Misplaced Pages

Behaviour therapy

Article snapshot taken from Wikipedia with creative commons attribution-sharealike license. Give it a read and then ask your questions in the chat. We can research this topic together.

Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology . It looks at specific, learned behaviours and how the environment, or other people's mental states , influences those behaviours, and consists of techniques based on behaviorism's theory of learning: respondent or operant conditioning . Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists . They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.

#120879

137-428: Behavioural psychotherapy is sometimes juxtaposed with cognitive psychotherapy . While cognitive behavioural therapy integrates aspects of both approaches, such as cognitive restructuring , positive reinforcement , habituation (or desensitisation ), counterconditioning , and modelling . Applied behaviour analysis (ABA) is the application of behaviour analysis that focuses on functionally assessing how behaviour

274-506: A conceptual framework and a clinical approach for understanding common cognitive processes of mental disorders while specifying the unique features of the specific disorders. Cognitive restructuring involves four steps: There are six types of automatic thoughts: Other major techniques include: Socratic questions are the archetypal cognitive restructuring techniques. These kinds of questions are designed to challenge assumptions by: "What might be another explanation or viewpoint of

411-450: A "missed shock" is detected as a stimulus, and can act as a reinforcer. Cognitive theories of avoidance take this idea a step farther. For example, a rat comes to "expect" shock if it fails to press a lever and to "expect no shock" if it presses it, and avoidance behavior is strengthened if these expectancies are confirmed. Operant hoarding refers to the observation that rats reinforced in a certain way may allow food pellets to accumulate in

548-575: A big step, the smaller you start the easier it will be for the person to master each step. This technique has also been applied to people dealing with agoraphobia, or fear of being in public places or doing something embarrassing. Contingency contracting has been used to effectively deal with behaviour problems in delinquents and when dealing with on task behaviours in students. Token economies are used in controlled environments and are found mostly in psychiatric hospitals. They can be used to help patients with different mental illnesses but it doesn't focus on

685-406: A certain way in certain situations. Behaviour therapy is based upon the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B.F. Skinner . Classical conditioning happens when a neutral stimulus comes right before another stimulus that triggers a reflexive response. The idea is that if the neutral stimulus and whatever other stimulus that triggers

822-478: A client or patient accountable of their behaviours in an effort to change them. This is called a contingency contract, which is a formal written contract between two or more people that defines the specific expected behaviours that you wish to change and the rewards and punishments that go along with that behaviour. In order for a contingency contract to be official it needs to have five elements. First it must state what each person will get if they successfully complete

959-438: A cognitive therapist often practice more flexible ways to think and respond, learning to ask themselves whether their thoughts are completely true, and whether those thoughts are helping them to meet their goals. Thoughts that do not meet this description may then be shifted to something more accurate or helpful, leading to more positive emotion, more desirable behavior, and movement toward the person's goals. Cognitive therapy takes

1096-545: A conditioned stimulus, or after a primary reward if no conditioned stimulus exists. These neurons are equally active for positive and negative reinforcers, and have been shown to be related to neuroplasticity in many cortical regions. Evidence also exists that dopamine is activated at similar times. There is considerable evidence that dopamine participates in both reinforcement and aversive learning. Dopamine pathways project much more densely onto frontal cortex regions. Cholinergic projections, in contrast, are dense even in

1233-454: A course of action. In a broad sense, this could be called behavior therapy whenever the behavior itself was conceived as the therapeutic agent. Ancient writings contain innumerable behavioral prescriptions that accord with this broad conception of behavior therapy. 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

1370-415: A craving for the associated drug may reappear. For example, anti-drug agencies previously used posters with images of drug paraphernalia as an attempt to show the dangers of drug use. However, such posters are no longer used because of the effects of incentive salience in causing relapse upon sight of the stimuli illustrated in the posters. In drug dependent individuals, negative reinforcement occurs when

1507-405: A deceased person). Virtual reality therapy deals with fear of heights, fear of flying, and a variety of other anxiety disorders. VRT has also been applied to help people with substance abuse problems reduce their responsiveness to certain cues that trigger their need to use drugs. Shaping and graded task assignments has been used in dealing with suicide and depressed or inhibited individuals. This

SECTION 10

#1732782694121

1644-533: A development towards combining techniques to treat psychiatric disorders. Cognitive interventions are used to enhance the effects of more established behavioural interventions based on operant and classical conditioning. An increased effort has also been placed to address the interpersonal context of behaviour. Behaviour therapy can be applied to a number of mental disorders and in many cases is more effective for specific disorders as compared to others. Behaviour therapy techniques can be used to deal with any phobias that

1781-468: A drug is self-administered in order to alleviate or "escape" the symptoms of physical dependence (e.g., tremors and sweating) and/or psychological dependence (e.g., anhedonia , restlessness, irritability, and anxiety) that arise during the state of drug withdrawal . Animal trainers and pet owners were applying the principles and practices of operant conditioning long before these ideas were named and studied, and animal training still provides one of

1918-638: A factor underlying gambling addiction. Human beings have an innate resistance to killing and are reluctant to act in a direct, aggressive way towards members of their own species, even to save life. This resistance to killing has caused infantry to be remarkably inefficient throughout the history of military warfare. This phenomenon was not understood until S.L.A. Marshall (Brigadier General and military historian) undertook interview studies of WWII infantry immediately following combat engagement. Marshall's well-known and controversial book, Men Against Fire, revealed that only 15% of soldiers fired their rifles with

2055-675: A few of the many problems that behaviour therapy have functionally analyzed include intimacy in couples relationships, forgiveness in couples, chronic pain, stress-related behaviour problems of being an adult child of a person with an alcohol use disorder, anorexia, chronic distress, substance abuse, depression , anxiety, insomnia and obesity. Functional analysis has even been applied to problems that therapists commonly encounter like client resistance, partially engaged clients and involuntary clients. Applications to these problems have left clinicians with considerable tools for enhancing therapeutic effectiveness. One way to enhance therapeutic effectiveness

2192-400: A focus on the underlying "schema"—the underlying ways in which people process information about the self, the world or the future. This new cognitive approach came into conflict with the behaviorism common at the time, which claimed that talk of mental causes was not scientific or meaningful, and that assessing stimuli and behavioral responses was the best way to practice psychology. However,

