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





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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


Communication and problem-solving strategies

Operant conditioning


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Specific Treatment Techniques

Classical conditioning


Contingency contracting


Positive reinforcement

Quid pro quo



Systematic desensitization


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Specific Treatment Techniques

Job Card Grounding



Premack Principle

Disputing irrational thoughts

Thought stopping

Self-instructional training

Modeling and role playing

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Role of the Therapist





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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