OLABISI ONABANJO

UNIVERSITY

DEPARTMENT OF PSYCHOLOGY

AGO-IWOYE, OGUN STATE

NIGERIA

COURSE TITLE: BEHAVIOUR MODIFICATION

COURSE CODE: PSY 415

COURSE DEVELOPMENT TEAM:

Dr. A.T. Tamuno-opubo

Course outline
  Define the concept of behaviour (Explain types of behaviour, Explain
development and acquisition of behaviour).
 Discuss the notion of behaviour modification.
 Explain personality and human behaviour.
 Discuss why people seek therapy.
 Discuss who provides psychotherapeutic services.
Explain the process of measuring in psychotherapy.
Analyze therapeutic approaches.
Discuss biological approaches in behaviour modification.
Discuss behaviour therapy.
Discuss cognitive, humanistic, and psychodynamic therapies.

ASSESSMENT
Continuous Assessment - 30%
Examination - 70%
100
Topics for Presentations and Papers (Not a Full List)
Learning Theories
1. Classical Conditioning (Pavlovian Conditioning):
 Definition: A learning process that pairs a neutral stimulus with
an unconditioned stimulus to elicit a conditioned response.
 Example: Pavlov's dogs salivating at the sound of a bell
associated with food.
2.Operant Conditioning (Skinnerian Conditioning):
 Definition: A learning process where behavioural patterns are
influenced by the consequences that follow.
 Key Concepts: Reinforcement (positive and negative) and
punishment.
 Example: A child receiving a treat for good behaviour (positive
reinforcement).
3. Observational Learning (Social Learning):
 Definition: Learning by observing and imitating the behaviour of
others.
 Proponent: Albert Bandura.
 Example: A child learns social manners by watching their
parents.
4. Cognitive Learning:
 Definition: Involves mental processes like thinking, reasoning,
and problem-solving.
 Example: Learning to solve a math problem through
understanding and applying a specific method.

Factors Influencing Behavioral Development

1. Genetic Factors: Inherited traits that predispose individuals to certain
behaviours.
2. Environmental Influences: External factors like family, culture, and
experiences that shape behaviours.
 3. Interplay of Nature and Nurture: A combination of genetic and
environmental factors contributing to behaviour development.
4. Reinforcement History: Past experiences of reinforcement or
punishment that shape future behaviour.
5. Cognitive Factors: Individual perceptions, beliefs, and decision-
making processes influencing behaviour.
Behavioural Modification Application
 Objective: To change maladaptive behaviours into more positive,
adaptive behaviours.
 Techniques: Utilise principles of learning theories (like reinforcement
in operant conditioning) to encourage desirable behaviours and
discourage undesirable ones.

Techniques for Adaptive Behaviour:

1) Token Economy 2) Social Skills Training 3) Assertion Training 4) Rational
Emotive Behaviour Therapy 5) Schema-Focused Cognitive Therapy 6)
Cognitive Therapy for Delusions and Hallucinations 7) Self-Instructional
Training 8) Problem-Solving Therapy/Training 9) Stress Inoculation Training
10) Cognitive-Behavioural Couple Therapy 11) Acceptance and Commitment
Therapy 12) Mindfulness-Based Cognitive Therapy 13) Emotional Regulation
Techniques 14) Time Management 15) Goal Setting 16) Self-monitoring 17)
Acceptance Commitment Therapy 18) Behaviour Contracts 19) Response
Cost 20) Virtual Reality Exposure Therapy (can be used for adaptive
behaviour) 21) Biofeedback (can be used for adaptive behaviour) 22)
Functional Behaviour Assessment (FBA) (can be used for adaptive behaviour)
23) Reality Therapy (can be used for adaptive behaviour) 24) Shaping (can
be used for adaptive behaviour) 25) Extinction (can be used for adaptive
behaviour) 26) Cueing (can be used for adaptive behaviour)

Techniques for Maladaptive Behaviour:

1) Behavioural Parent Training 2) Systematic and In Vivo Desensitization
(including Flooding) 3) Eye Movement Desensitization Therapy (EMDR) 4)
Behaviour Therapy for Chronic Pain 5) Behaviour Therapy for Adherence to
Medical Regimens 6) Behaviour Therapy for Prevention of/Treating Physical
Illnesses 7) Behaviour Therapy for Treating Enuresis and/or Encopresis 8)
Behaviour Therapy for Treating Tic Disorders 9) Behaviour Therapy for
Insomnia and Sleep Problems 10) Behaviour Therapy for Anorexia and/or
Bulimia Nervosa 11) Behaviour Therapy for Autism Spectrum Disorders 12)
Behaviour Therapy for a Specific Anxiety Disorder 13) Behaviour Therapy for
a Specific Mood Disorder 14) Behaviour Therapy for any other DSM V
Disorder 15) Biofeedback (can be used for maladaptive behaviour) 16)
Functional Behaviour Assessment (FBA) (can be used for maladaptive
behaviour) 17) Reality Therapy (can be used for maladaptive behaviour) 18)
Shaping (can be used for maladaptive behaviour) 19) Extinction (can be used
for maladaptive behaviour) 20) Cueing (can be used for maladaptive
behaviour)

General Techniques for Therapy:

1) Virtual Reality Exposure Therapy 2) Biofeedback 3) Cognitive
Restructuring 4)
Chaining/Shaping/Extinction/Punishment/Overcorrection/Cueing 5) Functional
Behaviour Assessment (FBA) 6) Aversive Therapy 7) Reality Therapy
Introduction

Psychologists widely acknowledge the intricacies of the human being within

our vast universe. The complexity of human disposition is evident in the
distinctiveness of behaviour across various situations, even those that seem
comparable or analogous. The comprehension of human actions is largely
contingent on their familiarity and predictability. However, due to the
intricate nature of humans, understanding and anticipating behaviour
become formidable endeavours. Human behaviour encompasses a spectrum
of functions, including personal and concealed cognitive processes such as
intricate chains of information processing—perception, conception,
reasoning, remembering, memory processes, and even creativity. The
emotional components of human conduct dynamically interact with cognitive
processes and actions, involving complex covert behaviour patterns. As
noted by Akinboye in 1984 and cited by Adomeh in 2005, concealed
behavioural patterns can only be deduced from observable actions.

