Lecture
Plan.
one.
The behavioral direction in the psycho-correctional work originates from the works of D. Volpe and A; Lazarus (mid 50s - early 60s), although its roots go back to the behaviorism of D. Watson and E. Thorndike.
At the heart of this direction there are three classic psychological areas:
Currently, three major trends coexist in behavioral psycho-correction:
1. The classical theory of conditioned reflexes I.P. Pavlova was the foundation on which the modern building of behavioral correction was built. Based on the principles of classical conditioning, behavioral correction techniques such as aversive conditioning, stimulus control techniques, etc. have been created.
I.P. Pavlov for the first time answered the question of how a neutral stimulus can become a conditioned stimulus and cause the same reaction as an unconditioned reflex, which proceeds automatically. I.P. Pavlov showed that the formation of a conditioned reflex is subject to a number of requirements:
Thus, one of the ways to control behavior is to manage the presentation of incentives that cause a certain reaction, as well as the organization of the external environment and control over it. By organizing the external environment, a certain way can be formed
human behavior.
2. The theory of operant conditioning is associated with the names of E. Thorndike and B. Skinner. In contrast to the principle of classical “stimulus - reaction” conditioning, scientists developed the principle of operant conditioning “reaction-stimulus”, according to which behavior is controlled, by its results and consequences. From here follows a possible way of influencing behavior through influencing its results.
When using operant methods, the behavior results are controlled to influence the behavior itself. Therefore, special importance is attached to the functional analysis or behavioral diagnostics stage. The task of this stage is to determine the reinforcing significance of the objects surrounding the client, establishing the hierarchy of their reinforcing power. direct observation of human behavior and the establishment of a connection between the frequency and intensity of the behavior manifested (the dependent variable ) And available at the time the objects and events in the environment (the independent variable).
Operant methods can be used to solve the following problems:
- the formation of a new stereotype of behavior, which was not previously in the behavioral repertoire of a person (for example, a self-affirming type of behavior in a passive child, elements of playing together in a shy child, etc.), use different strategies for shaping such behavior - “shaping” , "Fading" and others;
- consolidation (reinforcement) of the socially desirable stereotype of behavior already present in the client’s repertoire. To solve this problem, stimulus control, positive and negative reinforcement are used;
- reduction or extinction of undesirable behavior is achieved by using methods of punishment, extinction, saturation, deprivation of all positive reinforcements, evaluation of the response;
- maintaining the desired stereotype of behavior in normal (natural) conditions.
3. Multimodal programming, or multimodal behavioral correction. In this direction, a central place is given to the impact on the integral organization of the individual, Within this newest direction (A. Lazarus, A: Bandura, T. Neylans, etc.), which includes cognitive-oriented modeling techniques, behavior formation, received, the development of the program self-regulation, cognitive self-regulation, cognitive behavior modification.
In recent years, this trend is finding more and more supporters. One of the latest achievements of behavioral psychotherapy is the removal of post-traumatic syndrome with the help of bilateral saccodic eye movements. Opened in 1987 (F. Shapiro), this method has proven itself in working with Vietnam veterans, victims of violence, etc.
At the head of modern behavioral theories of man is the idea that man is a product and at the same time a producer of its environment. A significant difference from traditional behaviorism is its focus on real actions. That is, a person is treated as an actor, who changes reality by his actions. Not a reaction, but its action - this is the difference between the modern behavioral concept in its interpretation of man.
As part of this approach, a number of behavioral modeling methodologies have been developed, with the help of which the following tasks are solved:
The theory of learning is characterized by the separation of two phases: the acquisition of a stereotype of behavior and the execution of this stereotype. A. Bandura found that reinforcement plays a significant role not in the phase of stereotype acquisition, but in the execution phase.
When learning with the help of a model, the observer acquires a new stereotype of behavior, which was previously absent in his repertoire. Observing a model reinforces or reinforces certain behavioral stereotypes (observing the positive effects of a particular behavior reinforces this stereotype and vice versa); enhances the function of discrimination stimulus, having the character of positive or negative reinforcement.
