Behavioral approach in psychological counseling

Stages of behavior therapy

Behavioral psychotherapy, as a separate direction, was identified around the middle of the last century. This teaching was rapidly gaining popularity, as it made it possible to achieve positive results in two or three sessions of psychotherapy.

Behavioral therapy is based on the idea that some types of mental disorders are associated with malformed behavioral skills. Such disorders include phobias, behavioral disorders and various addictions, sleep and eating disorders, difficulties in speech development in children and other problems for which a specific symptom can be identified for correction.

Treatment is carried out in several stages:

1. Behavior analysis. This stage is the longest, sometimes lasting several weeks. The psychotherapist comprehensively studies the patient’s behavioral characteristics in order to create the most optimal treatment regimen.

2. Drawing up a treatment plan. Once the patient’s problems have been identified, we can proceed to their correction. If several problems are found, they are solved sequentially.

3. Therapy ends when the patient has developed behavioral skills that allow him to cope with the problem.

In behavioral therapy, the therapist acts as a teacher who helps the patient acquire new behavioral skills. In this case, a person’s motivation plays a huge role. The patient must clearly understand the meaning of all techniques and methods used by the psychotherapist. This helps you complete all tasks correctly and motivates you to continue studying.

Basic methods in behaviorism

The main methods in behaviorism are:

• Observation (of behavior).
• Oral recording method.
• Method of conditioned reflexes.

Watson completely denied the existence of hereditary traits and instincts and defended the decisive importance of the influence of education and the environment on the development of the child.

As for emotions, according to Watson, emotions are the body's reaction to certain stimuli. These stimuli cause both internal changes in the body and those external reactions that arise during the learning process. This theory does not assume conscious awareness of emotions and sensations.

Watson's view of the thinking process fits organically into the general concept of behaviorism. In particular, he tried to reduce thinking to implicit motor behavior. He argued that thinking is a certain kind of sensorimotor behavior (muscle movements of the larynx). Consequently, thinking becomes a kind of silent internal conversation.

Another prominent representative of behavioral psychology is Skinner, who focused his research on such an aspect as operant behavior.

As a radical behaviorist, Skinner rejected all notions that people are autonomous and their behavior is determined by the supposed existence of internal factors (unconscious impulses, archetypes, personality traits). Such ideas, in his opinion, originated in primitive animism and persist because the environmental conditions that determine behavior are ignored.

Skinner's theory makes no attempt to question or speculate on the processes of a person's internal state. This is considered inapplicable to the scientific explanation of behavior. To avoid the observation that description amounts to explanation, Skinner argued that the human body is a “black box” whose contents (motives, drives, conflicts, emotions, etc.) must be excluded from the scope of empirical investigation. Variable body sizes contribute nothing to our understanding of human activity and serve only as a brake on the development of scientific analysis of behavior.

Skinner recognized that behavior can be reliably confirmed and predicted by environmental conditions. Understanding behavior means controlling it and vice versa. Skinner believed that data obtained from animal experiments could be used to analyze human behavior. Just as science progresses from simple to complex, it is possible to extrapolate data from simple animals to humans. Therefore, Skinner focused his research on the study of reciprocal and operatic behavior, as well as on the study of types of reinforcement and punishment.

C. L. Hull and I. R. Guthrie also contributed to the study of learning. In particular, Guthrie introduced the concept of “one-trial learning” (one combination of stimulus and response is enough to establish a connection). Hull also introduced the concepts of primary and secondary amplification.

Further research within the framework of behaviorism gradually began to take into account the presence of internal intervention variables between stimulus and response. This includes E. C. Tolman with his ideas about "intervening variables" (factors that determine behavior). Although intervening variables were observed in Tolman's studies, he was one of the first to show interest in these variables. Also noteworthy is his concept of “latent learning” (which is truly a cognitive concept).

Differences between behavior therapy and other areas of psychology

Any type of psychotherapy is aimed at changing the patient's personality. This is deep work that requires a lot of dedication from the psychotherapist. There are a large number of areas of psychotherapy, each of which has its own characteristics:

• Gestalt therapy puts the patient’s “I” in the first place, calling on him to satisfy his needs and desires at the moment they arise by any socially acceptable means. It is believed that various kinds of psychological problems arise in a person when he does not follow his desires, but tries to live up to the ideal imposed on him by the people around him;

• psychoanalysis evaluates the patient’s dreams, as well as associations that are caused by various objects, people and situations;

• art therapy allows you to resolve psychological problems through the influence of artistic methods. The patient is offered to draw, sculpt, etc.

There are also other directions, but only behavioral therapy will allow a person to discover irrational logic and warnings in the deep consciousness.

align=”justify”>Inner beliefs are questioned and given a new assessment. To achieve such results, the therapist asks the patient many different questions, some of them tricky, others funny or simply idiotic.

As a result of cognitive behavioral therapy, the psychologist's patient gets the opportunity to look at his internal beliefs from the outside and understand the absurdity of some of them. Reconsidering your assessment of the world around you, people and yourself allows you to get rid of psychological disorders such as depression and anxiety, as well as increase self-esteem and confidence in your abilities.

Structure of the Consulting Process

None of the theoretical orientations or schools of psychological counseling reflects all possible situations of interaction between a consultant and a client. Therefore, let us consider the most general model of the structure of the consultation process, the so-called eclectic model (WE Gilland and associates; 1989). This systemic model, which includes six closely interconnected stages, reflects the universal features of psychological counseling or psychotherapy of any kind.

• Research of problems. At this stage, the adviser establishes contact (report) with the client and achieves mutual trust: It is necessary to listen carefully to the client when he talks about his difficulties, and to show the highest degree of sincerity, empathy and caring, without resorting to judgment or manipulation. It is necessary to encourage the client to take a deep look at his problems and become aware of his feelings, the content of statements and non-verbal behavior.
• Two-dimensional formulation of the problem. During this stage, the counselor attempts to accurately characterize the client's problems and cover both emotional and cognitive aspects. Issues are clarified until client and consultant have the same understanding; problems are specifically identified. Accurate identification of problems allows us to understand their causes and sometimes indicates ways to solve them. When difficulties or ambiguity arise in defining problems, we must return to the exploratory phase.

Identifying alternatives. At this stage, possible alternatives to solve problems are identified and openly discussed. By asking open-ended questions, the consultant encourages the client to name all possible alternatives that he considers appropriate and realistic, helps introduce other alternatives, but does not impose solutions. During the discussion, you can create a written list of alternatives to make it easier to compare them. Alternatives must be found to solve the problem that the customer can use directly.

