Behaviour couple therapy is concerned about how people learn and unlearn dysfunctional behaviours. The model relies on cognitive behaviour theory whereby the general assumption is that changing the cognitions of an individual is critical to help clients overcome their problematic behaviours and bring about change.

The theory also believes that behaviour is maintained by its consequences. The consequences that accelerate the behaviour are termed reinforcers where as those that hinder the behaviour are termed punishers. Reinforcement occurs when a behavioural response is strengthened by an outcome.

There are two types of reinforcements, negative and positive reinforcement. Positive reinforcement occurs when behaviour is strengthened by a positive reward. For example, a husband that puts his dirty socks in a laundry basket is rewarded by his wife with praise and recognition. This reinforces his efforts to pick up his socks.

Negative reinforcement occurs when behaviour is strengthened by the removal of a negative stimulus. For example, wife insuring that dinner is ready on time to reduce the likelihood of the husband getting angry and abusive to her. This reinforces the wife’s behaviour of getting dinner ready early so as to remove the negative stimuli of the husband’s anger.

According to this theory, people in relationships strive to maximise rewards and minimise costs. The cost/ benefit analysis helps clients determine how much effort they should put in to meet their partner’s expectations. It is believed that through this, individuals can have their expectations met. 

The cornerstone of this approach is that symptoms of relational dysfunction are learned responses, thus the intervention focuses on the symptoms themselves and therapists are on the lookout for responses that reinforce the problem behaviour (Nichols Schwartz, 2004; Brown Brown, 2002).

Assumptions of the Behaviour Couple Model

1. Behaviour is maintained by its consequences.
2. Symptoms are learned responses that are caused by involuntary dysfunctional reinforcement.
3. Behaviour change is best brought about by accelerating positive behaviour and decreasing aversive control, as well as by improving communication and problem solving skills.
4. Action and not personality is what’s deemed important.
5. The focus is on dyadic interactions.
6. Insistence on observation and empirical evaluation.
7. Treatment is tailored to the specific family.

Goals of Behaviour Couple Therapy

1. Modify certain patterns of behaviour to improve presenting problems.
2. Improve positive reinforcements in couples.
3. Teach new skills (communication, assertiveness and problem solving skills).
   Alter dysfunctional thoughts.
4. Implement client specific treatment.
5. Maximize benefits and minimise costs.
6. Treatment is usually time limited and symptom focused.

(Nichols Schwartz, 2004; Brown Brown, 2002; Long Young, 2007)

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Vernon, Ann. 512 Pages.
2002, USA: Love Publishing Company

Children and adolescents of the 21st century encounter challenges and difficulties that are indicative of contemporary society, thus it is important that as therapists we equip ourselves with the most pertinent up-to-date information available. Counseling children and adolescents (2009) by Ann Vernon acknowledges the changing face of society and within it the complexities confronting our young people.  This latest edition includes practical strategies and ‘how to’ information for counselling children and adolescents, as well as information in regard to working within the family and parental contexts. 

Editor and contributing author, Ann Vernon is an expert in counselling children and adolescents.  In compiling this book she has drawn on her vast experience within the field to bring together a variety of skilled practitioners all of whom offer a wealth of knowledge. The information offered is written in clear understandable terms with case studies utilised throughout to punctuate and reinforce the reader’s comprehension of the theory.

Chapters are included on play therapy, brief counselling and rational-emotive behaviour therapy – all of which are tailored to working with this particular clientele. It also contains innovative and creative approaches to working with clients from specialised groups including at-risk youth, exceptional children and children and adolescents with special needs. 

Counseling children and adolescents (2009) is innovative in both approach and information.  It is a must-have text for those working with young people.  It acknowledges the intricacies of the sector whilst providing straightforward responses to challenges faced by both clients and practitioners.  Highly recommended!

Reviewed By: Anda Davies

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The Bachelor of Counselling is a careful blend of theory and practical application. Theory is learnt through user-friendly learning materials that have been carefully designed to make your studies as accessible and conducive to learning as possible.