Learning is an integral facet of life, involving the continuous acquisition and

unlearning of various aspects of day-to-day experiences. Behavioural
counselling operates on the premise that behaviours are learned and can be
unlearned. Approaches based on principles of reward, reinforcement, and
punishment aim to induce desired changes in behaviour. However, the
traditional behavioural approach, which viewed human behaviour as solely
governed by external stimuli, was criticised for its mechanistic nature.
Humans are not purely mechanical, and the emergence of the cognitive-
behavioural approach, articulated by scholars such as Ellis (1962), Beck
(1976), and Meichenbaum (1977), emphasised the significance of thoughts,
perceptions, feelings, and beliefs in shaping behaviour.

Contrary to the mechanical stimulus-response (S-R) mechanism, the

cognitive-behavioural approach considers the subjective experiences of
individuals. Unlike the traditional behavioural view, which portrays
individuals as passive beings devoid of free will, the cognitive-behavioural
approach recognises thoughts, ideas, and beliefs as integral to human
behaviour. In this course, we delve into the meaning of the behaviour and
cognitive approaches to counselling. The procedures associated with each
approach will be explored, encompassing various techniques under
behavioural modification and the cognitive approach. Additionally, we will
discuss the potential and limitations inherent in both behavioural and
cognitive approaches to counselling.

The goal of behavior modification

Understanding the development and acquisition of behaviour is crucial in

behavioural modification. It involves recognising the role of various learning
theories and factors influencing behaviour. This knowledge allows for the
effective application of behavioural modification techniques to foster positive
behavioural change.
 CHAPTER ONE
INTRODUCTION TO BEHAVIOUR MODIFICATION
Behaviour modification, also known as behavioural counselling, is a
psychotherapy approach that draws upon the principles of classical
conditioning and operant conditioning, which are theories of learning. It
utilises these principles of learning to induce favourable modifications in
behaviour and diminish or eradicate bad behaviour. Behavioural modification
utilises scientifically validated strategies to enhance behaviour and/or
diminish maladaptive/undesirable behaviour. It mostly pertains to methods
of enhancing adaptive behaviour through reinforcement and reducing
maladaptive behaviour through extinction or punishment.

Thorndike is credited with coining the term "behaviour modification" in 1911.

He discussed the Law of Effect, which states that responses that are
accompanied by a pleasing outcome are reinforced, while responses that are
followed by a dissatisfying outcome are diminished or stopped. The learning
theories of classical conditioning, proposed by Pavlov, and operant
conditioning, developed by Skinner, have significantly contributed to the
advancement of the behaviour modification method in counselling. Classical
conditioning suggests that our behaviour or responses are conditioned
through a link between a stimulus that triggers the response and our
subsequent response. When this association is reinforced through rewards,
conditioning occurs, and the behaviour is acquired. This is the fundamental
conditioning process. Operant conditioning is founded upon the principle of
the law of effect. This conditioning involves the occurrence of behaviour that
is followed by outcomes that are pleasing to the organism, therefore leading
to its repetition. Undesirable outcomes will deter behaviour. For instance,
when a youngster exhibits a temper tantrum, parents acquiesce to his
request. Consequently, the child acquires the understanding that by
exhibiting tantrums, his desires would be fulfilled. The attention and
acquiescence of parents serve as reinforcement for the child, leading to the
repetition of the same behaviour in the future.

Definition of Behaviour

First, let us define the concept of behaviour. The term "behaviour" is

frequently used, yet its precise meaning may not be fully understood by
many. When discussing behaviour, we employ phrases such as diligent,
compassionate, outgoing, unappreciative, self-reliant, and self-centred. Upon
analysis, it becomes evident that these labels do not specifically represent
the characteristics we observe in an individual when we describe them as
hard-working or selfish, for example. While we may have a basic
understanding of what selfish behaviour or nervous behaviour entails, we
may not be aware of the specific manifestations of a person's nervousness,
such as nail biting, fidgeting, or pacing in a room. It is crucial that we discuss
behaviour in a really particular manner. Behaviour encompasses all spoken
and non-verbal actions performed by an individual. Behaviour modifiers
typically employ specific language when discussing behaviour. This aids in
directing attention towards the specific feature of behaviour that requires
modification, whether it is overt (observable/visible) or covert (hidden)
behaviour.

Behaviour can be categorised as either deficits or excesses. Behavioural

deficit refers to a deficiency in behaviour, such as a child's inability to
socialise and interact with peers or a lack of knowledge of proper restaurant
etiquette for eating. It can also manifest as a teacher's inability to control
their anger when a student disrupts the class or a manager's lack of skills in
conducting themselves appropriately during a board meeting. Behavioural
excesses pertain to uncontrolled behaviour, such as a toddler displaying
tantrums, an adult engaging in persistent smoking or drinking, a child
constantly consuming chocolates and toffees, or prolonged television
viewing.