• Planning. At this stage, a critical assessment of the selected solution alternatives is carried out. The counselor helps the client determine which alternatives are appropriate and realistic in light of past experiences and current readiness for change. Creating a realistic plan to solve the problem should also help the client understand that not all problems are solvable. Some problems take too much time, others can only be partially solved by reducing their destructive, disruptive behavior. The problem solving plan should include the means and methods by which the client will check the feasibility of the chosen solution (role-playing games, “rehearsals” of actions, etc.).

5th event. At this stage, the plan to solve the problem is consistently implemented. The consultant helps the client structure activities, taking into account circumstances, time, emotional effort, as well as the possibility of not achieving goals. The client must understand that partial failure is not a disaster, and that it is necessary to continue to implement the plan to solve the problem and link all actions to the end goal.

• Rating and feedback. At this stage, the client, together with the consultant, evaluates the degree to which the goal has been achieved (the degree to which the problem has been solved) and summarizes the results achieved. If necessary, you can modify the solution plan. If new or deeply hidden problems arise, it is necessary to return to the previous steps.

This model, which mirrors the counseling process, only helps to better understand how a particular counseling process works. The actual counseling process is much more extensive and often does not follow this algorithm. The division of stages is conditional, since in practice some stages overlap with others, and their interdependence is more complex than in this scheme.

Areas of application

The cognitive approach can be applied to all people who feel unhappy, unsuccessful, unattractive, unsure of themselves, etc.

An attack of self-torture can happen to anyone. Cognitive therapy in this case can identify the thinking pattern that served as the trigger for creating a bad mood, replacing it with a healthy one.

This approach is also used to treat the following mental disorders:

• depression;
• suicidal tendencies;
• panic attacks, anxiety, suspiciousness;
• various types of addictions, including alcohol;
• social phobia (fear of communicating with people);
• unreasonable fears;
• eating disorders (anorexia, bulimia);
• attention deficit hyperactivity disorder;
• manic-depressive psychosis;
• antisocial behavior pattern (lying, kleptomania, sadism).

Cognitive therapy can remove difficulties in relationships with family and friends, and also teach you how to establish and maintain new connections, including those with the opposite sex.

What does cognitive science study? Find out the answer right now.

World of Psychology

Basic goals

• Eliminating deficits in behavioral responses.
• Strengthening adaptive behavior.
• Reducing or eliminating inappropriate behavior.
• Eliminate debilitating anxiety reactions.
• Developing the ability to relax.
• Developing the ability to assert oneself.
• Developing the ability to self-regulate.

Methodological basis

• Works on classical conditioning by Ivan Petrovich Pavlov (1849-1936).
• Works on conditioning by the founder of behaviorism, John Broadus Watson (1878-1958).
• Operant behaviorism Burres Frederick Skinner (1904-1990).
• Works on reciprocal inhibition by Joseph Wolpe (1915).

Psychological counseling invariably begins with a behavioral assessment or functional analysis of clients' problem areas. Three types of reactions are recorded:

1. Situational past stimulus (C). For example: “Yesterday at 15.30 I needed to present my project to 15 colleagues.”
2. Reaction variables (R). For example: “I was worried, I spoke quickly.”
3. Consequences or outcome variables (P). For example: “The audience seemed moderately interested. The boss congratulated me and approved of my activities.”

Data collection, according to the sequence outlined above, is called SBR analysis. Sometimes this data is compiled in the form of a behavioral monitoring diary:

When collecting information, questions that begin with the word “Why” are ignored. Questions are asked that begin with the words “How”, “When”, “Where”, “What”. Information is collected by:

• interview,
• medical examination,
• reports of previous psychological observations,
• questionnaires designed for self-report (for example, the “Fear Questionnaire”, recording how much it is when communicating with superiors, colleagues, people of the opposite sex, etc.),
• self-observation and filling out tables in a special diary, - direct observation in a natural setting,
• indirect observation in a natural setting - information is collected from people familiar with the client,
• direct observation in a simulated setting (for example, a role-play setting).

After collecting information, the goals of counseling are determined - which variables need modification. We try to define goals as clearly as possible so that both the consultant and the client can easily evaluate changes. Sometimes there are several priorities. The work starts with the most important problem.

To combat such reflex reactions as hyperexcitation and hyperirritation, the method of progressive muscle relaxation (Progressive Relaxation - from the Latin relaxatio - relaxation) by Edmund Jacobson, popularized by Joseph Wolpe, is used. The essence of the technique is that with the help of concentration, the client first develops the ability to detect tension in the muscles and a feeling of muscle relaxation. Then the skill of mastering voluntary relaxation of tense muscle groups is practiced. The exercises consist of tensing muscle groups for 5-7 seconds, which then completely relax. The client's attention is focused on a feeling of relaxation.

In cases where it is necessary to combat anxiety, fears (monophobia), systematic desensitization techniques and other types of desensitization are used. This technique was proposed by J. Wolpe in 1952.

Theoretical foundations of the method of systematic desensitization:

• Maladaptive human behavior, including neurotic behavior, including interpersonal behavior, is largely determined by anxiety and is supported by a decrease in its level.
• Actions performed in the imagination can be equated to actions performed in reality, including if done in a state of relaxation.
• Fear and anxiety can be suppressed if stimuli that cause fear and stimuli that are antagonistic to fear are combined in time.
• In humans, one of the effective stimuli that counteracts fear is relaxation.

Therefore, if you teach the client deep relaxation and in this state encourage him to conjure up stimuli that cause an increasing degree of anxiety, the client will be desensitized (decrease in sensitivity) to real stimuli or situations that cause fear.

The essence of the technique. A person in a state of deep relaxation (achieved using E. Jacobson's progressive muscle relaxation technique) evokes in his mind ideas about situations that lead to fear. He imagines these situations for 5-7 s, then eliminates the anxiety that has arisen by increasing relaxation (up to 20 s). The work begins with the situation that causes the least fear. The presentation of the situation is repeated several times, and if the client does not experience anxiety, they move on to the next, more difficult situation. During one lesson, 3-4 situations are worked out. The number of sessions can vary from 4-5 to 12 or more. The work ends when the strongest stimulus no longer causes fear in the client.

