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| Where Do We Fit in: Behavior Analysis in Psychiatric and Medical Settings |
| Monday, May 29, 2006 |
| 3:00 PM–4:20 PM |
| Greenbriar |
| Area: CBM; Domain: Applied Research |
| Chair: Ivy M. Chong Crane (William Beaumont Hospital) |
| Discussant: Martin J. McMorrow (Center for Comprehensive Services, Inc.) |
| CE Instructor: Ivy M. Chong Crane, Ph.D. |
| Abstract: The role of behavior analysts working amongst inter-disciplinary teams within health care settings has varied over time. In the age of managed care the need for empirically based treatment options has amplified the utility of behavior analysis within these settings. However, due to the constraints of the philosophical underpinnings of the medical model behavior analysts have been forced to adapt. Although behavior analysts typically follow a functional approach to understanding human behavior, much success has been witnessed by integrating these two models. The current symposium examines the specific dynamics within this integrative model through an exploration of theoretical concepts, challenges involved and current case examples within both psychiatric and primary care facilities |
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| The Role of Behavior Analysts in Psychiatric Settings. |
| KIMBERLY DWYER-MOORE (Our Lady of Peace), Jaime Flores (Our Lady of Peace), Katherine Miriam Johnson-Patagoc (Our Lady of Peace) |
| Abstract: This paper examines the history and current practice of behavior analysis in psychiatric settings. Whereas the psychiatric approach to care has traditionally been predominated by the medical model, the effectiveness of combining the medical model with the behavior analytic treatment model is examined. A case illustration of this model in practice at Our Lady of Peace psychiatric hospital is presented. This facility is a unique and multi-faceted organization that provides state-of-the-art services to a range of inpatient and outpatient populations. Within this 200-bed facility behavior analyst work specifically with children and adolescents with developmental disabilities or brain injuries and psychiatric disorders including bi-polar disorder, conduct disorder and oppositional defiant disorder. Behavior Analysts work in conjunction psychiatrists and other trans-disciplinary team members to develop and implement individualized function based behavioral support plans derived from functional assessment outcomes. The role of behavior analysts in designing and implementing behaviorally based data collection procedures to aid psychiatrists in making clinically relevant decisions regarding medications, community access, length of stay and discharge placement is discussed within this case example. |
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| A Present Day Illustration of Behavior Analysis in a Psychiatric Setting. |
| JAIME FLORES (Our Lady of Peace), Kimberly Dwyer-Moore (Our Lady of Peace), Beth A. Duncan (Our Lady of Peace) |
| Abstract: The current paper depicts the role of behavioral assessment, data collection, treatment and staff training within Our Lady of Peace psychiatric hospital. Within this 200-bed facility, the Innovations and Neurobehavioral Centers encompass 62 beds and employ a unique combination of the behavior analytic and medical treatment models. The inpatient acute level of care required for admission and the rapid rates of admission and discharge necessitate immediate initiation of data collection and basic standard treatment protocols. While these basic protocols are in place, the behavior analyst immediately begins a thorough assessment including preference assessments, descriptive analyses, and analog functional analyses as appropriate. Following assessment, individualized function-based behavior intervention plans are developed. Intervention plans consist of customized data collection, proactive procedures, antecedents to problematic behaviors, strategies for teaching replacement behaviors and function based crisis intervention. A major focus of the behavior analysts is staff, family, and community provider training. Case illustrations exemplify the diverse and challenging population served and the innovative interventions implemented focusing on least restrictive treatment alternatives in a psychiatric setting. Challenges to providing treatment in this setting are explored. |
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| Beaumont Hospital Brings HOPE: Behavior Analysis Within the Medical Model. |
| JENNIFER A. DELANEY (William Beaumont Hospital), Ivy M. Chong Crane (William Beaumont Hospital), Veronica J. McAtee (William Beaumont Hospital), Ruth M. Anan (William Beaumont Hospital) |
| Abstract: The Division of Developmental-Behavioral Pediatrics has been providing diagnostic, assessment, and treatment services since 1968. An inter-disciplinary team including developmental pediatricians, child psychiatrists, child psychologists, and clinical social workers collaborate to identify problems and develop treatment plans for children with variety of diagnosis (e.g. autism, selective mutism, ADHD, disruptive behavior disorders). More recently behavior analysts have increasingly been involved in treatment decisions and interventions (i.e., functional assessment, parent training, intensive early intervention, and behavioral consultation). Historically behavior analytic services have been dichotomized from the medical model, as they are traditionally viewed as educational in nature rather than psychological or medical. As the healthcare community continues to strive for empirically based, efficacious treatment modalities, behavior analysts have been able to provide reimbursable services within the medical model. Currently, seven members of the psychological staff are nationally recognized Board Certified Behavior Analysts. Case examples of children who were treated with behavioral analytic principles and procedures under a mental health billing system will be reviewed. |
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