BEHAVIOUR MODIFICATION


BEHAVIOUR MODIFICATION


QUESTION:
Choose one behavioral problem common to adults in Tanzania, assume a person come to your professional help towards modification of that particular behavior, suggest practical method and procedures you world employ for the task.

Response



One among the common behavior in Tanzania is alcoholism which seems to be the most problems in many adults, after the age of 18 most of the boys and girls feel free to engage in excessive drinking of alcohol and led them toward the addiction and later on led to a lot of social, economic, and family problem
In professional and research contexts, the term "alcoholism" sometimes encompasses both alcohol abuse and alcohol dependence, and sometimes is considered equivalent to alcohol dependence. (Farrell 1992) observes that alcoholism in the classical disease model follows a progressive course: if a person continues to drink, their condition will worsen. This will lead to harmful consequences in their life, physically, mentally, emotionally and socially.
Baldwin (1981), explores the emotional progression of the addict’s response to alcohol. He looks at this in four phases. The first two are considered “normal” drinking and the last two are viewed as "typical" alcoholic drinking.
Johnson's four phases consist of, learning the mood swing. A person is introduced to alcohol (in some cultures this can happen at a relatively young age), and the person enjoys the happy feeling it produces. At this stage there is no emotional cost.
 Seeking the mood swing. A person will drink to regain that feeling of euphoria experienced in phase 1; the drinking will increase as more intoxication is required to achieve the same effect. Again at this stage, there are no significant consequences.
 At the third stage there are physical and social consequences, i.e., hangovers, family problems, work problems, etc. A person will continue to drink excessively, disregarding the problems.
 The fourth stage can be detrimental, as Johnson cites it as a risk for premature death. As a person now drinks to feel normal, they block out the feelings of overwhelming guilt, remorse, anxiety, and shame they experience when sober. (Gladding 1988)
The prevailing theory today seems to be that alcoholism is a disease, a biological affliction that can only be ameliorated by abstinence or medication. However, there are those who believe alcoholism has its roots in environmental influences and that the disorder is a maladaptive pattern of behavior
Alcoholism is characterized by a physical dependence on the substance. Alcoholics crave a drink regardless of the physical, financial, emotional and legal consequences. They cannot stop. Unlike a person who abuses alcohol, an alcoholic has no control over when or how much h/she drinks.
Behavior can be defined as the way in which an individual behaves or acts.  It is the way an individual conducts herself /himself. Behavior should be viewed in reference to a phenomenon, an object or person. It can be seen in reference to society norms, or the way in which one treats others or handles objects.( Baldwin 1981)