2329-432: A food tray instead of retrieving those pellets. In this procedure, retrieval of the pellets always instituted a one-minute period of extinction during which no additional food pellets were available but those that had been accumulated earlier could be consumed. This finding appears to contradict the usual finding that rats behave impulsively in situations in which there is a choice between a smaller food object right away and

2466-415: A global reinforcement signal to postsynaptic neurons ." This allows recently activated synapses to increase their sensitivity to efferent (conducting outward) signals, thus increasing the probability of occurrence for the recent responses that preceded the reinforcement. These responses are, statistically, the most likely to have been the behavior responsible for successfully achieving reinforcement. But when

2603-433: A great many applications of operant principles have been suggested and implemented. The following are some examples. Positive and negative reinforcement play central roles in the development and maintenance of addiction and drug dependence . An addictive drug is intrinsically rewarding ; that is, it functions as a primary positive reinforcer of drug use. The brain's reward system assigns it incentive salience (i.e., it

2740-409: A job soon." Beck also identified a number of other cognitive distortions , which can contribute to depression, including the following: arbitrary inference, selective abstraction, overgeneralization, magnification and minimization . In 2008, Beck proposed an integrative developmental model of depression that aims to incorporate research in genetics and the neuroscience of depression. This model

2877-403: A larger food object after some delay. See schedules of reinforcement . The first scientific studies identifying neurons that responded in ways that suggested they encode for conditioned stimuli came from work by Mahlon deLong and by R.T. Richardson. They showed that nucleus basalis neurons, which release acetylcholine broadly throughout the cerebral cortex , are activated shortly after

SECTION 20

#1732782694121

3014-455: A mistake at work, a man may believe: "I'm useless and can't do anything right at work." He may then focus on the mistake (which he takes as evidence that his belief is true), and his thoughts about being "useless" are likely to lead to negative emotion (frustration, sadness, hopelessness). Given these thoughts and feelings, he may then begin to avoid challenges at work, which is behavior that could provide even more evidence for him that his belief

3151-437: A neutral CS (conditioned stimulus) is paired with the aversive US (unconditioned stimulus); this idea underlies the two-factor theory of avoidance learning described below. In free-operant avoidance a subject periodically receives an aversive stimulus (often an electric shock) unless an operant response is made; the response delays the onset of the shock. In this situation, unlike discriminated avoidance, no prior stimulus signals

3288-563: A person causes themselves disturbance by labeling an upcoming situation as "awful", rather than envisaging how the situation may actually unfold, and Must-ing, when a person places a false demand on themselves that something "must" happen (e.g. "I must get an A in this exam.") According to Beck's theory of the etiology of depression, depressed people acquire a negative schema of the world in childhood and adolescence; children and adolescents who experience depression acquire this negative schema earlier. Depressed people acquire such schemas through

3425-461: A person may have. Desensitization has also been successfully applied to other issues such as dealing with anger, if a person has trouble sleeping and certain speech disorders. Desensitization does not occur over night, there is a process of treatment. Desensitization is done on a hierarchy and happens over a number of sessions. The hierarchy goes from situations that make a person less anxious or nervous up to things that are considered to be extreme for

3562-414: A person variable would be behavioural competence. Behavioural competence looks at whether a person has the appropriate skills and behaviours that are necessary when performing a specific response to a certain situation or stimuli. When making a behavioural assessment the behaviour therapist wants to answer two questions: (1) what are the different factors (environmental or psychological) that are maintaining

3699-484: A process model of research, which makes it unique compared to traditional behaviour therapy and cognitive behavioural therapy . Functional analytic psychotherapy has a strong research support. Recent functional analytic psychotherapy research efforts are focusing on management of aggressive inpatients. Behaviour therapists complete a functional analysis or a functional assessment that looks at four important areas: stimulus, organism, response and consequences. The stimulus

3836-468: A response is paired together often enough that the neutral stimulus will produce the reflexive response. Operant conditioning has to do with rewards and punishments and how they can either increase or decrease certain behaviours. Contingency management programs are a direct product of research from operant conditioning . Behavioural therapy based on operant and respondent principles has considerable evidence base to support its usage. This approach remains

3973-470: A result of consequences as satisfying or discomforting. In the 20th century, operant conditioning was studied by behavioral psychologists , who believed that much of mind and behaviour is explained through environmental conditioning. Reinforcements are environmental stimuli that increase behaviors, whereas punishments are stimuli that decrease behaviors. Both kinds of stimuli can be further categorised into positive and negative stimuli, which respectively involve

4110-411: A schedule of reinforcement. Noncontingent reinforcement is the delivery of reinforcing stimuli regardless of the organism's behavior. Noncontingent reinforcement may be used in an attempt to reduce an undesired target behavior by reinforcing multiple alternative responses while extinguishing the target response. As no measured behavior is identified as being strengthened, there is controversy surrounding

4247-441: A skill-building approach, where the therapist helps the person to learn and practice these skills independently, eventually "becoming their own therapist." "Consistent with the cognitive theory of psychopathology, CT is designed to be structured, directive, active, and time-limited, with the express purpose of identifying, reality-testing, and correcting distorted cognition and underlying dysfunctional beliefs". The cognitive model

Behaviour therapy - Misplaced Pages Continue

4384-572: A soldier's behavior. Other improvements to military training methods have included the timed firing course; more realistic training; high repetitions; praise from superiors; marksmanship rewards; and group recognition. Negative reinforcement includes peer accountability or the requirement to retake courses. Modern military training conditions mid-brain response to combat pressure by closely simulating actual combat, using mainly Pavlovian classical conditioning and Skinnerian operant conditioning (both forms of behaviorism ). Modern marksmanship training

4521-406: A token economy to be effective there must be consistency in administering the program by the entire staff. Procedures must be clearly defined so that there is no confusion among the clients. Instead of looking for ways to punish the patients or to deny them of rewards, the staff has to reinforce the positive behaviours so that the clients will increase the occurrence of the desired behaviour. Over time

4658-455: A total of four consequences: Schedules of reinforcement are rules that control the delivery of reinforcement. The rules specify either the time that reinforcement is to be made available, or the number of responses to be made, or both. Many rules are possible, but the following are the most basic and commonly used The effectiveness of reinforcement and punishment can be changed. Most of these factors serve biological functions. For example,

