Tuesday, 23 June 2009

Useful sites for CBT

Institute of Psychiatry - Kings College London
http://www.iop.kcl.ac.uk/
The Institute of Psychiatry provides post-graduate education and carries out research in psychiatry, psychology, and allied disciplines, including basic and clinical neurosciences. The Institute is world renowned for the quality of its research and it became a school of King's College in August 1997.

King's College London
http://www.kcl.ac.uk
King's College London is one of the two oldest and largest colleges of the University of London: a major multi-faculty university institution with some 19,200 students. It occupies several historic sites in central London. These include the Strand (its founding campus, next to Somerset House); the former Public Record Office building in Chancery Lane; Guy's Hospital, London Bridge; Denmark Hill, South London (which includes The Institute of Psychiatry), and St Thomas' Hospital, Lambeth Palace Road.

South London and Maudsley NHS Trust
http://www.slam.nhs.uk
The South London and Maudsley NHS Trust is closely affiliated to the Institute of Psychiatry and provides mental health and substance misuse services to people from Croydon, Lambeth, Southwark and Lewisham, and substance misuse services in Bexley, Greenwich and Bromley. It also provides specialist services to people from across the UK.

British Association of Behavioural & Cognitive Psychotherapies
http://www.babcp.org.uk
The British Association for Behavioural and Cognitive Psychotherapies (BABCP)is a multi-disciplinary interest group for people involved in the practice and theory of behavioural and cognitive psychotherapy. There are excellent sections on the BABCP website relating to Training Courses and Accreditation, as well as a search facility for a Private BABCP Accredited Therapist.

Association for Psychological Therapies
http://www.apt.ac
The Association for Psychological Therapies is a provider in basic training in CBT.

International Association for Cognitive Psycotherapy
http://www.cognitivetherapyassociation.org
The International Association for Cognitive Psychotherapy (IACP) is a professional, scientific, interdisiplinary organisation whose mission is to facilitate the utilisation and growth of cognitive psychotherapy as a professional activity and scientific discipline. In addition, the Association serves as a resource and information centre for matters related to cognitive psychotherapy.

Association for the Advancement of Behavior Therapy
http://www.aabt.org
The Association for Advancement of Behaviour Therapy is a professional, interdisciplinary organisation that is concerned with the application of behavioural and cognitive sciences to understanding human behaviour, developing interventions to enhance the human condition, and promoting the appropriate utilisation of these interventions.

British Psychological Society
http://www.bps.org.uk
The British Psychological Society (BPS) is the representative body for psychologist and psychology in the UK.

United Kingdom Council for Psychotherapy
http://www.psychotherapy.org.uk
United Kingdom Council for Psychotherapy (UKCP) exists to promote and maintain the profession of psychotherapy and the highest standards in the practice of psychotherapy throughout the United Kingdom, for the benefit of the public.

The British Confederation of Psycotherapists
http://www.bcp.org.uk
The British Confederation of Psychotherapists (BCP) is a national body linking mostly long-standing training and professional organisations in the field of psychoanalysis, analytical psychology, psychoanalytic psychotherapy, and child psychotherapy.

British Association for Counselling and Psycotherapy
http://www.bacp.co.uk
The British Association for Counselling and Psycotherapy (BACP) is leading the effort to make counselling and psychotherapy widely recognised as a profession whose purpose and activity is understood by the general public.

PsychNet-UK
http://www.psychnet-uk.com/
PsychNet-UK is an independent private web site which was conceived, developed and is run for the benefit of mental health professionals or those interested in mental health practices.

Mental Health Care
http://www.mentalhealthcare.org.uk/
Mental Health Care is aimed at anyone providing support to someone experiencing mental illness. The web site contains information about mental health and mental illness, research findings from the Institute of Psychiatry and South London and Maudsley Trust and personal stories written by carers.

Monday, 8 June 2009

Cognitive Behavioural Anxiety Management

Behavioral and Cognitive Approaches In Anxiety Management
Behavioral And Cognitive Approaches In The Management Of Anxiety

Behavioural and Cognitive Approaches in the Management of Anxiety

The Behavioural Model sees the cause of abnormality as the learning of maladaptive habits. It aims to discover, by laboratory

experiment, what aspect of the environment produced this learning, and it sees successful therapy as learning new and more

adaptive ways of behaving. There are two kinds of basic learning processes that exist: Operant and Pavlovian conditioning.

These have generated a set of behavioural therapies.

Pavlovian or Classical therapies begin with the assumption that emotional habits have been acquired by the contingency

between a conditioned stimulus and an unconditional stimulus. The formerly neutral conditioned stimulus now produces a

conditioned response, which is the acquired emotion. Two Pavlovian therapies, Systematic Desensitisation and Flooding,

extinguish some maladaptive emotional habits quite successfully.