Hence, there exists a divergence in behaviour, characterised by either a

deficiency or an abundance of behaviour, that gives rise to the issue and
necessitates resolution. Behaviour modification facilitates the alteration of
problematic behaviours and the establishment of suitable behaviour. It is
important to examine the background, culture, and ethics of the individuals
involved when identifying behavioural deficiencies or excesses. Self-injurious
(self-harm) behaviour is universally inappropriate, regardless of the situation.

The Concept of Behaviour

Behaviour, a multifaceted and integral aspect of human and animal life,

serves as a lens through which psychologists, biologists, and researchers
gain insights into the intricate workings of the mind and body. This concept,
central to various scientific disciplines, encapsulates a broad spectrum of
actions, reactions, and responses to internal and external stimuli. In the
realm of psychology, a unanimous agreement exists regarding the definition
of psychology as the science of human behaviour and mental processes.
Adhering to the scientific method, psychologists engage in meticulous,
systematic, and objective observation. This scientific approach distinguishes
them from poets, novelists, playwrights, artists, and philosophers who
employ non-scientific methods. It is essential to note that the exclusion of
these individuals from the psychologist category does not negate the value
of their insights into human behaviour.

Psychologists predominantly focus on the study of individual behaviour, in

contrast to most sociologists who delve into group behaviour. While
psychologists may investigate how others' behaviour impacts the individual,
their primary emphasis remains on the individual rather than the group itself.
The subsequent exploration delves into various definitions of behaviour
provided by scholars in the field.

Colman (2003) defines behaviour as the physical activity of an organism,

encompassing overt bodily movements and internal physiological processes
—a culmination of the organism's physical responses to its environment.
Santrock (2000) succinctly describes behaviour as everything directly
observable in an individual's actions.

Behaviour, strictly speaking, refers to directly observable responses like

pushing a button, kicking someone, or talking. However, these observable
responses are used to infer subjective events, such as goals, thoughts, and
feelings. Therefore, the subject matter of psychology encompasses virtually
anything an individual does or experiences. The term "behaviour" is often
applied to relatively large, global responses, while minutiae that interest
biologists are generally not labelled as behaviour.

Akinboye (1984, as cited in Adomeh, 2005) notes the lack of consensus

among psychologists regarding the precise meaning of the word "behaviour."
Definitions vary from the most general to the most specific, depending on
the perspective of the definer or their area of emphasis. Some psychologists
view behaviour as the activities organisms engage in, considering observable
activities as inferences of subjective events.

In contrast, other psychologists, emphasising the neurological foundation of

human behaviour, define it as the response of the neuromotor system to
perceived stimuli. In this context, behaviour is not isolated; it is a reaction to
perceived environmental contingencies. For behaviour to occur, a stimulus,
whether internal or external, must prompt the organism to act.

Behavior, considered an activity, is a fundamental function of the physical

structure of individual organisms. It is the action of muscles and glands
coordinated by various structures in the central nervous system. Behavioural
scientists define behaviour in terms of its function as an activity of the
organism that changes in an orderly way with certain variables, whether or
not this orderly relationship can be demonstrated.
Scholars like Schlinger (2002) assert that behavioural scientists have made
significant strides in identifying the functional units of behaviour. Pioneers
like Pavlov, Thorndike, and Skinner discovered basic units—respondents,
operants, and discriminated operants, respectively. This course will explore
the principles and assumptions underlying behaviour modification,
examining the foundational concepts and techniques that have evolved over
the last century.

In-Depth Exploration:
Behaviour, strictly observable, extends beyond immediate actions. Adomeh
(2005) notes that behaviour also serves as a gateway to understanding
subjective events, such as thoughts, goals, and feelings. Pushing a button or
kicking someone may be directly observable responses, but these actions
can be used to infer the internal, subjective experiences of an individual.
Furthermore, behaviour is not limited to overt actions. It encapsulates
relatively large, global responses, making it applicable to the study of
psychological phenomena. The term, however, tends to be less associated
with minute, specific phenomena that capture the interest of biologists
(Adomeh, 2005). This distinction highlights the interdisciplinary nature of the
concept, straddling the domains of psychology and biology.

Definitional Challenges:
Despite the fundamental role of behaviour in psychology, scholars like
Akinboye (1984, cited in Adomeh, 2005) highlight the lack of consensus
among psychologists regarding its precise meaning. Definitions range from
the general to the specific, reflecting varied perspectives and areas of
emphasis. The diversity of definitions underscores the dynamic and evolving
nature of the concept.

