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| Behavior Therapy: Let Natural Reinforcers Do Their Job |
| Thursday, November 29, 2001 |
| 2:00 PM–2:50 PM |
| Barbantini Hall |
| Area: CBM; Domain: Applied Behavior Analysis |
| Chair: Elbert Van der Meijde (Altrecht, Location Utrecht City) |
| Abstract: Behavior Therapy by natural reinforcers is probably the smoothest way for both therapist and client to get rid of symptoms and getting back to a sense of being o.k. It may look like working the other way around, but the first step is: highlighting the moments from a client's daily life when he already felt reasonably o.k. about himself and being rather symptom free as well. It comes down to getting underlined the effectiveness of natural reinforcers without actual interference from the therapist. It happens unobtrusively, just like natural reinforcers do! Consequently generalization will occur under control of reinforcers that already are on a certain operative level for the particular client. The particulars of this approach are maybe unusual but quite explainable and comprehensible too. A case study will illustrate how it is done in practice. A pilot study on the effects of this approach shows some promising results on decrement of all sorts of symptoms referring to various kinds if mental illness. |
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| The Exclusive Use of Natural Reinforcement in the Treatment of Clients with Mental Symptoms |
| PETER WIERINGA (Altrecht, Institute for Mental Healthcare; Utrecht, Netherlands) |
| Abstract: To maintain his well being every person develops an individual pattern of behavior regulation. We can recognize this personal style by defining the stimuli controlling it. Best circumstances enable a person to do something which guarantees he will not be disqualified in social respect. Doing so yields a feeling of fulfillment, or, in other words: the assurance that he is all right as a human being. As long as the circumstances offer opportunities of this kind, the person will function without any serious existential problems. However, in the absence of those opportunities, his pattern of behavior regulation will fail and dysregulation is bound to occur. So the lacking of regulating stimuli is responsible for the occurrence of mental symptoms. Underlining the pattern of successful behavior in a specific way appears to be a very strong instrument in increasing a person's ability to safeguard his well-being. We make use of the client's present pattern of behavior regulation as the natural result of his individual conditioning history. |
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| Restoring and Strengthening Present Patterns of Behavior Regulation |
| HENDRIK VLAMINGS (Regional Institute for Ambulatory Mental Health Care, Midden Holland; Gouda, Netherlands) |
| Abstract: Clients ask for treatment when their symptoms occupy their minds and consequently obstruct their habitual pattern of behavior. The basic strategy in behavior therapy by natural reinforcers is both to restore and to strengthen a client's habitual pattern of successful behavior. It is done by enhancing the prominence of the controlling stimuli. Three different treatment techniques, called: Discrimination of States, Response Search and Opportunity Scan, are suited to achieve the required strengthening. In this way symptoms disappear without direct attack. The procedure, the rationale and the impact of the fore mentioned techniques will be explained and illustrated with a case study. |
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| Does Behavior Therapy by Natural Reinforcers Really Work? A Pilot Study |
| FREDERIK PRINS (Regional Institute for Ambulatory Mental Health Care; Zaanstreek/Waterland, Netherlands) |
| Abstract: In this study the results of strengthening the individual-specific functioning of psychiatric patients were measured. The study was conducted in a Mental Health Institution in the Netherlands, where outpatients receive treatment for a variety of symptoms. It equaled the "one-group pretest-posttest” design. Fortunately there had been conducted a highly similar study of treatment-effects in general ("care-as- usual"), with the same measurements and the same patient-characteristics (sort of complaints/symptoms and disorders, social demographic features, and so on) just two years before. That presented an outstanding opportunity to compare the results of the Behavior Therapy by Natural Reinforcers with those of general treatment. So, actually, the study took the form of a controlled and randomized pretest-posttest experiment! Concerning the outcome of the study it is clear that the Behavior Therapy under study does not yield to "care as usual". In fact there is a slightly better result of its experimental condition when looked at the percentage of patients who fully recovered from their complaints: 42% vs. 24%. The experimental design, the methodology as well as the outcome will be outlined in detail. |
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