Systematic Desensitisation is a behaviour therapy primarily used to treat phobias and specific anxieties. The phobic is first

given training in deep muscle relaxation and is progressively exposed to increasing anxiety-evoking situations (real or

imagined). Because relaxation and fear are mutually exclusive, stimuli that formerly induced panic are now greeted calmly. A

classic demonstration of this therapy was carried out by Jones (1924). She successfully treated a young boy's fear of rabbits

by having him eating in the presence of a rabbit, while gradually bringing the rabbit closer to him over a number of

occasions. The encourage of a pleasant response such as eating is incompatible with fear.

In Flooding the phobic is exposed to situations or objects most feared for an extended length of time without an opportunity

to escape. In one study, agoraphobics went through several sessions in which they had to go out into the street and walk

alone until they could no longer manage. A few such sessions led to a marked improvement as judged by both client and

therapist (Emmelkamp and Wessels ,1975). In flooding, the treatment is carried out in vivo, that is, in real life. But,

real-life exposure to threatening stimuli is often impossible or impractical. It's not all that easy to bring snakes and dogs

into a therapist's office to do flooding therapy. Under the circumstances, the next best thing is in vitro, in a simulation,

and refers to the use of imagery. One example is implosion therapy, and the patient must imagine the most terrifying

situation he could possibly conceive.

Another behaviour therapy technique, Aversion therapy, tries to attach negative feelings to stimulus situations that are

initially very attractive so that the patient will no longer want to approach them. The object of this endeavour is to

eliminate behaviour patterns that both patient and therapist regard as undesirable. Examples are overeating, or excessive

drinking.

Operant conditioning is based on three concepts: Reinforcer, operant and discriminative stimulus. Operant therapies are based

on the assumption that people acquire voluntary habits by positive reinforcement and punishment. Operant therapies provide

new and more adaptive repertoires of voluntary responses. Among such therapies are Selective Positive Reinforcement,

Selective Punishment and Extinction. In Selective Positive Reinforcement the therapist delivers positive reinforcement

contingent on the occurrence of one particular behaviour. In Selective Punishment, the therapist negatively reinforces a

certain target event, causing it to decrease in probability. Extinction occurs when there is a negative contingency between

the conditioned stimulus and the unconditioned stimulus. These three techniques have all been applied with success to such

disorders as Anorexia Nervosa, a disorder in which the individual has an intense fear of becoming fat, eats too little to

sustain herself, and has a distorted body image.

Avoidance Learning, the act of getting out of a situation that has been previously associated with an aversive event, there

by preventing the aversive event, combines operant and Pavlovian theory, and helps us in the treatment of

obsessive-compulsive disorders.

Cognitive school is an outgrowth and reaction to the behavioural school. In contrast to the behaviourists, the cognitive

school holds that mental events are not epiphenomena, rather they cause behaviour. More particularly, disordered cognitions

will alleviate and sometimes cure psychopathology. Cognitive therapy is carried out by attempting to change different sorts

of mental events, which can be divided into short-term mental events and long-term mental events. Some short-term mental

events consist of expectations, including outcome (a person's estimate that a given behaviour will lead to the desired

outcome) and efficacy expectations (a person's belief that he can successfully execute the behaviour that will produce a

desires outcome). Other short-term mental events are appraisals, or mental evaluations of our experience, and attributions,

the designations of causes concerning our experience. Long-term mental events include beliefs, some of which are irrational

and illogical.

The main components to cognitive therapy are education, identification of negative automatic thoughts and challenging

dysfunctional schemata. In education, the individual may have little information about anxiety, or may have mistaken

information such as a belief that a panic attack is the same as a heart attack. A key step in cognitive therapy is helping

the individual to identify the negative automatic thoughts that are intimately connected with feelings of depression and

anxiety. These may be identified in the clinical sessions themselves, for example, by asking the individual to role-play a

difficult encounter, or they can be identified in homework by asking the individual to keep a diary of such thoughts in the

situations in which they arise. Once identified, the individual is then encouraged to test their validity, to question them,

and to check for the evidence for and against. The identification and challenging of negative thoughts leads into the final

phase of cognitive therapy which is challenging the dysfunctional schemata that underlie the negative thoughts.

Many therapists practice both cognitive and behavioural therapy and are called cognitive-behavioural therapists. Multi-model

therapy is an example of the use of cognitive and behavioural techniques along with techniques from the other models.

Thus, behavioural therapy is concerned with unwanted, overt behaviour rather than hypothetical underlying causes. Techniques

used are derived from classical and instrumental conditioning. Cognitive therapies are for internal anxieties. The therapy is

concrete and of a directive orientation , but there is no emphasis on conditioning. It tries to change the way the patient

thinks about his/her situation. Other types include various attempts to advance the patients social education, using

techniques such as graded task assignments, modelling and role-playing.

However, phobias and obsessive-compulsive disorders are dominated by the behavioural approach and anxiety by the cognitive

approach.

REFERENCES

Comer,R (1992) Abnormal Psychology. U.S.A.:W.H.Freeman and Company.

Emmelkamp & Wessels (1975) "Flooding in imagination vs. flooding in vivo: A comparison with agoraphobics". Behaviour research

and therapy (13) 7-15.

