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EFFECTS OF BEHAVIOURAL THERAPY FOR SCHIZOPHRENIA AND BIPOLAR
AFFECTIVE DISORDER
1
Sheranov Qurol Sheranovich
2
Umarova Feruza Elboy qizi
3
Sharapova Dilfuza Nematillayevna
1-2
Student of group 509 of the medical faculty of Samarkand State Medical University,
Samarkand, Republic of Uzbekistan
3
Course of Psychiatry, Clinical ordenator, Samarkand State Medical University, Samarkand,
Republic of Uzbekistan
https://doi.org/10.5281/zenodo.14749929
Abstract. The behavioural approach to psychotherapy was formed as a direction of
theoretical psychology under the influence of behaviorism, as the main subject of learning that
determines its behavior ("behavioural"). We also note that behaviorism in its traditional model is
characterized by a special understanding of psychopathology-as a result of improper study, the
acquisition of maladaptive forms of response to external stimuli for some reason; such a view
predetermines the optimistic prospects of actively changing behavior of behavioral psychotherapy,
and also determines the main direction of the method and technique used – teaching new, flexible
types of reactions, strengthening them, inhibiting pre-existing maladaptation.
Keywords: Behavioural therapy, schizophrenia, bipolar affective disorder, psychotherapy.
Introduction.
Leading theorists in the field of behaviorism I. P. Pavlov, B. Skinner, A.
Bandura. This concept formed an important alternative to psychoanalysis for much of the 20th
century (of course, in foreign countries). This approach was known for defining psychology as a
behavioral science and prioritizing the principle of learning, believing that a person's behavior, as
well as his experiences (later developers of the approach also began to refer to behavior, or rather,
its internal variables) the result of the interaction of an individual with the environment, that is, the
result of learning [1, 2].
For many years of the development of this direction of psychology, three main models of
learning have been identified: classical conditioning, operant conditioning, and social learning.
Within the framework of the study of academic psychology in the behavioral direction, a
large number of general and private educational laws were based, techniques and algorithms were
developed that were used to form the necessary skills. As for behavioral psychotherapy, it is very
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multifaceted and includes techniques that differ in generalization, equipment, but are always
pragmatically oriented, aimed at active changes in behavior [3-5].
The first attempts to influence patients with mental disorders on the basis of the behavioral
model began more than half a century ago, the author of the idea of operant conditioning B. When
Skinner, together with colleagues, conducted a study with patients from psychiatric hospitals – it
was carried out within the framework of this model of learning. Group B, which is not limited to
ethical standards and requirements for the organization of scientific research. Skinner and his
colleagues used special boxes (in the case of the famous Skinner's "problem box" for animals),
where the patient could receive a reward in the form of candy or cigarettes if it was a simple act
performed correctly [6-8]. In this case, it is not intended to take into account the feelings of
patients. The results of the study showed that patients suffering from mental pathology, as well as
healthy individuals, are able to master simple algorithms when using operant reinforcement, that
is, the latter is very suitable for patients as a way to change behavior [9].
It is important that the quality and severity of the leading clinical symptoms are ignored by
the researchers. Proving the possibility of a direct impact on patient behavior later led to a
triumphant approach to therapy in many hospitals in the United States known as the "token system"
[10]. It is based entirely on the principles of operant conditioning, which are used to change the
behavior of mental patients. The programs offered range from individual programs that set the task
of reducing "psychotic" behavior, such as speech inconsistency, resonance, or artistic rituals, to
broader curricula aimed at improving patient social adaptation by teaching adaptive behavior. The
manifestation of this was personal hygiene, self – service, labor and later social skills. The
established programs often became the basis not only for changing the behavior of patients, but
also for the new organization of the stationary environment [11-15].
Analysis of the first successful variants of programs (there) showed that the organization
of regular exposure to the patient's behavior using material and social reinforcement can reduce
the manifestation of various symptoms – from eating disorders, speech, aggressive or obsessive
behavior to mutism, impulsiveness and deviant behavior. In addition, the program includes already
known systemic desensitization methods, relaxation techniques, "shaping", "modeling" and
another set of techniques of behavioral therapy [16-19].
Already at this stage, a certain paradox of the methodological feature appeared, since
psychiatrists who used speech and behavior disorders in patients as diagnostic criteria (including
for diagnosing schizophrenia) faced a significant reduction in these symptoms in some cases.
