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| CBM Poster Session 5 |
| Monday, May 31, 2010 |
| 6:00 PM–7:30 PM |
| Exhibit Hall A (CC) |
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| 48. Development of a Functional Analytic Psychotherapy Analogue Protocol: Brief Relationship Enhancement |
| Area: CBM; Domain: Applied Behavior Analysis |
| GARETH I. HOLMAN (University of Washington), Kevin Haworth (University of Washington), Sarah Liu (University of Washington), Mavis Tsai (Independent Practice), Robert J. Kohlenberg (University of Washington) |
| Abstract: Functional analytic psychotherapy (FAP) is a behavioral approach to psychotherapy that emphasizes behavior change shaped in the therapy relationship as a therapeutic mechanism; however, this mechanism is difficult to study due to its idiographic nature and the variety of factors involved in therapy. The purposes of this study were to (1) develop a focused analogue of FAP to facilitate future study of mechanism, and (2) to conduct a wait-list controlled randomized trial of the analogue protocol. Brief relationship enhancement (BRE) is a four-session protocol that aims to improve the quality of clients’ romantic relationships and focuses on work in the therapy relationship guided by principles of FAP. We are recruiting couples (n = 8-15) without current relationship distress or other psychological problems. Both members of each couple will complete assessments of relationship quality at pre- and post-treatment. One member of each couple (the client) will be randomized to receive immediate or waitlist BRE. Clients will complete a daily diary of relationship satisfaction and conflict throughout the study period. We will report aggregate results (data to be collected) from the trial along with illustrative single-subject analyses illustrating key FAP principles. This study lays groundwork for future analogue studies of FAP mechanism. |
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| 49. Functional Analytic Psychotherapy Therapist Training: A Behavioral Rationale and Preliminary Data |
| Area: CBM; Domain: Applied Behavior Analysis |
| SARAH LIU (University of Washington), Gareth I. Holman (University of Washington), Kevin Haworth (University of Washington), Mary D. Plummer (University of Washington), Mavis Tsai (Independent Practice), Robert J. Kohlenberg (University of Washington) |
| Abstract: Functional analytic psychotherapy (FAP) is a behavioral approach to psychotherapy that emphasizes behavior change strategically shaped in the context of an intense, genuine, and evocative therapy relationship. FAP
therapists must therefore combine skill in behavior analysis and change with interpersonal sensitivity, self-awareness, courage, and compassion. FAP therapist training is a one-year group training that aims to develop
these therapist qualities through formation of an evocative training community that engages in a series of experiential exercises structured to evoke and strengthen key behaviors related to interpersonal relationships. This
poster will (1) describe and present a behavioral analysis and rationale for the key exercises involved in FAP therapy training; and (2) present preliminary data (to be collected) from a non-randomized study that
examines the impact of FAP training relative to standard clinical training on therapist interpersonal qualities. Student therapists enrolled in the FAP training (n = 6) or standard clinical training (n = 6) will complete assessments at the beginning and end of the training
year. Therapist training in general is a crucial yet under-studied practice. This study aims to lay groundwork for future more rigorous studies of FAP therapist training and support behavioral conceptualization of therapist training practices. |
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| 50. Comparison of Process Analyses in Five Clients Utilizing the Functional Analytic Psychotherapy Rating Scale |
| Area: CBM; Domain: Applied Behavior Analysis |
| KATHRYN S. HOLMAN (University of Wisconsin-Milwaukee), Cristal E. Weeks (University of Wisconsin-Milwaukee), Jonathan W. Kanter (University of Wisconsin-Milwaukee) |
| Abstract: A behavior analytic method for analyzing therapy sessions is to use a molecular coding approach that tracks therapist-client interactions on the moment-to-moment level by focusing on each turn of speech. Functional analytic psychotherapy (FAP), is a radical behavioral therapy which utilizes the moment-to-moment contingencies inherent in outpatient therapy by strategically applying contingent reinforcement to shape client behavior in-session (Baruch et al., in press). The FAP rating system (FAPRS) was designed to measure turn-by-turn client and therapist behavior in order to investigate FAP’s purported mechanism of change: therapist contingent responding. Using FAPRS one session each from five clients participating in a non-concurrent, multiple baseline A/A +B single subject design was coded to compare processes and outcomes. The baseline phase consisted of assessment to identify idiographic target behavior for clients to track outside of session and FAP interventions excluding therapist contingent responding. At the phase shift, therapists were instructed to begin to contingently respond to contingent responding behavior. Participants included five clients diagnosed with major depressive disorder and one or more personality disorders. The current study will present the results of a FAPRS analysis of these five clients’ sessions to explore the role of contingent responding in all five clients, and compare different interactional processes and their outcomes. |
