Hockenbury Discovering Psychology 5th txtbk

592 CHAPTER 14 TherapiesFigure 14.2 The Effectof Operant ConditioningTechniques These graphsdepict the changes in threespecific sleep-related problembehaviors of a 4-yearoldgirl over the course ofbehavioral therapy. Theintervention for each problembehavior was introducedseparately overseveral weeks. As you cansee, behavior therapy produceda rapid reduction inthe rate of each problembehavior. The green areashows the maintenance ofdesired behavior changesover a six-month follow-up.Source: Adapted from Ronen (1991).Number of nightstoken economyA form of behavior therapy in which thetherapeutic environment is structured toreward desired behaviors with tokens orpoints that may eventually be exchangedfor tangible rewards.cognitive therapiesA group of psychotherapies based on theassumption that psychological problems aredue to illogical patterns of thinking; treatmenttechniques focus on recognizing andaltering these unhealthy thinking patterns.642064206420rational-emotive therapy (RET)A type of cognitive therapy, developed bypsychologist Albert Ellis, that focuses onchanging the client’s irrational beliefs.Enters Parents’ BedThe parents next identified severalvery specific behavioral goals fortheir daughter. These goals includednot crying when she was putto bed, not crying if she woke up inthe night, not getting into her parents’bed, and staying in her ownCries More Than 10 Minutesbed throughout the night.The parents were taught operanttechniques to decrease the undesirablebehaviors and increase desirableones. For example, to extinguish thegirl’s screaming and crying, the parentswere taught to ignore the be-Leaves Own Bedhavior rather than continue to reinforceit with parental attention. Incontrast, desirable behaviors were tobe positively reinforced with abundantpraise, encouragement, social7 8 1 2 3 4 5 6attention, and other rewards. FigureWeeksMonths14.2 shows the little girl’s progressTimefor three specific problem behaviors.Operant conditioning techniqueshave been applied to manydifferent kinds of psychological problems, from habit and weight control to helpingautistic children learn to speak and behave more adaptively. Techniques based onoperant conditioning have also been successfully used to modify the behavior ofpeople who are severely disabled by retardation or mental disorders (see Zinbarg &Griffith, 2008).The token economy is another example of the use of operant conditioning techniquesto modify behavior. A token economy is a system for strengthening desired behaviorsthrough positive reinforcement in a very structured environment. Basically, tokensor points are awarded as positive reinforcers for desirable behaviors and withheldor taken away for undesirable behaviors. The tokens can be exchanged for other reinforcers,such as special privileges.Token economies have been most successful in controlled environments in whichthe behavior of the client is under ongoing surveillance or supervision. Thus, tokeneconomies have been used in prisons, classrooms, inpatient psychiatric units, and juvenilecorrection institutions (Ringdahl & Falcomata, 2009; Field & others, 2004).They have been shown to be effective even with severely disturbed patients whohave been hospitalized for many years (Paul & Menditto, 1992). Although effective,token economies are difficult to implement, especially in community-basedoutpatient clinics, so they are not in wide use today (Lieberman, 2000).A modified version of the token economy has been used with outpatients intreatment programs called contingency management. Like the token economy, acontingency management intervention involves carefully specified behaviors that“earn” the individual concrete rewards. Unlike token economies, which covermany behaviors, contingency management strategies are typically more narrowlyfocused on one or a small number of specific behaviors (Prochaska & Norcross,2010). Contingency management interventions have proved to be especially effectivein the outpatient treatment of people who are dependent on heroin, cocaine,alcohol, or multiple drugs (Lamb & others, 2004; Petry & others, 2004;Stitzer & others, 2007). In some cases, the contingency management interventionssignificantly reduced substance abuse in patients for whom other forms oftreatment had failed.Table 14.3 summarizes key points about behavior therapy.1 2 3 4 5 6Baseline (in weeks) Intervention (in weeks) Follow-up (in months)