Exposure and Behavoiral Therapies

Final Essay

Exposure and Behavioral Therapies

December 12, 2006

In psychotherapy there are many different ways that a therapist can decide how to treat a client. In my paper I will discuss how Exposure Therapy and Behavioral Therapy work together with a client. I will focus on the nature of the problem, the process of change, theory in practice, multicultural considerations, and the types of clients and clinical problems.

The Nature of the Problem: In both Exposure and Behavioral Therapy the main focus is on anxiety. These anxieties area conditioned response (Prochaska & Norcross, 2005, p.238 & 264). In Exposure Therapy and Behavioral Therapy the client avoids situation where there will be confrontation or fear where it could be provoked. By avoiding things in their lives the client then is not able to function fully because the avoidance has taken over their lives. People learn what their anxieties are. If a client got bite by a dog when they were a child that is where they anxiety started. For then on the client then may avoid going by dogs for the fear that they may get bitten again. Foa and exposure therapists conceptualize anxiety-based psychopathologies in terms of both the traditional behavioral theory and an emotional processing theory. The emotional processing theory proposes that special efforts are required to process the traumatic event, and that the completion of this process is necessary for recovery (Prochaska & Norcross, 2005, p. 238). Accordingly, Foa's exposure therapy aims both to reverse the behavioral conditioning and to correct the client's erroneous cognitive and emotional process (Prochaska & Norcross, 2005, p. 238).

The Process of Change: In Exposure Therapy and Behavioral Therapy the therapist gradually confronts the clients fear. The therapist will expose whatever the feared stimulus is to the client it stages. The therapist acts as an active and directive teacher Corey, 2005, p. 478) or firm parent to the client (Prochaska & Norcross, 2005, p.241). If the client is afraid of dogs then the therapist would attempt response prevention, which would entail prohibiting the child from leaving the dog until practically all anxiety was eliminated (Prochaska & Norcross, 2005, p. 239). The can work with Behavioral Therapy with enough pairings of the anxiety-inhibiting response with the anxiety-evoking stimuli, the new, more adaptive response is eventually substituted for the maladaptive anxiety response. So in simple terms, do the opposite of the problem and the problem will disappear (Prochaska & Norcross, 2005, p. 266). By the client doing the opposite the anxiety of the dog will disappear just by being in the presence of the dog.

Theory in Practice: There is a trusting relationship between the client and therapist, where confidence is modeled to help the client show them that their fears won't hurt them. Systematic desensitization is used in both Exposure and Behavioral Therapies. The therapist does breathing and relaxation techniques beforehand with the client. Exposure therapy uses three processes to help client with their fears. The three processes are in vivo flooding, in vivo exposure, and imaginal flooding. In vivo flooding consists of 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 (Corey, 2005, p.244). In vivo exposure to actual traumatic events (airplane crash, rape, fire, flood) is often not possible nor is it appropriate for both ethical and practical reasons (Corey, 2005, p.244). Also a therapist could have the client wear something from the incident to help with this exposure. The last one is imaginal flooding can re-create the circumstances of the trauma in a way that does not bring about adverse consequences to the client. Flooding is frequently used in the behavioral treatment for anxiety-related disorders, phobias, obsessive-compulsive disorders (OCD), post-traumatic stress disorder (PTSD), and agoraphobia (Corey, 2005, p.244).

Multicultural Considerations: Cultural differences may see exposure therapy as worse than the disorder (Prochaska & Norcross, 2005, p.252). Therapist should show empathy with clients instead of using terrifying visualization scenes for the client to deal with. In Exposure therapy the therapist's empathy is used as a more freighting scene. Trauma victims in search of sensitivity, support, and empowerment are provided more, higher decibel