4795-402: A variable ratio schedule yields reinforcement after the emission of an unpredictable number of responses. This schedule typically generates rapid, persistent responding. Slot machines pay off on a variable ratio schedule, and they produce just this sort of persistent lever-pulling behavior in gamblers. The variable ratio payoff from slot machines and other forms of gambling has often been cited as

4932-924: A variety of socially significant behaviors and issues. In many cases, practitioners use operant techniques to develop constructive, socially acceptable behaviors to replace aberrant behaviors. The techniques of ABA have been effectively applied in to such things as early intensive behavioral interventions for children with an autism spectrum disorder (ASD) research on the principles influencing criminal behavior , HIV prevention, conservation of natural resources, education, gerontology , health and exercise , industrial safety , language acquisition , littering, medical procedures , parenting, psychotherapy , seatbelt use, severe mental disorders , sports, substance abuse , phobias , pediatric feeding disorders, and zoo management and care of animals . Some of these applications are among those described below. Providing positive reinforcement for appropriate child behaviors

5069-461: A vital area of clinical psychology and is often termed clinical behavior analysis . Behavioral psychotherapy has become increasingly contextual in recent years. Behavioral psychotherapy has developed greater interest in recent years in personality disorders as well as a greater focus on acceptance and complex case conceptualizations. One current form of behavioural psychotherapy is functional analytic psychotherapy . Functional analytic psychotherapy

5206-529: Is "wanted" or "desired"), so as an addiction develops, deprivation of the drug leads to craving. In addition, stimuli associated with drug use – e.g., the sight of a syringe, and the location of use – become associated with the intense reinforcement induced by the drug. These previously neutral stimuli acquire several properties: their appearance can induce craving, and they can become conditioned positive reinforcers of continued use. Thus, if an addicted individual encounters one of these drug cues,

5343-734: Is a greater call for behavioural psychologists to be involved in rehabilitation efforts. Two large studies done by the Faculty of Health Sciences at Simon Fraser University indicate that both behaviour therapy and cognitive-behavioural therapy (CBT) are equally effective for OCD. CBT is typically considered the "first-line" treatment for OCD. CBT has also been shown to perform slightly better at treating co-occurring depression. Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy ( habit reversal training ) has been found to be highly effective for treating tics. There has been

5480-402: Is a longer duration behaviour therapy. Functional analytic therapy focuses on in-session use of reinforcement and is primarily a relationally-based therapy. As with most of the behavioural psychotherapies, functional analytic psychotherapy is contextual in its origins and nature. and draws heavily on radical behaviourism and functional contextualism . Functional analytic psychotherapy holds to

5617-423: Is a loss of a reward or privilege after someone performs an undesirable behaviour. Like token economies this technique is used mainly in institutional and therapeutic settings. Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy, habit reversal training , has been found to be highly effective for treating tics. Currently, there

Behaviour therapy - Misplaced Pages Continue

5754-407: Is a major focus of parent management training. Typically, parents learn to reward appropriate behavior through social rewards (such as praise, smiles, and hugs) as well as concrete rewards (such as stickers or points towards a larger reward as part of an incentive system created collaboratively with the child). In addition, parents learn to select simple behaviors as an initial focus and reward each of

5891-405: Is a technique in which an aversive (painful or unpleasant) stimulus is used to decrease unwanted behaviours from occurring. It is concerned with two procedures: 1) the procedures are used to decrease the likelihood of the frequency of a certain behaviour and 2) procedures that will reduce the attractiveness of certain behaviours and the stimuli that elicit them. The punishment side of aversion therapy

6028-513: Is a treatment in which the client slowly substitutes a new learned response for a maladaptive response by moving up a hierarchy of situations involving fear. Systematic desensitization is based in part on counter conditioning. Counter conditioning is learning new ways to change one response for another and in the case of desensitization it is substituting that maladaptive behaviour for a more relaxing behaviour. Exposure and response prevention techniques (also known as flooding and response prevention)

6165-567: Is a type of psychotherapy developed by American psychiatrist Aaron T. Beck . CT is one therapeutic approach within the larger group of cognitive behavioral therapies (CBT) and was first expounded by Beck in the 1960s. Cognitive therapy is based on the cognitive model , which states that thoughts, feelings and behavior are all connected, and that individuals can move toward overcoming difficulties and meeting their goals by identifying and changing unhelpful or inaccurate thinking, problematic behavior, and distressing emotional responses. This involves

6302-428: Is addressed by several theories of avoidance (see below). Two kinds of experimental settings are commonly used: discriminated and free-operant avoidance learning. A discriminated avoidance experiment involves a series of trials in which a neutral stimulus such as a light is followed by an aversive stimulus such as a shock. After the neutral stimulus appears an operant response such as a lever press prevents or terminate

6439-467: Is called "the price elasticity of demand." Certain commodities are more elastic than others; for example, a change in price of certain foods may have a large effect on the amount bought, while gasoline and other everyday consumables may be less affected by price changes. In terms of operant analysis, such effects may be interpreted in terms of motivations of consumers and the relative value of the commodities as reinforcers. As stated earlier in this article,

6576-489: Is complex. The complex behaviours that need to be learned are broken down into simpler steps where the person can achieve small things gradually building up to the more complex behaviour. Each step approximates the eventual goal and helps the person to expand their activities in a gradual way. This behaviour is used when a person feels that something in their lives can not be changed and life's tasks appear to be overwhelming. Another technique of behaviour therapy involves holding

6713-520: Is entirely possible that no one intentionally sat down to use operant conditioning or behavior modification techniques to train soldiers in this area…But from the standpoint of a psychologist who is also a historian and a career soldier, it has become increasingly obvious to me that this is exactly what has been achieved. Nudge theory (or nudge) is a concept in behavioural science , political theory and economics which argues that indirect suggestions to try to achieve non-forced compliance can influence

6850-428: Is expanded through the idea of behavioral chains, which are sequences of responses bound together by the three-term contingencies defined above. Chaining is based on the fact, experimentally demonstrated, that a discriminative stimulus not only sets the occasion for subsequent behavior, but it can also reinforce a behavior that precedes it. That is, a discriminative stimulus is also a "conditioned reinforcer". For example,