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However, controversy did not arise, since in such a period the understanding and
understanding of this contradiction did not seem relevant, at the same time the ideas and practice
of behavioral therapy were adopted by both health enthusiasts and (most importantly) health
organizers. Since then, the use of behavioral programs has expanded greatly in a number of
Western countries (of course, the United States led) [20-23].
The culmination of the approach was the creation of "therapeutic environment" models,
where the most famous is "token Economy", of which the founders are. Thanks to such programs,
significant changes have occurred in the views of specialists who help the mentally ill: the existing
psychotherapeutic nihilism in relation to seriously disturbed mental patients has been eliminated,
the role of psychosocial intervention has become more noticeable, the tool for diagnosing
behavioral problems has received impetus. Critical voices sounded, and it was argued that it was
impossible to influence the clinical signs of schizophrenia in the first place, especially those that
were effective [24, 25]. Critics of the approach also warned that the long-term effects of education
are questionable. Nevertheless, in schizophrenia psychotherapy, the behavioral approach has
shown its effectiveness, and now individual methods of changing behavior are included in the
broader programs of psychotherapeutic and psychosocial support for patients [26].
Teaching social skills should be seen as a particularly successful contribution to
psychotherapeutic work with patients. In Western countries, including the United States, the main
criterion for assessing the behavior of a subject, including in terms of mental health, was
functionality, that is, the criterion of flexibility. Patients with schizophrenia immediately pay
attention to social adaptation, deficiency, which predetermined the choice of the direction of
educational impact. This essentially empirical, pragmatic approach led to the creation of programs
defined on the first topic within the framework of the general direction. We also note that during
this period he received a. Bandur published his own work on "Vicarage education", which also
became a source of ideas for practitioners [27].
Currently, operant conditioning models focus on the general regulation and organization
of behaviors, planning their actions, studying various ways of self – management, including
effective symptoms, social skills, communication, conflict resolution, etc [28].
In addition to the principles of the" Token system", other ideas were used, in particular,
ideas about the need to normalize the functions of information processing through self-
construction, concentration, self-control, as proposed. More specialized training in social skills,
the need for psycho-educational impact on patients, was also justified; this type of intervention
was later extended to the family members of the patient. Subsequently, examination of these
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programs in randomized studies confirmed their effectiveness, attractiveness to patients and staff,
and long-term effects [29-33]. Let’s name the most popular behavioral orientation and programs
that have remained relevant to the present day (as an integral part of broader and expanded
projects), which in different years were used by the authors for psychotherapy and psychosocial
rehabilitation in the schizophrenia clinic:
- stress management software, stress management behavior development training;
- teaching reliable behavior;
- teaching communication skills;
- teaching problem solving behavior;
- teaching cognitive and social skills offered by local authors.
In addition to these programs, many other programs have also been offered, more local in
a task that is usually solved. Numerous empirical studies have confirmed the effectiveness of such
an intervention in the recovery phase of patients with schizophrenia. It should be noted separately
that it is convenient to include these programs in treatment using psychopharmacotherapy [34-39].
The above assessment of the possibilities of psychotherapy in relation to patients Frida
Fromm-Reichman's bipolar affective disorder affected not only psychodynamically oriented
psychotherapists. For a long time-almost until the end of the 20th century-bipolar affective
disorder was not a serious development in the field of psychotherapy [40-45]. And this is despite
the fact that psychotherapeutic approaches proposed to manage patients with unipolar depression
and other psychopathological diseases are rapidly developing and increasing. However, it should
be noted that the neglect of psychotherapy can be explained by the significant achievements of
psychopharmacotherapy bipolar affective disorder in the same period; against the background of
these achievements, the problem of stabilizing the condition of patients has almost been solved
[46-49].
However, it gradually became known that, despite the adequacy of the created drugs and
pharmacotherapy regimes, problems remain in patients and require psychotherapeutic help. Thus,
clinical observations indicate low patient compliance with bipolar affective disorder, significant
behavioral disorders, high readiness to use psychoactive substances, which is associated with the
possibility of developing dependence. In fact, these unresolved problems with pharmacotherapy
were the first goal of psychotherapeutic interventions recommended for patients with bipolar
affective disorder [50-55].
