Form  A  -­‐  Peter  ‘Max’  Quinn  Critical  Evaluation  Format  CN528  Counseling  &  Development  Professor  Ciri  -­‐  November  21,  2011    Theory:  Behavior  Therapy    

KEY  Concepts  of  Behavior  Therapy:    

-­‐View  of  Human  Nature  /  Basic  Characteristics  &  Assumptions  /  MOST  Important  Concepts-­‐  • Observable  Behavior  • Current  Determinants  of  Behavior  • Learning  Experiences  that  promote  change  • Tailoring  Treatment  Strategies  to  Individual  Students  • Rigorous  Assessment  &  Evaluation  • Behavioral  Conditioning  Techniques  are  effective,  an  alternative  to  what  Psychoanalytic  Theory  tells  us  

 Contemporary  Behavior  Therapy  -­‐  First  Wave  Cognitive  Behavior  Therapy  -­‐  Second  Wave    

• Four  Areas  of  Development  1. Classical  Conditioning:  Respondent  Conditioning  

§ What  happens  prior  to  learning  that  creates  a  response  through  pairing  § Ivan  Pavlov  -­‐  “Placing  food  in  a  dog’s  mouth  leads  to  salivation,  which  is  a  respondent  behavior.  

When  food  is  repeatedly  presented  with  some  originally  neutral  stimulus  (something  that  does  not  elicit  particular  response),  such  as  the  sound  of  a  bell,  the  dog  will  eventually  salivate  to  the  sound  of  the  bell  alone.”    

§ Principles  of  learning  derived  from  the  experimental  laboratory  can  be  applied  clinically  § Desensitization  can  be  applied  to  people  who,  through  classical  conditioning,  developed  an  intense  

fear  of  flying  after  having  a  frightening  experience  while  flying.    

2. Operant  Conditioning  § Most  of  the  significant  responses  we  make  in  everyday  life  are  examples  of  operant  behaviors  

• Reading  • Writing  • Driving  a  Car  • Eating  with  Utensils  

§ Learning  in  which  behaviors  are  influenced  mainly  by  consequences  that  follow  them  § If  the  environmental  changes  brought  about  by  the  behavior  are  reinforcing  -­‐  If  they  provide  some  

reward  to  the  student,  chances  are  increased  that  the  behavior  will  occur  again.  § If  the  environmental  changes  produce  no  reinforcement  or  reward,  the  changes  are  lessened  that  the  

behavior  will  recur.  § Positive  &  Negative  reinforcement,  punishment,  and  extinction  techniques  illustrate  how  operant  

conditioning  applied  in  settings  be  instrumental  in  developing  pro-­‐social  and  adaptive  behaviors.    

3. Social  Learning  Theory:  Combines  Classical  &  Operant  Conditioning  with  Observational  Learning  § Triadic  reciprocal  interaction  among  the  environment,  personal  factors,  and  individual  behavior  § Environmental  events  on  behavior  are  mainly  determined  by  cognitive  processes  governing  how  

environmental  influences  are  perceived  by  and  individual  and  how  these  events  are  interpreted  § People  develop  effective  social  skills  after  they  are  in  contact  with  other  people  who  effectible  model  

interpersonal  skills    

4. Cognitive  Behavior  Therapy  § Mid-­‐1970’s  Cognitive  Behavior  Therapy  replaced  Behavior  Therapy  § Interaction  among  affective,  behavioral,  and  cognitive  dimensions  Cognitive  process  that  involve  

private  events  such  as  the  students  self-­‐talk  as  mediators  of  behavior  change  § Focus  on  students’  cognitions  (thoughts  and  beliefs)  that  maintain  psychological  problems  

     

• View  of  Human  Nature  o Systematic  and  Structured  approach  to  Counseling  o The  person  is  the  producer  and  the  product  of  his  or  her  environment  o Developing  procedures  that  actually  give  control  to  students  and  thus  increase  their  range  of  freedom  o Increase  student’s  skills  to  that  they  have  more  options  for  responding  o By  overcoming  debilitating  behaviors  that  restrict  choices,  students  are  freer  to  select  from  possibilities  that  

were  not  available  earlier,  increasing  individual  freedom.    

