Behavioral therapy types of psychological counselors' exam counseling

Behavioral therapy types of psychological counselors' exam counseling

Behavioral therapy is an important part of the whole psychotherapy system, including many standardized and complete sets of treatment methods, mainly including the following seven kinds.

Desensitization method of (1) system

This method was invented by psychiatrist Volpa in the 1950s. It is one of the earliest methods systematically applied to the whole behavioral therapy. At first, Volpa applied this method to animal experiments. He put a cat in a cage and gave a strong electric shock as soon as food appeared, which caused the cat to eat. After repeated times, the cat had a strong fear reaction and refused to eat. Finally, it developed into a fear response to the cage and the entire environment of the laboratory. That is, the so-called "experimental phobia" has been formed. Then, Volpa corrected the cat with systematic desensitization method, and gradually eliminated the fear reaction of the cat. As long as the electric shock is stopped, it will eventually return to the cage and eat without fear. Since then, Volpa has widely applied systematic desensitization therapy to human clinical practice. When carrying out this therapy, we should first deeply understand what kind of stimulating situation the patient's abnormal behavior (such as anxiety, fear, etc.) is, and arrange all anxiety reactions into "anxiety class" according to the order from weak to strong. Then teach patients a way to react against anxiety and fear, that is, to relax the reaction, so that patients feel relaxed and relieve anxiety; Then, at the same time, the relaxation response technology is gradually and systematically paired with those anxiety classes from weak to strong, forming a situation of interactive inhibition (that is, gradually using relaxation response to suppress those weak anxiety reactions and then inhibiting those strong anxiety reactions). In this way, the anxiety reactions with different intensities formed by bad conditioned reflex (that is, learning) are eliminated one by one from weak to strong, and finally the strong anxiety reaction (that is, the target behavior we want to treat) is also eliminated (that is, desensitization). The abnormal behavior was overcome, and the patient re-established a normal behavior that was accustomed to contact with harmful stimuli and was no longer sensitive. This is systemic desensitization therapy. Clinically, it is often used to treat phobia, obsessive-compulsive neurosis and some maladaptive behaviors.

(2) aversion therapy

It helps people (including patients) to combine the target behavior (or symptoms) they want to quit with some offensive or punitive stimulus, and get rid of or reduce the appearance of the target behavior through the role of offensive conditions. This therapy is also one of the earliest and most widely used methods in behavioral therapy. Clinically, it is mostly used for smoking cessation, drug abuse, alcoholism, various sexual behaviors and some maladaptive behaviors, and can also be used to treat some obsessive-compulsive disorder.

Aversive stimuli can be pain stimuli (such as elastic pain stimuli and electrical stimuli), emetics (such as apomorphine) and unbearable odor or sound stimuli. Can also be deprived of food or social interaction. And it can also make people's minds appear extremely disgusting or unacceptable imaginary scenes through imagination, so as to achieve the purpose of strengthening aversion to stimuli. For example, to get rid of the bad behavior of alcoholism, we can do it at the moment when alcoholics like drinking most in their personal habits, and use punitive stimuli such as vomiting morphine or electric shock to arouse their aversion to alcohol, so as to prevent and eliminate the original bad behavior of alcoholism. For another example, if you want to quit smoking, you can use "quit smoking candy" and "quit smoking mouthwash", which can directly or indirectly make smokers feel an unpleasant smell when smoking, and they will feel disgusted with smoking and eventually give up the bad behavior of smoking.

(3) Behavior shaping.

This is a behavioral therapy technique designed according to Skinner's operating conditioned reflex principle, aiming at causing some expected good behavior through reinforcement (that is, reward). Generally, homework is graded step by step, and rewards are given according to the situation when the homework is completed (that is, reinforcement) to promote the increase of expected good behavior. Some people think that one of the most effective reinforcement factors (that is, reward methods) is the behavior record table, which requires patients to correctly record their progress every hour and draw charts. Doing so in itself is a powerful driving force for behavior improvement. According to the progress shown in the chart, the therapist can also apply other reinforcement factors to give praise or reward when the performance exceeds a certain index. In addition, patients can be provided with favorite food or entertainment, and in this way, new behaviors can be shaped to replace old and abnormal behaviors. In order to maintain and consolidate the therapeutic effect, it is necessary to pay special attention to how to help patients translate the behaviors learned in specific therapeutic situations into the real environment of daily life at home or at work. The scope of application of this law includes the speech of autistic children, improving or eliminating the behavior of neurosis such as phobia, anorexia nervosa and obesity; It can also be used to improve or promote the social and work behaviors of patients with schizophrenia; In social education, it can be used to train mental retardation and treat some sexual dysfunction.

(4) Symbolic therapy

This is a behavioral therapy based on Skinner's conditioned reflex theory, especially the principle of conditional reinforcement. Through a certain reward system, when patients make expected good behaviors, they can be rewarded immediately, which can be strengthened, so that patients' good behaviors can be formed and consolidated, and their bad behaviors can be subsided at the same time.