Rosenham,D & Seligman,M (1989) Abnormal Psychology. London: W.W.Norton & Company Ltd.

Tuesday, 24 March 2009

Rational emotive behaviour therapy .ellis.albert

In 1953 Albert Ellis expounded his theory of Rational Behavior Therapy, later this became known as Rational Emotive Behavior Therapy as Ellis recognised the importance of emotion in his theory.

The fundamental proposition of REBT is that much of our psychological, emotional and behavioral problems are caused by our holding irrational beliefs (IB's). REBT proposes that humans have an innate capacity for both rational and irrational thinking. Irrational beliefs prevent goal attainment, lead to inner conflict (frustration, anxiety and depression), conflict with others (anger) and low self esteem. Rational beliefs lead to attainment of goals and greater self acceptance, acceptance of others and positive self-regard. Irrational beliefs are likely to be illogical, based on limited evidence and assumptions, absolutistic and inflexible. Rational beliefs are more flexible, based in reality and logical.

Ellis states that events alone do not cause a person to feel depressed, angry, or anxious. Rather, it is one’s beliefs about the events which contributes to unhealthy feelings and self defeating behaviors. In other words it is not what is happening that disturbs us but the thoughts that we have and the things that we tell ourselves about what is happening that causes us to feel disturbed. Such a disturbed individual can take this irrationality a step further and become disturbed about our disturbances. For example, feeling guilty about being angry is a disturbance about a disturbance.

Often, these irrational beliefs take the form of extreme or dogmatic 'musts', 'shoulds', or 'oughts'; they contrast with rational and flexible desires, wishes, preferences and wants. The presence of extreme philosophies can make all the difference between healthy negative emotions (such as sadness or regret or concern) and unhealthy negative emotions (such as depression or guilt or anxiety). For example, after experiencing a loss one person's philosophy might take the form: "It is unfortunate that this loss has occurred. It is sad that it has happened, but it is not awful, and I can continue to function." Another's might take the form: "This absolutely should not have happened, and it is horrific that it did. These circumstances are now intolerable, and I cannot continue to function." The first person's response is apt to lead to sadness, while the second person may be well on their way to depression.

It is important to note that REBT maintains all individuals have it within their power to change their beliefs and philosophies profoundly, and thereby to change radically their state of psychological health. Albert Ellis has suggested three fundamental core philosophies that cause disturbance, all irrational beliefs fit within either of these philosophies:

Beliefs about self:
“I must be thoroughly competent, adequate, achieving, and lovable at all times, or else I am an incompetent worthless person." This belief usually leads to feelings of anxiety, panic, depression, despair, and worthlessness.

Beliefs about other people:
“Other significant people in my life, must treat me kindly and fairly at all times, or else I can’t stand it, and they are bad, rotten, and evil persons who should be severely blamed, damned, and vindictively punished for their horrible treatment of me." This leads to feelings of anger, rage, resentment, and vindictiveness.

Beliefs about the world:
"Things and conditions absolutely must be the way I want them to be and must never be too difficult or frustrating. Otherwise, life is awful, terrible, horrible, catastrophic and unbearable." This leads to low-frustration tolerance, self-pity, anger, depression, and to behaviors such as procrastination, avoidance, and inaction.

Just as there are three fundamental irrational philosophies (see above) there are contrasting rational philosophies, they are.

Beliefs about self;
“I am a fallible being, I have my good points and bad points, there is no need for me to be perfect, despite my good and bad points I am no less worthy and no more worthy than any other person”

Beliefs about others;
“other people may treat me unfairly from time to time, there is no reason why people must be fair at all times, people who treat me unfairly are no less and no more worthy than any other person”

Beliefs about life;
“life does not always work out the way I would like it to, there is no reason why life must always be the way I want it to be, life is not always pleasant but it is very rarely unbearable.”

Because the irrational beliefs are viewed as the source of psychological disturbance the goal of REBT is to change the irrational beliefs to more rational ones. REBT takes a directive and educational approach to therapy in which the therapist teaches the client how to identify and challenge irrational thinking and how to think in more rational and flexible ways. Rational Emotive Behaviour Therapy teaches the client to identify, evaluate, dispute, and take action against their irrational self- defeating beliefs, thus helping the client to not only feel better but to get better and to stay better. This is a contrast to problems solving approaches in which the focus is on the immediate problems and solving those problems. In such an approach the individual is not changing the way they respond to events and so when problems arise in the future they are not as well equipped to cope with their problems.

REBT uses a model known as the A-B-C model, this outlines in very simple terms the process and theory of REBT. In the A-B-C model, A is the Actuating event, B is the Belief about the event and C is the consequence. A client may come to therapy feeling disturbed about something that has happened; they will explain that their disturbance is caused by what happened (event A). REB Therapist will work with the client to demonstrate how their disturbance (Consequence C) is not caused by the event (A) but by the belief (B) about what happened.

