Gail Notes

1. Classical conditioning- Pavlov

Unconditional stimulus such as food elicits and unconditional response such as salivating. Conditional stimulus, like the bell, paired with food will result in salivation. Conditioned response is salivating when the bell is heard.

2. Operant conditioning- refers to activity strengthened or weakened by its consequences. (Weight loss and weight gain). Operant behavior is under the control of the individual. He or she can use the behavior to change or modify the environment. A reinforcer influences the individual. A reinforcer is anything that increases the probability of a response.
3. Generalization- adaptive behavior used in a situation may be used in similar situation. For example, the client learns to verbalize feelings in a hospital setting. He or she may verbalize feelings at home.
4. Discrimination- a client is positively reinforced for completing a task and ignored if the task is not completed and then consistently completes tasks. By doing this, the client is making a discriminating response.
5. Extinction- withholding reinforcers to reduce the probability of a response. For example, the staff ignores a client’s attention seeking behavior and positively reinforces group participating behavior. The client then stops the attention seeking behavior.
6. Prompting and fading- Prompting is cuing and fading is reduction
7. Shaping-continual reinforcement of a desired target behavior
8. Chance reinforcement- may strengthen maladaptive behavior. Ex; staff that spoon-feeds a client, who refuses to eat, even though material reinforcers are given if he eats, may be reinforcing the behavior by giving attention and getting the reinforcer for eating.
9. Secondary reinforcement- a primary reinforcer may be bingo but can turn into a secondary reinforcer for increasing verbal communication.
10. Reinforcement schedules:
1. Continuous- every expected response is reinforced
2. Intermittent- only selected responses are reinforced

1. Fixed ratio- an example would be that every third response is reinforced.
2. Variable ratio- an example is: the first day the 3^rd response may be reinforced and the next day the 6^th response will be reinforced. The response being reinforced is changed periodically

• Cognitive processing- thinking processes are involved in psychological distress. The approaches try to correct distorted thinking patterns. The goal is to decrease subjective distress and increase productive behavior.

Assessment:

• Collect objective and subjective data. The behavior or target problem must be clearly identified.

1. Find out the problem behavior
2. The situation in which the behavior occurs
3. The consequences of the behavior
4. The parameters of the problem
5. The client’s perception of the problem

Nursing diagnosis

Planning

Goal setting

Interventions

• Involves reinforcement schedules, manipulation of the environment, and the following:

1. Self- management programs- includes weight loss and smoking cessation. Observing and recording ones own behavior is a reinforcer.
2. Contracting
3. Narrative interventions- encouraging the client to keep a journal
4. Cognitive therapies- relaxation techniques, thought stopping (by yelling stop after expressing illogical behavior), self-talk, visualization, remodeling, reframing, modeling (imitation), imagery, role playing, assertiveness training, problem solving and progressive muscle relaxation (tense and relax main muscle groups of the body)

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