Nursing 212

Health Differences Across the Lifespan 2 Study Guide

Behavior Modification Therapy Behavior therapy involves changing the behavior of the patient to reduce the dysfunction and improve the quality of life. The principles of behavior therapy are based on early studies of classical conditioning by Pavlov (1927) and operant conditioning by Skinner(1938). Classical conditioning is the learning of involuntary responses by pairing a stimulus that normally causes a particular response with a new, neutral stimulus. After enough pairings, the new stimulus will also cause the response to occur. Through classical conditioning, the old, undesirable responses can be replaced by desirable ones. There are several techniques that have been developed using this type of learning to treat the disorders such as phobias, obsessive compulsive disorder, and similar anxiety disorder. Systemic Desensitization This is based on the behavior principle of counter conditioning for assisting individuals in overcoming their fears of phobic stimulus. Systematic desensitization is a behavioral therapy technique where by a person overcomes the maladaptive anxiety elicited by a situation or an object by approaching the feared situation gradually, in a psycho physiological state that inhibits the anxiety. The technique of systematic desensitization involves a therapist guiding the client through a series of steps meant to reduce fear and anxiety. Systematic desensitization is useful in cases of clearly identifiable anxiety provoking stimulus such as, phobias , obsessive compulsive disorder , sexual disorders, and anxiety disorder. Systematic desensitization consists of three steps: 1. Relaxation training 2. Hierarchy construction 3. Desensitization of stimulus Relaxation training: This is first step of systematic desensitization. Relaxation produces physiological effects opposite to those of anxiety: The signs of relaxation are: • Physiological signs: slow heart rate; increased peripheral blood flow and neuromuscular stability; pupil constriction; increased peripheral temperature; decreased oxygen consumption • Cognitive signs: altered state of consciousness; heightened concentration on a single mental image • Behavior changes: lack of attention and concern for the environmental stimuli; no verbal interaction; no voluntary change in theposition Techniques used for relaxation: The Jacobson progressive muscle relaxation is a common relaxation technique. It was developed by the psychiatrist Edmund Jacobson. The patient learns to relax through deep muscle relaxationtraining. Patients relax major muscle groups in a fixed order, beginning with the small muscle group of the feet and working up to the head or vice versa. The procedure includes: • Putting the patient in a comfortable position • Providing light or soft music/pleasant visual cues • Giving a brief explanation about the progressive musclerelaxation

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