Behavior Modification Techniques in the Field of Health Therapeutic Intervention Areas CONTROL TECHNIQUES FOR THE ACTIVATION
Descriptive
The various techniques for controlling activation (technical relaxation) are among the most commonly used behavioral treatments. Its use is common, either in isolation, as a constituent of other therapeutic or within broader measures. Its basic objective is to teach the subject to control your own level of activation through direct modification of physiological conditions without the aid of external resources.
It has a wide range of control techniques of activation, ranging from the various methods of relaxation, meditational strategies, through techniques of breath control or suggestion procedures, such as hypnosis.
Of these, the most widely used is progressive relaxation, in alternating tension and relationship between different muscle groups. The technique used to modify the general stress level the body, or only that of a particular area (receiving differential relaxation)
is also widely used autogenous training, based on the use of a series of statements made to induce states of physiological relaxation through suggestions on sensations of weight, heat, heart and respiratory control ... also includes, in its upper meditation exercises.
There are other less widely relaxation procedures as the passive relaxation, which are only used relaxation exercises muscle groups, without straining before combining with the induction of sensations of weight and heat taken from autogenic training and breathing exercises. This technique is indicated for people for whom it is not possible or advisable to stress certain muscle groups. The relaxation
conditional relaxation is associated to a word or phrase, usually the subject content relaxing says to himself. You can also call on the imagination or visualization of relaxing scenes. These variants of relaxation have the advantage of being applicable in any situation or context, allowing the subject to relax in everyday life situations.
As an alternative to the various relaxation procedures are gaining importance because of the brevity of the training and easy to learn, techniques of breath control, aimed at providing basic voluntary control of breathing control and automate the way to stay in different types of situations, including those that are more problematic. The most common is the training in diaphragmatic breathing, aimed at achieving a more complete utilization of the lungs that facilitates a deep breath, a slow and regular.
Finally, emerging as, in recent years by inducing hypnotic relaxation. Hypnosis leads to a decrease of consciousness, without never a total loss of consciousness, using different methods, all of which are central to the imagination and suggestions.
Applications in the field of health
The application of techniques of control of activation in the field of health is very common, and covers diverse areas, including:
a) disorders associated with excessive activation or stress (eg Cardiovascular, gastro, asthma)
Carlson and Hoyle made a quantitative review of research published since 1980 on progressive relaxation. Analyzed 29 papers all of which at least part of the sample received only relaxation training, without any other additional technical. The results showed that relaxation was effective in the treatment of conditions examined, the effect being especially noticeable for headaches, and better individual training group. In addition to more practice and training, better effects.
b) Problems of pain
relaxation applies to the treatment of various pain syndromes such as back pain, arthritis, dysmenorrhea, headache, phantom limb pain, etc.. In fact, relaxation training is included in nearly all treatment programs chronic pain. Its usefulness is related to the overall decline of sympathetic activation, lower levels of excessive muscle tension and reducing high levels of anxiety. The technique used in this type of problem is the gradual relaxation in their various abridged versions and to a lesser extent, autogenic training or diaphragmatic breathing. It is important to adapt the exercises to the needs of the patient, avoiding areas where tension has pain, not to aggravate the problem. The evidence indicates that relaxation techniques are effective for the treatment of chronic pain, regardless of the type of pain or syndrome. Also evidence of the effectiveness of hypnosis.
control techniques of activation also apply in the prevention of acute pain (eg childbirth preparation).
c) Preparation for hospitalization and various medical interventions (eg surgery, diagnostic tests painful)
The applied relaxation training in surgical patients to provide a method of self-control. In this context, the techniques used for its brevity and ease of application include progressive relaxation, passive relaxation and diaphragmatic breathing. An important element for the effectiveness of this technique is the time of application: It is important to allow time for the patient to practice the technique and acquire the necessary skills before considering its application.