• Basic  Characteristics  &  Assumptions  o People  are  capable  of  self-­‐directed  behavior  change  o Self-­‐efficacy  is  the  individual’s  belief  of  expectation  that  he  or  she  can  master  a  situation  and  bring  about  

desired  change  o Use  behavioral  methods  to  attain  humanistic  ends  

 Ø Six  Key  Characteristics  of  Behavior  Therapy:  

1. Experimentally  derived  principles  of  learning  are  systematically  applied  to  help  students  change  their  maladaptive  behaviors  

a. Systematic  adherence  to  precision  and  empirical  evaluation  b. State  treatment  goals  in  concrete  objective  terms  to  make  replication  of  interventions  possible-­‐  agree  c. Through  relationship,  assess  problem  behaviors  and  the  conditions  that  are  maintaining  them  d. Procedures  are  to  be  stated  explicitly,  tested  empirically,  and  revised  continually  

2. Behavior  Therapy  deals  with  the  student’s  current  problems  and  the  factors  influencing  them,  as  opposed  to  an  analysis  of  possible  historical  determinants  

a. Emphasis  on  specific  factors  hat  influence  present  functioning  and  what  factors  can  be  used  to  modify  performance  

b. Look  to  the  current  environmental  events  that  maintain  problem  behaviors  and  help  students  produce  behavior  change  by  changing  environmental  events,  through  Functional  Assessment  or  Behavioral  Analysis  

3. Students  involved  in  behavior  therapy  are  expected  to  assume  an  active  role  by  engaging  in  specific  actions  to  deal  with  their  problems  

a. Students  are  requires  to  do  something  in  order  to  change  b. Students  monitor  their  behaviors,  learn  and  practice  coping  skills,  and  role-­‐play  new  behavior  c. “Homework”  Assignments  d. Action-­‐oriented  and  an  educational  approach    -­‐  Learning  is  the  core  to  Behavioral  Therapy  e. Learn  new  and  adaptive  behaviors  to  replace  old  and  maladaptive  behaviors  

4. Change  takes  place  without  insight  into  underlying  dynamics  a. Changes  in  behavior  can  occur  prior  to  or  simultaneously  with  understanding  of  one-­‐self  b. Behavioral  changes  may  well  lead  to  an  increased  level  of  self-­‐understanding  c. Knowing  that  one  has  a  problem  and  knowing  how  to  change  it  are  two  different  things  

5. The  focus  is  on  asserting  overt  and  covert  behavior  directly,  identifying  the  problem,  and  evaluating  change  

a. Direct  assessment  of  the  target  problem  through  observation  of  self-­‐monitoring  b. Assess  students  cultures  as  part  of  understanding  social  environments,  including  social  support  

networks  relating  to  target  behaviors  6. Behavioral  treatment  interventions  are  individually  tailored  to  specific  problems  experienced  by  

students  a. “What  treatment,  by  whom,  is  the  most  effective  for  this  individual  with  that  specific  problem  and  

under  which  set  of  circumstances?”    

Therapeutic  Process:    

Most  important  Therapeutic  Goals  • Increase  personal  choice  and  to  create  new  conditions  for  learning  • Assess  behaviors  that  are  targets  of  change  • Continual  assessment  throughout  relationship  determines  the  degree  to  which  identified  goals  are  being  met  • Stress  students’  active  role  in  deciding  about  their  treatment  • Goals  must  be  clear,  concrete,  understood,  and  greed  on  by  the  student  and  professional  • Discuss  the  behaviors  associated  with  the  goals,  the  circumstances  required  for  change,  the  nature  of  subgoals,  and  a  

plan  of  action  to  work  toward  these  goals  -­‐  Contract  the  guides  the  relationship      

Functions  and  Role  of  the  Student  Affairs  Professional  • Assist  students  in  formulating  specific  measureable  goals  • Conduct  a  Functional  Assessment  (behavioral  analysis)  -­‐  Identify  the  maintaining  conditions  by  systematically  

gathering  information  about  situational  antecedents,  the  dimensions  of  the  problem  behavior  and  the  consequwnces  or  the  problem.  

