Behavior Therapy in Psychiatric Practice. The Use of by Joseph Wolpe

By Joseph Wolpe

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Additional info for Behavior Therapy in Psychiatric Practice. The Use of Behavioral Procedures by Psychiatrists

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The behavior first singled out for modification was the chronic grin. The grin was described for him, a video replay was shown demonstrating its omnipresence, and the modelling of an alternative expression was demonstrated to him. He was requested to concentrate only on modi­ fying this one aspect of his behavior (the grin) during the first working session. Modelling was frequently repeated, followed by his own attempt and then videotape feedback. The silent movie technique was especially helpful, the patient being required to convey his message mainly through facial expression.

Of days after admission FIG. 1. Patient's caloric intake during hospitalization. refusal to eat was based primarily on a fear of changes in appearance concomitant with eat­ ing (the desensitized hierarchy), normal eating behavior could be reestablished without desen­ sitization to caloric intake per se. A contingency plan involving "practical retraining" in normal eating behavior was prepared for use in case such behavior were not to be fully reestablished by the desensitization. To facilitate the transition to normal eating, it was decided that increases in caloric intake should occur only after the patient reported no anxiety or abdominal dis­ comfort for a 24-hr period at a given caloric level.

The authors found this sex difference difficult to explain. A methodological consideration which may have contributed to these puzzling findings was the heterogeneity of the sample, which was chosen without regard to psychiatric diagnosis. In a recent study, Gay et al. (1975) compared high and low assertive college students on WOLPE (1958, 1973) argues that assertive responses are incompatible with anxiety and are therefore effective in overcoming neurotic fear through the mechanism of reciprocal inhibition.

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