6987-720: Is how it (behaviour analysis) goes about evaluating treatment effects. The individual subject is where the focus of study is on, the investigation is centred on the one individual being treated. A third characteristic is that it focuses on what the environment does to cause significant behaviour changes. Finally the last characteristic of applied behaviour analysis is the use of those techniques that stem from operant and classical conditioning such as providing reinforcement, punishment, stimulus control and any other learning principles that may apply. Social skills training teaches clients skills to access reinforcers and lessen life punishment. Operant conditioning procedures in meta-analysis had

SECTION 50

#1732782694121

7124-419: Is influenced by the observable learning environment and how to change such behaviour through contingency management or exposure therapies , which are used throughout clinical behaviour analysis therapies or other interventions based on the same learning principles. Cognitive-behavioural therapy views cognition and emotions as preceding overt behaviour and implements treatment plans in psychotherapy to lessen

7261-449: Is made more likely to occur by contingently praising said behavior. Hundreds of studies have demonstrated the effectiveness of praise in promoting positive behaviors, notably in the study of teacher and parent use of praise on child in promoting improved behavior and academic performance, but also in the study of work performance. Praise has also been demonstrated to reinforce positive behaviors in non-praised adjacent individuals (such as

7398-430: Is modified. These terms are defined by their effect on behavior. "Positive" and "negative" refer to whether a stimulus was added or removed, respectively. Similarly, "reinforcement" and "punishment" refer to the future frequency of the behavior. Reinforcement describes a consequence that makes a behavior occur more often in the future, whereas punishment is a consequence that makes a behavior occur less often. There are

7535-424: Is not necessary to maintain avoidance behavior. Some theorists suggest that avoidance behavior may simply be a special case of operant behavior maintained by its consequences. In this view the idea of "consequences" is expanded to include sensitivity to a pattern of events. Thus, in avoidance, the consequence of a response is a reduction in the rate of aversive stimulation. Indeed, experimental evidence suggests that

7672-605: Is referred to as the Father of operant conditioning, and his work is frequently cited in connection with this topic. His 1938 book "The Behavior of Organisms: An Experimental Analysis", initiated his lifelong study of operant conditioning and its application to human and animal behavior. Following the ideas of Ernst Mach , Skinner rejected Thorndike's reference to unobservable mental states such as satisfaction, building his analysis on observable behavior and its equally observable consequences. Skinner believed that classical conditioning

7809-469: Is repeatedly followed by reinforcement, and in consequence the animal begins to respond to the stimulus. For example, a response key is lighted and then food is presented. When this is repeated a few times a pigeon subject begins to peck the key even though food comes whether the bird pecks or not. Similarly, rats begin to handle small objects, such as a lever, when food is presented nearby. Strikingly, pigeons and rats persist in this behavior even when pecking

7946-549: Is such an excellent example of behaviorism that it has been used for years in the introductory psychology course taught to all cadets at the US Military Academy at West Point as a classic example of operant conditioning. In the 1980s, during a visit to West Point, B.F. Skinner identified modern military marksmanship training as a near-perfect application of operant conditioning. Lt. Col. Dave Grossman states about operant conditioning and US Military training that: It

8083-569: Is the condition or environmental trigger that causes behaviour. An organism involves the internal responses of a person, like physiological responses, emotions and cognition. A response is the behaviour that a person exhibits and the consequences are the result of the behaviour. These four things are incorporated into an assessment done by the behaviour therapist. Most behaviour therapists use objective assessment methods like structured interviews, objective psychological tests or different behavioural rating forms. These types of assessments are used so that

8220-422: Is the general technique in which a therapist exposes an individual to anxiety-provoking stimuli while keeping them from having any avoidance responses. Virtual reality therapy provides realistic, computer-based simulations of troublesome situations. The modelling process involves a person being subjected to watching other individuals who demonstrate behaviour that is considered adaptive and that should be adopted by

8357-729: Is to use positive reinforcement or operant conditioning. Although behaviour therapy is based on the general learning model, it can be applied in a lot of different treatment packages that can be specifically developed to deal with problematic behaviours. Some of the more well known types of treatments are: Relaxation training, systematic desensitization , virtual reality exposure, exposure and response prevention techniques, social skills training, modelling, behavioural rehearsal and homework , and aversion therapy and punishment. Relaxation training involves clients learning to lower arousal to reduce their stress by tensing and releasing certain muscle groups throughout their body. Systematic desensitization

SECTION 60

#1732782694121

8494-461: Is true. As a result, any adaptive response and further constructive consequences become unlikely, and he may focus even more on any mistakes he may make, which serve to reinforce the original belief of being "useless." In therapy, this example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and patient would be directed at working together to explore and change this cycle. People who are working with

8631-406: Is used when a patient feel hopeless and they have no way of changing their lives. This hopelessness involves how the person reacts and responds to someone else and certain situations and their perceived powerlessness to change that situation that adds to the hopelessness. For a person with suicidal ideation, it is important to start with small steps. Because that person may perceive everything as being

8768-437: Is using behavioural methods to modify certain behaviours that are seen as being important socially or personally. There are four main characteristics of applied behaviour analysis. First behaviour analysis is focused mainly on overt behaviours in an applied setting. Treatments are developed as a way to alter the relationship between those overt behaviours and their consequences. Another characteristic of applied behaviour analysis

8905-417: Is when an aversive stimulus is presented at the same time that a negative stimulus and then they are stopped at the same time when a positive stimulus or response is presented. Examples of the type of negative stimulus or punishment that can be used is shock therapy treatments, aversive drug treatments as well as response cost contingent punishment which involves taking away a reward. Applied behaviour analysis

9042-423: The (aversive) stimulation of bright light in one's eyes. (This is an example of negative reinforcement, defined above.) Behavior that is maintained by preventing a stimulus is called "avoidance," as, for example, putting on sun glasses before going outdoors. Avoidance behavior raises the so-called "avoidance paradox", for, it may be asked, how can the non-occurrence of a stimulus serve as a reinforcer? This question

9179-448: The 1970s saw a general "cognitive revolution" in psychology. Behavioral modification techniques and cognitive therapy techniques became joined, giving rise to a common concept of cognitive behavioral therapy . Although cognitive therapy has often included some behavioral components, advocates of Beck's particular approach sought to maintain and establish its integrity as a distinct, standardized form of cognitive behavioral therapy in which