Functionality and Analysis:

Behaviour, as an activity, serves a vital function in the physical structure of
organisms. It involves the coordinated effort of muscles, glands, and the
central nervous system. Behavioural scientists, akin to researchers in natural
sciences, aim to discover basic units of functional analysis. This entails
studying the function of behaviour and identifying underlying principles.
Scholars like Schlinger (2002) note significant progress in delineating the
functional units of behaviour over the past century. Notable contributors,
including Pavlov, Thorndike, and Skinner, identified units such as
respondents, operants, and discriminated operants, respectively. These units
form the basis for understanding behaviour's functionality and adaptive
nature.
The concept of behaviour is pivotal in unravelling the complexities of human
and animal life. From observable actions to hidden cognitive processes,
behaviour encapsulates a diverse range of phenomena. Definitions and
interpretations vary, reflecting the interdisciplinary nature of the concept. Its
exploration involves not only understanding overt actions but also delving
into the intricate interplay between external behaviours and internal
subjective experiences. As behavioural science continues to evolve, the
concept of behaviour remains at the forefront of research, contributing to a
deeper comprehension of the intricacies of life

Chapter Two
Basic Principles and Assumption about Behaviour by Psychologists

The exploration of behaviour is a multifaceted endeavour, and understanding

it requires a comprehensive examination from various psychological
perspectives. This discussion delves into the fundamental principles and
assumptions associated with the behaviourist, psychoanalytic, humanistic,
and cognitive approaches.
Behaviorist Approach: The behaviourist approach, epitomised by figures
like Watson and Skinner, places a paramount emphasis on environmental
factors as primary influencers of behaviour. Learning, particularly through
conditioning (both classical and operant), takes centre stage in this
perspective. The 'S - R' (stimulus-response) psychology characterises
behaviourism, where observable behaviour is explained in terms of
environmental stimuli. Classical conditioning involves triggering a response
predictably, whereas operant conditioning forms associations through
reinforcement. Behaviourists advocate for simplicity in the mechanisms
proposed by theories and stress the use of operational definitions for
concepts (Gross, 2010). The ultimate goal of this approach is to predict and
control behaviour.

Psychoanalytic Approach: Freudian psychoanalysis introduces a distinct

lens to understand behaviour, asserting that much of human conduct is
determined byunconscious thoughts, wishes, and memories. Freud's iceberg
analogy illustrates that only a fraction of our thoughts are consciously
accessible, with the rest residing in the preconscious or unconscious realms.
Techniques like free association, dream interpretation, and transference are
fundamental to making unconscious elements conscious. Repression, a key
element, involves burying threatening or unpleasant experiences, forming a
major part of ego defence. While criticised for lacking scientific rigour,
Freud's theories offer profound insights into human behaviour, demanding
consideration in the broader context of psychology.

How did Freud view personality?

Freud's model portrays personality as a dynamic system directed by three
mental structures: the id, the ego, and the Superego. According to Freud,
most behaviour involves the activity of all three systems. (Freud's theory
includes a large number of concepts.
The Id
The id is made up of innate biological instincts and urges. It is self-serving,
irrational, impulsive, and totally unconscious. The id operates on
the pleasure principle. That is, it seeks to express pleasure-seeking urges
of all kinds freely. If we were solely under the control of the id, the world
would be chaotic beyond belief. The id acts as a well of energy for the
entire psyche (sigh-KEY) or personality. This energy, called libido (lih-BEE-
doe), flows from the life instincts (or Eros). According to Freud, the libido
underlies our efforts to survive, as well as our sexual desires and pleasure-
seeking. Freud also described a death instinct. Thanatos, as he called it,
produces aggressive and destructive urges. Freud offered humanity's long
history of wars and violence as evidence of such urges. Most id energies,
then, are aimed at discharging tensions related to sex and aggression.

The Ego
The ego is sometimes described as the "executive" because it directs
energies supplied by the id. The id is like a blind king or queen whose power
is awesome but who must rely on others to carry out orders. The id can only
form mental images of things it desires. The ego wins power to direct
behaviour by relating the desires of the id to external reality. Are there other
differences between the ego and the id? Yes. Recall that the id operates on
the pleasure principle. The ego, in contrast, is guided by the reality
principle. The ego is the system of thinking, planning, problem-solving, and
deciding. It is in conscious control of the personality and often delays action
until it is practical or appropriate.

The Superego What is the role of the Superego? The Superego acts as a
judge or censor for the thoughts and actions of the ego. One part of the
Superego called the conscience, reflects actions for which a person has
been punished. When standards of the conscience are not met, you are
punished internally by guilt feelings. A second part of the Superego is
the ego ideal. The ego ideal reflects all behaviour one's parents approve of
or reward. The ego ideal is a source of goals and aspirations. When its
standards are met, we feel pride. The Superego acts as an "internalised
parent" to bring behaviour under control. In Freudian terms, a person with a
weak superego will be a delinquent, criminal, or antisocial personality. In
contrast, an overly strict or harsh superego may cause inhibition, rigidity, or
unbearable guilt.

Humanistic Approach: In stark contrast to determinism, the humanistic

approach champions free will and individual agency. Rejecting the
deterministic nature of psychoanalysis and behaviourism, humanistic
psychologists, including Maslow and Rogers, emphasise the subjective
experience of individuals. Maslow introduces the concept of self-actualisation
at the pinnacle of a hierarchy of needs, emphasising healthy growth. Rogers
and Maslow highlight the actualising tendency, an inherent drive for personal
development. This perspective sees behaviour through the lens of individual
subjectivity, acknowledging humans as interpreters of their own experiences
(Gross, 2010).

Cognitive Approach: While undeniably influential, cognitive psychology

lacks clear boundaries compared to other major approaches. It encompasses
diverse theories, research programs, and psychotherapeutic forms with a
cognitive tilt. Cognitive psychology is characterised by the study of mental
processes such as perception, memory, and problem-solving. Despite its
diffuse identity, the cognitive approach has left an indelible mark on
psychological inquiry.