Also, these techniques have been applied in the treatment of diabetes, conditioned nausea and vomiting in cancer patients undergoing chemotherapy (progressive relaxation) and to improve health and quality of life. On the other hand, it is customary for inclusion in multi-component programs for the treatment of various problems such as smoking, obesity, etc. Within
listings empirically validated treatments APA appear control techniques such as activation probably effective treatments for two types of disorders: for the treatment of obesity include hypnosis in conjunction with cognitive behavioral therapy, and migraines, relaxation, biofeedback completed weld temperature. However, most health problems that appear in the list (headache, pain associated with rheumatic disease, etc..) Is included as a treatment well-established or probably efficacious, what the authors call behavior therapy or therapy cognitive-behavioral term that is often designated a multicomponent programs that used to be present a control procedure activation.
TECHNICAL EXHIBITION
Descriptive
The exhibition is a therapeutic component included in most of the treatments for the reduction of anxiety is based on the repeated presentation of the stimulus that evokes anxiety until it subsides. The basic rule is applicable to the individual presenting the situation to which tends to make avoidance behavior, making faces at her repeatedly until the discomfort subsides. Is indicated when the objective is to overcome the patient's avoidance of situations or events objectively safe.
The exhibition takes various forms that can be placed along a continuum, depending on the graduating feared stimuli or situations. The pole of highest rank would be occupied by systematic desensitization (SD), while the minimum degree of flooding would be, in which the exhibition takes place in a massive and prolonged.
Applications in the field of health
exposure techniques have great value for the disposal of medical fears.
The treatment of some of these phobias follows a similar pattern to that of other simple phobias, and is based on the systematic presentation, either in imagination or, preferably, in vivo, the feared stimulus or situation and can be used relaxation as a response incompatible with anxiety. However, blood phobias and injections have certain peculiarities. Specifically, while other phobias are characterized by the appearance of anxiety responses and increased activation, blood phobias and injections are characterized by nausea, vomiting, dizziness and fainting, which occur even before the storytelling, anxiety may appear with the anticipation of fainting. Also, have a distinct physiological pattern: in the blood phobias and injections usually occurs biphasic response in which such increases are followed by a rapid fall in blood pressure and heart rate can lead to fainting. This type of reaction called vagal syndrome, occurs in all kinds of subjects, however, in the case of phobic subjects is more pronounced. However, not all phobic to blood or injections exhibit this pattern.
To prevent fainting caused by vagal syndrome can use strategies to encourage the blood flow to the brain (lie down, down head), induction of muscle tension or a response of anger, which are generally applied in combination with in vivo exposure to phobic stimuli, which normally involves submission of photos or films that appear injured, interventions medical, etc.. as well as with exposure in imagination. Should not, however, apply the relaxation, since it may facilitate the onset of fainting. An alternative is the voltage applied, which combines the power of large muscle groups and exposure to phobic stimuli.
medical fears are particularly relevant in children. In this type of population in addition to standard exposure techniques in adults is usually resorted to the application of emotional imagination, whose aim is to provoke emotions in the child's reaction incompatible with fear. Its application involves the preparation and presentation, in imagination, the scenes with the heroes and favorite characters of the child and, as a natural part of the narrative, the various elements that cause anxiety.
emotional imagination is common ingredient in psychological programs in pediatric oncology applied to reduce anxiety and pain caused by invasive procedures, as well as preparation programs of children for hospitalization.
operant techniques INCREASE TO PURCHASE OR CONDUCT
Descriptive
operant techniques are based on the principles of operant conditioning and involves the orderly arrangement of antecedent and consequent stimuli in order to alter the probability of emission of a behavior. It is a heterogeneous group of procedures that can be used to maintain or increase behaviors (eg, direct reinforcement programs, behavioral contracting, token economy, stimulus control, rules) to teach or to establish new behaviors (eg, chaining, shaping), or to eliminate or reduce, as will be discussed.
operant techniques figure prominently among the behavioral intervention strategies, to the extent that it is difficult to imagine an intervention that are not involved or not used at one time or another, throughout treatment . Also, usually part of the behavioral programs are applied in the field of health, with the basic objective for the emergence of behavior and health habits, and reduce emissions of harmful health behaviors or deteriorate the quality of life of individuals, or that interfere with healthy behaviors emission. Often, your application involves the participation of people in the middle of the subject.