9316-558: The CS and the US through classical conditioning and, because of the aversive nature of the US, the CS comes to elicit a conditioned emotional reaction (CER) – "fear." b) Reinforcement of the operant response by fear-reduction. As a result of the first process, the CS now signals fear; this unpleasant emotional reaction serves to motivate operant responses, and responses that terminate the CS are reinforced by fear termination. The theory does not say that

9453-466: The Stoic philosophers". Albert Ellis worked on cognitive treatment methods from the 1950s (Ellis, 1956). He called his approach Rational Therapy (RT) at first, then Rational Emotive Therapy (RET) and later Rational Emotive Behavior Therapy (REBT). Becoming disillusioned with long-term psychodynamic approaches based on gaining insight into unconscious emotions, in the late 1950s Aaron T. Beck came to

9590-502: 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 . Skinner's student Ogden Lindsley is credited with forming a movement called precision teaching , which developed a particular type of graphing program called the standard celeration chart to monitor

9727-404: The addition or removal of environmental stimuli. Operant conditioning differs from classical conditioning , which is a process where stimuli are paired with biologically significant events to produce involuntary and reflexive behaviors. In contrast, operant conditioning is voluntary and depends on the consequences of a behavior. The study of animal learning in the 20th century was dominated by

9864-478: The analysis of these two sorts of learning, and they are still at the core of behavior analysis. They have also been applied to the study of social psychology , helping to clarify certain phenomena such as the false consensus effect . Operant conditioning, sometimes called instrumental learning , was first extensively studied by Edward L. Thorndike (1874–1949), who observed the behavior of cats trying to escape from home-made puzzle boxes. A cat could escape from

10001-402: The application of reinforcement is either less immediate or less contingent (less consistent), the ability of dopamine to act upon the appropriate synapses is reduced. A number of observations seem to show that operant behavior can be established without reinforcement in the sense defined above. Most cited is the phenomenon of autoshaping (sometimes called "sign tracking"), in which a stimulus

10138-405: The autoshaping procedure has, in fact, become one of the most common ways to measure classical conditioning. In this view, many behaviors can be influenced by both classical contingencies (stimulus-response) and operant contingencies (response-reinforcement), and the experimenter's task is to work out how these interact. Reinforcement and punishment are ubiquitous in human social interactions, and

10275-416: The aversive stimulus. In early trials, the subject does not make the response until the aversive stimulus has come on, so these early trials are called "escape" trials. As learning progresses, the subject begins to respond during the neutral stimulus and thus prevents the aversive stimulus from occurring. Such trials are called "avoidance trials." This experiment is said to involve classical conditioning because

10412-480: The basic findings from which Skinner developed his account of operant conditioning. He also drew on many less formal observations of human and animal behavior. Many of Skinner's writings are devoted to the application of operant conditioning to human behavior. In 1948 he published Walden Two , a fictional account of a peaceful, happy, productive community organized around his conditioning principles. In 1957, Skinner published Verbal Behavior , which extended

10549-406: The behaviour therapist can determine exactly what a client's problem may be and establish a baseline for any maladaptive responses that the client may have. By having this baseline, as therapy continues this same measure can be used to check a client's progress, which can help determine if the therapy is working. Behaviour therapists do not typically ask the why questions but tend to be more focused on

10686-676: The box by a simple response such as pulling a cord or pushing a pole, but when first constrained, the cats took a long time to get out. With repeated trials ineffective responses occurred less frequently and successful responses occurred more frequently, so the cats escaped more and more quickly. Thorndike generalized this finding in his law of effect , which states that behaviors followed by satisfying consequences tend to be repeated and those that produce unpleasant consequences are less likely to be repeated. In short, some consequences strengthen behavior and some consequences weaken behavior. By plotting escape time against trial number Thorndike produced

10823-412: The clearest and most convincing examples of operant control. Of the concepts and procedures described in this article, a few of the most salient are the following: (a) availability of primary reinforcement (e.g. a bag of dog yummies); (b) the use of secondary reinforcement, (e.g. sounding a clicker immediately after a desired response, then giving yummy); (c) contingency, assuring that reinforcement (e.g.

10960-449: The clicker) follows the desired behavior and not something else; (d) shaping, as in gradually getting a dog to jump higher and higher; (e) intermittent reinforcement, as in gradually reducing the frequency of reinforcement to induce persistent behavior without satiation; (f) chaining, where a complex behavior is gradually constructed from smaller units. Applied behavior analysis is the discipline initiated by B. F. Skinner that applies

11097-494: The client. This exposure involves not only the cues of the "model person" as well as the situations of a certain behaviour that way the relationship can be seen between the appropriateness of a certain behaviour and situation in which that behaviour occurs is demonstrated. With the behavioural rehearsal and homework treatment a client gets a desired behaviour during a therapy session and then they practice and record that behaviour between their sessions. Aversion therapy and punishment

11234-479: The cognitive shift is the key mechanism of change. Aaron and his daughter Judith S. Beck founded the Beck Institute for Cognitive Therapy and Research in 1994. This was later renamed the "Beck Institute for Cognitive Behavior Therapy." In 1995, Judith released Cognitive Therapy: Basics and Beyond , a treatment manual endorsed by her father Aaron. As cognitive therapy continued to grow in popularity,

11371-530: The concept had its share of advocates and critics in the west, its introduction in the Asian setting, particularly in India 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. While many behaviour therapists remain staunchly committed to the basic operant and respondent paradigm, in

11508-607: The conclusion that the way in which his patients perceived and attributed meaning in their daily lives—a process known as cognition —was a key to therapy. Beck outlined his approach in Depression: Causes and Treatment in 1967. He later expanded his focus to include anxiety disorders, in Cognitive Therapy and the Emotional Disorders in 1976, and other disorders later on. He also introduced

11645-457: The desired behaviour. Secondly those people involved have to monitor the behaviours. Third, if the desired behaviour is not being performed in the way that was agreed upon in the contract the punishments that were defined in the contract must be done. Fourth if the persons involved are complying with the contract they must receive bonuses. The last element involves documenting the compliance and noncompliance while using this treatment in order to give

11782-400: The desired final (or "target") behavior. Next, the trainer chooses a behavior that the animal or person already emits with some probability. The form of this behavior is then gradually changed across successive trials by reinforcing behaviors that approximate the target behavior more and more closely. When the target behavior is finally emitted, it may be strengthened and maintained by the use of