As a positive reinforcement, tokens can be expressed in different forms, such as scorecard, chips, securities and other symbolic ways. Tokens should have the function of "coins" in real life, that is, they can be exchanged for various reward items or activities that patients are interested in, thus gaining value. The advantage of using tokens for reinforcement is that it is not limited by time and space, and it is very convenient to use and can be continuously strengthened. As long as the patient has the expected behavior, reinforcement can be realized immediately; By exchanging tokens for different physical objects, we can satisfy some preferences of the recipients, avoid the satisfaction of the physical object itself from becoming reinforcement, and will not reduce the motivation to pursue reinforcement (reward). And when patients have bad behavior, tokens can be deducted, so that positive reinforcement and negative reinforcement work at the same time, resulting in a double reinforcement effect.

Token therapy can be used not only for individuals, but also for collective behavior correction. It can be widely used in hospitals, schools, even mental hospitals, special education classes, work-study schools, reformatory schools and prisons. Clinical practice shows that token therapy has a good effect in the treatment of ADHD children, drug addicts and alcoholics, as well as in the rehabilitation of degenerative mental patients.

(5) exposure therapy

This is a behavioral therapy technique, which is mainly used to treat phobia. The principle of its treatment is to let patients imagine the concept of terror for a long time or be in a serious horrible environment, so as to achieve the purpose of eliminating fear. In 1967, Steinfuer and Levis first reported a behavioral therapy to treat phobia by gradually exposing patients to horrible situations. This is the earliest exposure therapy, but it was called blasting therapy at that time. There are some similarities between this method and systematic desensitization therapy, such as the need to expose patients to horrible objects (things or situations). However, there are also differences between them: ① In the process of exposure therapy, there is no need to take relaxation or other measures to fight against terror when a horrible situation appears. ② Exposure therapy needs to expose the patient to a horrible situation for a long time. For example, it takes about 2 hours or more to treat patients with severe agoraphobia and severe anxiety. ③ Systemic desensitization is generally only effective for mild phobia; Exposure therapy is often used to treat severe patients. ④ Exposure therapy can be used not only for individual therapy, but also for group therapy. For agoraphobia, 5-6 patients can be treated at the same time, that is, they are exposed to horror situations at the same time, and the curative effect is the same as that of individual application.

(6) Relaxation reaction training

This is a kind of behavior training technology that makes the body relax through self-regulation training, and then leads to the relaxation of the whole body and mind, so as to resist the nervous reaction of sympathetic nerve excitement caused by psychological stress, thus eliminating tension, strengthening the body and getting rid of diseases. The general relaxation response training method is a gradual relaxation method initiated by Jacobson. This method can make the subjects learn to alternately contract or relax their skeletal muscles, and at the same time experience the degree of muscle tension and relaxation, and consciously feel the tightness, lightness and coldness of limbs and body, so as to achieve the effect of relaxation. China's qigong, Indian yoga and Japanese meditation can all play a similar role. It is generally believed that no matter what kind of relaxation response training technique, as long as it produces relaxation response, it must contain four components: ① quiet environment; ② Passive and comfortable posture; ③ Calm mood and relaxed muscles; (4) Mental internal defense (usually achieved by repeating a sound, a word or a short sentence).

According to the experimental research at home and abroad, relaxation response training can produce the following physiological effects: sympathetic nervous system activity decreases, oxygen consumption decreases, heart rate and respiratory rate slow down, systolic blood pressure decreases, and brain waves are mostly A waves. Therefore, generally speaking, therapies that can produce relaxation reactions can resist tension and anxiety. Relaxation response therapy is not only an important part of system desensitization, because it is simple and easy to operate, and it can train itself. It can also achieve the effect that biofeedback therapy can not achieve when biofeedback instrument is used alone; It has good curative effect on hypertension, insomnia, headache, arrhythmia and various diseases caused by psychological stress. Nowadays, various relaxation response training techniques have been widely used all over the world as an effective way to enhance people's physique and prevent and treat diseases, especially chronic diseases. But also widely used in sports competitions, cultural performances and all occasions that may cause tension and anxiety, in order to fight against tension and anxiety, so as to maintain and play a good game and performance effect.

(7) biofeedback therapy

It is a behavior correction technology that lets people know that their bodies are changing with the help of electronic instruments. Through biofeedback therapy, patients can adjust and control their heart rate, blood pressure, gastrointestinal peristalsis, muscle tension, sweat gland activity and brain waves, which include almost all body functions, thus improving the functional state of various organ systems in the body, correcting inappropriate responses to stress, and achieving the purpose of preventing and treating diseases.

Biofeedback is an experimental study of animal visceral response training, which was started in 1960s by American psychologist Miller according to the theory of operant conditioned reflex learning. 1967 succeeded for the first time, thus creating this brand-new treatment technology. According to the traditional concept, skeletal muscles (voluntary muscles) can be controlled at will, while smooth muscles such as viscera and glands (voluntary muscles) are controlled by autonomic nerves and cannot be controlled at will. The biofeedback technology founded by Miller broke this traditional concept for the first time. Scientific facts have proved that through special study and training, people can also learn to know and control the activities of their heart, blood vessels, gastrointestinal tract, kidneys, glands and other internal organs at will.

Clinical practice has proved that biofeedback is indeed an effective behavioral therapy technique. The combination of biofeedback and relaxation response training can make people learn to use relaxation response to combat and eliminate general psychological and emotional stress symptoms more quickly and effectively. At the same time, it is widely used to treat psychosomatic diseases, neurosis and some mental diseases in clinic.