In the behavioral direction, the concept of personality is not only not developed, but simply absent. The basic concepts applied to an individual relate to its behavior. Therefore, the main reactions that are directed by the psychologist are real human behavior in the real world.
In accordance with the general orientation of the behavioral concept, the main goal of corrective actions is to provide new conditions for learning, i.e. developing a new adaptive behavior or overcoming behavior that has become maladaptive. The goals of corrective actions in behavioral psycho-correction are formulated either as teaching new adaptive forms of behavior or as extinction and inhibition of the maladaptive forms of behavior existing in the subject. Private goals may include the formation of new social skills, mastering psychological methods of self-regulation, overcoming bad habits, relieving stress, getting rid of emotional trauma, etc.
The position of the psychologist. In the behavioral psycho-correction, the psychologist plays the role of a clearly defined teacher, mentor, or doctor. In accordance with the fixed role, he should be ready to take on the burden of the socio-psychological model, the role model he is acting in the eyes of the client, and also be aware of the specifics of the protective identification mechanism that plays an important role for the client in behavioral psycho-correction.
Requirements and expectations from the client. The role of the psychologist is clearly fixed. The role of the client is also clearly defined. Activity, consciousness in setting goals, desire to cooperate with a psychologist and improvisation with new forms of behavior are encouraged.
The most important moment is the development of readiness to implement new forms of behavior. Since the behavior of the applicant is mainly subject to correction, the task of correctional activity is the formation of optimal behavioral skills. And mental disorders of various types are considered as forms of non-adaptive behavior.
Techniques
1. The method of "negative impact." It is based on the paradoxical assumption that an obsessive negative habit can be eliminated if you consciously repeat it repeatedly. According to the Pavlovian principle of extinction, a conditioned stimulus without reinforcement leads to the extinction (extinction) of the conditioned reflex.
K. Denlap offered a method of getting rid of obsessive movements, ticks, some forms of stuttering, which was that the person was asked to consciously reproduce unwanted reactions 15-20 times in a row.
If during a psychologist's conversation with a client (the topic of the conversation is free), the client has an undesirable reaction, the conversation is interrupted and resumed only after the client repeatedly consciously reproduces the entire range of reactions. For example, a client with a stutter is recommended to specifically stutter "many times (15–2 (1 times) repeating a word or phrase that causes difficulty. A client with intrusive movements is offered 10–15 minutes to specially repeat the aggression.
The first meeting lasts about 30 minutes, the next - up to 1 h. The frequency of meetings - 2-3 times a week.
With a high authority of the psychologist, the effectiveness of the method increases.
2. The technique of "skill therapy" (proposed by D. Meikhenba-
mind, 1976) is aimed at the development of self-regulation and
self-control skills. The author has developed a correctional program for changing the behavior of impulsive, hyperactive, unorganized schoolchildren. The program contains a series of successive steps:
1. Modeling. At this stage, the adult sets the task, and, arguing out loud, solves it.
2. Joint task execution. The adult sets the task and together with the child speaks the course of its solution.
3. Verbalization of independent performance of the task. The child independently formulates tasks, and, pronouncing the solution out loud, independently encourages himself (“I can do it”; “I can cope” ...) and evaluates the result achieved.
4. “Hidden” task execution. The child solves the problem, pronouncing the solution "to himself" (solves the problem in the internal plan).
3. Methods of formation of behavior. "Shaping". The technique is used for the phased modeling of complex
behavior that was not previously characteristic of man.
A chain of consecutive steps is made, mastering
which leads to the ultimate goal - the assimilation of a new program of behavior. In this chain, the most important is the first element, which should be clearly differentiated, and the criteria for assessing its achievement should be very clear. The first element is sufficiently connected with the ultimate goal of shaping, the success of the entire program depends on mastering it, since it is he who directs all behavior in the right direction.
To facilitate the mastery of the first element of the desired stereotype of behavior, it is necessary to create conditions under which this will happen most quickly and easily. In particular, a variety of reinforcement is used (both material and social - approval, praise, etc.). For example, when teaching a child self-dressing skills, the first element may be drawing attention to bright clothes.
"Clutch". The technique is similar to the method of "shaping" in structure and is directed back according to the scheme of formation of the desired behavior.