The course and its subjects are structured to progressively develop your knowledge and skills from foundational, theoretical concepts through to more complex concepts and advanced skills and applications.

We have now opened the 2010 Second Semester intake for the Bachelor of Counselling. Places are strictly limited and applications are assessed and offered on a first in basis, so please act now.

Here are some facts about the course:

1. You can study from home.
2. Most cost effective Bachelor of Counselling in the country (save over $13,000.00).
3. Enrol now and pay later with government FEE-HELP.
4. Study from anywhere in Australia, even overseas.
5. Practical skills honed at residential schools.

Fee Help is a government loan scheme that assists eligible fee-paying students to pay their tuition fees. Under Fee Help the government pays your fees in advance and you repay them once your annual income exceeds a minimum amount (currently $41,595 per annum).

Learn more here: www.aipc.net.au/degree2010

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With a number of people undergoing grief, it is important to understand signs of normal grief. Worden (2005) identified four categories that demonstrate normal grief. This includes feelings, cognitions, physical sensations and behaviours. It is also important to remember that these signs of grief will vary from individual to individual.

Feelings

Sadness is a common feeling experienced after the loss of a loved one. This is often demonstrated by crying, a gesture that evokes a sympathetic and protective reaction from others. Not allowing sadness to be experienced with or without tears has the potential to lead to complicated grief.

Numbness or shock is often experienced immediately after a loss. This serves as a defense to block pain and to protect the bereaved from being overwhelmed. It allows opportunity to be gradually introduced to the reality of the loss.

Angeris frequently associated with loss. It is not uncommon for the anger experienced to be directed at either the deceased of the bereaved, the bereaved themselves  or both. Worden (2005) suggests that anger comes from a sense of frustration due to an inability to prevent the death and as a regressive experience that occurs after losing someone close. Anger experienced by the bereaved needs to be appropriately identified in order to bring it to a healthy conclusion.

Guilt is also common in the process of grief (Worden, 2005). The bereaved might feel guilty about being alive while the loved one is dead. Guilt is often manifested over something that occurred during the time of death that the bereaved individual feels they could have prevented somehow.

Most guilt is irrational and can be overcome by “testing reality” except where the bereaved is responsible for the death, then other interventions will be more appropriate. Guilt may also relate to unfinished business the bereaved might have with the loved one. For example, things left unsaid, a longing to have done things differently and other potential regrets can all encourage the bereaved to feel guilty.

Anxiety is a common feeling associated with loss and it comes primarily from; a fear that they will not be able to take care of themselves and a heightened sense of personal death awareness. The anxiety experienced may vary from mild anxiety to more extreme panic attacks. In this sense, being confronted with the reality of death can be a little frightening.

Other feelings associated with grief include loneliness, fatigue, helplessness, yearning and emancipation (Freeman, 2005; Worden, 2005).
    
Cognitions

The most common cognitive response to death is a preoccupation with the deceased, which occurs as a form of obsessional thinking. Some preoccupation may be in the form of intrusive thoughts that may be related to guilt or other unresolved issues. This commonly occurs in the early stages of grief and disappears after a short while.

Prolonged experience of these thoughts may trigger depression.  Hallucination (visual and auditory) of the deceased loved one is also a frequent experience of the bereaved. Other cognitive responses may include confusion, disbelief, and passive suicidal thoughts.

Physical Sensations

In addition to feelings and cognitions associated with grief, there are also physical sensations that transpire during the grieving process. Although often overlooked, they may be key indicators of the individual’s grief reaction. Examples of commonly reported physical sensations are listed in the table below.

Physical sensations of grief:

1. Hollowness in the pit of the stomach
2. Tightness in the chest and throat
3. Oversensitivity to noise
4. Breathlessness
5. Lack of energy
6. Dry mouth
7. Muscular weakness

Source: (Worden, 2005)

Behaviours

There are a number of behaviours associated with a normal grief reaction too. These are often experienced immediately after a loss and correct themselves over time. Disturbances in sleep and eating patterns are very common during times of grief. Absent mindedness and social withdrawal are also common behaviours that are evident in the grieving process. Behaviours such as dreams of the deceased and avoiding reminders of the deceased are also reported in the early stages following loss.