Behavior, therefore, is the way an individual acts towards people, society or objects.  It can be either bad or good.  It can be normal or abnormal according to society norms.  Society will always try to correct bad behavior and try to bring abnormal behavior back to normal.(ibid 1981)
Behavior modification is a term used in behavioral therapies to denote methods for conditioning behavior. It has its roots in classical conditioning, which involves the pairing of a behavior with a reinforcement. The main idea is to reward a person if they implement a desired behavior or if they stop undesired behavior. Behavior modification can also involve incurring an unpleasant consequence for undesired behavior. (Carlson  2010)
Behaviour modification is based on a simple idea of learning.  It is based on the idea that behavior followed by reward is more likely to be repeated, or retained, than not. On the other hand, behaviour which results in an unpleasant outcome tends to be quickly dropped or disappear.
Behaviour modification is based on the idea that behavior is, in part, controlled by its consequences.  The idea has been demonstrated in both humans and animals. (ibid 2010)
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing. It is medically considered a disease, specifically a neurological disorder, and in medicine several other terms are used, specifically "alcohol abuse" and "alcohol dependence," which have more specific definitions.
In modifying the alcoholism behavior the following are the suggested practical methods and procedures to be employed.
Cognitive-behavior therapy, CBT, is one of the most commonly used therapeutic models for treating addiction. In CBT, a therapist will help their client to change their behaviors and attitudes towards drinking. Cognitive-behavioral therapy (CBT) uses a structured teaching approach as a method of modifying abnormal behavior and may be better than Alcoholics Anonymous (AA) for people with severe alcoholism. Patients are given instruction and homework assignments intended to improve their ability to cope with basic living situations, control their behavior, and change the way they think about drinking. (Kazdin  2001).
The following are examples of procedures, Patients might write a history of their drinking experiences and describe what they consider to be risky situations, they are then assigned activities to help them cope when exposed to "cues" (places or circumstances that trigger their desire to drink), and Patients may also be given tasks that are designed to replace drinking. An interesting and successful example of such a program was one that enlisted patients in a softball team. This gave them the opportunity to practice coping skills, develop supportive relationships, and engage in healthy alternative activities.(ibid 2001)
The client is helped to associate the thought and feeling in order to identify typical actions that proceed as a reaction to the thoughts and feelings experienced. Once a client is able to pair thought to feeling to action, then learning techniques to redirect the maladaptive thoughts begin the process of change. As CBT continues, the client is introduced to cue exposure to further teach a form of extinguishing cravings via repeated exposure to the alcohol. As this process continues, the goal is to have weaker alcohol cravings despite the alcohol being present and directing the alcohol-related thoughts toward recovery vs. relapse. The work required during CBT is then extended into homework to solidify the skills learned. (Baldwin 1981)
Rational Emotive Behavioral Therapy. Rational emotive behavioral therapy (REBT) is a behavioral approach that attempts to help a person explore emotional and behavioral problems to find resolution and create fulfillment in life. The premise is an ABC model, which concludes that an activating event (A), contributes to disturbed beliefs (B) and emotional and behavior consequences (C). Rational and irrational tendencies are explored through REBT and ultimately lead to empowering a person to realize personal choice can prevent unhealthy behavior. REBT is also a shorter-term therapeutic approach and emphasizes active participation of the client throughout the process. (Laurence 1999).
Rational emotive behavior therapy is one among the well known treatment in modifying alcoholism behavior .most of the alcoholism posses a certain kind of believes about alcohol that was activated by event, example family problem, financial, personality or certain disability which make them to drink and cause undesirable consequences .The procedures is to enable client think rational and positive by showing them that drinking alcohol does not help a person toward solving difficult problems. 
Behavior Modification Therapy The contract would specify limits toward alcohol use per day, self-monitoring of behavior, practicing refusals to alcohol, having a reward system when goals are achieved, learning what precedes drinking behavior, learning what to do instead of drinking and building coping skills for ongoing recovery. The client is in control of his choices, and this is emphasized through conditioning techniques. Behavioral therapy does not emphasize motivation for change, merely accountability and choices toward sobriety. (Baldwin 1981)
Behaviorist also uses Family therapy, as another effective treatment approach. In family and couples therapy, loved ones are educated about addiction. Also, they can work on damage their drinking behavior that causes the family disunity (Kazdin 2001)
Aversion therapy is a form of psychological behavioral modification in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. (Cautela 1967) This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations in order to stop the specific behavior. Aversion therapies in alcoholism can take many forms, for example placing unpleasant-tasting substances on the alcohol to discourage drinking habit (Maguire 1964)
Group Therapy Group therapy can be extraordinarily helpful in achieving sobriety. With other recovering peers, the client may have the opportunity to share information about how to stay sober, including changing friends and avoiding places that cause craving. (Cutter 1985) .
The use of Medication on modifying alcoholism behavior. Medications especially when combined with therapy, is an important part of alcohol dependence treatment. There are a number of medical treatment methods available to treat alcoholism. Ant-abuse, or disulfiram, has long been used as a deterrent to drinking. The Mayo Clinic reports that Ant-abuse produces a violent physical reaction if anyone drinks while taking the drug. Although it doesn't prevent cravings or treat any of the underlying causes of the excessive drinking problem, it can provide alcoholics with a reason to pause before taking a drink and getting sick. Revia, or naltrexone, can block the high that comes from drinking, removing one of the reasons an alcoholic drink. Another drug that does help to reduce cravings is called Campral, or acamprosate. An injectable drug called Vivitrol works similarly to naltrexone by blocking cravings in the brain. It's administered monthly and is only available to those who abstain from alcohol for a week and are receiving ongoing therapy. (Harvey 2011).
Another procedure used is sensitization, in which drinking is repeatedly paired with something aversive until the alcoholic loses all desire to drink,(Cautela 1967),Despite the reputed evidence of a biological etiology of alcoholism, there are some schools of thought that believe alcoholism has its roots in the environment. These theories claim that alcoholism is a behavior built on the learned contingency between drinking and relief from unpleasant affect. Some treatments in cognitive-behavioral therapy are aimed at breaking that contingency. One frequently employed method is exposing the alcoholic to the cues which they have previously associated with drinking, such as a specific place, a thought, or a feeling. The alcoholic is then prevented from drinking, thus destroying the association they have made between the stimulus and the need to drink. (Kraft 2005)
.An alcoholic's behavior and mental impairment, while drunk, can profoundly affect those surrounding them and lead to isolation from family and friends. This isolation can lead to marital conflict and divorce, or contribute to domestic violence. Alcoholism can also lead to child neglect, with subsequent lasting damage to the emotional development of the alcoholic's children. For this reason, children of alcoholic parents can develop a number of emotional problems. For example, they can become afraid of their parents, because of their unstable mood behaviors. In addition, they can develop considerable amount of shame over their inadequacy to liberate their parents from alcoholism. As a result of this failure, they develop wretched self-images, which can lead to depression.







REFERENCES

Harvey S, (2011),Physician, Massachusetts General Hospital,Reviewed by David Zieve,                                          MD,
Farrell .T ,(1992),Behavior marital therapy for male alcoholics, Behavior Therapy, 23, 529
Cutter, H.G. & Floyd, F.J. (1985), Evaluating behavioral marital therapy for male alcoholics.                                                          Behavior Therapy, 16, 147–67.
Cautela. J.R. (1967), Covert Sensitization,Psychological Reports 20: 259–468.
Kraft .T & Kraft D. (2005), Covert Sensitization Revisited,Six Case Studies' Contemporary                                                   Hypnosis, 22: 202–9.
Maguire, R.J. & Valance, M. (1964), Aversion therapy by electric shock, a simple technique.                                                                     British Medical Journal, 1: 151–3.
Baldwin, D. (1981), Behavior Principles in Everyday Life, Prentice                                                                             Hall Inc. London
Carlson N.R (2010), Psychology the Science of Behavior 7TH Edition, Pearson Education Inc.                               Publishing
Gladding .S T, (1988) ,Counseling: A Comprehensive Profession; Merrill Pub.Co:                                                    Columbus.
Kazdin .N, (2001), Behavior Modification in applied setting 6th edition, Belmont C.A Wadswoth.
Laurence .M, (1999) International Journal of Emergency Mental Health                                                                  Format :Paperback

Prepared by Reward Gerald Kihedu-Bachelor of Education in Guidance and Counseling

Phone +255757260116



 


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