A crucial part of the REBT is in teaching the connection between the Belief and the Consequence. Understanding this connection shows that it is not the event at A but it is the belief about the event that causes distress. The event at (A) is likely to be something that is not changeable; however the belief (B) is changeable. Changing the belief about the event liberates the individual from the distress (consequence C).

Once the therapist has established the A-B-C and has educated the client to the connection between B and C the REBT moves on to step D of the ABC model. During step D the therapist engages the client in discussions about their irrational beliefs with the intention of changing the irrational beliefs. At this point the therapist is taking a directive role in challenging the client to evaluate their thinking processes and to explore new ways of thinking. If the client is able to realize that their currently held beliefs are irrational and that alternative rational beliefs are more productive and emotionally stable, the client will adopt the new belief and let go of the old beliefs.

REBT has been criticized for its confrontational apporach, not all people cannot accept having their beliefs questioned and may feel like they are being attacked. Ellis himself has said that he practiced the Rogerian principle of unconditional positive regard in his therapy but he also administered “tough love” in disputing with clients. Much of this confrontational style came from Ellis' personality and other practitioners may not be so harsh with their clients.

As with all models of psychotherapy, REBT does not work for everyone. Ellis had his own explanation for why REBT sometimes failed. He suggested that people who claim to putting the principles of REBT to use where doing no such thing. In other cases people just did not want the direct advice that Ellis dispensed. For such clients that are not able to handle the Ellis way of doing therapy, there are other therapeutic approaches which focus on the cathartic expression of feelings or the exploration and solution of problems.

Monday, 23 March 2009

the treatment of stress and anxiety using REBT

the treatment of stress and anxiety using REBT



Anxiety is something we all experience form time to time. Anxiety is a normal response to situations that we see threatening to us. Preparing for an interview, giving a speech at a special occasion would be situations when many people would naturally feel anxious. For some people however anxiety becomes a problem that prevents them from functioning at normal levels. Albert Ellis provided a solution for this in the form of Rational Emotive Behaviour Therapy.



Introduction to Albert Ellis, REBT, Irrational Beliefs.



Albert Ellis developed a therapeutic model for the treatment of emotional and behavioural problems. This model known as Rational Emotive Behaviour Therapy (REBT) proposes that much of our psychological, emotional and behavioural problems are caused by our holding irrational beliefs. According to Ellis Human beings on the basis of their belief system actively, though not always consciously, disturb themselves, and even disturb themselves about their disturbances.



REBT proposes that humans have an innate capacity for both rational and irrational thinking. Irrational beliefs prevent goal attainment, lead to inner conflict (frustration, anxiety and depression), conflict with others (anger) and low self esteem. Rational beliefs lead to attainment of goals and greater self acceptance, acceptance of others and positive self-regard. Irrational beliefs are likely to be illogical, based on limited evidence and assumptions, absolutistic and inflexible. Rational beliefs are more flexible, based in observable facts and logical.



REBT theory explains that irrational beliefs will take the form of dogmatic, extreme and inflexible philosophies. The presence of these philosophies can make all the difference between healthy negative emotions (such as sadness, regret or concern) and unhealthy negative emotions (such as depression, guilt or anxiety). For example, one person's philosophy after experiencing a loss might take the form: "It is unfortunate that this loss has occurred, although there is no actual reason why it should not have occurred. It is sad that it has happened, but it is not awful, and I can continue to function." Another's might take the form: "This absolutely should not have happened, and it is horrific that it did. These circumstances are now intolerable, and I cannot continue to function." The first person's response is apt to lead to sadness, while the second person may be well on their way to depression.



REBT takes a directive and educational approach to therapy in which the therapist teaches the client how to identify and challenge irrational thinking and how to think in more rational and flexible ways.



The REBT View of Anxiety.



According to REBT an individual becomes anxious and remains anxious due to the beliefs they hold about their reality and the thoughts they have about their situation. An individual becomes anxious when they overestimate the negative aspects of their situation and underestimate their ability to cope and function in problem situations. The anxious individual will imagine and create even more negative consequences than are actually present. A more rational approach would be to focus on the task at hand, not engage in imagining negative outcomes, not engage in exaggerating possible negative outcomes, act in ways which enhance the ability to cope and function with challenging situations.



Introduction to ABC model.



REBT uses a model known as the A-B-C model. In the A-B-C model, A is the Actuating event, B is the Belief about the event and C is the consequence of the belief about A. A crucial part of REBT is in teaching the connection between the Activating event the Belief and the Consequence. Understanding this connection shows that it is not the event at A but it is the belief about the event that causes distress. The event at (A) is likely to be something that is unchangeable; however the belief (B) is changeable. Changing the belief about the event liberates the individual from the distress (consequence C).


Once the therapist has established the A-B-C the therapy moves on to step D of the ABC model. During step D the therapist engages the client in discussions about their irrational beliefs with the intention of changing the irrational beliefs. At this point the therapist is taking a directive role in challenging the client to evaluate their thinking processes and to explore new ways of thinking. If the client is able to realize that their currently held beliefs are irrational and that alternative rational beliefs are more productive and emotionally stable, the client will adopt the new belief and let go of the old beliefs.