The following types of desensitization are also distinguished:

1. Desensitization in vivo (in real life). This type of desensitization is applicable to those situations that can be repeated many times in reality. Stages of work:
   a hierarchy of situations that cause fear is compiled;
2. Real Situation Training: The client is encouraged to face fearful situations in the presence of a psychologist whom the client trusts and in whose presence he feels a deep sense of security. Here, the factor opposing fear is the feeling of security in the presence of a specific person - a psychologist.
3. Contact desensitization. The client is encouraged to touch the feared object (for example, a dog) in the presence of a psychologist and with guarantees of safety. This is often preceded by modeling: another person who does not experience this fear, in front of the client, performs a series of actions with an object that causes fear in the client, according to a pre-compiled list.
4. Emotive imagination. Used when working with children. The child in the role of his favorite hero, acting out situations from his life, gradually encounters situations that previously caused him fear. Children's well-developed imagination helps them switch to different methods of emotional response than were previously observed.

If interpersonal interaction skills are insufficiently developed (inability to listen to the interlocutor, self-disclose, provide feedback), the method of behavior rehearsal is used - role-playing games, in which the client is encouraged to act out new adequate reactions.

If the client has a habit of reacting with anxiety to the behavior of other people, assertiveness training is used. J. Volpe defines assertiveness as the ability to acceptably express any emotion other than anxiety that relates to another person. The counselor supports the client in expressing legitimate emotions. Initially, assertiveness training was aimed at a person defending his rights and developing oppositional behavior. Recently, more and more attention has been paid to the manifestation of various shades of positive emotions towards another person: love, attention, care (where appropriate).

The consultant and the client discuss a lot what behavior will be most appropriate in different situations; the client’s individual behavior style is taken into account. The training is used in the form of both individual and group work. The results of the client's assertive behavior in real life are analyzed, the consultant draws the client's attention to the positive consequences of this behavior.

Reinforcement techniques are used to change behavior through its consequences.

There are positive and negative reinforcing stimuli: positive ones involve the presentation of something, and negative ones involve the removal of something in a given situation.

When the appropriate reinforcer fades, the likelihood of a response decreases.

Praise, displays of affection, and interest are used as positive reinforcing stimuli.

Sometimes special questionnaires are used to assess which stimuli will be more significant for the client (Cautela Reinforcement Research Plan, McPhillamy and Levinson Plan of Pleasant Events).

In applied environments, the main method of behavior change is positive reinforcement. At the same time, alternative, incompatible with undesirable types of behavior can be positively reinforced. Positive reinforcement programs are often created with the help of significant others. Reinforcement can be provided indirectly - with the help of symbols (for example, tokens), which can subsequently be exchanged for stimuli that are meaningful to the subject. Reinforcement can be indirect - when clients observe models - people who receive a reward for the desired behavior.

The psychologist actively assists clients in obtaining the desired reinforcements: they are helped to actively search for people, activities, situations that could provide reinforcement.

Methods of punishment may also be used. An example of this type of technique is the “time-out” technique, which is used with children who have an “explosive” character. Such children are removed from situations in which they can receive reinforcement (for example, a child's disruptive behavior in the classroom aimed at gaining attention). At the same time, children must be clearly warned what behavior entails a “time out.” For children, “time out” is prescribed in a time period from 5 to 20 minutes, for very young children - from 1 to 5 minutes.

One of the methods of using reinforcement is the procedure of observing oneself and then constructing diagrams that display the proportion of elements of desired and undesirable behavior in the life of a given person per unit of time (for example, a diagram of the number of cigarettes smoked per day, a diagram of weight changes, etc.).

Another method born from the idea of ​​reinforcement is the environmental control method. The client is encouraged to remove from view all objects that may induce the undesired behavior and to place in the field of view those objects that may induce the desired behavior. For example, a client who is struggling with excess weight can be asked to organize the space around him in such a way that food and objects related to it are out of sight for most of the day, and the attributes of sports activity are always visible and, as it were, invited to engage in activity. associated with movement.

You can invite the client to actively use self-reinforcement methods to achieve their goals. An example of positive self-reinforcement is when a person tells himself every time he does something successfully: “well done”, “amazing”, “great”, “cool”, etc. Examples of self-punishment are giving a certain amount to charity for every extra 100 calories eaten, imagine unpleasant consequences while performing unwanted actions, imagine being scolded when eating chocolate cake.

Concept

Cognitive methods in psychotherapy work with the patient's thinking model.

The goal of cognitive therapy is awareness and correction of destructive patterns (mental schemes).

The result of treatment is complete or partial (at the patient’s request) personal and social adaptation of the person.

People, faced with unusual or painful events at different periods of their lives, often react negatively, creating tension in the body and brain centers responsible for receiving and processing information. This releases hormones into the blood that cause suffering and mental pain.

In the future, such a pattern of thinking is reinforced by repetition of situations, which leads to mental disorders. A person ceases to live in peace with himself and the world around him, creating his own hell.

Cognitive therapy teaches you to react more calmly and relaxed to inevitable changes in life, turning them into a positive direction with creative and calm thoughts.

The advantage of the method is working in the present tense, without focusing on:

• events in the past;
• influence of parents and other close people;
• feelings of guilt and regret about lost opportunities.

Cognitive therapy allows you to take your destiny into your own hands, freeing yourself from harmful addictions and the unwanted influence of others.

For successful treatment, it is advisable to combine this method with behavioral, that is, behavioral.

What is cognitive therapy and how does it work? Find out about it in the video:

What is a cognitive ability test for? Read about it here.

Cost of consultation

In my practice, I also use cognitive-behavioral techniques; I conduct face-to-face consultations in Moscow, and also receive via Skype. You can see the cost of consultations below:

Methods used in cognitive behavioral psychotherapy

All therapy sessions using this method take place in the form of a conversation, during which the patient is asked to conduct experiments and answer a number of questions. This can be individual therapy or group sessions, which are more like training aimed at improving the patient's psychological state now and in the future.

Cognitive behavioral therapy for mental disorders is carried out using the following methods:

1. Cognitive restructuring can reduce the patient's anxiety. This is achieved by assessing your fears and reality. The psychotherapist's client independently fills out a table that includes the situation that frightens him. He is then asked to predict several worst-case scenarios. When this stage is completed, it is necessary to recall similar situations from the past and describe their real outcome. For greater clarity, fears are assigned a probability coefficient as a percentage, after which the patient can see that his worst fears were not justified.

2. Socratic (Socratic) dialogue can be used not only during psychotherapy, but also in any other conversation. This method was used by Socrates during classes with his students. First you need to agree with your opponent, then question his rightness, and then argue your thoughts. Skillful use of this method allows you to resolve any controversial situation.