• Teach  concrete  skills  through  provision  of  instructions,  modeling,  and  performance  feedback  o Students  are  encouraged  to  experiment  for  the  purpose  of  enlarging  their  repertoire  of  adaptive  behaviors  

• Increase  person  choice  and  to  create  new  conditions  for  learning  • The  student,  with  the  help  of  practitioner,  define  specific  treatment  goals  at  the  outset  • Formal  assessment  takes  place  prior  to  treatment  to  determine  behaviors  that  are  targets  of  change  • Continual  assessment  determines  the  degree  to  which  identified  goals  are  being  met  • Devise  a  way  to  measure  progress  toward  goals  (based  on  empirical  validation)  • Student  and  practitioner  discuss  the  behaviors  associated  with  the  goals,  the  circumstances  required  for  change,  the  

nature  of  sub  goals,  and  a  plan  of  action  to  work  toward  these  goals  • Alter  goals  throughout  the  relationship  as  needed  • SA  PRO  should  be  active,  directive,  and  function  as  consultants  and  problem  solvers  

o Summarize,  reflect,  clarify,  open-­‐ended  questioning    The  students’  role  in  the  Therapeutic  Process  

• Define  specific  goals  at  the  outset  of  relationship  • Enable  a  well-­‐defined  system  of  procedures  to  employ  • Awareness  of  participation  • Engage  in  behavioral  rehearsal  wit  feedback  until  skills  are  well  learned  and  generally  receives  active  homework  

assignments  to  complete  • Be  motivated  to  change  and  are  expected  to  cooperate  in  carrying  out  activities,  especially  in  every-­‐day  life  • Experiment  for  the  purpose  of  enlarging  their  repertoire  of  adaptive  behaviors  • Actions  must  follow  verbalizations  

 -­‐  Applications:  Techniques  and  procedures  of  the  Behavior  Therapy  approach  -­‐  

 -­‐Techniques  and  methods  of  Behavior  Therapy  in  Student  Affairs  practice-­‐  

• ABC  Model:  Antecedents,  Behaviors,  Consequences  o Behavior  (B)  is  influenced  by  some  particular  events  that  precede  it,  antecedent  events  (A),  and  by  certain  

events  that  follow  it,  consequences  (C)  o Antecedent  Events  -­‐  Ones  that  cue  or  elicit  a  certain  behavior  o Consequences  -­‐  Events  that  maintain  a  behavior  in  some  way  either  by  increasing  or  decreasing  it  o Assessment  Interview  -­‐  Identify  the  particular  antecedent  and  consequent  events  that  influence  or  are  

functionally  related  to  an  individual’s  behavior    

• Applied  Behavioral  Analysis:  Operant  Conditioning  Techniques  o Students  respond  in  predictable  ways  because  of  the  gains  they  experience  (positive  reinforcement)  of  

because  of  the  need  to  escape  or  avoid  unpleasant  consequences  (negative  reinforcement)  o Positive  Reinforcement  

§ The  addition  of  something  of  value  to  the  individual  as  a  consequence  of  behavior  § Ex)  Praise,  attention,  money,  or  food  -­‐  “Positive  Reinforcer”  

o Negative  Reinforcement  § The  escape  from  or  the  avoidance  of  aversive  (unpleasant)  stimuli  § Motivated  to  exhibit  a  desired  behavior  to  avoid  the  unpleasant  condition  

o Extinction  § Withholding  reinforcement  from  a  previously  reinforced  response  § Eliminate  a  connection  between  a  certain  behavior  (e.g.  temper  tantrums)  and  positive  

reinforcement  (e.g.  attention)  § Can  invoke  negative  side  effects:  Anger  and/or  Aggression  

o Positive  Punishment  (aversive  control)  § The  consequences  of  a  certain  behavior  result  in  a  decrease  of  the  behavior  § Aversive  stimuli  is  added  after  the  behavior  to  decrease  the  frequency  of  a  target  behavior  

o Negative  Punishment  § Reinforcing  stimulus  is  removed  following  the  behavior  to  decrease  the  frequency  of  a  target  

behavior    

• Relaxation  Training  o Aimed  at  achieving  muscle  and  mental  relaxation  and  is  easily  learned  

§ Systematic  Desensitization  § Assertion  training  § Self-­‐Management  Programs  § Audiotape  recordings  § Biofeedback  § Hypnosis  § Meditation  § Autogenic  Training  (Control  of  bodily  and  imaginal  functions  through  autosuggestion)  

 • Systematic  Desensitization  

o Students  imagine  successively  more  anxiety-­‐arousing  situations  at  the  same  time  that  engage  in  a  behavior  that  competes  with  anxiety  -­‐  Allows  them  to  systematically  become  desensitized  to  the  anxiety-­‐arousing  situation  

o Like  exposure  therapy,  students  are  required  to  expose  themselves  to  anxiety-­‐arousing  images  as  a  way  to  reduce  anxiety  

o Use  a  very  quiet,  soft,  and  pleasant  voice  to  teach  progressive  muscular  relaxation  o Ask  student  to  create  imagery  of  previously  relaxing  situations  -­‐  Reach  state  of  calm  and  peacefulness  o Develop  a  Anxiety  Hierarchy  for  each  identified  area  

