|Behavioral Family Therapy|
PsychPage links on Beginning Therapy
Bowenian Family Therapy
The DSM IV
Negative Effects of Therapy
Findings on Preparation for Therapy
The Therapeutic Relationship-Part I
The Therapeutic Relationship -Research and Theory
The Ingredients of Psychotherapy
Strategic Family Therapy
Based in part on Nichols and Schwartz book on Family Therapy
Behaviorists are distinguished by their methodological and directive approach to assessment and evaluation, their analysis of behavioral sequences before treatment, their assessment of therapy in progress, and their evaluation of the final results. Many non-behavioralist therapist use behavior techniques (Minuchin), or combine cognitive and behavioral techniques.
Originally, behavioral therapists saw only individuals, such as the wife in a problematic marriage or the child in a problematic family. However, the basic tenets of behavioral therapy are assumed to be applicable to them.
II.Normal Family DevelopmentSince they ignore past history, behavioralists have little to say about normal development. Rather, they focus on the functioning of the family in the here and now.
III.Development of Behavior DisordersA.Incorrect Reinforcement
Often parents don't know how to reinforce desirable behaviors and reinforce undesirable behaviors. This is a pretty much linear model, which may reach high levels of complexity (interlocking reciprocal behaviors), but is still linear.
B.Aversive Control Techniques
Spouse attempts to control other spouse use of aversive techniques (nagging, threatening, withdrawing), to which the other spouse responds with aversive techniques.
C.Poor Problem-Solving Skills
IV.Goals of Behavioral Therapy
V.Conditions for Behavioral Change
VI.TechniquesA.Behavioral Parent Training involves accepting the parent's view that the child is the problem, and teaching skills to handle the problem or change the child's behavior. Assessment methods fall into 3 categories
c.baseline data collection
Assessment steps include
B.Behavioral Marriage Therapy began as science with its use of data only, then developed to art with the inclusion of systems's level ideas.
Strategic Behavioral Therapy-Duncan et al, (88)
Strategic Behavioral Therapy (SBT) is an alternative brief model for therapy integrating strategic goals and individual cognitive-behavioral frames at theoretical and pragmatic levels.
On the pragmatic level, the two models are very complementary regarding their area of expertise and their emphasis on Type I or Type II change, and similar on a process and conceptual level. On a theoretical level, the two approaches combine a social systems process view with a constructionist's view. This enables the integration of different approaches for depending on the specific client.
On a pragmatic Level, behavioral interventions teach specific skills and are very helpful if compliance can be maintained, which strategic approaches can help do. In some cases, skill acquisition is deemed appropriate to "throw a wrench into the works" of the problem cycle, but strategic approaches are unconcerned with teaching specific skills and thus may limit treatment options. The strategic approach focuses on the repetitive use of an inappropriate response, but ignores the battery of skills from which the response was drawn
While type I intervention, skill acquisition, may really be all that is needed to interrupt the problem cycle, it may also really be just "more of the same" type of repeated use of inappropriate coping attempts. In such cases a type II, change in the system rules or functioning, is needed. A new skill may change the person's perception of the problem (or the rules governing the problem) or may open up new options for coping (thus changing the meaning or context of the problem). Type I and type II approaches are complementary.
On both a pragmatic and a theoretical level:
On a theoretical level, the client's perception of the problem is important to the behavioral approach and the client's reality to the strategic approach. Both also view the construction of a new frame for a problem or new reality for the problem as paramount in changing the system.
Schmaling et al, (88) introduce
Behavioral Marital Therapy (BMT)This is the application of cognitive-behavioral and social learning principles to the treatment of marital distress. Behavior Exchange (BE) and problem solving (PS) techniques have been the traditional interventions. The couple feel helpless, and each feels therapy is to change the other.
The idea of BE is to increase the positive experiences between them such that they are reinforced for being with each other. Each makes a list of the things that they could do to please the other, and is then asked to do them.
The idea of PS is to improve communication and problem solving. Tendencies to make overgeneralizations are discouraged. Receptive listening skills, reflection, empathy, I statements, validating, communication at the verbal and non-verbal levels are taught. Problem definition, problem resolution, and solution implementation are taught as well. When a spouse is going to bring up a problem, s/he gives
The couple is taught to do this initially by the therapist intervening and helping them do it, then by doing it on their own with the therapist evaluating the plan of action and helping the couple learn to do this. The data shows its not bad. However, traditional couples with wives with high affiliative needs and husbands with high independence needs don't respond as well. Wives who are committed, more feminine, and have more + feelings towards their husband showed better response.
BMT is indicated for couples who report
but not for couples where
Spouses can be involved at 2 levels, as a therapist aid to provide support to the other or as an active participant in marital therapy.