Applications in the field of health
applications of these techniques within the field of health are very diverse, and include any program that will try to increase, enhance or maintain emission a response (usually through positive reinforcement and behavioral contracts or token economy program) or, less often, teach a new behavior, does not exist in the repertoire of the subject (and either by molding or chaining). Among its most common uses:
a) Improving adherence to medical treatment.
apply positive reinforcement programs director, or token economy behavioral contracts, in which the subject is enhanced compliance with medical prescriptions, and may also punish breaches.
b) Maintenance and improvement of health behaviors and quality of life of individuals (eg, change of eating habits, exercise)
Such programs usually involve the establishment of progressive goals, strengthening behaviors to enhance and, where appropriate, the cost of response for non-compliance or for behavior incompatible with them. The program conditions are usually specified in behavioral contracts. This type of program is especially relevant in behaviors such as exercise, positive consequences occur in the long term, while short-term consequences are aversive. In these cases it is crucial to resort to the application of external enhancers that help the subject to maintain the behavior in those early moments in which it obtains only negative consequences.
c) Treatment of chronic pain
As part of treatment programs for these problems include techniques the reorganization of the reinforcement contingencies in the environment of the subject and contribute to maintaining the subject's pain behaviors. Complaints, requests for assistance and requests for rest of the patients with pain, are behaviors that are often reinforced by the attention of people around the patient, as well as avoidance and delegation of responsibilities. It is essential to train family members and people living with the patient in the basic principles of learning and teaching to extinguish inappropriate behaviors and reinforcing, instead, the patient's adaptive behaviors.
d) Other applications
have also been used token economy programs to promote health and self-control behaviors among patients with cognitive impairment, or older institutionalized children in residential care. You can also use the application of molded or chaining to teach basic hygiene habits are not present in the behavioral repertoire of the subject, or self-administered medical treatments.
It is also frequent use of behavioral contracts, focusing on various aspects of therapy, which include time, duration, compliance with homework, active cooperation, participation in follow-up sessions, etc. This type of contract acts as a facilitator of adherence to treatment or as a motivating factor, to increase the latter effect can even set up a contingency contract accompanied by a monetary deposit that the individual will recover gradually, and contingent on attendance at various stages of treatment and subsequent follow-ups.
operant techniques CONDUCT TO ELIMINATE OR REDUCE
Descriptive
Although the primary goal of behavioral interventions is the development of new behaviors that allow a more adaptive and appropriate action in Sometimes it is necessary to reduce certain behaviors that alter, inhibit or prevent the development or implementation of these adaptive behaviors. To this end, various techniques can be applied to emphasize the control of the presence of reinforcing stimuli, and essentially based on operant conditioning processes. These include the species, the different procedures of differential reinforcement, response cost, time out of reinforcement, satiation and overcorrection.
These procedures differ from those that achieve the reduction or elimination of social behavior through the presentation of aversive stimuli.
In general, the techniques focus on the reduction / elimination behavior should be accompanied by the application of other, aimed at developing alternatives to those behaviors to be eliminated.
Applications in the field of health
have been used for modifying or risk damaging habits that are present in the repertoire of the patient (eg, snuff, alcohol, ...) using essentially the cost of response, to be complemented by positive reinforcement of adaptive behaviors and incompatible with the behavior to eliminate. The program conditions are usually specified in a behavioral contract between therapist and client. This strategy is usually a basic part of the multicomponent treatment, for example, smoking, used mainly in the early stages, given its low cost and ease of application.
aversive techniques
Descriptive
aversive techniques associated with a behavior or unwanted behavior pattern and socially sanctioned, with an unpleasant stimulation, or reorganize the situation so that the consequences of this behavior is unpleasant for the subject, causing cessation total emission of that behavior. In fact, aversive techniques are very different. However, they all have the common feature the use of aversive stimuli, which include electric shock, chemicals, etc.