The desired behavioral stereotype is considered as a chain of individual behavioral acts, with the end result of each act being a discriminant stimulus that triggers the next behavioral act.
The formation of the desired behavior begins with the formation and consolidation of the last behavioral act, which is closest to the end of the chain, to the goal.
Exercises continue until the desired behavior of the whole chain is carried out using normal stimuli.
Fading (attenuation) is a gradual decrease
magnitudes of reinforcing stimuli. With a well-formed stereotype of behavior, the client must respond to minimal reinforcement in the same way. "Fading" is widely used in remedial work with fears. One of the variants of the method is that slides with the image of a frightening object or a frightening situation are used as incentives at the beginning. Right away
after the presentation of the stimulus slides to the client, slides are shown that are calming. This alternation continues until the alarm level drops significantly? caused by the appearance of a frightening object.
2
The main provisions of cognitive psychotherapy were formulated by Beck (A.T. Beck) independently of Ellis (A. Ellis), who in the 1950s. developed a method of rational-emotional psychotherapy. As an independent direction Cognitive psychotherapy was formed already later - in the 60s. Cognitive psychotherapy is the development of behavioral psychotherapy in which emotional reactions and mental disorders are considered as mediated by cognitive structures and actual cognitive processes acquired in the past, in other words, in which thought (cognition) acts as intermediate variables.
Like rational-emotional psychotherapy, cognitive psychotherapy is based on the fact that the perception of an object or event is mediated by thinking, and only by realizing this mediating link can one understand the reaction of the individual, first of all its emotional and behavioral aspects. The scheme of interaction between the environment and the individual is represented as S-> 0-> R (a stimulus is a reaction with an intermediate variable O, which includes primarily the cognitive processing of the perceived). Cognitive psychotherapy is based on the assumption that psychological disorders preceding the stage of neurophysiological disorders are associated with thinking aberration. Under the aberration of thinking, Beck understood violations at the cognitive stage of information processing (designation, selection, integration, interpretation) that distort the vision of an object or situation. Distorted cognitions cause misconceptions and self-signals and, therefore, inadequate emotional responses. Therefore, the goal of cognitive psychotherapy is to correct inadequate cognitions. In cognitive psychotherapy, it is considered highly desirable to maximize the use of the patient’s experience in positively solving life tasks and generalizing the rules for solving them in problem areas. Beck compared the work carried out by the cognitive therapist with the correction of the motor stereotype when playing a musical instrument. Awareness of the rules of inadequate information processing and replacing them with correct ones are the main tasks of cognitive psychotherapy. It is most shown to people with the ability to self-observe and analyze their thoughts. Cognitive psychotherapy involves the mutual cooperation of the therapist and the patient when the relationship between them is close to the partner. The patient and psychotherapist must at the very beginning reach agreement on the goal of psychotherapy (the central problem to be corrected), the means to achieve it, the possible duration of treatment. In order for psychotherapy to be successful, the patient must generally have a basic position of cognitive psychotherapy about the dependence of emotions on thinking: "If we want to change feelings, we must change the ideas that caused them." Establishing contact can begin with the psychotherapist taking some of the patient’s perceptions of the disease with a gradual transition to cognitive psychotherapy. Blind following a psychotherapist and heightened skepticism are two poles of a negative attitude towards the upcoming treatment. Therefore, bringing such positions to the center is the key to the success of psychotherapy.
An important task of the initial stage is the reduction of problems (identification of problems that are based on the same causes and their grouping). This task relates to both symptoms (somatic, psychopathological) and emotional problems. When this is achieved, the integration of the targets of psychotherapeutic effects. Another way to fix problems is to identify the first link in the chain of symptoms, which triggers the whole chain, which sometimes leads to a perceptual level.