Helping people change



REBT maintains that individuals have it within their power to change their beliefs and philosophies profoundly, and thereby to change radically their psychological health. In disputing irrational beliefs the therapist seeks to educate the client about their thinking process and about their observation of reality. The therapist works with the client to challenge the irrational beliefs, by asking the client to think in alternative ways and to look for evidence for and against their thought processes.



Effectiveness of REBT

Research carried out by David et al, (2005) shows that REBT has medium to high effect size compared to control conditions. this data show that REBT systematically has a highly positive outcome when compared with other therapies. Meta-analyses conclude that REBT is successful in improving subjects’ well-being. The same studies have found that REBT has about the same efficacy as most behavioural treatments for obsessive-compulsive disorders, social phobia and social anxiety. REBT in conjunction with medication has been found more effective than medication alone for major depression. Also, REBT seems to be an effective adjunct in the therapy of inpatients with schizophrenia.


The same research also arrived at the following conclusion:

* REBT seems to be useful for a large range of clinical diagnoses and clinical outcomes
* REBT is equally efficient for clinical and non clinical populations for a large age range (9-70) and both for males and females.
* No significant difference between individual and group REBT.
* The higher the training of the therapist the grater-better the results of REBT intervention.
* Higher numbers of REBT sessions correlate with better outcomes.



References:

David, D., Szentagotai, A., Eva, K., & Macavei, B 2005. A Synopsis of Rational-Emotive Behavior Therapy (REBT) Fundamental and applied Research. Journal of Rational-Emotive Behavior Therapy, 23,

Dryden, W. Yankuna, J. Neenan, M. 2004. Counselling Individuals A Rational Emotive Behavioural Handbook.

Sunday, 25 January 2009

Explanation of Classical / Operant conditioning

Visit The Psychology Forum for further discussion of Leanring, Conditioning and Behavior

LEARNING/CONDITIONING

Learning seems to be one process that many people take for granted (just assume it happens and happens basically the same way for most people) but know very little about.

So, how do we learn? How do other animals learn? Do we learn the same way? What are our limitations? Can we learn anything? Is there one right way to learn? To answer these questions, we need to first establish a definition of learning. Our definition is comprised of several different components:

The 4 Factors That Form The Definition of Learning:

1) learning is inferred from a change in behavior/performance*

2) learning results in an inferred change in memory

3) learning is the result of experience

4) learning is relatively permanent

This means that behavior changes that are temporary or due to things like drugs, alcohol, etc., are not "learned".

* Behavior Potential - once something is learned, an organism can exhibit a behavior that indicates learning as occurred. Thus, once a behavior has been "learned", it can be exhibited by "performance" of a corresponding behavior.

It is the combination of these 4 factors that make our definition of learning. Or, you can go with a slightly less comprehensive definition that is offered in many text books: Learning is a relatively durable change in behavior or knowledge that is due to experience.

We are going to discuss the two main types of learning examined by researchers, classical conditioning and operant conditioning.

I. Classical Conditioning

Classical Conditioning can be defined as a type of learning in which a stimulus acquires the capacity to evoke a reflexive response that was originally evoked by a different stimulus.

A. Ivan Pavlov - Russian physiologist interested in behavior (digestion).

1) Pavlov was studying salivation in dogs - he was measuring the amount of salivation produced by the salivary glands of dogs by presenting them meat powder through a food dispenser.

The dispenser would deliver the meat powder to which the animals salivated. However, what Pavlov noticed was that the food dispenser made a sound when delivering the powder, and that the dogs salivated before the powder was delivered. He realized that the dogs associated the sound (which occurred seconds before the powder actually arrived) with the delivery of the food. Thus, the dogs had "learned" that when the sound occurred, the meat powder was going to arrive.

This is conditioning (Stimulus-Response; S-R Bonds). The stimulus (sound of food dispenser) produced a response (salivation). It is important to note that at this point, we are talking about reflexive responses (salivation is automatic).

2) Terminology (if you are still confused by these definitions, please look in the non-Psychology jargon glossary on the AlleyDog.com homepage):

a) Unconditioned Stimulus (US) - a stimulus that evokes an unconditioned response without any prior conditioning (no learning needed for the response to occur).

b) Unconditioned Response (UR) - an unlearned reaction/response to an unconditioned stimulus that occurs without prior conditioning.

c) Conditioned Stimulus (CS) - a previously neutral stimulus that has, through conditioning, acquired the capacity to evoke a conditioned response.

d) Conditioned Response (CR) - a learned reaction to a conditioned stimulus that occurs because of prior conditioning.

*These are reflexive behaviors. Not a result from engaging in goal directed behavior.

e) Trial - presentation of a stimulus or pair of stimuli.

Don't worry, we will get to some examples that make this all much more clear.

3) Basic Principles:

a) Acquisition - formation of a new CR tendency. This means that when an organism learns something new, it has been "acquired".