Integration and Future Exploration: As we explore these diverse

psychological principles and assumptions, it is crucial to recognise the
foundations they lay for understanding human behaviour. Each approach
contributes a unique perspective, and the nuances between them pave the
way for a holistic understanding of psychological phenomena. This
foundational knowledge serves as a precursor to in-depth discussions on
various forms of psychotherapy, where these theoretical frameworks find
practical applications (Nye, 2000).
 Chapter Three
Types of Behaviour

Behaviour encompasses a wide array of actions and reactions exhibited by

living organisms in response to internal and external stimuli. Understanding
the various types of behaviour is crucial for psychologists, biologists, and
researchers seeking insights into human and animal conduct. However,
Understanding the diversity of behaviour allows researchers and
practitioners to explore the complexities of human and animal conduct,
contributing to advancements in psychology, biology, and related fields.
Here is a brief overview of some fundamental types of behaviour:
Type of Definition Example
Behaviour
Observable Actions that can be seen and Raising hand in class
measured
Covert Internal processes that are not Feeling anxious
directly observable
Voluntary Actions under conscious control Choosing to exercise
Involuntary Reflexive actions not under Blinking
conscious control
Learned Behaviors acquired through Playing the piano
experience
Innate Instinctual behaviours Baby's thumb sucking

Development and Acquisition of Behaviour

The development and acquisition of behaviour are fundamental concepts in

behavioural psychology and behavioural modification. These processes
explain how individuals learn and adapt behaviours over time, influenced by
various internal and external factors.
1. Innate Behaviour:
  Also known as instinctive behaviour, innate behaviour is
genetically programmed and inherited. It is observed in nearly all
members of a species without prior exposure or learning.
2. Learned Behaviour:
 Unlike innate behaviour, learned behaviour is acquired through
experience, education, or interactions with the environment. It
can be modified based on exposure to new stimuli and includes
classical conditioning, operant conditioning, observational
learning, and cognitive learning.
3. Voluntary Behaviour:
 Actions that are under conscious control and can be initiated or
halted at will are classified as voluntary behaviour—movements
like walking or speaking fall into this category.
4. Involuntary Behaviour:
 In contrast, involuntary behaviour occurs without conscious
control. Examples include reflexes, such as the knee-jerk reflex,
which happens automatically in response to a stimulus.
5. Prosocial Behaviour:
 Prosocial behaviour involves actions that benefit others or
society as a whole. Acts of kindness, cooperation, and altruism
are considered prosocial behaviours.
6. Antisocial Behaviour:
 Antisocial behaviour encompasses actions that harm or disrupt
social order. Aggression, defiance, and criminal activities fall
within this category.
7. Aggressive Behaviour:
 Aggression involves actions intended to cause harm or gain
dominance. It can manifest physically, verbally, or relationally,
and its expression varies across species.
8. Cooperative Behaviour:
  Cooperative behaviour involves individuals working together for
mutual benefit. Cooperation is observed in social species where
collaborative efforts enhance survival and success.
9. Territorial Behaviour:
 Many animals exhibit territorial behaviour, defending and
marking specific areas. Territoriality helps in resource protection,
mate attraction, and establishing dominance.
10. Reproductive Behaviour:
 Reproductive behaviour encompasses activities related to
mating and ensuring the survival of offspring. Courtship rituals,
mating displays, and parenting behaviours fall into this category.
11. Exploratory Behaviour:
 Curiosity and the search for new information characterise
exploratory behaviour. It involves investigating the surroundings,
learning, and adapting to the environment.
12. Habitual Behaviour:
 Habits are behaviours that become automatic through repetition.
They require minimal conscious thought and are often triggered
by specific cues or situations.
13. Adaptive Behaviour:
 Adaptive behaviour helps individuals adjust to their environment,
enhancing their chances of survival and reproduction. It involves
learning, problem-solving, and flexibility.
14. Maladaptive Behaviour:
 Conversely, maladaptive behaviour is detrimental to an
individual's well-being. It hinders adaptation and may lead to
negative consequences for the individual or their social group.
 Chapter Four
Understanding Why People Seek Therapy

Therapy, also known as psychotherapy or counselling, is a process through

which individuals seek to understand their feelings, thoughts, and
behavioural patterns and work towards personal growth and problem-
solving. People pursue therapy for many reasons, each deeply personal and
often interlinked with various aspects of their lives. This class note explores
the primary motivations behind why individuals seek therapy.

Common Reasons People Seek Therapy

1. Emotional Distress and Mental Health Disorders

 Many individuals seek therapy to address emotional pain and
psychological distress. Conditions such as depression, anxiety
disorders, bipolar disorder, and PTSD are common reasons.
Therapy provides a supportive environment to understand and
manage these conditions.

2. Coping with Major Life Transitions

 Life transitions such as moving to a new city, starting a new job,
going through a divorce, or coping with the loss of a loved one
can be overwhelming. Therapy helps individuals navigate these
changes, offering strategies for adjustment and coping.

3. Improving Relationships
 Relationship issues, whether with a partner, family members, or
colleagues, can significantly impact one's well-being. Therapy
can help individuals improve communication skills, understand
relationship dynamics, and resolve conflicts.

4. Personal Growth and Self-Understanding

  Some individuals seek therapy not for specific problems but for
personal growth. They may want to understand themselves
better, explore their identity, or work towards personal goals and
self-improvement.

5. Stress Management
 Chronic stress from work, school, or other sources can lead to
burnout and physical health problems. Therapy can provide
techniques for stress management, helping individuals to lead
more balanced lives.

6. Behavioural Changes and Habit Control

 Therapy can assist those looking to change harmful behaviours
such as substance abuse, eating disorders, or aggression. It
provides a framework for understanding these behavioural
patterns and developing healthier coping mechanisms.

