THERAPEUTIC INTERVENTION

MS CLINICAL PSYCHOLOGY 1ST

SEMESTER
• HIRA SIDDIQUE
• ADILA SHEHZADI
• SOFIA SATTAR
• M.AKASH
What is behaviour

Behavior
 Any action, direct or indirect, that is based on
a conscious or unconscious thought
What is behaviour modification

 Behavior modification is the use of

empirically demonstrated behavior change
techniques to increase or decrease the
frequency of behaviors, such as altering an
individual’s behaviors and reactions to stimuli
through positive and negative reinforcement
of adaptive behavior and/or the reduction of
behavior through its extinction, punishment
and/or satiation. Behavior modification has
revised to what is now known as Applied
behavior analysis (ABA).
Characteristics

 Focus on behavior  Implemented by people in everyday

 life
Guided by the theory and philosophy
of behaviorism  Measurement of behavior change
 Based on behavioral principles  De-emphasis on past events as
 causes of behavior
Emphasis on current environmental
events  Rejection of hypothetical underlying
 causes of behavior
Precise description of procedures
Behaviour modification program
step’s

Assessment
A. Describe the Target Behavior
Look for patterns in the Where does the behavior occur (only at
behavior by finding the answer to these home? At school? In the presence of
questions. Do NOT rely on subjective opinion particular persons or objects?)?
but try to watch the actual behavior. An  When does it occur (time of day?
interview of the subject or of persons familiar
Day of week? Weekends vs
with the subjects’ behavior may be helpful if
weekdays?)?
you use focused questions and get specific
answers.
When the behavior occurs, how long does
it endure?
How intense is the behavior (e.g., is the
child talking or screaming)?
How frequently does it happen? Per hour,
per day, per week, per year (select the
single most meaningful period of time).
What was present or occurring 5-10
minutes prior to the behavior?
What was present or occurring within 2-3
minutes after the behavior?
 Who was present during an instance of
the behavior? Describe how these
people are related to the subject.
B. Avoid these mistakes when describing
the behavior

confusing motivation and behavior.  Do not use concepts like “personality,” or

“insight” or “traits”.
 Motives are theories, not actual behavior.
 Trait names, such as “shy,” “anxious,”
 Don’t say he/she: “wanted to” “interested “aggressive,” also fail to describe the behavior
in” “liked” or “disliked”. because they refer to theories about the cause of
Inferring the behavior.

 Evaluating the desirability of the behavior.

covert behavior from directly observable
(overt) behavior  Behavior is of neutral value. .
 Its effects may be desirable or undesirable to a
Infusing
particular objective
 Infusing theories of behavior into your report.
 when describing it, avoid those judgments
C. Measure the behavior to get
precise data for the above questions.

 There are a number of methods. Several may  If, for example, you want to smoke fewer
work for any particular behavior. There is no cigarettes in order to save money on buying
rule to say which is best other than that you them, then you need to count the number of
use the method that targets the behavior you total cigarettes consumed per day. Counting
intend to change. the length of time it takes you to smoke one
(while still smoking the same number) won't
give you the information you need to achieve
your goal.
Methods:

Typically, multiple methods are used in a single project

because multiple facets are of interest.
 Frequency: # of times a response is performed Intensity: the magnitude or size of the
per a unit of time (e.g., day). For example, response. Does the subject smoke the
smokes 24 cigarettes every day. cigarette down to the filter or takes a
 Amount of time: the length of time a response few puffs and puts it out?
lasts. This may be measured in terms of the  Latency: the time that elapses until a
duration of the behavior (from start to finish), response is performed. For example,
for example., takes 2 minutes or 20 minutes to how long can a person goes until
smoke a single cigarette. they pull out a cigarette.
Before beginning your assessment

 You will need to answer the following When during the day and what days of
questions. the week will you observe the behavior?
 Do you need to consider weekends in
How many times will you collect
addition to weekdays?
data?
 Who and how many observers will
 How long will each observation
there be? How will you train the
period be? (long enough to get
observer to be accurate?
several samples of behavior).

D. Identify a baseline (aka operant
level) for the behavior.

 Behavior modification is about real change.