§ Stimuli  that  elicit  anxiety  in  a  particular  area  -­‐  Rejection,  jealousy,  criticism,  disapproval,  or  any  phobia  are  analyzed  

§ Construct  a  ranked  list  of  situations  that  elicit  increasing  degrees  of  anxiety  or  avoidance  o Desensitization  begins  several  session  after  initial  interview  

§ Professional  moves  progressively  up  the  hierarchy  until  the  student  signals  they  are  experiencing  anxiety  

§ The  scene  is  reintroduced  again  until  little  anxiety  is  experienced  to  it  § Treatment  ends  when  the  student  is  able  to  remain  in  a  relaxed  state  while  imagining  the  scene  that  

was  formerly  the  most  disturbing  and  anxiety  producing.  § Repeated  exposure  in  the  imagination  to  anxiety-­‐evoking  situations  without  experiencing  any  

negative  consequences  o Appropriate  technique  for  treating  phobias  o Students  are  in  control  of  the  process  by  going  at  their  own  pace  and  terminating  exposure  when  they  begin  

to  experiences  more  anxiety  than  they  want  to  tolerate  (Safeguard)    

• In  Vivo  Exposure  &  Flooding  o Exposure  Therapies  -­‐  Designed  to  treat  fears  and  other  negative  emotional  responses  by  introducing  

students,  under  carefully  controlled  conditions,  to  the  situations  that  contributed  to  such  problems  o Systematic  confrontation  with  a  feared  stimulus,  either  through  imagination  or  in  vivo  (live)  

§ In  Vivo  Exposure  Involves  student  exposure  to  the  actual  anxiety-­‐evoking  events  rather  than  simply  imagining  these  situations.  Together,  professional  and  student  generate  a  hierarchy  of  situations  for  the  student  to  encounter  in  ascending  order  of  difficulty.  Students  engage  in  brief  graduated  series  of  exposures  to  feared  events.    § Flooding  

               In  vivo  or  imaginal  exposure  to  anxiety-­‐evoking  stimuli  for  a  prolonged  period  of  time  § In  Vivo  Flooding  

               Intense  and  prolonged  exposure  to  the  actual  anxiety-­‐producing  stimuli.  Remaining  exposed  to  feared                                 stimuli  for  a  prolonged  period  without  engaging  in  any  anxiety-­‐reducing  behaviors  allows  the  anxiety     to  decrease  on  its  own.      

• Eye  Movement  Desensitization  &  Reprocessing  (EMDR)  o Imaginal  flooding,  cognitive  restructuring,  and  the  use  of  rapid,  rhythmic  eye  movements  and  other  bilateral  

stimulation  to  treat  students  who  have  experienced  traumatic  stress  o Designed  to  assist  students  in  dealing  with  posttraumatic  stress  disorders,  asexual  abuse  victims,  combat  

veterans,  victims  of  crime,  rape  survivors,  accident  victims,  and  individuals  dealing  with  anxiety,  panic,  depression,  grief,  addictions,  and  phobias  

 • Social  Skills  Training  

o Deals  with  individual’s  ability  to  interact  effectively  with  others  in  various  social  situations  o Used  to  correct  deficits  students  have  in  interpersonal  competencies  

o Easily  tailored  to  meet  individual  needs  o Assertion  Training  -­‐  Useful  for  those  who  have  difficulty  expressing  anger  or  irritation;  those  who  have  

difficulty  saying  no;  those  who  are  overly  polite  and  allow  others  to  take  advantage  of  them;  those  who  find  it  difficult  to  express  affection  and  other  positive  responses;  those  who  feel  they  do  nit  have  a  right  to  express  their  thoughts,  beliefs,  and  feeling;  or  those  who  have  social  phobias  

o Students  have  the  right  to  express  themselves  o Increase  students  behavioral  repertoire  so  that  they  can  make  the  choise  of  whether  to  behave  assertively  in  

certain  situations  o Teaches  students  to  express  themselves  in  ways  that  reflect  sensitivity  to  the  feelings  and  rights  of  thers  o Assertion  does  not  mean  aggression;  truly  assertive  people  do  not  stand  up  for  their  rights  at  all  costs,  

ignoring  the  feelings  of  others  o Based  on  the  principles  of  Social  Learning  Theory    