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| 51. The Use of Restraint-Diminution, Aversives, and Reinforcement in the Treatment of a Homicidal Female |
| Area: CBM; Domain: Applied Behavior Analysis |
| NATHAN BLENKUSH (Judge Rotenberg Center), Matthew L. Israel (Judge Rotenberg Center), Susan M. Parker (Judge Rotenberg Center) |
| Abstract: Behavior analysis is often described by the psychiatric and psychological community as ill equipped to deal with complex cases of mental illness. Here, we describe the application of the principles of behavior to a homicidal young adult female diagnosed with schizoaffective disorder and a mixed personality disorder. The participant’s behavior problem was refractory to interventions attempted by the psychiatric and psychological community for almost a decade. Within that time period, the participant made numerous attempts to murder peers and staff. Treatment included: the creation of a safe situation so that staff were willing to work with the participant; use of restraint diminution to motivate behavior change; powerful positive rewards to accelerate positive social, nonverbal and verbal behaviors; use of aversives, both in a preventive and consequential mode, to decrease homicidal and other aggressive actions and thoughts; behavioral self-management; and eliminating psychotropic medication. Over the course of three years, the participant’s problem behaviors were nearly completely suppressed, a wide range of appropriate behaviors were increased, allowing the participant to graduate from high school, enroll in college, and terminate all forms of traditional psychiatric and psychological treatment. |
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| 52. Is the Behavioral Progress Made at Judge Rotenberg Educational Center Sustainable and Generalizable? A Follow-Up Study of Former Judge Rotenberg Educational Center Students |
| Area: CBM; Domain: Service Delivery |
| NICK LOWTHER (Judge Rotenberg Center), Joseph Assalone (Judge Rotenberg Center), Rosemary Silva (Judge Rotenberg Center), Robert Von Heyn (Judge Rotenberg Center), Matthew L. Israel (Judge Rotenberg Center) |
| Abstract: This study will examine the post-treatment outcomes of a sample of former students of the Judge Rotenberg Educational Center (JRC), a residential care facility that employs a highly consistent application of behavioral treatment and educational programming with some of the most behaviorally challenging individuals in the United States. The former JRC students will be evaluated post-discharge, using both a subjective general life adjustment rating (performed by guardians and/or former students) and objective counts of certain quality of life indicators. Quality of life variables of interest will include whether or not the former JRC students utilized formal treatment services, had negative encounters with law enforcement, received psychotropic medications, pursued further education, secured employment, participated in leisure activities and engaged in meaningful relationships post-JRC discharge. Of major interest is whether or not this sample of former JRC students will show significant improvement on the measures employed over their status prior to enrolling in JRC’s educational and treatment program. |
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| 53. The Effects of a Brief Group Intervention for Adolescent Females With Anger Using a Modified Dialectical Behaviour Therapy Skills Training |
| Area: CBM; Domain: Service Delivery |
| TANYA N. DOULEH (Western Michigan University), Amy E. Naugle (Western Michigan University), Scott T. Gaynor (Western Michigan University), Tara Elizabeth Adams (Western Michigan University), Alyssa Kalata (Western Michigan University), Marchion Hinton (Western Michigan University), Matthew T. Jameson (Western Michigan University) |
| Abstract: The goal of this study is to investigate the effectiveness of a skills-based treatment for middle school age girls with difficulties arising from anger-related behaviors. An open clinical trial was implemented to assist in determining if a subset of skills traditionally taught in dialectical behavior therapy are effective in decreasing self-reported anger and other indicators of anger problems (e.g., school suspensions, negative peer interactions), as well as effective in increasing positive interactions with others in a way that promotes healthy relationships. Participants received training in the skills of core mindfulness, emotion regulation, and interpersonal effectiveness over eight weeks of group skills training as part of an after school program. Results will include pre-test and post-test analyses of anger measures as well as analyses of repeated measures of the proposed mechanisms of change, including emotion regulation and mindfulness. |
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| 55. Group Contingencies in Addiction Treatment: Effect of Direct Observation of Target Behaviors by Group Members |
| Area: CBM; Domain: Applied Behavior Analysis |
| MARY LOUISE E. KERWIN (Rowan University), Beth J. Rosenwasser (Treatment Research Institute), Carolyn M. Carpenedo (Treatment Research Institute), Kimberly C. Kirby (Treatment Research Institute) |
