Behavioral and Cognitive-Behavioral Family Therapies
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Behavioral Family Therapy (B F T)
Fairly recent treatment methodology
Origins in research on modification of children’s actions by parents
Treatment procedures based on social learning theory
Functional Family Therapy – a type of B F T that is basically systemic
Cognitive-behavioral family therapy (C B F T) – cognitive behavioral techniques converted to a family context
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Major Theorists
Early Pioneers
John B. Watson
Mary Cover Jones
Ivan Pavlov
B. F. Skinner
First to use the term, behavioral therapy
Originator and proponent of operant conditioning
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Gerald Patterson
Credited with being the primary theorist who began the practice of applying behavioral theory to family problems
Instrumental in writing programmed workbooks for parents to employ in helping their children
Played a critical role in the extension of learning principles and techniques to family and marital problems
Has influenced other behaviorists to work from a systemic perspective in dealing with families
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Neil Jacobson
Found that 20% of male batterers, have lower hear rates during times of physical assault
Found that acceptance, or loving one’s partner as a complete person and not focusing on differences, may lead to an ability to overcome fights that continually focus on the same topic
Challenged marriage and family therapy practitioners to be more innovative and reflective in their work
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Premises of the Theory
Based on the theoretical foundations of behavioral therapy, particularly operant and classical conditioning
Maladaptive behaviors and not underlying causes should be the targets of change
Not everyone in the family has to be treated for change to occur
Emphasizes the major techniques of behavioral theory, such as stimulus, reinforcement, shaping, and modeling
Many behavioral therapists also emphasize cognitive aspects of treatment
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Behavioral Parent Training
Four styles of parenting have been identified:
Authoritative Parenting
Authoritarian Parenting
Permissive Parenting
Neglectful Parenting
One of the main tasks is to define a specific problem behavior
Parents are trained in social learning theory
Behavioral approaches with parents are known as parent-skills training and parent therapies
One example is parent-child interaction therapy
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Functional Family Therapy
Family-based, empirically supported treatment for behavioral problems, especially with adolescents
Based on the idea that all behaviors are adaptive and serve a function
Behaviors represent an effort by the family to meet needs in personal and interpersonal relationships
Relationships help family members achieve one of three interpersonal states
Contact/closeness (merging)
Distance/independence (separating)
A combination of states 1 and 2 (midpointing)
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Functional Family Therapy
Three-stage process of Functional Family Therapy:
Assessment – focus is on the function that the behavioral sequences serve
Change – purpose is to help the family become more functional
Maintenance – focus is on educating the family and training them in skills that will be useful in dealing with future difficulties
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Behavioral Treatment of Sexual Dysfunctions
Masters and Johnson (1970) pioneered the cognitive-behavior approach to working with couples in the late 1960s with the publication of Human Sexual Response.
Four phases of sexual responsiveness
Excitement
Plateau
Orgasm
Resolution
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P L I S S I T
A clinically relevant model for sexuality counseling:
P – Permission to talk about sexuality and sexual issues
L I – Limited information about the prevalence and etiology of problems
S S – Specific suggestions
I T – Intensive therapy
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Commonalities of Behavioral Approaches to Sex Therapy
Reduction of performance anxiety
Sex education
Skill training in communications
Attitude change methodologies
Overall, behavior-oriented therapy for sexual dysfunctions has been found to produce excellent outcomes
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Cognitive-Behavioral Family Therapy (C B F T)
Heavy emphasis placed on modifying personal or collective core beliefs, or schemas.
Important to help change stable, entrenched, and long-standing beliefs that family members have about family life
Teach families to think for themselves and think differently when it is helpful
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Cognitive-Behavioral Family Therapy (C B F T)
Behavioral component of C B F T focuses on the following actions:
“Excess negative interaction and deficits in pleasing behaviors exchanged by family members
Expressive and listening skills used in communication
Problem solving skills
Negotiation and behavior change skills”
(Dattilio, 2001, p. 11)
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General Treatment Techniques
Education
Communication and problem-solving strategies
Operant conditioning
Contracting
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Specific Treatment Techniques
Classical conditioning
Coaching
Contingency contracting
Extinction
Positive reinforcement
Quid pro quo
Reciprocity
Shaping
Systematic desensitization
Time-Out
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Specific Treatment Techniques
Job Card Grounding
Grounding
Charting
Premack Principle
Disputing irrational thoughts
Thought stopping
Self-instructional training
Modeling and role playing
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Role of the Therapist
Expert
Teacher
Collaborator
Coach
Therapists help families to set up behavioral and cognitive-behavioral management programs
Behavioral and C B T family therapists must learn to play man roles and to be flexible.
C B T family therapists concentrate on modifying or changing family members’ cognitions as well as their interactions.
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Process and Outcome
If successful:
Family members learn to modify, change, or increase certain behaviors to function better
Family members learn how to eliminate or decrease maladaptive or undesirable behaviors and/or dysfunctional thoughts.
Focuses on increasing parenting skills, facilitating positive family interactions, and improving sexual behaviors
C B F T helps families deal with stress, addiction, and adult sexual dysfunctions
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Unique Aspects of B F T and C B F T
The theory behind the approaches
The research
Their continued evolution
Their short term treatment
Their rejection of the medical model of abnormal behavior
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