11919-407: The environmental and self-imposed variables are. These variables are the things that are allowing a person to maintain their maladaptive feelings, thoughts and behaviours. In a behavioural assessment "person variables" are also considered. These "person variables" come from a person's social learning history and they affect the way in which the environment affects that person's behaviour. An example of

12056-529: The first known animal learning curves through this procedure. Humans appear to learn many simple behaviors through the sort of process studied by Thorndike, now called operant conditioning. That is, responses are retained when they lead to a successful outcome and discarded when they do not, or when they produce aversive effects. This usually happens without being planned by any "teacher", but operant conditioning has been used by parents in teaching their children for thousands of years. B.F. Skinner (1904–1990)

12193-434: The former). Two related terms are behaviour therapy and applied behaviour analysis . Since techniques derived from behavioural psychology tend to be the most effective in altering behaviour, most practitioners consider behaviour modification along with behaviour therapy and applied behaviour analysis to be founded in behaviourism . While behaviour modification and applied behaviour analysis typically uses interventions based on

12330-617: The functioning of people who were diagnosed with chronic schizophrenia. Early pioneers in behaviour therapy include Joseph Wolpe and Hans Eysenck . In general, behaviour therapy is seen as having three distinct points of origin: South Africa (Wolpe's group), the United States (Skinner), and the United Kingdom (Rachman and Eysenck). Each had its own distinct approach to viewing behaviour problems. Eysenck in particular viewed behaviour problems as an interplay between personality characteristics, environment, and behaviour. Skinner's group in

12467-619: The how, when, where and what questions. Tests such as the Rorschach inkblot test or personality tests like the MMPI ( Minnesota Multiphasic Personality Inventory ) are not commonly used for behavioural assessment because they are based on personality trait theory assuming that a person's answer to these methods can predict behaviour. Behaviour assessment is more focused on the observations of a person's behaviour in their natural environment. Behavioural assessment specifically attempts to find out what

12604-672: The individual working with the therapist to develop skills for testing and changing beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors. A cognitive case conceptualization is developed by the cognitive therapist as a guide to understand the individual's internal reality, select appropriate interventions and identify areas of distress. Precursors of certain aspects of cognitive therapy have been identified in various ancient philosophical traditions, particularly Stoicism . For example, Beck's original treatment manual for depression states, "The philosophical origins of cognitive therapy can be traced back to

12741-447: The individual's goals (by identifying thoughts, feelings or behavior that conflict with the goals). Beck initially focused on depression and developed a list of "errors" ( cognitive distortion ) in thinking that he proposed could maintain depression, including arbitrary inference , selective abstraction , overgeneralization, and magnification (of negatives) and minimization (of positives). As an example of how CT might work: Having made

12878-547: The issue by managing competing thoughts and emotions, often in conjunction with behavioural learning principles. A 2013 Cochrane review comparing behaviour therapies to psychological therapies found them to be equally effective, although at the time the evidence base that evaluates the benefits and harms of behaviour therapies was weak. Precursors of certain fundamental aspects of behaviour therapy have been identified in various ancient philosophical traditions, particularly Stoicism . For example, Wolpe and Lazarus wrote, While

13015-433: The key or pressing the lever leads to less food (omission training). Another apparent operant behavior that appears without reinforcement is contrafreeloading . These observations and others appear to contradict the law of effect , and they have prompted some researchers to propose new conceptualizations of operant reinforcement (e.g. ) A more general view is that autoshaping is an instance of classical conditioning ;

13152-570: The largest effect size for training social skills, followed by modelling , coaching, and social cognitive techniques in that order. Social skills training has some empirical support particularly for schizophrenia . However, with schizophrenia, behavioural programs have generally lost favour. Some other techniques that have been used in behaviour therapy are contingency contracting, response costs, token economies, biofeedback, and using shaping and grading task assignments. Shaping and graded task assignments are used when behaviour that needs to be learned

13289-399: The light that sets the occasion for lever pressing may be used to reinforce "turning around" in the presence of a noise. This results in the sequence "noise – turn-around – light – press lever – food". Much longer chains can be built by adding more stimuli and responses. In escape learning, a behavior terminates an (aversive) stimulus. For example, shielding one's eyes from sunlight terminates

13426-419: The loss of a parent, rejection by peers, bullying, criticism from teachers or parents, the depressive attitude of a parent or other negative events. When a person with such schemas encounters a situation that resembles the original conditions of the learned schema, the negative schemas are activated. Beck's negative triad holds that depressed people have negative thoughts about themselves, their experiences in

13563-469: The maladaptive behaviour and (2) what type of behaviour therapy or technique that can help the individual improve most effectively. The first question involves looking at all aspects of a person, which can be summed up by the acronym BASIC ID. This acronym stands for behaviour, affective responses, sensory reactions, imagery, cognitive processes, interpersonal relationships and drug use. Behaviour therapy based its core interventions on functional analysis. Just

13700-449: The modern behavior therapist deliberately applies principles of learning to this therapeutic operations, empirical behavior therapy is probably as old as civilization – if we consider civilization as having started when man first did things to further the well-being of other men. From the time that this became a feature of human life there must have been occasions when a man complained of his ills to another who advised or persuaded him of

13837-410: The motives, incentives and decision making of groups and individuals, at least as effectively – if not more effectively – than direct instruction, legislation, or enforcement. The concept of praise as a means of behavioral reinforcement is rooted in B.F. Skinner's model of operant conditioning. Through this lens, praise has been viewed as a means of positive reinforcement, wherein an observed behavior

13974-424: The non-profit "Academy of Cognitive Therapy" was created in 1998 to accredit cognitive therapists, create a forum for members to share research and interventions, and to educate the public about cognitive therapy and related mental health issues. The academy later changed its name to the "Academy of Cognitive & Behavioral Therapies". The 2011 second edition of "Basics and Beyond" (also endorsed by Aaron T. Beck)

14111-485: The occasion for responses that produce reward or punishment. Example: a rat may be trained to press a lever only when a light comes on; a dog rushes to the kitchen when it hears the rattle of his/her food bag; a child reaches for candy when s/he sees it on a table. Most behavior is under stimulus control. Several aspects of this may be distinguished: Most behavior cannot easily be described in terms of individual responses reinforced one by one. The scope of operant analysis