The next stage is awareness, verbalization of non-adaptive cognitions that distort the perception of reality. For this, several techniques can be used, for example, an experimental method. In this case, the patient receives a detailed understanding of some of the provisions of Cognitive psychotherapy with special attention to the need to distinguish between objective reality (sensory level of information processing) and perceived reality. The level of subjective perception depends on cognitive processes and is associated with the interpretation - processing of signals of the first level. At this level, there may be significant distortions due to failures, errors, and cognitive processes, due to the automatically included evaluation cognitions. The experimental method involves immersing the patient in significant situations, including the principle of "here and now", in the presence of a psychotherapist. Drawing the patient’s attention to the parallel flow of thoughts in such a situation, and verbalization of these thoughts, teach the patient a method of sequential analysis of his or her perception of an object or event. Recognition of non-adaptive cognitions can be facilitated by the use of automatic thought collection techniques. The term “non-adaptive cognition” is applied to any thought that causes inadequate or painful emotions and makes it difficult to solve any problem. The patient is asked to focus on thoughts or images that cause discomfort in a problem situation or similar to it. Non-adaptive cognitions, as a rule, have the character of “automatic thoughts”. They arise without any preliminary reasoning, reflexively, and for the patient always have the character of plausible, well-founded, not questioned. They are involuntary, do not attract his attention, although they direct his actions. By focusing on them, the patient can recognize them and fix them. Usually, outside of a meaningful, problematic situation, these thoughts are realized with difficulty, for example, in persons suffering from phobias. Their identification is facilitated by a real approach to such a situation. Repeated approach or immersion into the situation allows you to first realize, carry out "collecting" them, and then instead of the shortened version, as in a telegram, present it in a more expanded form. The method of “filling in voids” is used when the level of emotions or symptoms experienced is moderate and the cognitions accompanying them are insufficiently defined and unclear. In this case, the analysis scheme proposed by Ellis and called the A, B, C scheme is used. The patient is trained to observe the sequence of external events (A) and the response to them (C). The sequence becomes clear if the patient fills the void in his mind, which will be the link between A and C, i.e., he will designate B. These are thoughts or images that arose during this gap and make the connection between A and C clear. that cognitive psychotherapy recognizes the existence of non-adaptive cognitions in both figurative and verbal forms.
After the patient's training phase, the ability to identify their non-adaptive cognitions should be taught to consider them objectively. The process of objective consideration of thoughts is called estrangement; the patient views his non-adaptive cognitions, automatic thoughts as psychological phenomena separated from reality. Separation increases the patient's ability to distinguish between the opinion that needs to be substantiated (“I think”) and the irrefutable fact (“I know”), and develops the ability to differentiate between the outside world and its attitude towards it. Accepting the substantiation, proving the reality of his automatic thoughts to the sick psychotherapist facilitates distancing the patient from them, forms in him the skill to see in them hypotheses, not facts. In the process of distance, the patient becomes clearer the way of distorting the perception of the event.
The next stage conditionally received the name of the stage of change in the rules of regulation of behavior. According to cognitive psychotherapy, people use rules (prescriptions, formulas) to regulate their lives and the behavior of others. This system of rules largely determines the designation, interpretation and evaluation of events. Rules of regulation of behavior, which are absolute, entail regulation of behavior that does not take into account the real situation and therefore creates problems for the individual. In order for a patient to not have such problems, he needs to modify them, make them less generalized, less personalized, more flexible, more responsive to reality. The content of the rules of behavior regulation is centered around two main parameters: danger - safety and pain - pleasure. The axis of danger - safety includes events associated with physical, psychological or psychosocial risk. A well-adapted person has a fairly flexible set of precise rules that allow them to be correlated with the situation, to interpret and evaluate the existing degree of risk. In situations of physical risk, the indicators of the latter can be sufficiently verified by one or several characteristics. In situations of psychological or psychosocial threats, verification of such indicators is difficult. For example, a person who is guided by the rule “It will be terrible if I am not up to par” has difficulty in communicating due to the vague definition of the concept of “being up to par”, and his assessment of the effectiveness of his interactions with a partner is associated with the same uncertainty. The patient projects his assumptions about failure to his perception by others. All methods of changing the rules relating to the axis of danger - safety, are reduced to the restoration of the patient’s contact with the situation to be avoided. Such contact can be restored when immersed in a situation in the imagination, at the level of real action with a clear verbalization of the new rules of regulation, allowing to experience a moderate level of emotions.