7. Trauma Recovery
 Experiences of trauma, whether from childhood or more recent
events, can have lasting effects. Therapy offers a safe space to
process these experiences, helping individuals heal and move
forward.

8. Self-Esteem and Body Image Issues

 Struggles with self-esteem and body image can deeply affect
one's quality of life. Therapy can help individuals develop a
healthier self-image and improve their confidence.

The Role of Therapy

 Supportive Environment: Therapy provides a non-judgmental,

confidential space where individuals can express themselves openly.
  Professional Guidance: Trained therapists offer insights, coping
strategies, and therapeutic techniques tailored to each individual's
needs.

 Empowerment: Therapy empowers individuals by giving them tools to

manage their issues and make informed decisions about their lives.

The decision to seek therapy is highly personal and can be driven by a

variety of factors. Whether addressing specific mental health conditions,
navigating life's challenges, or pursuing personal growth, therapy offers a
valuable resource for support and change. Understanding the diverse
reasons people seek therapy can foster empathy and encourage a more
open conversation about mental health and well-being.
 Chapter five
Providers of Psychotherapeutic Services
Psychotherapeutic services are essential for addressing a wide range of
mental health issues, emotional difficulties, and life challenges. These
services are provided by a variety of professionals, each with specialised
training, qualifications, and areas of expertise. Understanding who these
providers are, their roles, and their qualifications is crucial for anyone
seeking therapy or working in the mental health field.

Types of Psychotherapeutic Service Providers

1. Clinical Psychologists

 Qualifications: Typically hold a doctoral degree (Ph.D. or

Psy.D.) in psychology. They have extensive training in
psychological assessment, diagnosis, and a wide range of
therapeutic techniques.

 Services Provided: Clinical psychologists offer therapy for

various mental health disorders, conduct psychological testing,
and provide cognitive and behavioural interventions.

2. Counseling Psychologists

 Qualifications: Hold a doctoral degree in psychology, with a

focus on counselling. Their training emphasises holistic and
developmental aspects of human experience.

 Services Provided: They provide counselling for emotional,

social, vocational, educational, health-related, developmental,
and organisational concerns.

3. Psychiatrists
  Qualifications: Medical doctors (MD or DO) who specialise in
psychiatry. They have completed medical school, plus a
residency in psychiatry.

 Services Provided: Psychiatrists can prescribe medication,

offer medical assessments, and provide psychotherapy. Like the
Clinical Psychologist, Psychiatrist often treat more severe mental
health conditions.

4. Licensed Clinical Social Workers (LCSWs)

 Qualifications: Hold a master's degree in social work (MSW)

and have completed additional clinical training and licensure
requirements.

 Services Provided: LCSWs provide therapy crisis intervention

and connect clients with community resources. They often work
in settings that address social and systemic issues.

5. Marriage and Family Therapists (MFTs)

 Qualifications: Hold a master's degree in marriage and family

therapy or a related field, with specialised training in family
systems and relationships.

 Services Provided: MFTs focus on relationship issues, family

dynamics, and individual psychotherapy within marital and
family systems.

6. Licensed Professional Counselors (LPCs)

 Qualifications: Hold a master's degree in counselling or a

related field, with extensive training in therapeutic techniques
and ethics.
  Services Provided: LPCs provide therapy for a wide range of
mental health issues, focusing on personal growth, career
development, and emotional health.

7. Psychiatric Nurses

 Qualifications: Registered nurses (RNs) with specialised

training in psychiatric nursing. Advanced practice psychiatric
nurses hold a master's or doctoral degree.

 Services Provided: Provide care for patients with psychiatric

disorders, including medication management, therapy, and
support for patients and their families.

8. Psychoanalysts

 Qualifications: Professionals who have undergone specialised

training in psychoanalysis after obtaining a degree in
psychology, psychiatry, social work, or a related field.

 Services Provided: Offer psychoanalytic therapy to explore

unconscious motivations and early developmental issues.

Choosing the Right Provider

 Specialisation and Approach: Consider the provider's specialisation,

therapeutic approach, and experience in dealing with specific issues or
populations.

 Licensing and Credentials: Ensure the provider is licensed and

credentialed in their field, indicating they meet the professional
standards required for practice.
 Personal Fit: The therapeutic relationship is crucial for effective
therapy. Finding a provider with whom one feels comfortable and
understood is important.
 Chapter Six
The Process of Measuring in Psychotherapy

