Behavioural Intervention.pptx

Introduction to Behaviour Therapy Dr. Ian Grey UAEU Objectives Introduce you to behaviour therapy Explain concepts using a case study Introduction Behaviour therapy is a big area of psychology Understanding behaviour therapy requires a background understanding in what is called often called ‘Learnin...

Introduction to Behaviour Therapy Dr. Ian Grey UAEU Objectives Introduce you to behaviour therapy Explain concepts using a case study Introduction Behaviour therapy is a big area of psychology Understanding behaviour therapy requires a background understanding in what is called often called ‘Learning Theory’ More specifically you neeed to understand four types of learning Classical or respondent learning or conditioning Operant learning or conditioning Social learning theory Relational Frame Theory (very complex) Goal Behavioral therapy is a term that describes a broad range of techniques used to change maladaptive behaviors. The goal is to strengthen desirable behaviors and eliminate unwanted ones. Basic Idea Unlike the types of therapy that are rooted in insight (such as psychoanalytic therapy), behavioral therapy is action-based. The behavior itself is the problem and the goal is to teach people new behaviors to minimize or eliminate the issue Basic Idea Behavioural therapy is an umbrella term for types of therapy that treat mental health disorders. This form of therapy looks to identify and help change potentially self-destructive or unhealthy behaviors. It's based on the idea that all behaviors are learned and that behaviors can be changed (that’s why learning theory is important) Critical Point Ask yourself how is what you do and what you think learned? We come into the world and we learn (to speak, to interact, to eat, to drive, to look after ourselves….the list of what we learn to vast) So the question of HOW do we learn is critical because if we know this then we can change bad learning and replace it with new learning Critical Point 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, behavioural psychologists 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 a certain way in certain situations Important Point Behavior therapy has developed and diversified over the years into a range of different psychological interventions when combined with other approaches. There is early behaviour therapy and later behaviour therapy Examples Behavioral therapy and cognitive psychology, resulting in Cognitive-Behavioral Therapy Mindfulness and CBT, resulting in Mindfulness-Based Cognitive Therapy Mindfulness and contextual behavioral science, resulting in Acceptance and Commitment Therapy CBT, mindfulness, and humanism, resulting in Dialectical Behavior Therapy Why Need to Know This? Cognitive Behaviour Therapy is perhaps the most common type of therapy It has lots of evidence that it works for a variety of problems Behaviour is in the name of the therapy so you need to know the ‘behaviour’ part. Lets Take a Real Case Luke is 6 years old Diagnosis of autism He has a particular problem WE are taking this case to explain some of the basic terms and concepts of behaviour therapy Case Study Currently only eating pureed baby jar food (7mth) Frequent gagging and vomiting when new foods placed in mouth Can self-gag and vomit when other foods are placed in his mouth Is this a Problem? Yes it is for a number of reasons It may affect his growth He cannot do normal activities such as eating out with parents Its difficult to keep preparing this type of food Is this a psychological problem? Or is it a medical problem? Is this a Problem? Malnutrition Growth retardation Dehydration Vulnerability to infectious diseases Medical factors At age 1 diagnosed with asthma and reflux Between 18-20 months PH tube inserted into nose to reach stomach to determine levels of stomach acid Traumatic experience for him Zantac prescribed 1 year until 30 months Grommets inserted at 20 months Fractured skull at 30 months because of food refusal Medical (cont) Possible problem with swallowing No specific food sensitivities other than eggs But his favourite food jar is egg custard with rice and no side effects observed Loose stools Broken teeth from head banging or throwing self down stairs Currently only on fish oils and multi-vitamins Life Story SLT at 24 months but no progress Diagnosed at age 30 months Home tuition at 32 months Began pre-school at 45 months Some OT involvement around feeding but no progress Current Eating Will eat two things Pureed baby food And Rusks So How Can Psychology Help? Parents have tried everything….rewards etc Nothing seems to work and they are becoming more stressed which is totally natural Psychology has to bring a different way of seeing the problem. That’s the whole idea of psychology… specialist knowledge around what to do to fix the problem. This is an important point. Learning Is Luke’s problem due to learning? Can we establish new learning? If so then the question is how? This depends on the way you look at the problem The Three Term Contingency Somethi ng Happens SD Trigger Behaviour1 Consequence Example Removal of Food SD Behaviour1 Consequence Negative Reinforcement When Luke is given any different foods then a range of behaviours follow it Crying Tantrums Food expulsion Vomiting Closing Mouth If these result in withdrawal of different foods then these behaviours will increase The Three Term Solution (Basic Level) SD Behaviour1 Consequence First Question Maybe it has something to do with the food? Is it the texture of the food? Assessment Conditions 1. Present age) 2. Present 3. Present 4. Present 5. Present 6. Present pureed food under normal conditions (4 mth slightly pureed food normal jar (no pureed) normal jar with mashed potato pureed food with cornflour pureed with lumps (¼ pea sized) Initial Assessment Conclusion Even when the taste is the same, changing textures slowly results in problem behaviour But he eats rusks which have a very hard texture so why is this is a problem? Think of Behaviour! What behaviour do you show with a very soft food like a soup? You swallow it What behaviour do you show with a very hard food like a rusk? You chew it Formulation Problem may be one of stimulus control Does not chew the pureed food even with small lumps in itgag/vomit However, chews 'hard' textures Formulation Puree = SD for immediate swallow but S∆ for chewing Hard = SD for biting and chewing but S∆ for immediate swallowing Gagging on soft food with small lumps because of no chewing Vomiting to escape feeding Intervention Idea We need to get Luke used to both textures at the same time and to get him to learn to chew a food with MIXED textures Rusk & Puree Latency Rusk & Puree Simultaneously: Under & Over Small Pieces of Rusk & Puree Simultaneously Systematic Desensitisation Using Non-Pureed Food Three Months Later Luke is eating age appropriate foods all the time Pizza, rice, etc Conclusion Behavioural psychology involves a different way of seeing clinical problems Behavioural psychology looks at behaviour and what affects behaviour The idea is that you must understand behavioural processes in order to change behavioural problems