3. The cognitive continuum allows you to work with polar thinking. Relatively speaking, patients are sure that there is only white and black, but during the session it turns out that there are many shades of gray.

4. ABC analysis. Every situation that happens to us in life (A) leads to the emergence of thoughts and internal conversation (B). Depending on internal beliefs, reaction (C) occurs. In the A→B→C scheme, our beliefs play the main role; the thoughts that arise in response to a situation, leading to negative or positive emotions, depend on them.

Also, psychotherapists who practice the cognitive-behavioral method of correcting mental disorders use other methods in their work. This area is actively developing, new works, developments and techniques are appearing.

Behavioral approach to counseling: essence, goals, objectives.

The founders of radical behaviorism were J. Watson and W.F. Skinner, who developed Trondike's ideas. This approach can be described as one that uses learning principles to help clients solve their behavioral problems. It is constantly being improved and enriched with the results of new research. Currently, its most prominent representatives are J. Volpe, G. Eysenck, A. Lazarus. The main ideas of this approach are based on the works of I.P. Pavlov, who was the first to consider behavior as a sequence of conditioned reflexes formed as a result of repeated reinforcements.

Basic theoretical principles.

The main task of a psychologist-behaviorist is to help change the client’s ineffective, maladaptive behavior. The psychologist, together with the client, tries to intervene in the latter’s life conditions in order to change them. Behavioral analysis is based on the following constructs:

1) Establishing a relationship between a psychologist and a client. Behavioral psychologists demonstrate a high level of empathy, internal harmony and ability to communicate, as well as warmth and respect for the client. Psychologists of this direction are distinguished by internal strength, as well as the ability to establish rapport, establish mutual understanding, and carefully structure the interview. They explain to the client the basic technical techniques and their meaning, as a result of which the client takes an active part in the counseling process;

2) Defining the problem through the operationalization of behavior. A behavioral psychologist collects information about the client in the most organized (compared to other areas) form. The general understanding of the client's problem in behaviorist terms is knowledge of how the client behaves. The client's life is viewed as a chain of individual actions. The psychologist works with “what is”, what can be seen in the client’s actual behavior, and what can be changed through scientific planning.

Example. The client complains that he is afraid and feels a sense of dread. In the psychodynamic approach, it is necessary to find the roots of fear in the past; in the humanistic direction, it is necessary to change the client’s ideas about the world. In behavioral counseling, the psychologist sets the task of determining what exactly the client does when he feels fear:

Psychologist: You said that you feel fear. Tell us more specifically what you do?

Client: There are times when I don’t want to leave the house. Sometimes I feel hopeless.

Psychologist: What is happening to your body?

Client: Sometimes I get tremors.. Sometimes I’m so scared that I can’t sleep, I don’t sleep the whole night. I listen to every creak, I’m terribly tense all the time.

These two questions clarified fear behavior for the psychologist. Reluctance to leave the house, trembling, insomnia, tension - these “operations” can be seen, measured, counted. The “feeling of hopelessness” remains unclear, that is, the operationalization of the sentence “Sometimes I feel hopelessness” is required.

Psychologist: You said that sometimes you feel hopeless. Could you tell us more about this?

Client: I can’t move my arm, I can’t do things, I have no energy at all. Sometimes I cry from my own powerlessness.

Psychologist: So, hopelessness for you is stiffness, inaction, tears... I think you said that?

Thus, the psychologist connects the client’s vague feeling of fear with more specific actions - operations.

The goal of operationalizing behavior is to translate vague words into objective actions that can be observed—operations. The key to operationalization is the following question: “Can I see, feel, touch the concepts that my client uses?”

3) Understanding the entire context of the problem through functional analysis. The second task of the behavioral psychologist is to establish an understanding of how the client behaves in his “natural environment.” Within the framework of behaviorism, analysis is carried out according to a three-stage model:

1) background;

2) the resulting action;

3) the consequences of such behavior.

By establishing cause-and-effect relationships, the psychologist comes to understand the sequence of events underlying the client’s behavior, that is, to understand the functional picture. Based on the functional picture, the psychologist develops a program for changing the picture of events. The goal of any functional analysis is to understand the client’s reward system, such as attention, approval, money, food, material values, affection, recognition. We must not forget about punishments, one of which is ignoring a person.

4) Establishing socially important goals for the client. At this stage, the psychologist and the client develop specific and achievable goals. You need to make concrete plans for the future, set specific goals: learn to swim, learn a foreign language, find a job. A behavioral psychologist will not use such a broad concept as “fear” in his work, but will break it down into observable, specific units of behavior, and will teach the client to act in such a way that their life becomes more successful and happy.

The psychologist focuses on specific actions and behaviors. The client must do something concrete: visible, audible, felt.

Consultative process

Goals of psychological assistance:

• providing conditions for learning, that is, assistance in mastering new behavior;

• formation of new social skills;

• overcoming bad habits;

• mastering self-regulation skills, etc.

Roles and functions of a consultant: fulfilling a clearly fixed role of a teacher (mentor); taking on the role of a model, role model.

Expectations from the client: desire to cooperate with the psychologist; activity; willingness to set goals and achieve them by experimenting with new behavior; willingness to apply new forms of behavior in everyday life.

Reasons for a counseling psychologist to study the basics of psychoanalysis:

• the possibility of conscious selection and use of behavioral methods to modify client behavior;

• the possibility of interrupting conditioned reflex connections between stimuli when they create a painful effect for the client (for example, post-traumatic phobias, anxiety reactions);

• the ability to deliberately not use behavioral methods in the absence of indications for working in this model.

Behavioral therapy and counseling techniques

To conduct behavioral therapy and counseling, the following skills are required: 1) to break behavior into fragments, that is, to operationalize it; 2) conduct a functional analysis to clarify the background of the problem, resulting behavior and consequences; 3) determine, together with the client, goals that are socially acceptable; 4) use special behavior change procedures. The most commonly used techniques are:

1.Relaxation. Behavioral psychologists consider it more effective not to search for the causes of physical tension, which can manifest itself in the form of insomnia, stiffness, high blood pressure, but to teach the client the mechanism of relaxation. Relaxation programs are usually based on techniques: a) tension-relaxation contrast. In the first stage, the client takes several deep breaths in and out with his eyes closed. On the second, the client is asked to alternately tense or relax different muscle groups until he feels the differences in these states. In the third, the client is asked to remember the difference between a tense and relaxed state in order to understand what muscle tension is. The fourth stage is devoted to the procedure of contrast compression - relaxation of muscle groups in a certain order to achieve relaxation. The fifth stage is related to the completion of the exercise; b) direct relaxation. In this case, the client simply relaxes muscle groups one by one. With this technique, the relationship between the psychologist and the client is especially important.