14248-428: The opposite to be the case, positive reinforcement proving to be the more effective form of learning when dopamine activity is high. A neurochemical process involving dopamine has been suggested to underlie reinforcement. When an organism experiences a reinforcing stimulus, dopamine pathways in the brain are activated. This network of pathways "releases a short pulse of dopamine onto many dendrites , thus broadcasting

14385-542: The organism "avoids" the US in the sense of anticipating it, but rather that the organism "escapes" an aversive internal state that is caused by the CS. Several experimental findings seem to run counter to two-factor theory. For example, avoidance behavior often extinguishes very slowly even when the initial CS-US pairing never occurs again, so the fear response might be expected to extinguish (see Classical conditioning ). Further, animals that have learned to avoid often show little evidence of fear, suggesting that escape from fear

14522-814: The patient. Modelling has been used in dealing with fears and phobias. Fears are thought to develop through observational learning, and so positive modelling, when a person's behaviour is imitated, can used to counter these effects. In a systematic review of 1,677 papers, positive modelling was found to lower fear levels. Modelling has been used in the treatment of fear of snakes as well as a fear of water. Aversive therapy techniques have been used to treat sexual deviations, as well as alcohol use disorder. Exposure and prevention procedure techniques can be used to treat people who have anxiety problems as well as any fears or phobias. These procedures have also been used to help people dealing with any anger issues as well as pathological grievers (people who have distressing thoughts about

14659-477: The persons involved consistent feedback about the target behaviour and the provision of reinforcers. Token economies is a behaviour therapy technique where clients are reinforced with tokens that are considered a type of currency that can be used to purchase desired rewards, like being able to watch television or getting a snack that they want when they perform designated behaviours. Token economies are mainly used in institutional and therapeutic settings. In order for

14796-423: The posterior cortical regions like the primary visual cortex . A study of patients with Parkinson's disease , a condition attributed to the insufficient action of dopamine, further illustrates the role of dopamine in positive reinforcement. It showed that while off their medication, patients learned more readily with aversive consequences than with positive reinforcement. Patients who were on their medication showed

14933-443: The principles of conditioning to the modification of socially significant human behavior. It uses the basic concepts of conditioning theory, including conditioned stimulus (S ), discriminative stimulus (S ), response (R), and reinforcing stimulus (S or S for reinforcers, sometimes S for aversive stimuli). Practitioners of applied behavior analysis (ABA) bring these procedures, and many variations and developments of them, to bear on

15070-399: The principles of operant conditioning to language, a form of human behavior that had previously been analyzed quite differently by linguists and others. Skinner defined new functional relationships such as "mands" and "tacts" to capture some essentials of language, but he introduced no new principles, treating verbal behavior like any other behavior controlled by its consequences, which included

15207-540: The process of satiation helps the organism maintain a stable internal environment ( homeostasis ). When an organism has been deprived of sugar, for example, the taste of sugar is an effective reinforcer. When the organism's blood sugar reaches or exceeds an optimum level the taste of sugar becomes less effective or even aversive. Shaping is a conditioning method often used in animal training and in teaching nonverbal humans. It depends on operant variability and reinforcement, as described above. The trainer starts by identifying

15344-551: The progress of clients. Skinner became interested in the individualising of programs for improved learning in those with or without disabilities and worked with Fred S. Keller to develop programmed instruction . Programmed instruction had some clinical success in aphasia rehabilitation. Gerald Patterson used programme instruction to develop his parenting text for children with conduct problems. (see Parent management training .) With age, respondent conditioning appears to slow but operant conditioning remains relatively stable. While

15481-857: The purpose of killing in combat. Following acceptance of Marshall's research by the US Army in 1946, the Human Resources Research Office of the US Army began implementing new training protocols which resemble operant conditioning methods. Subsequent applications of such methods increased the percentage of soldiers able to kill to around 50% in Korea and over 90% in Vietnam. Revolutions in training included replacing traditional pop-up firing ranges with three-dimensional, man-shaped, pop-up targets which collapsed when hit. This provided immediate feedback and acted as positive reinforcement for

15618-493: The question is still in need of answers. The behavioural approach to therapy assumes that behaviour that is associated with psychological problems develops through the same processes of learning that affects the development of other behaviours. Therefore, behaviourists see personality problems in the way that personality was developed. They do not look at behaviour disorders as something a person has, but consider that it reflects how learning has influenced certain people to behave in

15755-437: The reactions of the speaker's audience. Operant behavior is said to be "emitted"; that is, initially it is not elicited by any particular stimulus. Thus one may ask why it happens in the first place. The answer to this question is like Darwin's answer to the question of the origin of a "new" bodily structure, namely, variation and selection. Similarly, the behavior of an individual varies from moment to moment, in such aspects as

15892-451: The same behavioural principles, many behaviour modifiers who are not applied behaviour analysts tend to use packages of interventions and do not conduct functional assessments before intervening. Possibly the first occurrence of the term "behavior therapy" was in a 1953 research project by B.F. Skinner , Ogden Lindsley , Nathan Azrin and Harry C. Solomon . The paper talked about operant conditioning and how it could be used to help improve

16029-413: The second half of the 20th century, many therapists coupled behaviour therapy with the cognitive therapy , of Aaron Beck , Albert Ellis , and Donald Meichenbaum to form cognitive behaviour therapy . In some areas the cognitive component had an additive effect (for example, evidence suggests that cognitive interventions improve the result of social phobia treatment.) but in other areas it did not enhance

16166-550: The shock. Two crucial time intervals determine the rate of avoidance learning. This first is the S-S (shock-shock) interval. This is time between successive shocks in the absence of a response. The second interval is the R-S (response-shock) interval. This specifies the time by which an operant response delays the onset of the next shock. Each time the subject performs the operant response, the R-S interval without shock begins anew. This theory

16303-491: The situation? Why else did it happen?" "What's the effect of thinking or believing this? What could be the effect of thinking differently and no longer holding onto this belief?" "Imagine a specific friend/family member in the same situation or if they viewed the situation this way, what would I tell them?" Examples of socratic questions are: False assumptions are based on "cognitive distortions", such as: Rational emotive behavior therapy (REBT) includes awfulizing, when