Pavlov believed in contiguity - temporal association between two events that occur closely together in time. The more closely in time two events occurred, the more likely they were to become associated; s time passes, association becomes less likely.

For example, when people are house training a dog -- you notice that the dog went to the bathroom on the rug,. If the dog had the accident hours ago, it will not do any good to scold the dog because too much time has passed for the dog to associate your scolding with the accident. But, if you catch the dog right after the accident occurred, it is more likely to become associated with the accident.

There are several different ways conditioning can occur -- order that the stimulus-response can occur:

1. delayed conditioning (forward) - the CS is presented before the US and it (CS) stays on until the US is presented. This is generally the best, especially when the delay is short.

example - a bell begins to ring and continues to ring until food is presented.

2. trace conditioning - discrete event is presented, then the US occurs. Shorter the interval the better, but as you can tell, this approach is not very effective.

example - a bell begins ringing and ends just before the food is presented.

3. simultaneous conditioning - CS and US presented together. Not very good.

example - the bell begins to ring at the same time the food is presented. Both begin, continue, and end at the same time.

4. backward conditioning - US occurs before CS.

example - the food is presented, then the bell rings. This is not really effective.

b) Extinction - this is a gradual weakening and eventual disappearance of the CR tendency. Extinction occurs from multiple presentations of CS without the US.

Essentially, the organism continues to be presented with the conditioned stimulus but without the unconditioned stimulus the CS loses its power to evoke the CR. For example, Pavlov's dogs stopped salivating when the dispenser sound kept occurring without the meat powder following.

c) Spontaneous Recovery - sometimes there will be a reappearance of a response that had been extinguished. The recovery can occur after a period of non-exposure to the CS. It is called spontaneous because the response seems to reappear out of nowhere.

d) Stimulus Generalization - a response to a specific stimulus becomes associated to other stimuli (similar stimuli) and now occurs to those other similar stimuli.

For Example - a child who gets bitten by black lab, later becomes afraid of all dogs. The original fear evoked by the Black Lab has now generalized to ALL dogs.

Another Example - little Albert (I am assuming you are familiar with Little Albert, so I will give a very general example).

John Watson conditioned a baby (Albert) to be afraid of a white rabbit by showing Albert the rabbit and then slamming two metal pipes together behind Albert's head (nice!). The pipes produced a very loud, sudden noise that frightened Albert and made him cry. Watson did this several times (multiple trials) until Albert was afraid of the rabbit. Previously he would pet the rabbit and play with it. After conditioning, the sight of the rabbit made Albert scream -- then what Watson found was that Albert began to show similar terrified behaviors to Watson's face (just looking at Watson's face made Albert cry. What a shock!). What Watson realized was that Albert was responding to the white beard Watson had at the time. So, the fear evoked by the white, furry, rabbit, had generalized to other white, furry things, like Watson's beard.

f) Stimulus Discrimination - learning to respond to one stimulus and not another. Thus, an organisms becomes conditioned to respond to a specific stimulus and not to other stimuli.

For Example - a puppy may initially respond to lots of different people, but over time it learns to respond to only one or a few people's commands.

g) Higher Order Conditioning - a CS can be used to produce a response from another neutral stimulus (can evoke CS). There are a couple of different orders or levels. Let's take a "Pavlovian Dog-like" example to look at the different orders:

In this example, light is paired with food. The food is a US since it produces a response without any prior learning. Then, when food is paired with a neutral stimulus (light) it becomes a Conditioned Stimulus (CS) - the dog begins to respond (salivate) to the light without the presentation of the food.

first order:
1) light -- US (food)
\--> UR (salivation) 2) light -- US (food)
\--> CR (salivation)

second order:
3) tone -- light
\--> CR (salivation) 4) tone -- light
\--> CR (salivation )



B. Classical Conditioning in Everyday Life

One of the great things about conditioning is that we can see it all around us. Here are some examples of classical conditioning that you may see:

1. Conditioned Fear & Anxiety - many phobias that people experience are the results of conditioning.

For Example - "fear of bridges" - fear of bridges can develop from many different sources. For example, while a child rides in a car over a dilapidated bridge, his father makes jokes about the bridge collapsing and all of them falling into the river below. The father finds this funny and so decides to do it whenever they cross the bridge. Years later, the child has grown up and now is afraid to drive over any bridge. In this case, the fear of one bridge generalized to all bridges which now evoke fear.


2. Advertising - modern advertising strategies evolved from John Watson's use of conditioning. The approach is to link an attractive US with a CS (the product being sold) so the consumer will feel positively toward the product just like they do with the US.

US --> CS --> CR/UR

attractive person --> car --> pleasant emotional response

3. A Clockwork Orange - No additional information necessary! If you haven't seen this movie or read the book, do it. You will find it very interesting, and a wonderful example of conditioning in action.

II. Operant Conditioning

Operant conditioning can be defined as a type of learning in which voluntary (controllable; non-reflexive) behavior is strengthened if it is reinforced and weakened if it is punished (or not reinforced).