2. Systematic desensitization (or reduction of anxiety). This technique, developed by J. Volpe, is aimed at solving problems associated with anxiety and tension. It includes several stages: a) teaching the client the technique of deep muscle relaxation according to Jacobson; b) drawing up a hierarchy of situations that cause fear. To establish the starting and ending points, the most terrible situation is assigned 100 points, the state of absolute peace - 0 points; c) passing the fear scale from the bottom to the top in a state of deep muscle relaxation. In this case, the client learns to visualize all his fears in a state of relaxation.

3. Implosion (flood). The technique is similar to systematic desensitization, but is performed without muscle relaxation. After drawing up the hierarchy of fears, they move on to implosion - the presentation of situations of fear. Based on the client’s behavior (motor activity, muscle tension, facial expressions), the psychologist assesses the intensity of the fear experienced and the degree of involvement of the client. The psychologist's task is to maintain a high level of fear for approximately 40 - 45 minutes.

4. Paradoxical intention (desire). According to this technique, proposed by V. Frankl, the client is asked to stop fighting the symptom and, on the contrary, try to deliberately cause it and intensify it. The method consists not only of turning your fear around, but also of having a humorous attitude towards it.

5.Modeling. Using this technique involves demonstrating the desired behavior. The psychologist himself can show the client how to behave calmly in frightening situations (for example, how to kill spiders), or use a video recording.

6.Positive reinforcement (encouragement). Positive reinforcement from the psychologist can include smiles, attentive listening, and head nods. A token (coupon) system of rewarding desirable behavior is widespread.

7.Technique for inducing disgust (aversive conditioning). The method is based on the development of a conditioned reflex. Undesirable behavior of the client is combined with an unpleasant stimulus: sharp, loud sounds, electric shocks (with neurotic stuttering, enuresis, hand trembling), substances that cause vomiting (with alcoholism), etc.

8. Punishment. In this technique, punishment follows the unwanted behavior.

9. Self-control techniques. This technique involves the client taking an active role in defining counseling goals and implementing a program of positive change. Self-control is the basis for successful self-regulation of behavior. The psychologist helps the client identify short, clear, precise goals, the successful achievement of which leads to self-reinforcement.

10.Preventing relapses. These strategies help the client maintain desired behavior after counseling ends. The psychologist’s task is to help the client build a program that would help the client cope with relapses so that the newly acquired skills are not lost (fifth stage of the interview). Relapse prevention strategies can be divided into the following categories: a) anticipating difficult situations; b) regulation of thoughts and feelings; c) identifying the necessary additional skills (perseverance training, clear time schedule, etc.); d) building a system of meaningful rewards for desirable actions and correct behavior. Relapse prevention techniques allow the client to independently use a strategy to achieve desired behavior in conditions where the environment opposes these intentions (for example, the client wants to quit smoking, while the world around him - friends, television - forms the image of a “cool” smoker). These techniques are important for psychology in general, since relapse problems arise in any therapeutic approach.

Behavioral counseling is short-term. A typical case is concluding a contract with a client for 8–12 meetings. When completing counseling, the psychologist avoids abruptly stopping it, but gradually reduces classes, reducing their duration and reducing his own activity.

Behavioral therapy methods

In the process of correcting the patient’s behavior, the psychotherapist uses various methods, which can be divided into several large groups:

• the method of learning and assimilation allows you to teach a person the correct behavior while observing a model. The psychotherapist, his assistants, and other patients can act as such a model if the therapy is group. You can also learn the desired behavior by watching movies or reading books;

• the unlearning method is based on evoking negative emotions or sensations when negative behavior occurs;

• the elimination method allows you to remove inappropriate behavior. This method is successfully used in the treatment of various phobias.

Quite often, behavioral therapy is combined with cognitive psychocorrection (cognitive-behavioral psychotherapy). Many of the methods of behavioral therapy are widely used in pedagogy and management.

Advantages and limitations of the behavioral approach

The behavioral approach has many unique features (including aspects that are primarily cognitive-behavioral). Here is a list of the unique and strengths of the behaviorist approach.

• Directly addressing symptoms. Because most clients need help with specific problems, counselors who directly address symptoms can often provide clients with immediate help. In addition, the behavioral therapy approach is suitable for counseling clients with attention disorders, conduct disorders, eating disorders, drug addiction, psychosexual disorders, impulsive behavior, and phobic disorders (Seligman, 1997).
• Focus on the here and now. The client does not need to explore the past to get help in the present. The behavioral approach saves time and money.
• Availability of various techniques for use in counseling. Between 1969 and 1976, the number of behavioral therapies more than doubled, a trend that continues today. Counselors can use behavioral therapy techniques in a variety of settings. There are a number of behavioral counseling journals, such as the Journal of Applied Behavior Analysis.
• The basis is the study of a theory that explains well the process of learning new behaviors (Krumboltz & Thoresen, 1969, 1976). Learning theory continues to evolve and produce practical applications for use in many fields (Rescorla, 1988).
• Support the Association for the Advancement of Behavior Therapy (AAVT), which publishes ethical guidelines for its members (Azrin, Stuart, Risely, & Stolz, 1977). AABT promotes the practical application and explanation of behavioral counseling techniques in an effort to protect the public from unscrupulous practitioners.
• Backed by credible research on the impact of behavioral therapy techniques on the counseling process. Beginning consultants can use one of the many research designs as a model. A common feature of all behavioral therapy approaches is a commitment to objectivity and the use of assessments.
• Objectivity in identifying and solving problems. In this way, the counseling process is demystified and clients and independent evaluators are able to determine their level of responsibility (Gilliland et al, 1998).

The behavioral approach also has some limitations.