Conclusions.
The first variants of the guidelines for psychotherapeutic management of
patients use technologies already used (adapted) for patients with bipolar affective disorder
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unipolar depression, aimed at maintaining/forming compliance with treatment, as well as training
patients to early identify symptoms of impending exacerbation. It was also proposed that patients
be informed about their understanding of their disease using psycho-educational activities. An
important early stage in patient management-oriented psychotherapy was bipolar affective
disorder, which was dominated by cognitive psychotherapy techniques rather than relying on
behavioral skills.
REFERENCES
1.
Abdurashidovich N. O., Zamonbek o‘g‘li B. F., Temirpulotovich T. B. Assessment of the
relationship of the degree of conformity in patients with schizophrenia with clinical features
and socio-demographic factors //European journal of modern medicine and practice. – 2024.
– Т. 4. – №. 2. – С. 22-30.
2.
Asanova R. et al. Features of the treatment of patients with mental disorders and
cardiovascular pathology //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 545-550.
3.
Bo’Riyev B. et al. Features of clinical and psychopathological examination of young
children //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 558-563.
4.
Hamdullo o'g'li J. H., Temirpulotovich T. B. Features of the Clinical Course of Post-
Traumatic Epilepsy, Psychiatric and Neurosurgical Approaches //International Journal of
Cognitive Neuroscience and Psychology. – 2024. – Т. 2. – №. 2. – С. 8-14.
5.
Ibragimova M., Turayev B., Shernazarov F. Features of the state of mind of students of
medical and non-medical specialties //Science and innovation. – 2023. – Т. 2. – №. D10. –
С. 179-183.
6.
Murodullayevich K. R., Holdorovna I. M., Temirpulotovich T. B. The effect of exogenous
factors on the clinical course of paranoid schizophrenia //Journal of healthcare and life-
science research. – 2023. – Т. 2. – №. 10. – С. 28-34.
7.
Nematillayevna S. D. et al. Prevalence of anxiety and depressive disorders in elderly patients
//Scientific journal of applied and medical sciences. – 2024. – Т. 3. – №. 2. – С. 118-123.
8.
Novikov A. et al. Alcohol dependence and manifestation of autoagressive behavior in
patients of different types //Science and innovation. – 2023. – Т. 2. – №. D11. – С. 413-419.
9.
Ochilov U. et al. The question of the features of clinical and immunological parameters in
the diagnosis of juvenile depression with" subpsychotic" symptoms //Science and
innovation. – 2023. – Т. 2. – №. D12. – С. 218-222.
Yanvar, 2025-Yil
312
10.
Pachulia Y. et al. Assessment of the effect of psychopathic disorders on the dynamics of
withdrawal syndrome in synthetic cannabinoid addiction //Science and innovation. – 2023.
– Т. 2. – №. D12. – С. 240-244.
11.
Rotanov A. et al. Comparative effectiveness of treatment of somatoform diseases in
psychotherapeutic practice //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 267-
272.
12.
Sedenkov V. et al. Clinical and socio-demographic characteristics of elderly patients with
suicide attempts //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 273-277.
13.
Sedenkova M. et al. Features of primary and secondary cognitive functions characteristic of
dementia with delirium //Science and innovation. – 2023. – Т. 2. – №. D11. – С. 56-62.
14.
Sharapova D., Shernazarov F., Turayev B. Prevalence of mental disorders in children and
adolescents with cancer and methods of their treatment //Science and innovation. – 2023. –
Т. 2. – №. D12. – С. 373-378.
15.
Solovyova Y. et al. Protective-adaptive complexes with codependency //Science and
innovation. – 2023. – Т. 2. – №. D11. – С. 70-75.
16.
Spirkina M. et al. Integrated approach to correcting neurocognitive defects in schizophrenia
//Science and innovation. – 2023. – Т. 2. – №. D11. – С. 76-81.
17.
Sultanov S. et al. The impact of the covid-19 pandemic on the mental state of people with
alcohol addiction syndrome //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 296-
301.
18.
Temirpulatovich T. B. Clinical manifestations of anxiety depressions with endogenous
genesis //Iqro jurnali. – 2023. – Т. 1. – №. 2. – С. 45-54.
19.
