Psychology Primer: Behaviorism and Cognitive Behavioral Therapy

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Psychology Primer
By Cyndi Lupo, BA Psych

Tutorial 1: Theory

Tutorial 2: Application

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Behaviorism and Cognitive Behavioral Therapy

Born out of a rejection of the psychoanalytic school of thought, behaviorism sought to establish a rational and, more importantly, quantifiable explanation for human behavior. Although not the original founder of the philosophy, B.F. Skinner is the most widely recognized proponent of the school of thought.

Integral to the concept of behaviorism is the concept of behavior modification through rewards or consequences. Additionally, the concepts of behavior stemming purely from a response to a given stimulus are key. In modern practice, behavioral principles are utilized extensively in the areas of group dynamics and behavioral modification.

More broadly, they can be applied to the concept of socialization, that is the molding of a person’s behavior into a socially accepted form of expression through a figurative “stick and carrot” approach. Interestingly enough, this concept of rewards and consequences to modify behavior can easily illustrate one of Freud’s concepts: that of the pleasure/pain principle.

Although it can be credited for taking a more scientific approach to the understanding of human behavior, behaviorism seems better suited as an applied concept useful for interventions (efforts to address certain behaviors) than an actual construct capable of explaining the complexities of personality. Pure behaviorism also has a tendency to de-humanize, in that it recognizes no difference between human and animal behavior. While evolutionarily speaking, with regards to the corporeal body, this may be true, the acknowledgment of humans, and by extension in Star Trek, humanoids, as being a higher form of animal life due to sentience and all of the myriad of issues that accompany it, is lacking.

Behaviorism Modification

Where behaviorism has its strengths, however is in its application as a tool for behavior modification, particularly in social constructs. Through the use of positive and negative reinforcement techniques almost any negative or socially unacceptable behavior can be reduced while conversely positive behavior can be enhanced.

For example, lets say that you have a Simmer who is constantly “throwing a monkey wrench” into your sims, blowing up the ship, inviting hostile aliens aboard at inappropriate times, or generally just aggravating the heck out of the crew. You can count on the Command staff to address the behavior, but one of the ways that they will likely do so is to call upon you is to work with the simmer to modify their behavior so that the simmer can be retained aboard a particular vessel.

One technique for handling this sort of situation would be to use the “sandwich” technique of constructive criticism, wherein you would sit the young ensign down and praise them for something they’ve done, or acknowledge at the very least the important role that they play on board the ship and the potential that they have to be a great officer.

Then you would identify the negative behaviors that the command staff are concerned about and illustrate how those behaviors negatively impact the ensign’s ability to achieve that potential. It is here where you would explore the ensign’s difficulties in conformity to orders or etiquette, perhaps lay out possible consequences for continued negative behavior and if possible rewards for good behavior.

Maybe the ensign feels that the only attention he or she is receiving is negative. You could validate that it is important for the ensign to be recognized for work well done, and point out that the command staff is showing confidence in the ensign by referring him or her to you out of a desire to retain the ensign as a valuable member of the crew.

Then, after dealing with the negative and possible consequences for the ensign’s actions, you would again find a way to end the session on a positive and upbeat note. This is just one of the variations of “stimulus/ response” being utilized to achieve a positive outcome, and should form the foundation of your dealings with each crew member.

The following overview of Cognitive Behavioral Therapy, a methodology that evolved out of more traditional forms of Behaviorism has been taken from the Wikipedia:

CBT can be seen as an umbrella term for many different therapies that share some common elements and theoretical underpinnings.[1] While similar views of emotion have existed for millennia[citation needed], one of the earliest form of Cognitive Behavior Therapy was Rational Therapy pioneered by Albert Ellis (1913-2007) in the early 1950s. Ellis eventually called his system Rational Emotive Behavioral Therapy in the mid 1990s, or REBT. It was partly founded as a reaction against popular psychotherapeutic theories at the time, mainly psychoanalysis.[2] Aaron T. Beck, inspired by Ellis developed another CBT approach, called Cognitive Therapy, in the 1960s.[3] Cognitive therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today.

Concurrently with the pioneering contributions of Ellis and Beck, starting in the late 1950s and continuing through the 1970s, Arnold A. Lazarus developed what was arguably the first form of "Broad-Spectrum" Cognitive-Behavior Therapy. Indeed, in 1958, Arnold Lazarus was the first person to introduce the terms "behavior therapy" and "behavior therapist" into the professional literature (i.e., Lazarus, A. A. "New methods in psychotherapy: a case study". South African Medical Journal, 1958, 32, 660-664).[citation needed] He later broadened the focus of behavioral treatment to incorporate cognitive aspects (e.g., see Arnold Lazarus' 1971 landmark book Behavior Therapy and Beyond, perhaps the first clinical text on CBT). When it became clear that optimizing therapy's effectiveness and effecting durable treatment outcomes often required transcending more narrowly focused cognitive and behavioral methods, Arnold Lazarus expanded the scope of CBT to include physical sensations (as distinct from emotional states), visual images (as distinct from language-based thinking), interpersonal relationships, and biological factors. The final product of Arnold Lazarus' approach to psychotherapy is called Multimodal Therapy and is, perhaps, the most comprehensive form of CBT in addition to REBT that also shares many of the same assumptions and theorizing.