• He considers only the external behavior of a person, without addressing him as a person. Critics argue that many behaviorists, such as Skinner, have "disconnected" the individual from personality and replaced it with the study of laws that govern actions under certain conditions. This approach may be too simplistic to explain complex human interactions (Hergenhahn, 1994).
• Sometimes used mechanically. Goldstein (1973) points out that “the most common mistake made by new behavioral therapists is to apply methods too hastily” (p. 221). Although most behavioral therapists strive to connect with clients and consult collaboratively, some initially underestimate the importance of the client-counselor relationship, thereby damaging the reputation of the approach.
• It is best suited for controlled conditions that are difficult to replicate in normal counseling situations. Behind this observation is the consideration that many of the behavioral theories were developed from studies of animal behavior - rats and pigeons. Many consultants wonder whether the behavioral approach is effective when working with clients in less-than-ideal conditions.
• Using theory-ahead methods (Thoresen & Coates, 1980). The rapid proliferation of new methods has been initiated by behavior consultants, but the theory that should underlie these methods has not kept pace.
• Ignoring the client's history and his subconscious. Although the behavioral therapy approach can be very helpful for a client who has a particular behavioral problem, it cannot help those who want to resolve their past problems or bring about unconscious clarity.
• Stages of development are not considered (Sprinthall, 1971). Skinner (1974) points out that the child's inner world develops, but he and many other behaviorists believe that developmental stages provide little information to explain outer behavior. Instead, they argue that the process of knowledge acquisition has universal features.

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Behavioral psychotherapy (behavioral)

Goals of behavioral psychotherapy

. Behavioral therapy is based on the theory of learning and sees the cause of human difficulties and problems in the fact that in certain unfavorable environmental conditions the subject has learned “wrong” and maladaptive forms of behavior that bring suffering to him and the people around him. In contrast to psychoanalysis and the humanistic direction of therapy, behavioral consultants tend to focus not on internal conflicts and motives, but on human behavior visible to an external observer. Behavior therapists believe that problem behavior can be unlearned using special procedures based on the laws of learning. The goal of behavioral therapy is to eliminate inappropriate behavior (eg, excessive anxiety) and teach adaptive behavior (social interaction skills and assertive behavior). How to overcome the fear of speaking in front of an audience, improve the behavior of a capricious and aggressive child, wean yourself from overeating, protect yourself in a conflict situation and learn to interact with the opposite sex - typical tasks solved in behavioral counseling. The emphasis of the work is not on self-understanding, but on exercises and practicing certain skills.

Behavioral theory is associated with the development of the ideas of Pavlov and American psychologists Watson, Skinner, Wolpe and Eysenck

. John B. Watson (1878-1958) was the founder of an approach to psychology that aimed to study behavior and was called behaviorism (from the English word behavior). Wolpe and Eysenck made the most significant contribution to the development and popularization of the field now known as behavioral therapy and counseling.

Theorists in this direction are characterized by experimentation with animal behavior and the desire to impart strict scientific objectivity to their research. Basic concepts and mechanisms of assistance.

How does organisms learn? There are several types of learning, each of which is used in specific behavioral therapeutic techniques.

The outstanding Russian physiologist Ivan Petrovich Pavlov (1849-1936) created the doctrine of the unconditioned and conditioned reflex, which was called classical or respondent conditioning. The point of learning through classical conditioning is that the body begins to respond to an initially neutral signal that means nothing to it. Thus, by feeding dogs at the same time as turning on the metronome, it is possible to obtain a salivation response not to an unconditioned stimulus (food), but to a conditioned one - the sound of the metronome. A conditioned reflex is formed. The sound of the metronome affects the dog even in the absence of food. However, if the sound of the metronome is not repeatedly reinforced with food, then the salivation response to it fades away. The dog learned to respond to a stimulus (metronome), and then lost this skill.

Scientific fact: Death from drug overdose and Pavlov's theory. Death from a heroin overdose is a fairly common occurrence among drug addicts. It is known that as addicts become accustomed, they gradually increase the dose of the drug. At some point, he may move to significant doses, dangerous for the average person and relatively regular for himself. His body develops certain mechanisms of resistance to heroin. What is the reason that a drug addict dies from a large, but habitual dose of the drug? Pavlov's theory of conditioned reflexes provides an answer to this question. Let's assume that a drug is an unconditioned stimulus, and the body's resistance to it is an unconditioned response. When taking heroin in certain circumstances, for example, in the company of other drug addicts, the very situation of taking drugs becomes a conditioned signal, and another time the very ritual of preparing for an injection will already tune the body, triggering resistance mechanisms. Surveys of drug overdose survivors show that heroin use this time was carried out in an atypical environment (for example, in an unfamiliar place). In this case, the conditioned stimulus that triggered preparation for the drug hit was absent and the body could not cope with the usual dose.

If neutral stimuli are associated with danger, then in a calm situation they can provoke anxiety. For example, a person who accidentally gets stuck in an elevator and is very frightened may develop a fear of elevators. People with such neurotic fears, called phobias (from the Greek phobos - fear, fear), cannot bring themselves to sit in an elevator and, therefore, experience great inconvenience in ordinary life situations.

Behavioral psychologists have shown in their experiments that neurotic reactions of fear and anxiety can be formed experimentally. Joseph Volpe conducted fundamental laboratory research to teach cats neurotic fears and then wean them off them. The cats were first trained to search for food in response to a call. At the next stage of the experiment, feeding was carried out, the bell was turned on, and at the same time the cat was exposed to an electric shock when it showed a reaction aimed at obtaining food. 3-4 electric shocks were enough for the cats to resist being placed in the cage where the experiment was carried out, rushing around the cages, scratching, howling, crouching on the floor, breathing rapidly and raising their hair on end. Moreover, they refused to eat in the cages even after 2-3 days of fasting. All cats showed some of the symptoms outside the experimental cage. Their severity increased significantly upon presentation of the initial sound signals. Learned neurotic reactions inhibited the feeding of cats. This led Wolpe to believe that, under other circumstances, feeding might inhibit neurotic reactions. As the experiment continued, the cats were force-fed in anxiety-inducing cages. To do this, hungry neurotic cats in experimental cages were gradually pushed by a movable barrier towards a box containing appetizing food. The cats' reactions to the cage and the sound signal were gradually extinguished.

Wolpe explained the results as follows: when stimuli for the emergence of incompatible reactions are present simultaneously, the development of a dominant reaction in the current situation implies reciprocal (i.e., mutual) inhibition of other reactions. Wolpe was a pioneer of behavioral counseling. He transferred the results of experimental studies to the practice of treating anxiety disorders. He showed that if a person simultaneously evokes relaxation reactions, sexual reactions or anger reactions at the same time as anxiety, this leads to the extinction of anxiety. This is the basis of his method of systematic desensitization (reducing hypersensitivity, from the Latin sensibilis - sensitive). Systematic desensitization is a way to overcome fears and includes three elements: 1) Learning deep muscle relaxation. 2) Building a hierarchy of stimuli, i.e. ranking situations that provoke anxiety according to the strength of the anxiety caused. 3) Consistent imagination of disturbing situations from simple to more complex against the background of a state of relaxation induced in oneself. After teaching the client muscle relaxation, the type of situations that cause anxiety is selected, for example, fear of public speaking, fear of communicating with the opposite sex, fear of riding the subway, flying on an airplane, etc. If a client has several fears, then each of them is a separate topic and is dealt with separately. Further, in the process of therapeutic work, a number of situations are built that subjectively cause tension in increasing degrees of anxiety.

