TECHNIQUE OF BEHAVIOURAL FAMILY THERAPY

Methods based upon changing the consequences of the observable and measurable Behaviour of a symptomatic family member predominate the current Behavioural Family literature. The symptomatic individual, usually a child, is viewed by the family as the problem. A coalition is formed between parents and therapist and the therapist proceeds to “target” the misbehaviour. The frequency of occurrence of the target behaviour is recorded for a period of time, usually taken in the natural setting without further direct therapeutic interventions.This period is known as a “baseline” and is used to establish consensus on the degree of severity of the problem, as well as serve as a comparison with which to assess the effects of later programmed interventions. If the problem is one of excess behaviour (for example, temper tantrums), techniques including differential reinforcement of other more acceptable behaviours (DRO) might be used, as well as systematically diminishing the inadvertent reinforcement parents often give by excessive attention to the child during a tantrum (extinction procedure). If the problem is a deficit behaviour, positive reinforcement of gradual steps toward achieving the final desired behaviour might be the preferred conditioning technique (shaping). Altering the consequences of behavior through manipulation of the contingencies of reinforcement extends beyond the few examples mentioned above and may also be monitored by the therapist in the form of a verbal or written contract. The “contingency contract” specifies the treatment plan in a precise and operational manner and has become the most popular tool of the operant conditioning family therapist. When the therapist views the family problem from a cognitive- behavioral model, he is most likely to apply techniques derived from classical conditioning. Problems of interpersonal relationships thought to be mediated by anxiety, faulty beliefs, or lack of self-assertion are usually treated individually, but changes in all family members will invariably result if the behaviour of one member is radically altered in a short period of time.The changes in maladaptive anxiety states or cognitions are altered by techniques such as progressive desensitization, covert conditioning, cognitive restructuring,and assertive training (Craighead, et al., 1976).

Focusing on the vicarious processes of social learning presents another behavioural perspective from which the family-oriented therapist might proceed. The use of modeling, behavioural rehearsal, and guided participation for increasing adaptive social skills has recently begun to occupy a more standard and systematic set of techniques for applying to one or a number of family members. They are applied alone or in addition to the operant conditioning and cognitive-behavioral techniques.