Behavioral Assessment And The Therapeutic Process

Behavior therapy is designed for and meant to treat only learned behavioral problems. Sometimes, however, medical problems appear to be a learned behavioral problem; sometimes medical and a learned behavioral problems coexist. Before beginning behavior therapy, therefore, it is important for patients/clients to be evaluated to determine if they (1) have a learned behavioral problem alone, or (2) have one plus an unrelated, medical problem, or (3) have a learned behavior problem as a part of a psychosomatic disorder, or (4) have a medical problem that just appears to have been learned.

Behavioral assessment has three other goals: (1) to define the target behavioral problems; (2) to identify the cognitive habits that are maintaining those behavioral problems; and (3) to make it possible to objectively measure therapeutic progress. To best achieve the latter, behavior therapy focuses on the present manifestations of the target problems. But to ensure

Behavior Therapy the most comprehensive therapeutic results, the therapist gets a detailed personal and medical history. Such historical data are easily obtained using standard personal data forms. For the target problem, however, personal interviews by the therapist are essential.

Important information about the target problem includes the following: When were patient/clients free of their problem? What has been the progression of the problem? What makes it better or worse or temporarily disappear? What desirable or undesirable personal experiences does the problem prevent or cause? What are the patient/clients' beliefs about their problem and what are their expectations for therapy? For the most immediately useful clinical understanding of a patient/client's problem, putting these data in Ellis' ABC models of human emotions is invaluable.

Effective behavior therapy produces weekly therapeutic progress. The popular self-assessment and objective behavioral monitoring forms are usually adequate for this purpose. If weekly therapeutic progress is not happening, reassess the patient/client for overlooked medical or psychiatric problems, or for problems with therapeutic involvement or misunderstanding.

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