| Abstract: Group contingencies have been applied to groups functioning in a diversity of functional settings (e.g., classrooms, workplaces, hospital wards) to change a variety of behaviors such as academic or work performance, disruptive behavior, and attendance. The targeted behaviors tend to be those that are directly observable to the group members. The purpose of this study is to evaluate the effectiveness of group contingencies on behaviors that vary in the ability for group members to directly observe the behavior. Individuals in an intensive outpatient therapy group at a methadone clinic were divided into two teams. Each team could earn the opportunity to make one to four draws from a prize bowl for meeting the criterion or exceeding the team’s prior best performance. In addition, at the end of each week, the better performing team earned a $10 bonus. Target behaviors were the group’s mean cocaine abstinence assessed via urinalysis, scores on tests of knowledge of didactic material presented by the group therapist, and disruptive behavior during groups (e.g., swearing, off-task). Results indicate that group contingencies are not very effective when the contingency is placed on the product of a behavior (i.e., results of drug urinalysis). |
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| 56. Reexaming the Role of Alcohol in Sexual Assault: A Behavioral Perspective |
| Area: CBM; Domain: Applied Behavior Analysis |
| THOMAS A. BRIGHAM (Washington State University), Samantha Swindell (Washington State University), John Tarnai (Washington State University), Raymond O. Sacchi (Washington State University) |
| Abstract: Depending on how sexual assault is defined it is estimated that 10 to 54% of women will experience some form of sexual assault. We define sexual assault as oral, anal, or vaginal penetration and the rate for our sample was approximately 10%. Most analyses of sexual assault focus on the role of alcohol as either a cause or facilitator of the assault. Depending on the survey, alcohol is reported to be involved in one third to two thirds of sexual assaults with “more than 50%” being the most commonly reported value. These values are taken as indicative of the importance of alcohol as a causal variable. Most surveys ask if the perpetrator and/or the victim were drinking at the time of the assault but not the level of consumption. However, if you ask about level of drinking (did not drink, one to three drinks, four or more) then more complex analyses are possible. For example in our sample of over 1000 sexual assaults both people were probably intoxicated (consumed four or more drinks) in 17% of the incidents, but in 42% of the cases both people were sober. Similarly, in 62% of cases one or both people were sober. Clearly, alcohol cannot be the main driver of sexual assault. Alternative explanations are proposed from a behavioral perspective. |
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| 57. Promoting Positive Parenting Practices in Physically Abused Children |
| Area: CBM; Domain: Applied Behavior Analysis |
| CYNTHIA ROSAS ALQUICIRA (Universidad Nacional de Mexico) |
| Abstract: Currently experiencing a climate of violence, situation is not spared of the children. Given the wide scope that is child abuse field, it is necessary to design and evaluate models for their approach, therefore the interest of this study was to evaluate the effect of instructions, mirroring and praise to promote positive parenting practices in abusive mothers. Ten dyads mother-child participated, the ages of children ranged from forth to eight years old, three girls and seventh boys. We used an ABC single subject experimental design and we applied instructional procedures such as modeling, visual feedback and instructions. The results showed that the intervention program allowed the mothers to develop positive parenting practices. Finally, it was observed that the instructions, mirroring, and the praise increased the index of maternal responsiveness and promote increase prosocial behaviors so was decrease of the children´s aversive behaviors. |
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| 58. Evaluation of Skill Maintenance and External Validity in a Behavioral Parent Training Program |
| Area: CBM; Domain: Service Delivery |
| ANDREW SCHERBARTH (University of North Texas), Amy Murrell (University of North Texas), Richard G. Smith (University of North Texas), Vaishnavi Kapadia (University of North Texas), Barbara Carlson (University of North Texas), Michelle Lamancusa (University of North Texas), Carla M. Smith (University of North Texas), Ryan J. Brackney (University of North Texas) |
| Abstract: Child maltreatment affects 900 thousand children in the US every year and impacts all areas of daily functioning. Behavioral parent training (BPT) programs have effectively taught parenting skills & demonstrated externally valid outcomes (i.e., lower recidivism rates). Skill maintenance assessments for BPTs have mixed results. The Behavior Management and Parenting Services (BMAPS) program has shown effective skill training for court-mandated families. This study assessed skill maintenance using an ABAB single-case research design in phase 1. External validity was assessed via survey in phase 2. Results for phase 1 found most BMAPS parents acquired all parenting tools to criteria, dropped below criteria at the 3-month probe, then fully demonstrated their skills after a brief review. Classroom factors do not appear to have systematically influenced performance at any time, although homework completion was associated with better scores at the end of class. Phase 2 results found a 91% reunification rate and a 0% recidivism rate over 1-3 years. All limitations aside, the BMAPS program trains skills to criteria and these skills can be sustained with a booster session. The vast majority of parents we contacted were reunified with their children and none received additional charges of child maltreatment. |