The use of aversive techniques raises important ethical and social issues related to the unpleasant effects produced by stimulation used and popular animosity towards them. For this reason, its use is limited, restricted to cases that raise important issues or hazards to the subject and his environment. It also proved effective in the treatment of behaviors that are maintained by the appetizing triggering stimulus, such as, for example, addictions to various substances.
Applications in the field of health
Within the scope of health, aversive techniques have been used primarily for the elimination of harmful habits, mainly alcoholism and smoking, may apply to a lesser extent and less efficiently, in obesity. Also, we have used for the elimination of automatic behaviors, such as hysterical paralysis of a limb.
in the treatment of smoking behavior it has been conditioned to an aversive situation, most specific for this behavior. They also often involve the presentation of behavior, with a frequency or intensity high enough to make them disappear reinforcing aspects of it, becoming aversive, leading to a weakening or disappearance of habit. It is therefore satiation procedures (rapid smoking, the retention of smoke ...). These techniques are often used in multi-component programs and are designed to facilitate smoking cessation.
In the treatment of alcoholism choice stimuli are emetic drugs and covert aversion, which is used predominantly the image of nausea. As in the case of smoking addiction, the use of aversive techniques for the treatment of alcoholism is often framed within larger programs, since the short-term gains obtained by these procedures, are often not sustained over the long term. BIOFEEDBACK
Descriptive
The basic goal of biofeedback is the elimination or reduction of the disorder through the development of adequate control by by subject, the response altered physiological. For this, the resort to the use biofeedback instrumentation that gives the subject immediate, precise and direct the activity of its physiological functions, facilitating the perception of these and its voluntary control. Consequently, the key and essential element of the process is the information (feedback) that the subject receives on the physiological variable of interest.
Strictly speaking, biofeedback training in which the person intends to get control of a physiological response, which is usually associated with the presence of a disorder. From a broader perspective, their ultimate goal is to solve a problem or prevent the onset of a disorder, for which often included within broader treatment programs, in which addresses the many variables that affect the appearance and maintenance of this problem, among which are all seen as specific physiological change, other responses, both physiological and motor and cognitive skills.
There are various forms of biofeedback that are usually classified according to the type of reply, which provides information and specific aspects or dimensions of these responses are considered. These include: Biofeedback
- electromyographic (EMG), which provides information on the activity of muscle or muscle group on which the electrodes are located. Biofeedback
- electrokinesiológico, GIVES information on the movement of a joint. Biofeedback
- skin resistance activity, mainly skin conductance, which is related to the activity of the sympathetic branch of the autonomic nervous system.
- Biofeedback of skin temperature, provides a direct estimate of the peripheral circulation and, therefore, of sympathetic activation.
- Biofeedback heart rate. Biofeedback
- blood volume pulse, reports the amount of blood passing through a particular vessel or dilation it reaches. Biofeedback
- blood pressure.
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Pressure Biofeedback Biofeedback - electroencephalographic (EEG), reports of electrical activity in the cerebral cortex. Different forms
differentiate into two types, called direct and indirect uses. The policies are based on the assumption of specificity, and assume that there is a specific physiological dysfunction that is related to or associated with a disorder also specific (eg muscle tension, high tension headaches Front). From this point of view, biofeedback focuses on the modification of this dysfunction.
For their part, indirect uses are based on the assumption of generality, which implies that many specific disorders are common underlying factors (eg anxiety), biofeedback focusing on changing them. Such applications usually involve the use of frontal EMG biofeedback. In the same vein, we used the alpha rhythm EEG biofeedback, biofeedback of heart rate and skin resistance activity. At present this type of use is in remission for his undoubted theoretical, and economic efficiency. In contrast, the direct use of biofeedback maintained and even flourish.
Applications in the field of health
biofeedback (in its direct use) plays a central role in applied behavioral techniques in the biomedical context, being the areas where greater acceptance and success is having:
Rehabilitation -
- neuromuscular disorders involving excess muscle tension
- Cardiovascular basically arrhythmias, hypertension and peripheral circulatory disorders.
