CHAPTER 11 Behavioral and Cognitive Behavioral Family Therapies

CHAPTER 11: Behavioral and Cognitive. Behavioral Family Therapies Family Therapy: History, Theory, and Practice 6 th Edition Samuel T. Gladding Developed by Nathaniel N. Ivers, Wake Forest University © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved

Overview Behavioral Family Therapy (BFT) • • Functional Family Therapy • Cognitive-Behavioral Family Therapy (CFBT) • Major theorists • Premises • Techniques • Roles of therapist • Processes and Outcomes • Unique Aspects of BFT and CBFT Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -2

Behavioral Family Therapy (BFT) • 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 • Cognitive-behavioral family therapy (CBFT) Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -3

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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -4

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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -5

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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -6

Premises of the Theory • Based on 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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -7

Types of BFT and CFBT Therapies Behavioral Parent Training • • 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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -8

Types of BFT and CFBT Therapies Functional Family Therapy • • 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) Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -9

Functional Family Therapy Continued Three-stage process of Functional Family Therapy: • • Assessment • Change • Maintenance Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -10

Types of BFT and CFBT Therapies • Behavioral Treatment of Sexual Dysfunctions • Four phases of sexual responsiveness • Excitement • Plateau • Orgasm • Resolution Model for Sexuality • • PLISSIT Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -11

PLISSIT • P – Permission to talk about sexuality and sexual issues • LI limited information about the prevalence and etiology of problems • SS – specific suggestions • IT – intensive therapy Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -12

Types of BFT and CFBT Therapies • 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 Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -13

CBFT Continued Behavioral component of CBFT 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) Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -14

BFT: Treatment Techniques General BFT and CBFT techniques: • Education • Communication and problem-solving strategies • Operant conditioning • Contracting Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -15

BFT Treatment Techniques Specific behavioral and cognitive-behavioral techniques • • Classical conditioning • Coaching • Contingency contracting • Extinction • Positive reinforcement • Quid pro quo • Reciprocity Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -16

Specific BFT and CBFT Techniques Continued • Reciprocity • Shaping • Systematic desensitization • Timeout • Job Card Grounding • Charting • Premack Principle Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -17

Specific BFT and CBFT Techniques Continued • Disputing irrational thoughts • Thought stopping • Self-instructional training • Modeling and role playing Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -18

Role of the Therapist • Expert • Teacher • Collaborator • Coach • Helps families to set up behavioral and cognitivebehavioral management programs • Behavioral and CBT family therapists must learn to play man roles and to be flexible. • CBT family therapists concentrate on modifying or changing family members’ cognitions as well as their interactions. Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -19

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 • CBFT helps families deal with stress, addiction, and adult sexual dysfunctions Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -20

Unique Aspects of BFT and CBFT • The theory behind the approaches • The research • Their continued evolution • Their short term treatment • Their rejection of the medical model of abnormal behavior Gladding, Family Therapy: History, Theory, and Practice, 6 th Ed. © (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved 11 -21