 Identifying a baseline means you
 You cannot determine if real change has
occurred unless you know what behavior is
collect data over a period of time
typical. without trying to change the
 Typical behavior is the baseline against which behavior.
the success of your intervention is measured.  How long do you collect data? It
 If you fail to collect baseline data, then you depends on the characteristics of
have no way, let me repeat that, no way to
tell if your intervention worked.
the behavior. In general, you collect

enough that the behavior of interest
Behaviorists do not rely on memory which is
fallible. Without baseline data you do not shows a steady pattern. With some
have a behavior modification program. animal behaviors, that might be 1
hour. With some human behaviors, it
may take several weeks.
Deciding to Change Behavior

In this phase, commitment to the program is

developed and the groundwork for a successful
program is laid.

A. All significant parties are involved and

demonstrate commitment
 Encourage participation in decisions by the
subject and persons who will might have an
impact on the success or failure of the
program including parents, teachers,
administrators, spouses, children, bosses,
coworkers, etc.
B. Be specific and precise about the
behavioral goals.

As a number of people are involved, clear Example of a precise goal:

communication is critical. Even if it is a self-
change, writing our your goals and activities Not: “To eat healthily”
will ensure that you have actually been clear in  Better: “To reduce the number of
your planning. It can be a self-check.
snacks (defined as ice cream, candy,
 Clarity is a process of writing and rewriting. or Twinkies) from one with each
It is common, despite great effort to clarify,
to discover that some behaviors remain
meal and one in the evening to one
unclarified once the program is begun. every 3rd day and to increase the
Nevertheless, do your best and it will pay off number of vegetable portions (as
in a more successful outcome. defined by Government standards)
Include any conditions or restrictions. from one with my evening meal, to 6
portions per day.”
C. What are the ethical
considerations?

 Are there any dangers to the subject or others? For example, woman in an abusive
relationship may be accused of trying to be seductive if she loses weight and be beaten as
a consequence. Current health status impacts on the safety of exercise and eating
programs. A person exercising in a solitary place needs to consider safety factors.
 Are humane methods being used with animals? Punishment should be used very
cautiously and only with close supervision.
D. Consider the total context of the
behavior.

 What is initiating and maintaining a behavior (or the absence of a

behavior)? Another person may benefit in some way from the target
behavior and undermine change efforts. For example, a spouse may
want someone to eat comfort foods with her and feel neglected or
judged if the subject starts eating healthily. (If you say, “The spouse
can go on a diet too” consider the ethical issues above. The spouse
may not wish to and that would be imposing values and the person
would probably simply undermine efforts.) Some persons are rewarded
by another’s perceived difficulty. They will seek to continue getting their
reinforcement.
Beginning the program

A. Identify potential interventions and select one or several

that match the target behavior.
Various procedures can be used together for maximum effect, although a To a new environment (stimulus generalization;
program that is too complex is in danger of not being followed. Strike a stimulus control; modeling )
balance between every possible procedure and too few. to new behaviors (response generalization;
shaping; chaining; fading; prompting; modeling)
Categorize your target behavior as one of the following, then see your
textbook for appropriate interventions. over time (maintenance; intermittent
reinforcement; modeling)
 teach a never before performed behavior (reinforcement: positive
and negative )
Narrow an existing behavior to limited environments (e.g., only
 increase or strengthen an existing behavior (reinforcement, snacking in the kitchen) (also discrimination training; modeling)
contingency contract, token economy, modeling)  reduce or eliminate the display of an existing behavior
 extend an existing behavior (extinction; time-out; response cost; desensitization;
reinforcement of incompatible responses; modeling;
punishment;)
Most projects will use a type of
reinforcement.