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| 59. Can Mindfulness Training Enhance Court-Mandated Parent Coaching? |
| Area: CBM; Domain: Service Delivery |
| ALISON BEAUVAIS CARRIS (The Chicago School of Professional Psychology), Christine Gerhold (Chicago School of Professional Psychology), Melinda Delilah Hammond (Wheaton College), Kate Noth (Illinois Institute of Technology), Kevin Zalizniak (Illinois Institute of Technology), Daniel J. Moran (Trinity Services, Inc.) |
| Abstract: Research has shown that mindfulness can be taught as a skill which allows people to act with purpose, instead of impulsively reacting to the world around them, and is thought to be helpful in parenting. Participants in this study will be parents with children under 18 years of age who are seeking divorce and thus required to attend a state-mandated one-time 4-hour parenting session. Half of these participants will experience the traditional program curriculum, defined as treatment as usual. The remaining participants will engage in an integrated mindfulness-based and values curriculum. The dependent variables assessed will be (a) willingness to be mindful and parent mindfully (b) parenting skills and (c) perceived quality of life via pre-post and follow-up self reports. We hypothesize that incorporating mindfulness and values clarification into the parenting curriculum should aid parents in contacting the present moment, which will in turn increase their psychology flexibility and lead to more effective parenting. It is hoped that this study will clarify ways in which we can assist parents in increasing positive parenting behaviors using behavioral techniques. |
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| 60. An Application of the Matching Law in Maltreatment Children |
| Area: CBM; Domain: Applied Behavior Analysis |
| AGUSTIN JAIME NEGRETE CORTES (Universidad Nacional de Mexico) |
| Abstract: The purpose of this study was the application of some derived notions of the matching law; in order to establish how so much reinforcement maintain a specific level of responses and to determine the rich environmental of other alternative reinforcement sources in mother-child interactive patterns in abusive families. Participated five dyads mother-child, four children and one girl. The mother-child interaction was analyzed in an academic situation and the mother was asked to provide social reinforcement only to two child behaviors: on task and compliance, according to a counterbalanced design. The results are analyzed and discuss in relation to the importance of the maternal reciprocity with regard to the child social behavior´s, and the importance of structuring the social contingencies mother´s that lead to promote not only the child compliance but also other prosociales behaviors. |
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| 61. Direct Instruction: Training and Maintaining Treatment Integrity |
| Area: CBM; Domain: Applied Behavior Analysis |
| KATHLEEN M HINE (Life Span Institute, University of Kansas), Sara R. Major (Life Span Institute, University of Kansas), Roger Stanley (University of Kansas) |
| Abstract: Family care treatment (FCT) provided in-home training to 12 caregivers of children exhibiting challenging behaviors. Each behavior support plan was summarized in six or seven basic caregiver skills. Weekly the therapist and caregiver met and observed one another working with the child. The therapist recorded caregiver performance of each skill throughout baseline and intervention; the caregiver recorded data only during intervention with a data sheet limited to the training item(s). Direct instruction (modeling, practice and feedback) addressed, one at a time, skills the caregiver performed inconsistently or inaccurately. Caregivers received a gift certificate after every third session at 100% on training item(s). Five caregivers’ overall performance reached 90% correct or better during baseline. Of the remaining seven caregivers mastery followed direct instruction for at least one, and for as many as three skills. Improvement in caregiver performance of one to three untrained skills coincided with direct instruction. These data suggest that direct instruction can be used successfully in the home to teach behavior support skills to primary caregivers, and that this format promotes generalized improvement in the integrity with which overall treatment is demonstrated. |
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| 62. Behavioral Sleep Intervention for a Typically Developing Adolescent With Delayed Sleep Phase and Depression |
| Area: CBM; Domain: Service Delivery |
| Katherine Simpson Spencer (Kennedy Krieger Institute), VALERIE PAASCH (Kennedy Krieger Institute), Renee Corbett (Kennedy Krieger Institute), Leanna J. Herman (Kennedy Krieger Institute), Adrianna M. Amari (Kennedy Krieger Institute), Keith J. Slifer (The Kennedy Krieger Institute) |