The following is an example of a subjective scale of anxiety situations associated with taking exams. It is accepted that 0 points corresponds to a complete absence of anxiety, and a score of 100 points corresponds to maximum anxiety and fear. When creating such a series, it is important not to allow large gaps (more than 10 points) in the subjective anxiety scale. 0 points The school year has just begun. 10 points The teacher mentions an exam at the beginning of the school year. 20 points Random conversation about the exam a month before it 30 points A week before the exam. 40 points Anxious mood during consultation before the exam. 50 points The day before the exam, my palms are wet, and I feel like I’m forgetting basic things. 60 points Waking up in the morning before the exam. 65 points When I go to the exam, I shake all over and feel sick. 75 points Approach the notice board to find out where the exam will be held. 85 points Waiting outside the exam room 90 points When I enter the classroom, my hands are sweaty, I'm afraid I've forgotten everything and I want to run away. 95 points Looking at the exam card, I see with horror that I don’t know 1-2 questions. Tense stupor. 100 points Leaving an exam due to severe panic.

The client then imagines each of these situations in his imagination, trying to simultaneously maintain a state of relaxation and peace. They move on to the next situation only if anxiety has been extinguished through relaxation. Experience in behavioral therapy shows that there is a close connection between reducing the severity of clients' anxiety in imagination and in real life situations.

Another American scientist, Burres Frederick Skinner (1904-1990), made a great contribution to behavioral psychology. Skinner was interested not so much in ways to extinguish old reactions, but rather in the laws of formation and control of new behavior. Experimenting with animal training, he became a virtuoso trainer and could teach a pigeon to dance in a few minutes. Skinner believed that behavior is shaped and controlled by its consequences. Any stimulus that increases the likelihood of a particular response is a reinforcer. For example, if you reinforce every movement of a pigeon to the right with a grain, then very soon it will begin to intensify these movements. By now reinforcing only the strongest turns, it is possible to achieve using the method of successive approximations so that the pigeon makes rotational movements. The version of learning developed by Skinner is called operant conditioning. (From “operation,” the Latin word operatio is action. The use of the term “operant” emphasizes that behavior operates in the environment, producing consequences).

While Pavlov linked reinforcement to the stimulus (in classical conditioning, behavior is controlled by a stimulus that precedes the behavior), then according to Skinner's concept, behavior is dependent on the response. Classical and operant conditioning are the only two types of conditioning possible. Scientific fact: Impact on the teacher using the Skinner method. In one of the American colleges, students studying psychology performed the following experiment. Their teacher, while giving a lecture, had the habit of pacing from corner to corner. While he was walking to the window, the students who had agreed among themselves demonstrated in every possible way their interest in the subject. They carefully took notes, nodded, looked into his eyes and took interested poses. When the teacher walked to the door, the audience relaxed and showed a lack of attention and interest. Extraneous conversations began. After several lectures, the teacher’s walking stopped and he remained throughout the entire lecture in a certain corner by the window.

Problematic behavior in people can be seen from this perspective as the result of an ineffective system of reinforcement from significant others. For example, the social fear of a person who is constantly afraid of “doing wrong” may be due to the fact that he was repeatedly punished by parents who were impossible to please.

Close people constantly try to influence each other, using rewards and punishments. Why do they often not achieve the desired result?

Several conditions can be identified for the effective formation of someone else's behavior: 1) The system of reinforcements should not be contradictory. For example, a child is naughty and demands candy. Mom gets irritated and, as a rule, does not give. However, sometimes she gives in and gives in, thereby reinforcing his whims. The child receives the signal that if he whines long enough, the mother may give in. 2) Reinforcements should be focused on the needs of the subject. People who know how to give gifts and always know what to give to their loved ones invariably have great influence over them. 3) Reinforcement should be timely and mark any slight progress. If you are learning to play tennis and are trying to develop a certain stroke, then the coach’s spoken word at the right time greatly influences the development of the skill. Another example: parents, punishing for poor studies, take away the opportunity to use a computer from their son. After some time, not only twos, but threes and even one four appear in his grades. The parents decide that as long as there are no stable B grades, their son will not see any relief. After some time, the boy's grades become the same. The unsupported effort immediately fades away. 4) Positive reinforcement should prevail over punishment. The main reason punishments are ineffective is that they do not communicate what needs to be done. It prevents a person from learning what is the best behavior in a given situation. Prison is an excellent model for demonstrating the ineffectiveness of punishment. It does not teach prisoners more socially acceptable ways of behaving, rather it teaches the opposite. Punishment also does not work well if it is very distant in time from the committed action. The subject may not form a connection between the punishment and his past actions. With delayed punishment in animals this connection is never formed. Another disadvantage of punishment is that it encourages the punisher himself, causing a desire to increase the punishment more and more, despite its obvious ineffectiveness. The punishing subject often solves not the problem of teaching the punished, but demonstrates his power and dominant position. Punishment is more effective if it is used infrequently, is not harsh, occurs immediately after the problem behavior, and is stopped immediately when the behavior begins to improve. When working with young children who have explosive temperaments, behavior consultants often suggest the Time Out procedure. In the case of aggressive behavior, time-out involves removing the child from a situation rich in interesting stimuli, such as a playroom, for a few minutes. Skinner's ideas have permeated many areas and are used in individual sports teaching, animal training, computer training programs, parent-child interaction training, psychotherapy and counseling. If we consider psychotherapy as learning new reactions, then the influence of positive reinforcement on the part of the psychotherapist becomes clear.

