses typically reciprocate their partners' use of punishment, and a vicious bike develops" (p. 274 of text; based on Patterson & Reid, 1970). • Parents who reply aversively to children are likely to have aversive responses reciprocated. Dr. Ronald Werner-Wilson
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Goals of Therapy • Primary goal: modify specific behavior patterns to reduce symptoms. (Annotation: symptom change is not thought to atomic number 82 to symptom substitution.) • Help families accelerate positive behavior. Dr. Ronald Werner-Wilson
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Conditions for Beliefs Change • Beliefs will change when reinforcement contingencies are changes. Significant others are trained to employ contingency direction techniques. • Hallmarks of Therapy: • Careful and detailed assessment to • determine baseline frequence of problem beliefs, • guide therapy, • provide accurate feedback about effectiveness. • Blueprint specific strategies to modify reinforcement contingencies. • Therapists might need to work on family members' attributions (beliefs about others). Dr. Ronald Werner-Wilson
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Techniques Caveat: although the principles of behavior therapy are simple, the practice is not.
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Behavioral Parent Grooming • Ordinarily begins with an extensive assessment. SORKC • stimulus • state of the organism • target response • KC: nature and contingency of consequences • Emphasis on parent education. • Encourage families to try behavioral change experiments. • Application of operant conditioning that can include social or tangible reinforcers. Dr. Ronald Werner-Wilson
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Behavioral Couples Therapy • Begins with an elaborate, structured assessment to identify specific strengths and weaknesses. • Clinical interviews • Ratings of specific target behaviors • Standard marital assessment questionnaires • Jacobson's Pretreatment Assessment of Marital Therapy (Table 9.1, pp. 286-287): • Strengths and skills of the relationship • Presenting Issues • Sex activity and Affection • Future Prospects • Cess of Social Surround • Private Functioning of Each Spouse Dr. Ronald Werner-Wilson
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Behavioral Couples Therapy (cont.) • Therapist works with couples to identify "accentuate the positive, striving to maintain positive expectancies" (p. 287). • Goal: identify behaviors to advance. • Institute reinforcement reciprocity. • Treatment Strategies: • Increase rate of positive control and reduce the rate of aversive command. • Improve communication. Assist couples acquire to make clear, straight requests rather than expecting partner to intuit needs. • Constructive conflict appointment is necessary. Dr. Ronald Werner-Wilson
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The Cognitive-Behavioral Approach to Family unit Therapy • Premise: members of a family unit simultaneously influence and are influenced by others. This is consistent and compatible with systems theory. • Assessment: investigate schemas (core beliefs) of family members to assess cognitive appraisals. • Interventions are directed toward assumptions used by family unit members • to evaluate one another • the emotionsand behaviors generated in responses to the evaluations Dr. Ronald Werner-Wilson
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Treatment of Sexual Dysfunction • Assumption: nearly sexual problems are the result of conditioned anxiety. • Systematic desensitization: guide clients through a progressive series of encounters that pb to more intimate encounters while avoiding thoughts of erection or orgasm. Sensate focus is unremarkably used in sex therapy. • Assertiveness training: socially and sexually inhibited persons are encouraged to accept and express their needs and feelings. • Three stages of sexual response (based on Helen Singer Kaplan, 1979) so each tin lead to a different difficulty: • Desire • Arousal • orgasm Dr. Ronald Werner-Wilson
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Evaluating Therapy Theory Results • Behavior therapy is the well-nigh carefully studied form of family therapy. • Improvement in advice is commonly associated with relationship improvement Dr. Ronald Werner-Wilson
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