- sexual dysfunction.
- Gastrointestinal disorders.
Other applications include epilepsy, asthma, pain, urinary incontinence, insomnia, and other broader development recent, still be considered tentative, and oculomotor disorders, chronic constipation, dysmenorrhea, skin disorders or conditioned nausea and vomiting secondary to chemotherapy.
In all these disorders, biofeedback is applied to prevent its occurrence or, more commonly, as an intervention strategy once it has developed, either alone or as part of a larger therapeutic program, which is usually in addition to biofeedback includes a relaxation technique and other interventional procedures, which may involve drug therapy.
The effectiveness of biofeedback training in such disorders appears to be well established, although it remains to determine the process through which achieves its effects.
Moreover, in some cases, the cost and complexity of the instrumentation needed to implement the training can be difficult, if not impossible, to use.
MODELING
Descriptive
Modeling is a process of learning through observing the behavior of other people. The procedure is to show the adult child or one or more models that exhibit behavior, asking him to focus attention on such behavior, the context or situation appropriate behavior and the contingencies that follow. Through modeling
can modify motor behaviors, emotions and physiological arousal and cognitions such as opinions, beliefs and attitudes. Modeling as outlined in Bandura, can be used for the following functions: a) acquisition of new repertoires of behaviors or skills, b) inhibition or disinhibition of behaviors that the person had previously in his repertoire; c) facilitation of behaviors previously the presentation of models, not issued by the absence inducing stimulus, not for lack of skill or inhibition processes, d) increase environmental stimulation, e) changes in emotional arousal and affective valence.
Applications in the field of health
the model achieved wide application in the field of health psychology, and is applied singly or in combination with other techniques. The procedures can be quite varied, basically consist of getting the attention of observers, trained properly, present models that exhibit appropriate and inappropriate behaviors, which are the incentives or appropriate consequences and explanations. Among the most important applications are the following:
In primary prevention programs:
- learning and attitudes about risk behaviors, such as all the behaviors associated with risk of HIV infection, smoking, alcohol, drugs, etc..
- attitudinal changes favorable for the start of healthy habits (exercise, diet, etc..) Acquisition
- behaviors and health habits (hygiene, exercise, food, etc.).
- Learning self-protective behaviors (Training in prevention of assault and rape, search for help in problem situations, etc.).
- Social Skills Acquisition Training paraprofessionals
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In secondary prevention programs:
- Implement appropriate knowledge and attitudes about testing screening or early detection tests, immunodeficiency, periodic reviews, etc. Learn
- self-examination behavior. Facilitation
- behaviors of screening tests, periodic reviews, etc. Acquisition
- behaviors necessary for adequate treatment compliance physicians. Learning
- therapeutic behaviors. Preparation
- painful medical interventions or negative side effects.
In tertiary prevention programs:
- Establishment of codes of self-care behaviors, language and other skills.
- Learning
- troubleshooting maintenance and restoration of cognitive abilities in older
techniques for self Descriptive
The term self refers to specific behaviors in situations specific rather than global features such as willpower, determination, effort and integrity. Consequently, the self is a skill, the result of a learning process that can be trained through self-control techniques or programs.
self-control techniques can be defined as the set of procedures through which the therapist teaches subjects design strategies that allow them autointervenciones, in order to achieve certain goals in the short and long term, by changing their own behavior in different contexts, through the manipulation of the consequences or the reorganization of the background situations. It is, in short, that the subject himself to achieve control of their behavior, "learn to be your own therapist." To do this, teach the patient to know the principles of behavior to which he can apply the procedure to modify it to be the director of his own behavior, rather than relying on the therapist.
Applications in the field of health
self-control techniques are currently gaining a growing importance, being applicable to an extended range of problems, either as a single strategy, or more frequently within multicomponent programs. Within the field of health, applied to establish healthy habits and the elimination or correction of risk behaviors, playing an important role in prevention and health promotion.