Measuring psychotherapy progress is a critical aspect of the therapeutic

process, allowing both therapists and clients to evaluate treatment
effectiveness, identify improvement areas, and adjust interventions as
needed. This process involves various methods and tools designed to assess
various dimensions of a client's well-being and functioning.
Key Concepts in Measurement
1. Baseline Assessment: Establishing a baseline involves assessing the
client's initial state before treatment begins. This includes evaluating
symptoms, behaviours, life satisfaction, and overall functioning to
provide a point of comparison for future assessments.
2. Goal Setting: Collaboratively setting clear, measurable, achievable,
relevant, and time-bound (SMART) goals is essential for therapy. These
goals provide a framework for measuring progress and success in
therapy.
3. Continuous Monitoring: Regularly monitoring progress throughout
the therapeutic process helps identify changes in the client's condition,
adjust treatment plans, and ensure that therapy meets the client's
needs.
Measurement Tools and Techniques
1. Standardised Psychological Assessments
 These are scientifically validated tools designed to measure
specific psychological constructs such as depression, anxiety,
stress levels, and personality traits. Examples include the Beck
Depression Inventory (BDI) and the Generalized Anxiety Disorder
7-item scale (GAD-7).
2. Self-Report Questionnaires
  Self-report measures allow clients to report their experiences,
symptoms, and perceptions. These can be administered at
various points throughout therapy to track changes over time.
3. Behavioural Observations
 Therapists may use direct observation of behaviours within or
outside therapy sessions to assess changes in behaviour
patterns, coping strategies, and interpersonal interactions.
4. Therapeutic Outcomes Scales
 Scales such as the Outcome Questionnaire-45 (OQ-45) are
designed to measure overall therapeutic progress across various
domains of functioning, including symptom distress,
interpersonal relationships, and social roles.
5. Qualitative Feedback
 In addition to quantitative measures, qualitative feedback from
clients about their therapy experience, perceived changes, and
satisfaction with the process is invaluable for gauging progress.
Challenges in Measuring Progress
 Subjectivity: Self-report measures and qualitative feedback are
subjective and may be influenced by the client's current mood, biases,
or desire to please the therapist.
 Complexity of Change: Psychological change is multifaceted and
may not always be captured fully by standardised measures.
 Cultural and Individual Differences: Standardised tools may not be
equally valid across different cultural backgrounds or individual
circumstances, necessitating careful selection and interpretation of
assessment tools.
Ethical Considerations
 Informed Consent: Clients should be informed about the assessment
methods and how their information will be used.
 Confidentiality: Safeguarding the confidentiality of assessment
results is paramount.
 Cultural Sensitivity: It is important to choose and interpret
assessment tools in a way that is respectful and appropriate to the
client's cultural background.
 Chapter Seven
Therapeutic Approaches
Psychotherapy theories provide a framework for therapists and counsellors
to interpret clients' behaviour, thoughts, and feelings and help them
navigate their journey from diagnosis to post-treatment. Theoretical
approaches are an understandably integral part of the therapeutic process.
Nevertheless, with so many different methods, how do you know which
counselling approach works best for you? Whether you are a student
learning about counselling theories or a client looking for the right therapist,
the following detailed descriptions will give you a deeper understanding of
each counselling method.

1. Psychoanalysis/Psychodynamic Theory
Psychoanalysis or psychodynamic theory, also known as the "historical
perspective," has its roots in Sigmund Freud, who believed there were
unconscious forces that drive behaviour. The techniques he developed, such
as free association (freely talking to the therapist about whatever comes up
without censoring), dream analysis (examining dreams for important
information about the unconscious), and transference (redirecting feelings
about certain people in one's life onto the therapist) are still used by
psychoanalysts today.
In general, psychotherapists and counsellors who use this approach direct
much of their focus and energy on analysing past relationships and, in
particular, traumatic childhood experiences in relation to an individual's
current life. The belief is that treatment and healing can occur by revealing
and bringing these issues to the surface. This theory is highly researched,
and as neuroscience advances, counsellors are finding how psychodynamic
theory can positively affect a client's brain. Psychodynamic theory can be
more time-intensive than some short-term theories because it involves
changing deeply ingrained behavioural patterns and requires significant work
on understanding oneself.
Techniques: Techniques include free association, dream interpretation, and
analysis of resistance and transference.
2. Behavioural Theory
Behavioural theory is based on the belief that behaviour is learned. Classic
conditioning is one type of behavioural therapy that stems from early
theorist Ivan Pavlov's research. Pavlov executed a famous study using dogs,
which focused on the effects of a learned response (e.g., a dog salivating
when hearing a bell) through a stimulus (for instance, pairing the sound of a
bell with food).
Also, B. F. Skinner developed another behavioural therapy approach called
operant conditioning. He believed in the power of rewards to increase the
likelihood of a behaviour and punishments to decrease the occurrence of a
behaviour. Behavioural therapists work on changing unwanted and
destructive behaviours through behaviour modification techniques such as
positive or negative reinforcement.
3. Cognitive Theory
In the 1960s, psychotherapist Aaron Beck developed cognitive theory. This
counselling theory focuses on how people's thinking can change feelings and
behaviours. Unlike psychodynamic theory, therapy based on cognitive theory
is brief and oriented toward problem-solving. Cognitive therapists focus more
on their client's present situation and distorted thinking than on their past.
Cognitive and behavioural therapy are often combined as one form of theory
practised by counsellors and therapists. Cognitive behavioural therapy, or
CBT, has been found in research to help with a number of mental illnesses,
including anxiety, personality, eating, and substance abuse disorders.
PLEASE NOTE: A COMBINATION OF COGNITIVE AND BEHAVIOURAL
THERAPIES IS CALLED COGNITIVE-BEHAVIOURAL THERAPY.
Techniques: Techniques include cognitive restructuring, behavioural
experiments, exposure therapy, and skills training.
Outcomes: CBT is evidence-based and widely used for treating a variety of
disorders, including anxiety, depression, and eating disorders. It is known for
its structured, time-limited, and goal-oriented nature.