Temirpulatovich T. B. et al. Alkogolizm bilan kasallangan bemorlarda covid-19
o’tkazgandan keyin jigardagi klinik va labarator o’zgarishlar //journal of biomedicine and
practice. – 2023. – Т. 8. – №. 1.
20.
Temirpulotovich T. B. et al. Ways to Develop Speech and Overcome Them in Children With
Cerebral Palsy //European journal of modern medicine and practice. – 2024. – Т. 4. – №. 2.
– С. 355-368.
21.
Temirpulotovich T. B. Somatoform variant post-traumatic stress disorder //Journal of
healthcare and life-science research. – 2023. – Т. 2. – №. 9. – С. 45-52.
22.
Uskov A. et al. Atypical anorexia nervosa: features of preposition and premorbid //Science
and innovation. – 2023. – Т. 2. – №. D12. – С. 310-315.
Yanvar, 2025-Yil
313
23.
Uskov A. et al. Efficacy and tolerance of pharmacotherapy with antidepressants in non-
psychotic depressions in combination with chronic brain ischemia //Science and Innovation.
– 2023. – Т. 2. – №. D12. – С. 409-414.
24.
Usmanovich O. U. et al. Characteristic Features of Affective Disorders in Anxiety-Phobic
Neurosis //European journal of modern medicine and practice. – 2024. – Т. 4. – №. 2. – С.
251-259.
25.
Usmanovich O. U. et al. Clinical and Psychological Characteristics of Affective Disorders
in Children with Autism Disorders //European journal of modern medicine and practice. –
2024. – Т. 4. – №. 2. – С. 260-267.
26.
Viktorova N. et al. Formation of rehabilitation motivation in the conditions of the medical
and rehabilitation department of a psychiatric hospital //Science and innovation. – 2023. –
Т. 2. – №. D11. – С. 82-89.
27.
Xushvaktova D., Turayev B., Shernazarov F. Clinical features of mental disorders in
synthetic drug users //Science and innovation. – 2023. – Т. 2. – №. D10. – С. 242-247.
28.
Hamdullo o'g'li J. H., Temirpulotovich T. B. Features of the Clinical Course of Post-
Traumatic Epilepsy, Psychiatric and Neurosurgical Approaches //International Journal of
Cognitive Neuroscience and Psychology. – 2024. – Т. 2. – №. 2. – С. 8-14.
29.
Hamidullayevna X. D., Temirpulotovich T. B. Features of psycho-emotional changes in
women during pregnancy //Journal of Science in Medicine and Life. – 2024. – Т. 2. – №. 3.
– С. 71-77.
30.
Hamidullayevna X. D., Temirpulotovich T. B. Personality and interpersonal relationships of
primary school students with hyperactivity disorder of minimal brain dysfunction and
attention deficit //International Journal of Cognitive Neuroscience and Psychology. – 2024.
– Т. 2. – №. 3. – С. 22-27.
31.
Holdorovna I. M., Temirpulotovich T. B. Analysis of the psychopathological and
neurophysiological profile of children left without parental care //Journal of Science in
Medicine and Life. – 2024. – Т. 2. – №. 3. – С. 63-70.
32.
Holdorovna I. M., Temirpulotovich T. B. Psychopathological features of long-term
endogenous depressions //International Journal of Cognitive Neuroscience and Psychology.
– 2024. – Т. 2. – №. 3. – С. 15-21.
33.
Jalilova S. H., Kibriyev K., Turayev B. Contemporary accounts of schizophrenia //Modern
Science and Research. – 2025. – Т. 4. – №. 1.
Yanvar, 2025-Yil
314
34.
Qilicheva Z., Rahimova M., Turayev B. Psychoses observed in infectious diseases and their
peculiarities //Modern Science and Research. – 2025. – Т. 4. – №. 1.
35.
Ravshanova B. G. et al. Features of Conducting Art Therapy in Patients With Psychosis
Without Organic Changes //European journal of modern medicine and practice. – 2024. – Т.
4. – №. 2. – С. 15-21.
36.
Sadullayeva R., Sharafova M., Turayev B. The development of psychoses in infectious
diseases and their clinical features //Modern Science and Research. – 2025. – Т. 4. – №. 1.
– С. 124-129.
37.