Indeed, much of the risk behaviors are maintained by the immediate positive consequences, which take precedence over long-term negative consequences. For example, smoking behavior is maintained by the subjective pleasure, the same way, excessive intake of sweets immediately reinforced by the pleasant taste. In both cases, each issue of the conduct involves immediate and highly positive contingencies likely. Alternatively, health behaviors (physical exercise) lead to immediate negative consequences, positive consequences appear only in the long term.
Through self-control techniques encourages and facilitates health behavior at the same time it hampers or prevents the issuance of risky behavior. To achieve this, use different strategies based on:
- self-observation and self-registration, provide immediate feedback on progress.
- Establishment of short, medium and long term, adjusted to reality.
- Environmental Planning, eliminating or restricting the stimuli that trigger risky behaviors and encouraging, however, the appearance of those that provide the behavior health. It takes place primarily through control of stimuli, including contingency contracts also. Programming
- consequences, primarily in the form of reinforcement and self-imposed punishment.
Among the strategies used in the field of health, include:
- To control the intake and the establishment of proper dietary habits.
- To establish regular exercise habits
- In the treatment of addictive behaviors, such as the consumption of snuff
can also use self-control procedures to increase adherence to treatment doctors, or to take precautions during sex, and treatment of sleep problems, especially insomnia.
A variant of self-management techniques, useful in the field of health, is training in time management that helps streamline the use of time by learning a lifestyle that includes work activities in a rational and allow the individual to have time for rest and recreation.
These procedures are keen to stress management and, therefore, for the treatment and prevention of various disorders associated with it, likewise, can play an essential role in the treatment of subjects with Type A behavior pattern
COGNITIVE TECHNIQUES
cognitive techniques cover a very broad set of procedures and strategies with different objectives. These techniques can focus on the following aspects of cognitive activity:
- events or cognitive events, such as in the training self of Meichenbaum, which aims to change the internal dialogue or self-instruction, or Beck's Cognitive Therapy when working on the modification of automatic thoughts.
- Cognitive processes, such is the case of Problem Solving D'Zurilla, Problem Solving Spivack and Shure or modifying attribution styles and errors of inference or deduction, within Beck's Cognitive Therapy.
- cognitive structures (schemas, beliefs), as in Ellis Racional.Emotiva therapy or cognitive therapy.
- coping skills, for Stress Inoculation Meichenbaum, Training in the Management of Anxiety Suinn and Richardson, Self-Control Desensitization Goldfried.
Moreover, the techniques involve the application of cognitive behavioral procedures, but here are used as experiments to modify or generate beliefs, thought processes or content that, once altered or optimized, will produce a consistent and effective change in behavior.
The application of cognitive techniques in the field of health psychology is widespread in the last two decades
training self-talk and control
What people are say to themselves, the self-statements or AUTOFREN, guide or direct the behavior toward its objectives, serve to initiate and persevere, guide behavior, or to disrupt behavior chains. The training self is an important procedure for the control of behavior. The steps are basically consisting:
- self-observation and self-registration of self-talk.
- Defining the problem.
- approach to the problem.
- Focus of attention.
- self-reinforcement "I look at what I'm getting and I have to congratulate me for it."
- verbalizations to deal with errors. Self
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- self-reinforcement.
Self-observation and self-registration of internal dialogue and its effects on behavior is an essential for editing.
The training self in the field of health psychology has been used in the following areas: Training
- hyperactive and impulsive
- Training to overcome learning difficulties, writing, drawing or improved troubleshooting.
- training to improve interpersonal skills in the classroom, attention to the teacher or creativity.
- Training in stress management and anxiety disorders.
- self-treatment of problems related to difficulties in resisting the temptation, delay of gratification, tolerance to stimulation aversive or anger.
Troubleshooting
Troubleshooting The term refers to the cognitive process, emotional and behavioral through which an individual or group, identify or discover effective means of dealing with the problems found in daily life. Includes both the generation of alternative solutions, such as decision making or choice behavior. It is a learning process, a technique of self-management and coping strategies.
