Farmer & Chapman (2016). Behavioral interventions in cognitive behavior therapy
This summary was made for the course ‘Introduction to cognitive behavioral therapies’, a course for
third year psychology students at the University of Groningen.
This summary contains:
Chapter 1 – Overview
Chapter 2 – Principles, goals, and structure of initial assessment sessions
Chapter 3 – Behavioral case formulation and treatment planning
Chapter 4 – Changing behavior by changing the environment
Chapter 8 – Behavioral activation
Chapter 9 – Exposure based interventions
Note: for a summary of the articles of 2022-2023, see my other advertisement!
,Summary Introduction to cognitive behavioral therapies – Book of Farmer & Chapman – by CD3V
Chapter 1 - overview
Cognitive behavior therapy (CBT) has emerged as a widely used and efficacious treatment approach
for a variety of psychological conditions. In contrast to models that emphasize the predisposing or
causal properties of cognitive constructs, behavior theory and therapy generally avoid ascribing
mental concepts a causal role in behavior and instead place primary emphasis on the physical
environment. From a behavioral perspective, thinking and emotional responding are examples of
behavior and are subject to many of the same influences as more observable behaviors.
Behavioral views on abnormality
Within behavioral traditions, the search for internal causes of behavior is largely avoided. Although it
is acknowledged that genetic endowments might predispose individuals to respond in certain ways
when relevant situational features are present the behavioral tradition is primarily concerned with
what one does and the contexts within which behavior occurs. Furthermore, from the behavioral
perspective, notions of what constitutes normality and abnormality are found in cultural norms,
values, and practices.
From a behavioral perspective, the determinants of what might be regarded as abnormal behavior
are no different from the determinants that shape and maintain normal behavior
Behavioral interventions within CBT: description and application
Behavioral perspectives are associated with a number of assumptions about the individual, the
context within which he or she lives, and the factors that influence his or her behavior. As suggested
earlier, psychological disorders from a behavioral perspective are defined by behavior, occurring
both within the individual (sometimes called covert behavior) and as overt actions that can be
observed by others (or overt behavior). Behavioral perspectives on psychological disorders are
further concerned with the functional relationships that exist between the behavior of a person and
the environment that establishes the context for such behavior.
Within some forms of behavior theory, the three-term contingency represents the basic unit of
analysis (Skinner, 1969). When applied to behavior therapy, the three-term contingency concept
refers to the interaction of the person with his or her environment and includes three elements: the
occasion within which behavior occurs, the behavior itself, and the consequences that follow
behavior.
- The first of these three elements, the antecedents of behavior, includes conditions or stimuli
that set the occasion for behavior to occur
- The second of these three elements, behavior, refers to anything a person does (overt and
covert)
- The last element of the three-term contingency, consequences, refers to the effect that
behavior produces
A focus on why people act the way they do
When behaviorally oriented clinicians talk about the function of behavior, they are talking about why
people behave the way they do. Functionalism is based on Darwinian evolutionary principles, where
the physical structure of a particular species is determined by its associated feature (natural
selection). Within functional or selectionist accounts of human behavior, behavior is largely, if not
exclusively, determined. The selection of cultural replicators (e.g., customs, rules, values) involves the
process of selection acting on variations and the transmission of selected practices from one member
2
, Summary Introduction to cognitive behavioral therapies – Book of Farmer & Chapman – by CD3V
of a group to another through behavior transfer processes such as imitation, modeling,
reinforcement for rule following, and arrangement of social contingencies. Environmental
determinism is the overarching process associated with the selection of variations in an individual’s
behavior during his or her lifetime and in cultural practices over successive generations
Common features among behavioral assessments
There are different focusses in different therapies. For example:
- Interpersonal therapy focusses on social behavior and relations with others
- Cognitive therapy focusses on automatic thoughts, underlying assumptions and schemas.
- Humanistic therapies tend to emphasize immediate experiences, emotions and the provision
of validation by the therapist for these experience and emotions.
Behavior therapies are primarily concerned about the contexts within which a client’s problematic
behavior occurs. They are also concerned with the client’s behavioral repertoire on the basis of the
idea that some clients display problematic behaviors because they have not yet learned alternative
and more adaptive forms of action. Behavior therapists are more inclined to view motivation as a
state or condition resulting from environmental events
In the behavioral assessment of clients, several features associated with the functional context of
behavior are assessed and evaluated:
- The antecedents of problematic behavior . Are there situations in which problematic
behaviors frequently occur? Are there common internal antecedents that immediately
precede such behavior?
- The consequences of problematic behavior . What are the consequences that follow
problematic behavior?
- The client’s learning history as it relates to current problematic behaviors. What factors in
the client’s past shaped and established the behaviors that the client seeks to change? Are
these factors of any influence today?
- The client’s current behavioral repertoire . A comprehensive assessment of the client’s
behavioral repertoire would cover four response domains
o Overt behaviors. What forms do the client’s problem behaviors take? Does the client
display effective coping, social, and problem-solving skills?
o Thoughts. Is the person plagued by negative evaluations of self, world, or future?
Does the person confuse evaluations of events and objects with the actual events
and objects?
o Emotions. Does the client excessively experience negative emotions? Are the client’s
expressed emotional experiences appropriate in situations in which they are
displayed
o Physiological sensations or responses. Do certain physiological responses define part
of a larger response pattern? Does the client associate normal physiological activity
with catastrophic outcomes?
- The client’s motivation for change. Does the client indicate a willingness or motivation to
change his or her behavior? Can the client articulate personal values or goals?
The factors that influence the behavior vary across individuals.
Common features among behavioral interventions (discussed in chapter 4 through 10):
3