1 ) Identify appropriate reinforcers for the individual

2) Specify the conditions under which reinforcement can be earned.
3)You already trained any needed data collectors during the baseline. Continue to
collect data throughout using the same methods.
4)Apply intervention. Persist with intervention until
change occurs,
it is clear that change is not going to occur and the method needs evaluation and
refinement .
On to evaluation.
Evaluating the Program

Define evaluating the

program A. Graph the results
 Most data collection can be graphed
(occasionally a table is more
 Extensive planning increases the appropriate). Graphs quickly reveal
odds that a behavior change progress or lack thereof. They allow for
program will result in behavior evaluation of hypotheses as to what
change if appropriately happened (or didn’t). Small variations in
implemented. We cannot know if behavior are normal. Judge progress
that has succeeded until we measure based on viewing multiple data
the behavior and compare it to the collection periods (that might mean, for
baseline. example, looking at a week’s worth of
data, graphed by days).
B. Consider trying a “Reversal”

 To demonstrate true control over the behavior, remove the intervention. If the behavior
returns to baseline, then the chosen intervention and not some other event is the likely
cause of the change. (Of course, data is continuously collected).
 With some behaviors, reversals are not ethical (head banging in autistic children) or
possible (learning to speak a language).
C. Evaluate the results and reach
conclusions.

Conclusions will be similar to one of the following:

 The intervention was successful in producing change as shown by……
 The intervention was not successful in producing change as shown by…..
 The data offer a mixed picture. These elements were successful as shown
by….. These elements were not as shown by….


In each case, elaborate on the elements that worked well and those that didn’t.
Evaluate the stages of the project and identify what was learned about changing
the behavior that would be helpful “next time.”
 Behavior Modification is a science. Clear communication of conclusions and
possible implications is part of any science.
D. Modify your Intervention

 Based on what you learned, improve your program and try again. It is
through such evaluation and thoughtful reapplication that progress is
made.
Technique’s of behavior modification
Positive Consequences For
Behavior
 A reinforcing consequence is anything a person receives,
as a result of their behavior, that makes them more likely
to repeat that behavior on the future. Reinforcers act to
reinforce a behavior.
 Positive reinforcers are consequences people receive that
they enjoy. Positive reinforcement is used, in the context
of behavior modification, to encourage desirable
behaviors through a system of rewards.
 In behavior therapy, therapists often create contracts with
clients establishing the terms of the reward system.
 Often, an undesirable behavior exists because it is
rewarded. Many times, the reward is unintentional or
unknown on first observation.
Using Extinction To Stop a Behavior

 Parents can create behavior “extinction” Getting what they want by persistent begging.
by carefully observing their child’s
Getting what they want by withdrawing from
behavior and noticing what reward the conversation.
child receives for behaving inappropriately.
The specific reward can change from child to
 Remove the reward for the behavior, and child and from situation to situation.
the behavior often goes away (it becomes
 Time-out is one form of applied behavioral
“extinct”).
modification that hopes to achieve it’s goals
Some examples of “rewards” for by extinction. For example, by separating a
undesirable behaviors could be: child from the group when he or she
 misbehaves, parents hope to remove the
Getting what they cry or whine about.
expected reward of parental attention.

Behavior Modification Techniques:
Negative Consequences For Behavior

Negative consequences for

behavior are:
 Punishment
 Penalty
 Negative reinforcement
 Punishment happens when a person receives a
consequence that they don’t want as a result of their
behavior. For example, if you receive an electric
shock for turning on a light, you probably will not
attempt to do it again. The electric shock is a
punishment for the behavior of using the switch to
turn on the light.
 Penalties happen when a person loses something as
a result of a behavior. For example, loss of privileges
can be a type of penalty.
Punishment

 Punishment happens when a

person receives a consequence that
they don’t want as a result of their
behavior. For example, if you receive
an electric shock for turning on a
light, you probably will not attempt
to do it again. The electric shock is a
punishment for the behavior of using
the switch to turn on the light.
 Penalties

Penalties happen when a person loses something

as a result of a behavior. For example, loss of
privileges can be a type of penalty.
 Punishment or penalty for one behavior can
act as a negative reinforce for another
behavior. For example, in the light switch
example above, if you chose to leave the light
switch on at all times and use a circuit breaker
to operate the light, the shock for using the
switch (punishment) could be a negative
reinforce for using the breaker. (Yes, we know
this is extreme. It’s just to make a point.)
Negative reinforcement

 In a parenting situation,
negative reinforcement could be
withdrawal of television privileges,
temporary loss of a toy, or extra
clean-up duties as the result of an
inappropriate behavior to encourage
(or reinforce) a different appropriate
behavior.
Reference’s

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