|Applied Behavior Analysis in Therapeutic Contexts: Treating Children with Psychiatric Disorders
|Tuesday, May 27, 2008
|9:00 AM–10:20 AM
|Area: CBM/CSE; Domain: Service Delivery
|Chair: Jeannie A. Golden (East Carolina University)
|CE Instructor: Jeannie A. Golden, Ph.D.
Many children in the child welfare system develop the symptoms of childhood psychiatric disorders, such as attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, bipolar disorder and reactive attachment disorder due to early abuse/neglect, multiple placements and multiple caregivers. Often, the treatment focus follows the medical model with the assumption that behavioral symptoms are the result of underlying psychopathology. Behavior analysts are in a unique position to provide more comprehensive diagnosis that includes observations of behavior in a variety of settings to determine the effect of various stimulus conditions and setting events, functional assessments to determine the causes and maintainers of various behavioral symptoms, and careful analysis of learning histories to determine the efficacy of various reinforcers and punishers. Behavior analysts are also able to provide assessment-driven treatment approaches, to design therapeutic environments that support the learning of appropriate replacement behaviors and to facilitate typical development rather than psychopathology. However, the system within which they work is set up to provide therapy or counseling to these children which sometimes is at odds with what behavior analysts do. This symposium will address the issue of how behavior analysts can work within the existing system to provide for these childrens needs.
|Behavior Analysts and Counseling: Why are We Not There and How Can We Get There?
|LINDA S. HEITZMAN-POWELL (University of Kansas), Rachel L. White (University of Kansas), Nanette L. Perrin (Early Childhood Autism Program, Community Living Opportunities, Inc.)
|Abstract: Even with a rich history demonstrating how complex behaviors are acquired, traditional psychological domains are still not well represented in behavior analytic literature (Dougher & Hackbert, 2000). Several authors have provided descriptions of psychological terms and how those terms could be explained behaviorally. However, few authors have attempted to explain the therapy process from a behavior analytic perspective. This paper will define the process by which traditional counseling occurs followed by ways in which the characteristics and processes of traditional counseling can be explained based on the principles of behavior and by using behavior analytic terms. In order to provide a framework from which the traditional therapy approach can be viewed in behavioral terms, this paper will provide (1) an exploration of those disorders (or “clusters of behavior”) that typically bring individuals to “counseling”, (2) the components involved in a traditional therapy encounter, and (3) how the terms and techniques that appear to account for intervention effectiveness can be discussed using behavior analytic terms. Finally, this paper will present some traditional counseling programs that adhere to, or are based in, behavioral psychology and will offer some suggestions for areas of future research
|Trauma and Psychotherapy: Implications from a Behavior Analysis Perspective.
|WALTER WITTY PRATHER (Agency for Persons with Disabilities)
|Abstract: Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of abuse in children. This article examines attachment theory and traditional models of family therapy from the perspective of behavior analysis, and provides a rationale for a behavioral treatment approach for abused children and their foster or adoptive parents. A research model has been developed based on the integration of Attachment Theory and the Attachment Based Family Therapy model with basic concepts and principles of behavior analysis. The purpose of this model is to provide a context to examine how abuse and neglect, separation or loss, family therapy, parent-child relationships, and secure attachments may be integrated to predict positive outcomes in families with adoptive and foster children, and the relevant but implicit behavioral principles operating in the attachment rebuilding process. Questions are raised which suggest that family-therapy-based models compete with the acquisition of new functional behaviors, and provide the environment for learned dysfunctional habits that are then reinforced in therapy. Conclusions are reached that “familial environments” in which perception and previous learning guide parent and child interaction are more important than therapy, and implications for behavioral and cognitive interventions are suggested.
|Differentiating Behavioral and Traditional Case Formulations for Children with Severe Behavioral and Emotional Problems.
|JEANNIE A. GOLDEN (East Carolina University), Ennio C. Cipani (National University)
|Abstract: It appears to be the conventional wisdom of today that sending children with severe problem behaviors to “counseling” or “therapy” is the best method for changing these behaviors. This belief predominates despite a lack of empirical evidence demonstrating that severe behavior problems of children are effectively treated with such an approach. By analyzing the nature of the “counseling” or “therapy” interventions and what we now know about client behavior, we can determine why such approaches may be so ineffective for many children with problem behaviors. Behaviorists know that what works is to alter the maintaining contingency. In a functional behavioral treatment, the function of the presenting problem needs to be disabled, while an alternate function (that is more acceptable) needs to be enabled (Cipani & Schock, 2007). To determine how such consequences should be altered, a behavioral case formulation, relying heavily on ascertaining the social and environmental function of the presenting problems is needed. In this presentation, a behavioral case formulation is contrasted with traditional mental health formulations about children presenting severe behavior problems. A real life case example illustrates the utility of a behavioral case formulation and its direct relationship to treatment.
|Teaching Task Analysis and Sequencing Skills to a Young Adolescent Boy with Multiple Psychiatric Diagnoses.
|SHANNON PATON (East Carolina University)
|Abstract: The purpose of this study was to increase self-initiation and completion of snack-making and chores exhibited by an adolescent boy, Marcus, diagnosed with ADHD, ODD and borderline intellectual functioning. When Marcus perceived that something should have been done for him by his mom, and it was not, Marcus responded in anger (arguing, kicking things, walking away, and pouting/ignoring mom). During baseline, the researcher recorded the number of prompts needed for correct task completion. Then Marcus participated in a four phase intervention in which he had to complete each task within the allotted number of prompts for each step to earn his monetary reinforcement. The research design used was a multiple baseline across tasks with changing criterion. Following intervention, the number of prompts required for Marcus to correctly complete each task decreased tremendously. Through a behavioral intervention using sequencing, active prompting, and positive reinforcement, Marcus was taught to correctly complete multi-step tasks meeting or exceeding an expected standard. Marcus’ mom reported to the researcher during follow up that snack and chore time are much better because now she doesn’t consistently argue and fight with Marcus, and he is more willing to take responsibility for performing tasks himself.