16440-445: The small steps that their child achieves towards reaching a larger goal (this concept is called "successive approximations"). Both psychologists and economists have become interested in applying operant concepts and findings to the behavior of humans in the marketplace. An example is the analysis of consumer demand, as indexed by the amount of a commodity that is purchased. In economics, the degree to which price influences consumption

16577-402: The specific motions involved, the amount of force applied, or the timing of the response. Variations that lead to reinforcement are strengthened, and if reinforcement is consistent, the behavior tends to remain stable. However, behavioral variability can itself be altered through the manipulation of certain variables. Reinforcement and punishment are the core tools through which operant behavior

16714-431: The subject he is modelling the greater the effectiveness of the treatment. While undergoing exposure therapy, a person typically needs five sessions to assess the treatment's effectiveness. After five sessions, exposure treatment has been shown to provide benefit to the patient. However, it is still recommended treatment continue beyond the initial five sessions. Cognitive psychotherapy Cognitive therapy ( CT )

16851-594: The subject to make one or two simple, repeatable responses, and the rate of such responses became Skinner's primary behavioral measure. Another invention, the cumulative recorder, produced a graphical record from which these response rates could be estimated. These records were the primary data that Skinner and his colleagues used to explore the effects on response rate of various reinforcement schedules. A reinforcement schedule may be defined as "any procedure that delivers reinforcement to an organism according to some well-defined rule". The effects of schedules became, in turn,

16988-459: The term "modifying behavior". Through early research in the 1940s and the 1950s the term was used by Joseph Wolpe 's research group. The experimental tradition in clinical psychology used it to refer to psycho-therapeutic techniques derived from empirical research. It has since come to refer mainly to techniques for increasing adaptive behaviour through reinforcement and decreasing maladaptive behaviour through extinction or punishment (with emphasis on

17125-435: The tokens need to be replaced with less tangible rewards such as compliments so that the client will be prepared when they leave the institution and won't expect to get something every time they perform a desired behaviour. Closely related to token economies is a technique called response costs. This technique can either be used with or without token economies. Response costs is the punishment side of token economies where there

17262-516: The treatment group they are in. Operant conditioning Operant conditioning , also called instrumental conditioning , is a learning process where voluntary behaviors are modified by association with the addition (or removal) of reward or aversive stimuli. The frequency or duration of the behavior may increase through reinforcement or decrease through punishment or extinction . Operant conditioning originated with Edward Thorndike , whose law of effect theorised that behaviors arise as

17399-506: The treatment of the mental illness but instead on the behavioural aspects of a patient. The response cost technique has been used to successfully address a variety of behaviours such as smoking, overeating, stuttering, and psychotic talk. Systematic desensitization has been shown to successfully treat phobias about heights, driving, insects as well as any anxiety that a person may have. Anxiety can include social anxiety, anxiety about public speaking as well as test anxiety. It has been shown that

17536-450: The treatment, which led to the pursuit of third generation behaviour therapies. 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 inline with view of the behaviour analysts. Some research supports these therapies as being more effective in some cases than cognitive therapy, but overall

17673-419: The type of treatment). They may be single-blinded, the rater may not know the treatment the patient received, but neither the patients nor the therapists are blinded to the type of therapy given (two out of three of the persons involved in the trial, i.e., all of the persons involved in the treatment, are unblinded). The patient is an active participant in correcting negative distorted thoughts, thus quite aware of

17810-409: The use of systematic desensitization is an effective technique that can be applied to a number of problems that a person may have. When using modelling procedures this technique is often compared to another behavioural therapy technique. When compared to desensitization, the modelling technique does appear to be less effective. However it is clear that the greater the interaction between the patient and

17947-413: The use of the term noncontingent "reinforcement". Though initially operant behavior is emitted without an identified reference to a particular stimulus, during operant conditioning operants come under the control of stimuli that are present when behavior is reinforced. Such stimuli are called "discriminative stimuli." A so-called " three-term contingency " is the result. That is, discriminative stimuli set

18084-419: The world, and the future. For instance, a depressed person might think, "I didn't get the job because I'm terrible at interviews. Interviewers never like me, and no one will ever want to hire me." In the same situation, a person who is not depressed might think, "The interviewer wasn't paying much attention to me. Maybe she already had someone else in mind for the job. Next time I'll have better luck, and I'll get

18221-517: Was originally constructed following research studies conducted by Aaron Beck to explain the psychological processes in depression. It divides the mind beliefs in three levels: In 2014, an update of the cognitive model was proposed, called the Generic Cognitive Model (GCM). The GCM is an update of Beck's model that proposes that mental disorders can be differentiated by the nature of their dysfunctional beliefs . The GCM includes

18358-485: Was originally proposed in order to explain discriminated avoidance learning, in which an organism learns to avoid an aversive stimulus by escaping from a signal for that stimulus. Two processes are involved: classical conditioning of the signal followed by operant conditioning of the escape response: a) Classical conditioning of fear. Initially the organism experiences the pairing of a CS with an aversive US. The theory assumes that this pairing creates an association between

18495-544: Was titled Cognitive Behavioral Therapy: Basics and Beyond, Second Edition , and adopted the name "CBT" for Aaron's therapy from its beginning. This further blurred the boundaries between the concepts of "CT" and "CBT". Therapy may consist of testing the assumptions which one makes and looking for new information that could help shift the assumptions in a way that leads to different emotional or behavioral reactions. Change may begin by targeting thoughts (to change emotion and behavior), behavior (to change feelings and thoughts), or

18632-489: Was too simplistic to be used to describe something as complex as human behavior. Operant conditioning, in his opinion, better described human behavior as it examined causes and effects of intentional behavior. To implement his empirical approach, Skinner invented the operant conditioning chamber , or " Skinner Box ", in which subjects such as pigeons and rats were isolated and could be exposed to carefully controlled stimuli. Unlike Thorndike's puzzle box, this arrangement allowed

18769-447: Was updated in 2016 to incorporate multiple levels of analyses, new research, and key concepts (e.g., resilience) within the framework of an evolutionary perspective. Cognitive therapy has been applied to a very wide range of behavioral health issues including: A criticism has been that clinical studies of CT efficacy (or any psychotherapy) are not double-blind (i.e., neither subjects nor therapists in psychotherapy studies are blind to

#120879