The Training social Troubleshooting D'Zurilla, consists of 5 phases: 1) general approach to the problem, 2) definition and formulation the problem, 3) generation of alternative solutions, 4) decision making, and 5) implementation and verification of the solution.
Within the field of health psychology, the areas most used are:
- stress management, anxiety and anger
- Crisis intervention: divorce, separation, death
- addictive behaviors Control Disorders
- Power Training
- mothers of children with behavior problems. Troubleshooting
- daily life associated with chronic diseases.
- Problems of adherence to medical treatment
Cognitive Restructuring
cognitive restructuring therapies are based on the consideration that people faced with situations not automatically respond stimulus, but, before issuing an emotional or behavioral, perceive, classify, interpret, evaluate and assign meaning to the stimulus, depending on beliefs or tacit assumptions contained in cognitive schemas.
cognitive restructuring therapies most recognized and applied are rational-emotive therapy of Ellis and Beck's Cognitive Therapy.
Rational-Emotive Therapy, Ellis aims to change behavior through the modification of irrational beliefs, maladaptive, which uses strategies for identification of beliefs, discussion, logical analysis, reductio ad absurdum, etc., and behavioral techniques to prove the invalidity of irrational ideas, eradicate and replace with adaptive thoughts .
Beck's Cognitive Therapy is an active therapeutic intervention, time-limited, which uses an integrated combination of cognitive and behavioral techniques, with the aim of a) eliminate behavioral symptoms, primarily through the identification and elimination of negative automatic thoughts, b ) prevent relapse. This procedure takes place in a framework of collaborative empiricism which encourages patients to discuss their thoughts and beliefs as hypotheses to be tested empirically, relying primarily on the consequences of their behavior for reality testing. It uses the experience of the patient. The entire process is structured under a model of skills training, aiming to help patients develop strategies, which might be useful after completion of therapy to identify and modify dysfunctional thoughts and beliefs.
cognitive restructuring techniques have been applied with proven success in disorders of depression and other emotional disorders, although their use has spread to any disorder in which emotional state control is relevant. Health Psychology, the major application areas are:
- Eating disorders Addictive Disorders
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- Improved self-esteem on body image
- Prevention of anxiety disorders and depression and improved quality of life cancer patients.
- control negative emotional states of anxiety and depression and improving quality of life in chronic diseases such as asthma or diabetes.
- emotional impact reduction and adaptation after myocardial infarction treatment
- chronic pain
- Adaptation and improvement of quality of life in amputees
- stress coping health care workers and prevention and treatment of burnout.
Stress Inoculation Training
The Stress Inoculation Training is a process through which people learn to conceptualize and properly assess the stressful demands, they acquire a repertoire of skills to cope with stress and practice exposing themselves to different types of stressful events in increasing intensity graduates, thereby increasing their resistance to stress.
The Stress Inoculation Training consists of three phases:
- Education or conceptualization, the therapist instructs the patient or client about what his problem or stressful or painful event facing, how they can be controlled, the resources counts and the strategies that once learned, will equip you with the means to overcome and resist stress.
- Acquisition of skills, such as relaxation, problem solving, social skills, etc. Instruct the patient to break the stressful event into segments, to identify, in each of them, catastrophic or negative thoughts and replace them positive ones.
- implementation phase. Patient is exposed to stressful stimuli of increasing intensity and is varied to test the learned skills, improve their self-efficacy and sense of personal mastery of stress.
Use of Stress Inoculation Training in the field of health psychology, has been extensive. Among the applications:
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stress coping - Preparation medical interventions
- Pain Acute burn units
- Chronic Pain
- Psychological treatment for hypertension
- Control Type A behavior pattern and anger or hostility
- chronic disorders (diabetes, asthma)
- training in managing stressful situations and preventing burnout in occupational groups in the health field, as well as policemen, athletes, teachers, etc.
social skills training
Social skills are the abilities of people to perceive, understand and respond appropriately in social situations and, in particular, the behavior of others. In the field of health are important to ensure adequate health care, excellent communication health care to patients and family members and between members of the healthcare team.
social skills of health professionals
health care personnel should possess the social skills necessary to ensure:
- The establishment of a trust relationship with the patient to allow adequate assessment and collection of diagnostic information.