Note: Skinner referred to this as Instrumental Conditioning/Learning



A. The most prominent figure in the development and study of Operant Conditioning was B. F. Skinner

1. History:

a) As an Undergraduate he was an English major, then decided to study Psychology in graduate school.

b) Early in his career he believed much of behavior could be studied in a single, controlled environment (created Skinner box - address later). Instead of observing behavior in the natural world, he attempted to study behavior in a closed, controlled unit. This prevents any factors not under study from interfering with the study - as a result, Skinner could truly study behavior and specific factors that influence behavior.

c) during the "cognitive revolution" that swept Psychology (discussed later), Skinner stuck to the position that behavior was not guided by inner force or cognition. This made him a "radical behaviorist".

d) as his theories of Operant Conditioning developed, Skinner became passionate about social issues, such as free will, how they developed, why they developed, how they were propagated, etc.



2. Skinner's views of Operant Conditioning

a) Operant Conditioning is different from Classical Conditioning in that the behaviors studied in Classical Conditioning are reflexive (for example, salivating). However, the behaviors studied and governed by the principles of Operant Conditioning are non-reflexive (for example, gambling). So, compared to Classical Conditioning, Operant Conditioning attempts to predict non-reflexive, more complex behaviors, and the conditions in which they will occur. In addition, Operant Conditioning deals with behaviors that are performed so that the organism can obtain reinforcement.

b) there are many factors involved in determining if an organism will engage in a behavior - just because there is food doesn't mean an organism will eat (time of day, last meal, etc.). SO, unlike classical conditioning...(go to "c", below)

c) in Op. Cond., the organism has a lot of control. Just because a stimulus is presented, does not necessarily mean that an organism is going to react in any specific way. Instead, reinforcement is dependent on the organism's behavior. In other words, in order for an organism to receive some type of reinforcement, the organism must behave in a specific manner. For example, you can't win at a slot machine unless several things happen, most importantly, you pull the lever. Pulling the lever is a voluntary, non-reflexive behavior that must be exhibited before reinforcement (hopefully a jackpot) can be delivered.

d) in classical conditioning, the controlling stimulus comes before the behavior. But in Operant Conditioning, the controlling stimulus comes after the behavior. If we look at Pavlov's meat powder example, you remember that the sound occurred (controlling stimulus), the dog salivated, and then the meat powder was delivered. With Operant conditioning, the sound would occur, then the dog would have to perform some behavior in order to get the meat powder as a reinforcement. (like making a dog sit to receive a bone).

e) Skinner Box - This is a chamber in which Skinner placed animals such as rats and pigeons to study. The chamber contains either a lever or key that can be pressed in order to receive reinforcements such as food and water.

* the Skinner Box created Free Operant Procedure - responses can be made and recorded continuously without the need to stop the experiment for the experimenter to record the responses made by the animal.

f) Shaping - operant conditioning method for creating an entirely new behavior by using rewards to guide an organism toward a desired behavior (called Successive Approximations). In doing so, the organism is rewarded with each small advancement in the right direction. Once one appropriate behavior is made and rewarded, the organism is not reinforced again until they make a further advancement, then another and another until the organism is only rewarded once the entire behavior is performed.

For Example, to get a rat to learn how to press a lever, the experimenter will use small rewards after each behavior that brings the rat toward pressing the lever. So, the rat is placed in the box. When it takes a step toward the lever, the experimenter will reinforce the behavior by presenting food or water in the dish (located next to or under the lever). Then, when the rat makes any additional behavior toward the lever, like standing in front of the lever, it is given reinforcement (note that the rat will no longer get a reward for just taking a single step in the direction of the lever). This continues until the rat reliably goes to the lever and presses it to receive reward.



3. Principles of Reinforcement

a) Skinner identified two types of reinforcing events - those in which a reward is given; and those in which something bad is removed. In either case, the point of reinforcement is to increase the frequency or probability of a response occurring again.

1) positive reinforcement - give an organism a pleasant stimulus when the operant response is made. For example, a rat presses the lever (operant response) and it receives a treat (positive reinforcement)

2) negative reinforcement - take away an unpleasant stimulus when the operant response is made. For example, stop shocking a rat when it presses the lever (yikes!)

** I can't tell you how often people use the term "negative reinforcement" incorrectly. It is NOT a method of increasing the chances an organism will behave in a bad way. It is a method of rewarding the behavior you want to increase. It is a good thing - not a bad thing!

b) Skinner also identified two types of reinforcers

1) primary reinforcer - stimulus that naturally strengthens any response that precedes it (e.g., food, water, sex) without the need for any learning on the part of the organism. These reinforcers are naturally reinforcing.

2) secondary/conditioned reinforcer - a previously neutral stimulus that acquires the ability to strengthen responses because the stimulus has been paired with a primary reinforcer. For example, an organism may become conditioned to the sound of food dispenser, which occurs after the operant response is made. Thus, the sound of the food dispenser becomes reinforcing. Notice the similarity to Classical Conditioning, with the exception that the behavior is voluntary and occurs before the presentation of a reinforcer.