Behavior therapists help their clients learn new, more effective behaviors. An important element of social skills training is assertiveness training. Confident behavior increases the possibility of choice and control over one’s life, and contributes to the growth of self-esteem. Typically, they distinguish between insecure, confident and aggressive behavior. An insecure person holds back his feelings due to anxiety, guilt, and poor social skills. An aggressive person violates the rights of others through dominance, humiliation and insult. Aggression is not based on mature self-esteem and is an attempt to satisfy one's needs at the expense of another. Confident behavior is the ability to assert your rights without humiliating others, and earns the respect of others. Confidence training example

.
Client (18 years old, university student): It is very difficult for me to refuse other people.
I think that my friends often use me and abuse my patience. Yesterday, for example, a friend complained to me on the phone for 40 minutes, while I had to go out on business. For the third time I listened to what she would wear on Wednesday and how she had a fight with yet another friend of hers, but she still didn’t stop talking and didn’t stop talking. Therapist: It was difficult for you to interrupt her. K: Yes. I felt uncomfortable because she is my friend. T: How did you feel after the conversation? K: I was completely exhausted, I was late for the lecture and had a bad headache the whole evening. T: Let's decide how you would like to behave with this friend? K: Well, I wouldn’t want to offend her... But this is no longer possible. T: Would you like to be firm but not cruel with her? K: Yes. T: Remember at our last meeting we talked to you about insecure, confident and aggressive behavior options. Let's imagine what your reaction would be if you acted in one of these ways. K: Well, insecure, that's how I act now. I mumble, I stammer. T: Well, please, dear..., could you..., I’m very sorry..., it’s so awkward that I have to go... forgive me... K: Yes, that’s what I say (laughter). T: Okay, what would be an aggressive response? K: (loudly) To hell with your problems, I have no time for you! T: What an expression. Well, what about the sure option? K: You know Lena, I need to go urgently. Let's call you later. All. I am kissing you, bye. T: You did great. You said this in a tone that was both firm and friendly. K: Yes, I liked it myself. The therapy process and the therapist's position

.
In behavioral therapy, the client's complaints are accepted as significant material, and not as symptoms of the underlying problem, which is typical, for example, of psychoanalysis. Specific actions need to be changed and modified rather than resolving the internal conflicts underlying those actions or reorganizing the personality. Therefore, in behavioral therapy, the client's desired goal is clearly defined in behavioral terms. Referring to the example in the previous section, we see that the therapist does this in the following way: T: Let's decide how you would like to behave with this friend?
At the beginning of therapy, a so-called functional diagnosis of problem behavior is always carried out. It is determined what preceded the problem behavior, what it looks like and what its consequences are.

Referring again to our example: Background (stimulus):

A friend spends 40 minutes talking on the phone.
In this case, it is high time for the client to leave home. Behavior (reaction):
The client listens attentively, becoming more and more angry with her friend.
However, he does not interrupt the conversation on his own initiative. Consequences:
The client was completely exhausted, was late for the lecture and had a severe headache all evening.

Such functional diagnostics are carried out through questions from a therapist or through special self-observations by the client at home. In behavioral therapy, clients are often asked to keep special diaries of observing their behavior and recording changes for the better. (See, for example, the diary of observations on mastering the relaxation method).

Working in the Skinnerian tradition, the therapist reinforces every step for improvement: T: You did great. You said this in a tone that was both firm and friendly.

In behavior therapy, the method of behavior rehearsal is often used. Problematic situations can be played out in the therapy room with an analysis of various behavior options. The duration of behavioral therapy depends on the severity of the client’s difficulties and can amount to dozens of sessions, but never lasts for years, as in classical psychoanalysis. Further development of the behavioral approach in therapy is associated with increased attention to human cognitive functions and the so-called cognitive forms of learning (learning through observation, through reasoning, etc.).

Training: Progressive muscle relaxation.

The fundamentals of relaxation training were developed by Edmund Jacobson in 1929.
Muscle relaxation treatments can be used on their own or as part of more complex treatments, such as Wolpe's systematic desensitization, which has become very popular. Unlike Schultz's autogenic training, the method of progressive muscle relaxation does not set itself the task of self-education, however, being a simpler and more economical method, it allows you to immediately feel the effect of relaxation. Relaxation procedures are advisable to use in the presence of problems such as psychogenic headaches, insomnia, and a general feeling of tension and anxiety. When using progressive muscle relaxation, a “tension-relaxation” cycle is performed with each muscle group. Procedure
: Sit in a chair, place your hands on your knees, and spread your legs comfortably. Take two or three deep breaths and exhale. Feel how the air passes into the lungs to the diaphragm and back. Now extend your right hand (for left-handed people - your left hand), clench it tightly into a fist. Feel the tension in your fist as you clench it. After 5-10 seconds of concentrating on the tension, relax your hand. Unclench your fist and notice how the tension recedes and a feeling of relaxation and comfort takes its place. Focus on the differences between tension and relaxation. After about 15-20 seconds, clench your hand into a fist again. After 5-10 seconds, relax again. Feel relaxed and warm. Focus only on those muscle groups that you are working with at the moment, try not to strain other muscles at this time. Perform tension-relaxation cycles with other muscle groups in the following sequence: Right arm, clenching a fist and tensing the muscles of the lower arm. Right biceps, bending your elbow and squeezing your upper arm muscles. Left hand, clenching a fist and tensing the muscles of the lower arm. Left biceps, bending your elbow and squeezing your upper arm muscles. Forehead, raising eyebrows as high as possible. Eyes and nose, closing your eyes tightly and frowning your nose. Jaws, clenching teeth and stretching the corners of the mouth. Neck, tilting your head forward and resting your chin on your chest. Chest and shoulders, squeezing your shoulder blades together and taking a deep breath. Belly, pulling it towards the spine. Right thigh, extending your leg and lifting it a few centimeters above the floor. Right calf, pressing your toes to the top of the boot. Right foot, resting on the tips of the toes and turning the foot inward. Left thigh, extending your leg and raising it a few centimeters above the floor. Left calf, pressing your toes to the top of the boot. Left foot, resting on the tips of the toes and turning the foot inward. When completing the exercise, take two or three deep breaths, feeling how relaxation “flows” through your body from your arms through your shoulders, chest, and stomach to your feet. When you are ready to open your eyes, slowly count down from 10 to 1. With each number, feel more and more refreshed and alert.

It is common practice for behavioral therapy to work systematically with clients at home, outside of the therapy room. Control of mastering the relaxation method is carried out using a special diary. The following is an example of such a diary:

Date (December 10), Time (4 p.m.), Place (at home), Duration (15 minutes) Comments: I felt very stressed after the school day. Thoughts about talking with N. were distracting and at first prevented me from relaxing. However, after doing the exercises I felt much better.

Source: Encyclopedia “Avanta”, volume “Man”