- Improving satisfaction with care and reducing the stressful impact of hospitalization, the application diagnostic tests and treatments.
- proper issuance of diagnosis and prognosis.
- Knowing the bad news to
- by adherence to therapy. As summarized
Bayes, the basic skills they must display a health professional are:
- be able to show empathy with the patient.
- Scale, as far as possible, the negative information that provides
- provide messages and hopefully in a clear and understandable language.
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not lie - be affordable and available
- Ensure that information has a high degree of congruence with the others providing health care professionals who meet the same patient
- Facilitate conditions for the patient and family members can freely express their emotions
- Know
- endure silences
not afraid to ask - Being able to listen without interrupting patient care
- Being able to explore the fears, concerns and resources of patients and their families
- Try to avoid overprotection of the patient and encourage him the highest perception of control.
- Avoid unnecessary signs of worsening
- When the patient questions or comments his fitness mad, do not use verbal expressions closed, which cut the communication.
- Help the patient prioritize your goals, offering choices and suggest possible ways.
- Never throw in the towel
- Asking for help from a trained professional to adopt specific strategies.
Regarding verbal language, you must meet: Attention
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- Understanding personal Relevance
- Credibility
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Acceptability Regarding nonverbal language, must be careful
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- Facial expression gaze
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- posture gestures
- physical proximity
- physical contact
- vocal keys as tone, volume, speed ...
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personal appearance Likewise, social skills are essential for proper maintenance of a successful social climate.
social skills in patients
The acquisition of social skills is a key aspect to maintaining the health and welfare, and is very positive for the recovery of ill health and adaptation and maintaining quality of life in disorders chronic.
First, will allow to have a good social support network is an important predictor of maintaining healthy habits of screening tests and periodic reviews, as well as adherence to medical treatment and welfare and quality living with chronic diseases.
Secondly, compared to an illness, the patient must maintain assertive behavior and social relationships that allow them to establish appropriate relationships with care staff, reported diagnosis, prognosis, quality of treatment and ensure their rights properly.
Thirdly, both the patient and family must learn to manage stress, communicate their feelings and needs appropriately and manage personal interaction problems associated with the disease.
Finally, in the case of chronic disorders may be problems related to self-esteem, communication difficulties and social isolation. The social skills training is a necessary aspect of maintaining quality of life and to address specific communication problems that adversely affect social relationships.
FINAL CONSIDERATIONS
Behavior Modification provides a range of techniques Experimental Psychology based on providing objective criteria for assessing the effectiveness of the intervention. This is established by determining the objectives in the medium and long term satisfaction of the patient. The relevance of a given technique, and his choice to come always determined by the individual analysis of the case and specific treatment goals, adapting to the abilities and needs of the patient.
Psychological intervention in the health field has to be preceded by a thorough assessment of needs and possibilities of intervention to determine the specific contributions you can make the psychologist. Do not forget that this type of intervention is often framed within treatments and multidisciplinary teams.
light of these considerations, behavioral interventions in the health field take many forms ranging from community interventions (essential in primary prevention programs) to group and individual, always trying to reach the largest number of subjects with the lowest possible cost, and adjusting the programs to the real possibilities of the subject and available resources. The concept of the subject takes itself an ample consideration in this area and includes all those affected by or involved in disease treatment and assistance, that is, the patient, but also their relatives and health personnel and social services in its various segments.
All these circumstances make that much of the programs in use are not directly applied by the psychologist, so often resort to training paraprofessionals (health, people from NGOs ..) acting as agents for treatment. However, intervention by paraprofessionals is not always possible or advisable. Thus, operant procedures are particularly suitable for this type of application, while other techniques, more complex in its execution, require training specialized, and often remain reserved for the psychologist. In any case, corresponds to the behavior the role of evaluation and design of the intervention program, which require specific professional training.