4. Schedules of Reinforcement

There are two types of reinforcement schedules - continuous, and partial/intermittent (four subtypes of partial schedules)

a) Fixed Ratio (FR) - reinforcement given after every N th responses, where N is the size of the ratio (i.e., a certain number of responses have to occur before getting reinforcement).

For example - many factory workers are paid according to the number of some product they produce. A worker may get paid $10.00 for every 100 widgets he makes. This would be an example of an FR100 schedule.

b) Variable Ratio (VR) - the variable ration schedule is the same as the FR except that the ratio varies, and is not stable like the FR schedule. Reinforcement is given after every N th response, but N is an average.

For example - slot machines in casinos function on VR schedules (despite what many people believe about their "systems"). The slot machine is programmed to provide a "winner" every average N th response, such as every 75th lever pull on average. So, the slot machine may give a winner after 1 pull, then on the 190th pull, then on the 33rd pull, etc...just so long as it averages out to give a winner on average, every 75th pull.

c) Fixed Interval (FI) - a designated amount of time must pass, and then a certain response must be made in order to get reinforcement.

For example - when you wait for a bus example. The bus may run on a specific schedule, like it stops at the nearest location to you every 20 minutes. After one bus has stopped and left your bus stop, the timer resets so that the next one will arrive in 20 minutes. You must wait that amount of time for the bus to arrive and stop for you to get on it.

d) Variable Interval (VI) - same as FI but now the time interval varies.

For example - when you wait to get your mail. Your mail carrier may come to your house at approximately the same time each day. So, you go out and check at the approximate time the mail usually arrives, but there is no mail. You wait a little while and check, but no mail. This continues until some time has passed (a varied amount of time) and then you go out, check, and to your delight, there is mail.

5. Punishment - Whereas reinforcement increases the probability of a response occurring again, the premise of punishment is to decrease the frequency or probability of a response occurring again.

a) Skinner did not believe that punishment was as powerful a form of control as reinforcement, even though it is the so commonly used. Thus, it is not truly the opposite of reinforcement like he originally thought, and the effects are normally short-lived.

b) there are two types of punishment:

1) Positive - presentation of an aversive stimulus to decrease the probability of an operant response occurring again. For example, a child reaches for a cookie before dinner, and you slap his hand.

2) Negative - the removal of a pleasant stimulus to decrease the probability of an operant response occurring again. For example, each time a child says a curse word, you remove one dollar from their piggy bank.



6. Applications of Operant Conditioning

a) In the Classroom

Skinner thought that our education system was ineffective. He suggested that one teacher in a classroom could not teach many students adequately when each child learns at a different rate. He proposed using teaching machines (what we now call computers) that would allow each student to move at their own pace. The teaching machine would provide self-paced learning that gave immediate feedback, immediate reinforcement, identification of problem areas, etc., that a teacher could not possibly provide.

b) In the Workplace

I already gave the example of piece work in factories.

Another example - study by Pedalino & Gamboa (1974) - To help reduce the frequency of employee tardiness, the researchers implemented a game-like system for all employees that arrived on time. When an employee arrived on time, they were allowed to draw a card. Over the course of a 5-day workweek, the employee would have a full hand for poker. At the end of the week, the best hand won $20. This simple method reduced employee tardiness significantly and demonstrated the effectiveness of operant conditioning on humans.

There are also many clinical uses, including Ivar Lovaas' method of teaching autistic children how to speak.

Monday, 25 August 2008

Definition and purpose of cognitive therapy

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Definition of cognitive therapy

Cognitive behaviour therapy is an action oriented form of psychosocial therapy that assumes that maladaptive or faulty thinking patterns cause maladaptive behaviour and "negative" emotions. Maladaptive behavior is behavior that is counter productive or interferes with everyday living. The treatment focuses on changing the individual’s thoughts (cognitive patterns) in order to change their behavior and emotional state.

Purpose of cognitive therapy

Theoretically, cognitive therapy can be employed in any situation in which there is a pattern of unwanted behavior accompanied by distress and impairment. It is a recommended treatment for a number of mental disorders, social phobia, obsessive compulsive disorder (OCD), eating disorder, substance abuse, anxiety or panic, agoraphobia, post traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD). Cognitive Therapy is also frequently used as a tool to deal with chronic pain for patients with illnesses such as rheumatoid arthritis, back pain, and cancer. Patients with sleep disorders may also find cognitive behavior therapy a useful tool treatment for insomnia.

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Considerations when using Cognitive Behaviour Therapy

Considerations when using Cognitive Behaviour Therapy

Cognitive Behavior therapy may not be suitable for some patients. Those who don’t have a specific behavioral issue they wish to address and those whose goals for therapy are to gain insight into the past, may be better served by psychodynamic therapy. Patients must also be wiling to take a very active role in the treatment process.

Cognitive behavioral intervention may be in appropriate for severely psychotic patients and for cognitively impaired patients (for example, patients with organic brain disease or a traumatic brain injury), depending on their level of functioning.

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