Cognitive Behavioral Group Therapy (CBGT) is also a similar approach in treating mental illnesses, based on the protocol by Richard Heimberg.[4] In this case, clients participate in a group and recognize they are not alone in suffering from their problems. A sub-field of cognitive behavioral therapy used to treat Obsessive Compulsive Disorder makes use of classical conditioning through extinction (a type of conditioning) and habituation. (The specific technique, Exposure with Response Prevention (ERP) has been demonstrated to be more effective than the use of medication—typically SSRIs—alone). CBT has also been successfully applied to the treatment of Generalized Anxiety Disorder, health anxiety, Social phobia and Panic Disorder. In recent years, CBT has been used to treat symptoms of schizophrenia, such as delusions and hallucinations. This use has been developed in the UK by Douglas Turkington and David Kingdon.

Other types of Cognitive Behavioral Therapy include Dialectical Behavior Therapy, Self-Instructional Training, Schema-Focused Therapy and many others.[5]

CBT has good evidence for its effectiveness in reducing symptoms and preventing relapse. It has been clinically demonstrated in over 400 studies to be effective for many psychiatric disorders and medical problems for both children and adolescents. It has been recommended in the UK by the National Institute for Health and Clinical Excellence as a treatment of choice for a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa and clinical depression.

Cognitive Behavioral Therapy most closely allies with the Scientist-Practitioner Model of Clinical Psychology, in which clinical practice and research is informed by: a scientific perspective; clear operationalization of the "problem" or "issue"; an emphasis on measurement (and measurable changes in cognition and behavior); and measurable goal-attainment.

Cognitive Behavioral Therapy (CBT) is an umbrella-term for psychotherapies that deal with cognitions, assumptions, beliefs, evaluations and behaviors, with the aim of influencing emotions and behaviors that relate to maladaptive and dysfunctional appraisal of events. The general approach, developed out of behavior modification, Cognitive Therapy and Rational Emotive Behavior Therapy, has become widely used to treat various kinds of psychopathology, including mood disorders and anxiety disorders. The particular therapeutic techniques vary within the different approaches of CBT according to the particular kind of problem issues, but commonly may include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing cognitions, assumptions, evaluations and beliefs that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting. Relaxation, mindfulness and distraction techniques are also commonly included. CBT is widely accepted as an evidence- and empiricism-based, cost-effective psychotherapy for many disorders and psychological problems. It is sometimes used with groups of people as well as individuals, and the techniques are also commonly adapted for self-help manuals and, increasingly, for self-help software packages.

One of the objectives of CBT typically is to identify and monitor thoughts, assumptions, beliefs and behaviors that are related and accompanied to debilitating negative emotions and to identify those which are dysfunctional, inaccurate, or simply unhelpful. This is done in an effort to in a wide array of different methodologies replace or transcend them with more realistic and self-helping ways.

An example from cognitive therapy may illustrate this process: Having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this, in turn, tends to worsen his mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming his negative belief to himself. As a result, an adaptive response and further constructive consequence becomes unlikely, which reinforces the original belief of being "useless." In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change it. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the client escapes the negative thought patterns and destructive behaviors, the feelings of depression may, over time, be relieved. The client may then become more active, succeed and respond more adaptive more often, and further reduce or cope with his negative feelings.

Cognitive behavioral therapy generally is not an overnight process. Even after patients have learned to recognize when and where their mental processes go awry, it can take months of effort to replace a dysfunctional cognitive-affective-behavioral process or habit with a more reasonable and adaptive one.

The cognitive model especially emphasized in psychiatrist Aaron Beck's cognitive therapy says that a person's core beliefs (often formed in childhood) contribute to "automatic thoughts" that pop up in everyday life in response to situations. Cognitive Therapy practitioners commonly hold that clinical depression is typically associated with negatively biased thinking and dysfunctional thoughts.

Cognitive behavioral therapy (CBT) is often used in conjunction with mood stabilizing medications to treat conditions like bipolar disorder. The CBT approach is useful in dealing with sim characters suffering from some forms of depression or exhibiting self sabotaging behaviors, as well as treating some forms of anxiety and obsessive compulsive disorders as well.

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