5.5b Treatment of Psychological Disorders: Behavioral, Cognitive, and Group Therapies

Behavior therapists

Therapy that uses learning principles to reduce unwanted behaviors

Counterconditioning

Behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning

Exposure therapies

Behavioral techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imaginary or actual situations) to the things they fear and avoid

Systematic desensitization 

A type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli; commonly used to treat specific phobias

Virtual reality exposure therapy

A counterconditioning technique that treats anxiety through creative electronic simulations in which people can safely face specific fears, such as flying, spiders, or public speaking

Aversive conditioning

Associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)

Token economy

An operant conditioning procedure in which people earn a token for exhibiting a desired behavior and can later exchange tokens for privileges or treats

Cognitive therapies

Therapy that teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions

Rational-emotive behavior therapy (RBT)

A confrontational cognitive therapy, developed by Albert Ellis, that vigorously challenges people’s illogical, self-defeating attitudes and assumptions

Cognitive-behavioral therapy (CBT)

A popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

Group therapy

THerapy conducted with groups rather than individuals, providing benefits from group interaction

Family therapy

Therapy that treats people in the context of their family system; views an individual’s unwanted behaviors as influenced by, or directed at, other family members

Psychodynamic therapy presumed problem

Unconscious conflicts from childhood experiences

Psychodynamic therapy aim

Reduce anxiety through self-insight

Psychodynamic therapy technique

Interpret clients’ memories, dreams, and feelings

Person-centered therapy presumed problem

Barriers to self-understanding and self-acceptance

Person-centered therapy aim

Enable growth via unconditional positive regard, acceptance, genuineness, and empathy

Person-centered therapy technique

Listen actively and reflect clients’ feelings

Behavior therapy presumed problem

Dysfunctional behaviors

Behavior therapy aim

Learn adaptive behaviors; extinguish problem ones

Behavior therapy technique

Use classical conditioning (via exposure or aversion therapy) or operant conditioning (as in token economies)

Cognitive therapy presumed problem

Negative, self-defeating thinking

Cognitive therapy aim

Promote healthier thinking and self-talk

Cognitive therapy technique

Train people to dispute their negative thoughts and attributions

Cognitive-behavioral therapy presumed problem

Self-harmful thoughts and behaviors

Cognitive-behavioral therapy aim

Promote healthier thinking and adaptive behaviors

Cognitive-behavioral therapy technique

Train people to counter self-harmful thoughts and to act out their new ways of thinking

Group and family therapy presumed problem

Stressful relationships

Group and family therapy aim

Heal relationships

Group and family therapy technique

Develop an understanding of family and other social systems, explore roles, and improve communication

How does the basic assumption of behavior therapy differ from the assumptions of psychodynamic and humanistic therapies? What classical conditioning techniques are used in exposure therapies and aversive conditioning?

• Behavior therapies are not insight therapies, but instead assume that problem behaviors are the problem. Their goal is to apply learning principles to modify these problem behaviors

• Classical conditioning techniques, including exposure therapies (such as systematic desensitization and virtual reality exposure therapy) and aversive conditioning, attempt to change behaviors through counterconditioning — evoking new responses to old stimuli that trigger unwanted behaviors

What is the main premise of behavior therapy based on operant conditioning principles, and what are the views of its proponents and critics?

• Operant conditioning assumes that voluntary behaviors are strongly influenced by their consequences. Therapy based on operant conditioning principles therefore uses behavior modification techniques to change unwanted behaviors by positively reinforcing desired behaviors and ignoring or punishing undesirable behaviors

• Critics maintain that (1) techniques such as those used in token economies may produce behavior changes that disappear when rewards end, and (2) deciding which behaviors should change is authoritarian and unethical

• Proponents argue that treatment with positive rewards is more humane than punishing people or institutionalizing them for undesired behaviors

What are the goals and techniques of the cognitive therapies and of cognitive-behavioral therapy?

• The cognitive therapies, such as Aaron Beck’s cognitive therapy for depression, assume that our thinking colors our feelings, and that the therapist’s role is to change clients’ self-defeating thinking by training them to perceive and interpret events in more constructive ways

• Rational-emotive behavior therapy (REBT) is a confrontational cognitive therapy that actively challenges irrational beliefs

• The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy by helping clients regularly try out their new ways of thinking and behaving in their everyday life

• A newer CBT variation, dialectical behavior therapy (DBT), combines cognitive tactics for tolerating distress and regulating emotions with social skills training and mindfulness meditation

What are the aims and benefits of group and family therapies?