• Self-­‐Modification  Programs  &  Self-­‐Directed  Behavior  o Self-­‐monitoring,  self-­‐reward,  self-­‐contracting,  stimulus  control,  and  self-­‐as-­‐model  o Change  can  be  brought  about  by  teaching  students  to  use  coping  skills  in  problematic  situations  o Students  must  accept  the  responsibility  for  carrying  out  these  strategies  in  daily  life  1. Selecting  Goals  2. Translating  goals  into  target  behaviors  3. Self-­‐monitoring  4. Working  out  a  plan  for  change  5. Evaluating  an  action  plan    

• Multimodal  Therapy:  Clinical  Behavior  Therapy  o Systematic,  holistic  approach  to  behavior  Therapy  (Arnold  Lazarus)  o Open  system  that  encourages  technical  eclecticism  o Determine  precisely  what  relationship  and  what  treatment  strategies  will  work  best  with  each  students  and  

under  which  circumstances  o Professional  functions  as  trainers,  educators,  consultants,  and  role  models.  Provide  instruction,  

feedback,  and  modeling  assertive  behaviors.  Constructive  criticism  and  suggestions,  positive  reinforcements,  and  appropriately  self-­‐disclosing  

 Ø The  BASIC  I.D.  -­‐  (See  pg.  253  for  Questions  to  Ask)  

o B  =  Behavior;  Overt  behaviors,  including  acts,  habits,  and  reactions  that  are  observable  and  measurable  o A  =  Affective  responses;  Emotions,  moods,  and  strong  feelings  o S  =  Sensations;  Basic  senses  of  touch,  taste,  smell,  sigh,  and  hearing  o I  =  Images;  How  we  picture  ourselves,  including  memories,  dreams,  and  fantasies  o C  =  Cognitions;  Insights,  philosophies,  ideas,  opinions,  self-­‐talk,  and  judgments  that  constitute  one’s  

fundamental  values,  attitudes,  and  beliefs  o I  =  Interpersonal  relationships;  Interactions  with  other  people  o D  =  Drugs,  biological  functions,  nutrition,  and  exercise;  Drugs,  and  nutritional  habits,  and  exercise  

patterns    

• Mindfulness  &  Acceptance-­‐based  Cognitive  Behavior  Therapy  (Third  Wave)  o Mindfulness,  acceptance,  the  therapeutic  relationship,  spirituality,  values,  meditation,  being  in  the  present  

moment,  and  emotional  expression  o Dialectical  Behavior  Therapy  (DBT)  -­‐  Treatment  for  borderline  personality  disorders  

§ Developed  to  help  students  regulate  emotions  and  behavior  associated  with  depression  § Helps  students  accept  their  emotions  as  well  as  to  change  their  emotional  experience  § Being  in  the  present  moment,  seeing  reality  as  it  is  without  distortions,  without  judgment,  without  

evaluation,  and  without  trying  to  hang  on  to  an  experience  or  to  get  rid  of  it.  § Entering  fully  into  activities  of  the  present  moment  without  separating  oneself  from  ongoing  events  and  

interactions  o Mindfulness-­‐based  Stress  Reduction  (MBSR)  -­‐  8-­‐10  week  group  program  applying  mindfulness  techniques  

to  coping  with  stress  and  promoting  psychical  and  psychological  health  § Sitting  meditation  and  mindful  yoga  -­‐  Aimed  at  cultivating  mindfulness  (45  minutes  daily)  

o Mindfulness-­‐based  Cognitive  Therapy  -­‐  Primarily  used  for  treating  depression  o Acceptance  &  Commitment  Therapy  (ACT)  -­‐  Encouraging  students  to  accept,  rather  than  attempt  to  

control  or  change,  unpleasant  sensations.    § Fully  accepting  present  experience  and  mindfully  letting  go  of  obstacles  § Allowing  experience  to  come  and  go  while  pursing  a  meaningful  life  

• Integration  of  Behavioral  Techniques  -­‐  Contemporary  Psychoanalytic  Approaches  o What  children  learn  from  early  interaction  with  parents  clearly  affects  personality  development  and  may  

result  in  problematic  adult  relationships  o Meaningful  Assessment  -­‐  Professional  must  be  able  to  hear  the  stories  of  students,  to  grasp  their  

phenomenological  world,  and  to  establish  rapport  with  them  o Link  insights  gleaned  from  the  initial  assessment  phase  to  the  present  to  create  an  understanding  of  how  

early  relational  patterns  are  related  to  present  difficulties  o Behavioral  techniques  with  homework  assigned  are  emphasized  to  maximize  change    