Shernazarov F., Sharapova D., Turayev B. Features of the development of manic and mixed
episodes in patients with bipolar affective disorder who use cannabioids //Science and
innovation. – 2024. – Т. 3. – №. D3. – С. 123-128.
38.
Sultanov S. et al. Assessment of dental status in patients with schizophrenia //Modern
Science and Research. – 2025. – Т. 4. – №. 1. – С. 271-278.
39.
Sultanov S. et al. Methods for assessing the psycho-emotional state of patients on an
outpatient basis //Modern Science and Research. – 2025. – Т. 4. – №. 1. – С. 262-270.
40.
Sultanov S. et al. Psychotherapeutic preparation for orthopedic treatment of dental patients
and adaptation to prosthetics //Modern Science and Research. – 2025. – Т. 4. – №. 1. – С.
290-296.
41.
Sultanov S. et al. Psychotherapeutic problems in the process of treatment in various areas of
medicine //Modern Science and Research. – 2025. – Т. 4. – №. 1. – С. 279-289.
42.
Temirpulatovich T. B. Маиший ичкиликбозлик муаммоси бўлган шахсларга ижтимоий
омилларнинг covid-19 пандемиси даврида таъсири //Journal of biomedicine and practice.
– 2022. – Т. 7. – №. 4.
43.
Temirpulotovich T. B. Behavioral Changes of Individuals Who Abuse Synthetic
Psychostimulants //European journal of modern medicine and practice. – 2024. – Т. 4. – №.
2. – С. 369-376.
44.
Temirpulotovich T. B. Clinical Course of Alcoholic Polyneuropathy and Alcoholic
Myopathy Observed in Alcoholism //Journal of Medical Genetics and Clinical Biology. –
2025. – Т. 2. – №. 3. – С. 34-41.
45.
Temirpulotovich T. B. Clinical Pictures of Cognitive Dysfunctions Observed in Alcoholism
//Journal of Medical Genetics and Clinical Biology. – 2025. – Т. 2. – №. 3. – С. 42-50.
46.
Temirpulotovich T. B. et al. Psychopathological and neuropsychological features of negative
diseases in late schizophrenia. – 2024.
Yanvar, 2025-Yil
315
47.
Temirpulotovich T. B., Usmanovich O. U. Modern approaches to the diagnosis and
treatment of acquired mental retardation, epidemiology of dementia, clinical forms
(literature review) //Journal of biomedicine and practice. – 2024. – Т. 9. – №. 1.
48.
Turaev, B., and R. Khayatov. "Suicidal intentions in people with alcohol dependence
syndrome in the presence of depressive disorders." Journal Bulletin of the doctor 1.2 (2022):
115-117.
49.
Tursunboyev M., Yaxyayev M., Turayev B. Clinical psychopathological features of sleep
disorders //Modern Science and Research. – 2025. – Т. 4. – №. 1. – С. 130-139.
50.
Usmanovich O. U., Temirpulotovich T. B. Morphofunctional Foundations of the
Development of Vascular Cognitive and Emotional Disorders //International Journal of
Cognitive Neuroscience and Psychology. – 2024. – Т. 2. – №. 2. – С. 15-21.
51.
Очилов У. У., Тураев Б. Т., Жумагелдиев Н. Н. Особенности формирования и течения
алкоголизма у лиц с акцентуациями характера и личностными расстройствами
//Вестник науки и образования. – 2020. – №. 10-4 (88). – С. 101-103.
52.
Очилов, Улугбек Усманович. "Тураев Бобир Темирпулатович, Алимова Юлдуз
Шамсиддиновна, Алкаров Рустам Бахтиярович."." Клинические особенности
психопатического поведения у подростков с психическими расстройствами" Вестник
науки и образования 23-3 (2020): 101.
53.
Тураев Б. Т. и др. Диагностика и лечение коморбидности алкоголизма и депрессивных
расстройств //Вестник науки и образования. – 2021. – №. 4-2 (107). – С. 26-30.
54.
Тураев Б. Т. Медико-социальные проблемы употребления алкоголя в период
пандемии COVID-19 //ББК 5+ 28я43 П 781. – С. 125.
55.
Хаятов Р. Б. и др. Аффективные расстройства у больных алкогольной зависимостью
как фактор риска развития суицидального поведения //Достижения науки и
образования. – 2019. – №. 11 (52). – С. 96-98.