There is a wide variety of feelings, cognitions and behaviours that are associated with loss. As such, it is imperative for counsellors to understand behaviours of normal grief (Freeman, 2005; Worden, 2005).

Source: www.mentalhealthacademy.com.au

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Personality disorders are thought to result from a difficult temperament (as well as biological and social factors). Personality traits and temperaments are dimensional characteristics that are heritable and manifest early in life. These characteristics underlie or influence cognitive processes, interpersonal and social functions, emotional and affective states and biological stress systems (Howland, 2007; Shiner, 2005).

Traditionally temperament is distinguished from personality because it refers to stable individual differences that appear from birth onwards. Personality on the other hand develops over time and is thought of as emerging later in life (Shiner, 2005; Mervielde, De Clercq, Fruyt Leeuwen, 2005).

Temperament can be defined as a persons innate or biologically shaped basic disposition to emotional response. Buss and Plomin distinguished four temperamental dimensions: emotionality, activity and sociability Emotionality involves intense activation of the sympathetic nervous system and hence high emotional arousal. The second temperamental dimension is measured by the rate and amplitude of speech and movement, displacement of body movements and duration of energetic behaviour.

Sociability refers to the preference for being with others, the need to share activities and receive rewarding attentions as a result of social interaction. Goldsmith and Campos define temperament as individual differences in the probability of experiencing and expressing primary emotions and arousal (Mervielde, De Clercq, Fruyt Leeuwen, 2005).

Thomas and Chess (1977) conducted a study of 136 children whose development was closely monitored for a number of years. The authors identified nine categories of behaviour that they labelled temperament. The categories included activity level, rhythmicity (regularity), approach or withdrawal, adaptability, intensity of reaction, threshold of responsiveness (sensitivity to stimuli), quality of mood (disposition), distractibility, and attention span, and persistence.

That these aspects of temperament are observable shortly after birth and remain consistent throughout childhood indicates that they have some constitutional, if not genetic, basis. It has been suggested that it is the plasticity of the temperament that allows the environmental factors such as childrearing practices to have an equal or greater influence on development and our personality.

It is suggested that it is in the way the care giver responds to the child’s temperament that predisposes them to personality disorders.  Negatively emotional or “difficult” infants and toddlers are more affected by rearing experience that those with easy temperament (Belsky Pluess, 2009). Children with difficult temperament may result in their parents rejecting them or defaulting from providing adequate love that is critical in the early stages of development (Barlow Durand, 2009).

This rejection may in turn result in social alienation and low self esteem in adulthood, thereby causing entrenched dysfunctional ways of thinking, feeling, behaving and relating. For example, nervous parents might be unhappy with a baby who has a very active temperament and try to restrain him or her at every opportunity. The child might then develop an avoidant personality disorder as a way of coping with constant frustration and parental disapproval.

Problems develop when the environment (or adults) put demands on the child which are not congruent with the childs temperament. When a child fits with the demands of his or her environment, that child grows. When the child does not fit, problems in interaction with that environment occur predisposing that child to numerous personality disorders. Since children must learn to adapt to their specific care givers and families, they may develop personality disorders in the course of struggling to survive psychologically in disturbed or excessively stressful family environments (Barlow Durand, 2009).

Social theories hold the position that personality disorders reflect learned responses, having much to do with reinforcement, modelling, and aversive stimuli as contributing factors.  Psychoanalysts also agree that a traumatic childhood experiences such as abuse and neglect contributes towards the development of most personality disorders.

According to psychodynamic theories, personality disorders reflect deficiencies in ego and superego development which are related to poor mother-child relationships characterized by unresponsiveness, overprotectiveness, or early separation.

Source: www.mentalhealthacademy.com.au

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