• Application  to  Group  Counseling  o Teaching  students  self-­‐management  skills  and  a  range  of  new  coping  behaviors,  as  well  as  how  to  restructure  

their  thoughts  o These  techniques  can  help  students  to  control  their  lives,  deal  effectively  with  present  and  future  problems,  

and  function  well  after  they  complete  their  group  experience  o Increase  the  students  degree  of  control  and  freedom  in  specific  aspects  of  daily  life  

 -­‐Major  strengths  of  Behavior  Therapy  from  a  diversity  perspective-­‐  

• Some  students  hold  values  that  are  contrary  to  free  expression  of  feelings  and  the  sharing  of  personal  concerns  • Stresses  changing  specific  behaviors  and  developing  problem-­‐solving  skills  • Specificity,  task  orientation,  dealing  with  the  present  more  than  the  past,  emphasis  on  brief  interventions,  teaching  

coping  strategies,  and  problem-­‐solving  orientation  • Attention  is  given  to  transfer  of  learning  and  the  principles  and  strategies  for  maintaining  new  behavior  in  daily  life  • Action  plans  and  specific  behavioral  change  • Focuses  on  environmental  conditions  that  contribute  to  the  students  problems  • Takes  into  consideration  the  social  and  cultural  dimensions  of  the  students  life  • Experimental  analysis  of  behavior  in  the  students  own  social  environment  and  gives  special  attention  to    a  number  of  

specific  conditions    -­‐Evaluation  of  the  Behavior  Therapy  Approach-­‐    

• The  students  cultural  conception  of  problem  behaviors,  establishing  specific  therapeutic  goals,  arranging  conditions  to  increase  the  students  expectation  of  successful  outcomes,  and  employing  appropriate  social  influence  agents  are  key  concepts  for  change  

• Strict  reliance  is  placed  on  the  principles  of  the  scientific  method  • Concepts  and  procedures  are  stated  explicitly,  tested  empirically,  and  revised  continually  • Research  is  considered  a  basic  aspect  of  the  approach,  and  therapeutic  techniques  are  continually  refined  • Emphasis  on  the  interplay  between  the  individual  and  the  environment  • Bridges  humanistic  and  behavioral  therapies,  especially  with  the  current  focus  of  attention  on  self-­‐directed  

approaches  and  also  with  the  incorporation  of  mindfulness  and  acceptance-­‐based  approaches  into  behavioral  practice    -­‐The  Most  Significant  Contributions  of  Behavior  Therapy  as  related  to  Student  Affairs  Practice-­‐  Behavior  Therapy  moves  beyond  treating  students  for  a  specific  symptom  or  behavioral  problem.  Instead  it  stresses  a  thorough  assessment  of  the  person’s  life  circumstances  to  ascertain  not  only  what  conditions  give  rise  to  the  students  problems  but  also  whether  the  target  behavior  is  amenable  to  change  and  whether  such  a  change  is  likely  to  lead  to  a  significant  improvement  in  the  students  total  life  situation  (pg.  259-­‐260).  This  is  very  important  for  use  in  Student  Affairs  practice.  A  focus  on  environmental  factors  and  behavior  are  great  tools  that  Student  Affairs  practitioners  can  use  in  their  daily  interactions  with  students.  I  find  the  behavioral  therapy  to  be  the  most  applicable  theory  in  Student  Affairs  practice.  With  research  playing  a  major  role  in  the  assessment  of  treatment  outcomes,  this  shows  that  validity  of  this  theory  in  its  applicability  to  be  used  with  almost  all  students.    -­‐The  Most  Significant  limitations  of  Behavior  Therapy-­‐  

• Ethical  practice  involves  a  professionals  familiarity  with  the  students  culture,  as  well  as  competent  application  of  this  knowledge  in  formulating  assessment  and  diagnostic  and  treatment  strategies  

• Behavior  therapists  need  to  become  more  responsive  to  specific  issues  pertaining  to  all  critical  variables  that  influence  the  process  and  outcome  of  therapy                                

• Behavior  Therapy  may  change  behaviors,  but  it  does  not  change  feelings  • Behavior  Therapy  ignores  the  important  relational  factors  in  therapy  • Behavior  Therapy  does  not  provide  insight  • Behavior  Therapy  treats  symptoms  rather  than  causes  • Behavior  Therapy  involves  control  and  manipulation  by  the  therapist