Rules centered around the axis of pain - pleasure, lead to hypertrophied pursuit of certain goals at the expense of others. For example, a person who follows the rule "I will never be happy if I am not famous", condemns himself to ignoring other areas of his relationship in order to follow this rule slavishly. After identifying such positions, the doctor helps the patient to realize the inferiority of such rules, their self-destructive nature, explains that the patient would be happier and less suffering if he were guided by more realistic rules. The task of the therapist is to help the patient find them himself. Closely related to them are the rules relating to duty (having the character of “tyranny of necessity”, according to Horney (Nogpeu K.)). Understanding the overall strategy of cognitive psychotherapy helps to avoid unnecessary steps when working with a patient.The stage of self-observation of the patient should be sufficient, but not excessive, and aim at detecting distortions, self-prohibitions, self-reprimanding, establishing the entire range of rules explaining the appearance of the corresponding symptoms that caused the patient's treatment.
Changing attitudes to the rules of self-regulation, learning to see hypotheses in thoughts, rather than facts, checking their truth, replacing them with new, more flexible rules are the next stages of cognitive psychotherapy. In the beginning, it is desirable to use the skills of productive problem-solving by the patient in other areas, and then to generalize these skills into the problem sphere. The selection of stages of work with the patient allows the use of several techniques, including from other systems of psychotherapy, if they are aimed at achieving the same goal.
Cognitive psychotherapy refers to the insight-oriented types of psychotherapy (as well as rational-emotional psychotherapy). In the framework of cognitive psychotherapy, insight is considered as a process of establishing the connection between life events and psychological reactions. It is aimed at revealing the meaning that the individual attaches to the external environment and internal sensations.
Cognitive psychotherapy, like other types of reconstructive psychotherapy, seeks to achieve structural changes in the personality, in its regulatory system, so that the patient meets the requirements of the environment and is in greater harmony with their own needs. The main restructuring is carried out by replacing non-adaptive cognitions. Cognitive psychotherapy uses what is derived from conscious life experience, and does not look for hidden symbolic meaning in the statements of the patient.
The cognitive approach to emotional disorders changes a person’s view of himself and his problems. Clients are taught to see in themselves an individual who is inclined to give rise to erroneous ideas, but also capable of abandoning erroneous ideas or correcting them. Only by defining or correcting thinking errors can a client create a life with a higher level of self-existence for himself. The
main idea of A. Beck’s cognitive correction is that processing of information is the decisive factor for the organism’s survival. . A person survives by obtaining information from the environment, synthesizing it and planning actions based on this synthesis, i.e. developing independently the program of behavior.
The program may be normal (adequate) or inadequate. In the case of a cognitive shift in information processing, an abnormal program begins to form. For example, having gained some experience in some life situations, people begin to interpret tendentiously. Their experience: a person for whom the idea of possible sudden death has a special meaning (due to the fact that he has lost someone from close relatives) may survive a threatening episode, begin to interpret normal bodily sensations as a signal of coming death. He develops an anxiety state, which can develop into a painful and disturbing one, while his behavior program is activated by a survival program. From the entire incoming flow of information, “danger signals” will be selected and “safety signals” blocked.As a result, the client begins to react to relatively minor incentives as a strong threat, responding emotionally and behaviorally inadequately.
Activated program for the cognitive shift in information processing. A normal program of correctly perceived and interpreted data is replaced by an “alarming program”, a “depressive program”, a “panic program”, etc. When this happens, the person begins to experience symptoms of anxiety, depression, or panic.
A. Beck believes that every person in cognitive functioning has its weak point - “cognitive vulnerability”. It is she who disposes a person to psychological stress.
The personality (according to A. Beck) is formed by schemes or cognitive structures, which are basal beliefs. These schemes begin to form in childhood based on personal experience and identification with significant others. Each person forms his own concept of himself, others, the world and the concept of his existence in the world. These concepts are supported by further human experience and, in turn, influence the formation of other beliefs, values and positions.
Literature.
Main literature.
Additional literature.
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Часть 1 7 Types and types of psychotherapy. Behavioral psychotherapy. Cognitive psychotherapy A. Beck.
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The basics of psychotherapy
Terms: The basics of psychotherapy