4. Humanistic Approach
Humanistic therapists care most about the present and helping their clients
achieve their highest potential. Instead of energy spent on the past or
negative behaviours, humanists believe in the goodness of all people and
emphasise a person's self-growth and self-actualisation.
Humanistic theories include client-centred, Gestalt, and existential therapies.
Carl Rogers developed client-centred therapy, which focuses on the belief
that clients control their destinies. He believed that all therapists need to do
is show their genuine care and interest. Gestalt therapists' work focuses
more on what is happening at the moment than what is being said in
therapy. Existential therapists help clients find meaning in their lives by
focusing on free will, self-determination, and responsibility.
Techniques: Techniques include active listening, unconditional positive
regard, and exercises to enhance awareness and self-expression.
5. Holistic/Integrative Therapy
Holistic and integrative therapy involves integrating various elements of
different theories into the practice. In addition to traditional talk therapy,
holistic therapy may include nontraditional therapies such as hypnotherapy
or guided imagery. The key is to use the techniques and psychotherapy tools
best suited for a particular client and problem.
There are various therapies that counsellors can choose to study, but the
type of theory matters less than the success of the relationship between
client and therapist.
Techniques: An eclectic therapist might use cognitive restructuring from
CBT, dream analysis from psychodynamic therapy, and unconditional
positive regard from humanistic therapy, depending on the client's issues
and goals.
 Chapter Eight
Biological Approaches in Behavior Modification

Biological approaches to behaviour modification emphasise the role of

physiological and neurological factors in influencing human behaviour. These
approaches are grounded in the belief that biological systems, such as brain
chemistry, genetics, and nervous system functioning, play a crucial role in
shaping behaviours and can be targeted for effective behaviour modification.
Key Concepts
1. Neurotransmitters and Behavior
 Neurotransmitters are chemicals in the brain that transmit
signals across synapses from one neuron to another. Imbalances
or dysfunctions in neurotransmitter systems can influence mood,
cognition, and behaviour. Medications that alter neurotransmitter
activity are often used to modify behaviours associated with
mental health disorders.
2. Genetic Influences
 Genetics play a role in predisposing individuals to certain
behaviours and psychiatric conditions. Understanding the genetic
basis of behaviour can inform targeted interventions, such as
personalised medicine, to modify behaviours linked to genetic
predispositions.
3. Brain Structure and Function
 Specific areas of the brain are associated with different
behaviours and emotional responses. Techniques like
neuroimaging allow for the visualisation of brain activity and
structure, helping to identify abnormalities or dysfunctions that
may be targeted for behaviour modification.
4. Endocrine System
 The endocrine system, through hormones like cortisol and
adrenaline, affects how individuals respond to stress and can
 influence behaviour. Managing stress through biological
interventions can lead to behaviour modification, particularly in
stress-related behaviours.
Biological Interventions
1. Pharmacotherapy
 The use of medications to manage or alter brain chemistry is a
common biological approach. Antidepressants, antipsychotics,
and mood stabilisers can modify behaviours associated with
mental health disorders by targeting neurotransmitter systems.
2. Neurofeedback
 Neurofeedback is a technique that teaches individuals to alter
their brain activity. By monitoring brain waves, individuals can
learn to control certain physiological processes, which can be
used to modify behaviours, such as reducing impulsivity or
improving attention.
3. Electroconvulsive Therapy (ECT)
 ECT is used for severe cases of depression and other mental
health disorders when other treatments have failed. It involves
inducing controlled seizures to cause changes in brain chemistry
that can rapidly reverse symptoms of certain mental health
conditions.
4. Deep Brain Stimulation (DBS)
 DBS involves implanting electrodes in specific areas of the brain
to regulate abnormal impulses. It is used for treatment-resistant
disorders and has been shown to modify behaviours in conditions
like obsessive-compulsive disorder (OCD) and Parkinson's
disease.
5. Lifestyle Interventions
 Biological approaches include lifestyle changes that can
influence biological systems, such as diet, exercise, and sleep.
 These interventions can modify behaviours by improving overall
brain health and function.
Ethical Considerations
 Informed Consent: Patients must be fully informed about the
benefits, risks, and potential side effects of biological interventions.
 Autonomy: Respecting the individual's right to choose or refuse
treatment is paramount.
 Beneficence and Nonmaleficence: The potential benefits of an
intervention must outweigh the risks, and care must be taken to avoid
harm.
Biological approaches to behaviour modification offer powerful tools for
influencing behaviour through the manipulation of physiological and
neurological systems. These approaches are particularly relevant for
behaviours that have a strong biological component, such as those
associated with psychiatric disorders. Understanding the biological
underpinnings of behaviour can lead to more targeted and effective
interventions. However, it is crucial to balance these approaches with ethical
considerations and a holistic view of the individual.
References
Expectations
Presenting Complaints:
1. Emily's Social Withdrawal and Anxiety: Identified as maladaptive behaviours due to
the negative impact on her social interactions and self-esteem.
2. Alex's Aggression and Non-compliance: Identified as maladaptive behaviours affecting
his social relationships and causing discord within the family unit.
Intervention Goals:
 For Emily: To improve social skills and reduce anxiety in social situations. In order to
enhance self-esteem and emotional regulation.
 For Alex: In order to reduce aggressive behaviours and improve compliance with family
rules and routines.
Interventions:
For Emily's Social Withdrawal and Anxiety:
 Cognitive Therapy for Delusions and Hallucinations: Although Emily does not have
delusions, the cognitive therapy aspect can be adapted to challenge her negative thoughts
about herself and social situations.
 Mindfulness-Based Cognitive Therapy: To help Emily become more aware of her
thoughts and feelings without becoming overwhelmed by them, thus reducing anxiety.
 Social Skills Training: To equip Emily with the necessary skills to interact more
confidently with her peers and family.
 Emotional Regulation Techniques: To help Emily manage and express her emotions in
a healthier manner.