• Group therapy sessions can help more people at a lower cost compared to individual therapy. Clients may benefit in person or online from exploring feelings and developing social skills in a group situation, from learning that others have similar problems, and from getting feedback on new ways of behaving

• Family therapy aims to help family members discover the roles they play within the family’s interactive social system, improve communication, and learn new ways to prevent or resolve conflicts

Dr. Welle helps her clients by teaching them to modify the way they think when they are under stress or when they are experiencing symptoms. What form of therapy does Dr. Welle most likely practice?

A) Behavioral

B) Cognitive

C) Group

D) Family

B) Cognitive

What form of therapy is depicted in the graph?

A) Cognitive

B) Group

C) Family

C) Behavioral

C) Behavioral

Which of the following best describes the trends in the variables as depicted by the data in the graph?

A) The participants’ anxiety decreased after they were repeatedly exposed to heights while practicing relaxation techniques.

B) The participants’ anxiety increased after they were repeatedly exposed to heights while practicing relaxation techniques.

C) The participants’ anxiety decreased after they were repeatedly exposed to heights while undergoing aversive conditioning.

D) The participants’ anxiety increased after they were repeatedly exposed to heights while undergoing aversive conditioning.

A) The participants’ anxiety decreased after they were repeatedly exposed to heights while practicing relaxation techniques.

Jayne has been diagnosed with major depressive disorder. Her therapist suggested that she interact with her friends more frequently, and she helped Jayne learn how to decrease her worries about whether her friends want to be around her. What form of therapy is Jayne’s therapist using?

A) Cognitive-behavioral therapy

B) Group therapy

C) Rational-emotive behavior therapy

D) Behavior modification

A) Cognitive-behavioral therapy

Dr. Laremy meets with adolescents and their parents together to help them develop effective communication strategies. What form of therapy does Dr. Laremy use?

A) Self-help

B) Cognitive-behavioral

C) Dialectical behavioral

D) Family

D) Family

Dr. Mehari believes that the best way to treat clients is to use active listening and to help clients gain self-acceptance, while Dr. Rodriguez believes that the best way to treat clients is to help them change their thoughts and behaviors. Which statement is most accurate about Dr. Mehari’s and Dr. Rodriguez’s preferred therapy?

A) Dr. Mehari prefers psychodynamic therapy, while Dr. Rodriguez prefers cognitive-behavioral therapy.

B) Dr. Mehari prefers person-centered therapy, while Dr. Rodriguez prefers cognitive-behavioral therapy.

C) Dr. Mehari prefers person-centered therapy, while Dr. Rodriguez prefers cognitive therapy.

D) Dr. Mehari prefers psychodynamic therapy, while Dr. Rodriguez prefers behavioral therapy.

B) Dr. Mehari prefers person-centered therapy, while Dr. Rodriguez prefers cognitive-behavioral therapy.

Javi’s parents give him a marble each day he completes his homework. He can exchange marbles for privileges, such as a later weekend bedtime or a trip to the ice-cream store. Which of the following is described in this example?

A) Aversive conditioning

B) Token economy

C) Acceptance and commitment therapy

D) Systematic desensitization

B) Token economy

Which of the following scenarios best illustrates the concept of counterconditioning?

A) Kendall’s fear of flying gradually diminishes after he takes several flights without experiencing any turbulence.

B) Roman’s dislike for broccoli increases over time because he always has to eat it as part of his meals.

C) Jerri’s fear of dogs intensifies after a negative encounter with an aggressive dog at a park.

D) Logan’s preference for chocolate decreases when he repeatedly pairs its consumption with a foul taste.

D) Logan’s preference for chocolate decreases when he repeatedly pairs its consumption with a foul taste.

After repeatedly drinking an alcoholic drink mixed with a drug that produces severe nausea, Xander, who has a history of alcohol use disorder, developed a temporary conditioned aversion to alcohol. In this example of aversive conditioning, the nausea-producing drug is the

A) UCS, because it naturally elicits the response.

B) CS, because it naturally elicits the response.

C) UCS, because the association must be learned in order to elicit the response.

D) CS, because the association must be learned in order to elicit the response.

A) UCS, because it naturally elicits the response.