| Abstract: Delayed sleep phase syndrome is a circadian rhythm disorder characterized by persistent difficulty falling asleep and waking at a conventional time, insomnia, excessive daytime fatigue, and impaired social or occupational functioning. Comorbid affective disorders are common; however, the symptoms of sleep and affective disorders tend to covary. Data will be presented on the strategies utilized to change sleep phase and behavioral activation of an 18-year-old male with delayed sleep phase and depression. He was self-referred for outpatient therapy to achieve his desired wake time prior to beginning college. Sleep-focused intervention included self-monitoring, education on environmental control, cognitive-behavioral skills training, supporting environmental changes, and generalization to college. Self-monitoring and self-report were used to evaluate treatment outcomes. Although the patient was resistant to specific environmental recommendations (i.e., reducing computer time before bed), treatment effects were noted following behavioral activation recommendations (increase physical activity, time spent in sun, socialization) in a supportive environment (beach vacation), and then generalized. Treatment effects included decreased daytime sleep (nap elimination), increased nighttime sleep, and increased daytime activity. Results will be discussed in light of the common occurrence of sleep disturbance in teens and the likely interactive covariation between sleep and affective disorders in this population. |
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| 63. Utilizing a Systematic Desensitization Intervention Plan to Teach a Severely Brain Injured Client to Tolerate Male Caregivers During Personal Care |
| Area: CBM; Domain: Experimental Analysis |
| GLENN ADRIAN (Neurobehavioral Program), James C. K. Porter (Neurobehavioral Program) |
| Abstract: Very few systematic desensitization interventions have been documented for treating challenging client's with severe brain injuries in the applied behavior analysis literature. In particular, individuals who acquire brain injuries who are exhibiting verbal and physical aggression to "escape" participating in essential personal care activities. The purpose of this "poster presentation" is to review a clinical case study of an adult male who refused all personal care from male staff for more than three years. Following the implementation of a comprehensive systematic desensitization program, which lasted for five months, not only was the client receptive to personal care being provided by males, but also, he permitted male staff to shower him without exhibiting physical aggression. This poster presentation will be useful for clinicians to teach client's the necessary tolerance skills to benefit from life enhancing rehabilitation. |
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| 64. The Effectiveness of Proactive Relaxation Strategies Used by Residential Youth |
| Area: CBM; Domain: Service Delivery |
| AMANDA MARIE MCLEAN (Boys Town Outpatient Behavioral Pediatric and Family Services), Jennifer L. Resetar Volz (Dr. Azarcon and Associates, LLC) |
| Abstract: Those working with troubled youth could benefit from interventions that effectively prevent escalation of disruptive and aggressive behaviors. One such option may be self-control and/or relaxation strategies. Research on relaxation strategies has largely focused on the effectiveness of these approaches for decreasing anxiety (Ost & Lars-Goran, 1987). Less research has been conducted to evaluate their effectiveness when used with noncompliant youth (Bornmann, et al., 2007; Lopata & College, 2003). The purpose of this poster presentation is to describe the effectiveness of proactive relaxation strategies for youth with emotional and behavioral disorders placed in a short-term residential placement. Participants were 35 youth, ages 12 to 17. Youth were provided with information on seven relaxation or self-control techniques. On occasions when staff recognized youth becoming agitated, youth were instructed to use these strategies. Upon completion of the relaxation strategy, the youth was asked to fill out a brief survey. Results were significant for change in youths’ self-report of calm before and calm after the strategy was implemented. It appears that self control strategies may be a promising method of de-escalation for residentially placed youth with emotional and behavioral disorders. |
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| 65. EEG Neurofeedback: A Safe and Efficacious Non-Drug Operant Training Method for Children With Attention Deficit Hyperactivity Disorder |
| Area: CBM; Domain: Service Delivery |
| LYNDA KIRK (Austin Biofeedback & EEG Neurotherapy Center) |
| Abstract: Neurofeedback is a well-established operant training method for attention deficit hyperactivity disorder (ADHD). ADHD may affect as many as 8% of school children and often persists into adulthood. With additional recent "black box" warnings on a number of the most popularly prescribed ADHD medications, concerned parents and consumers are seeking effective, safe non-drug alternatives. This poster will present information on the operant origins of EEG neurofeedback from its early studies to present day usage. This poster will explain what neurofeedback is and how it works at the brain level of operant conditioning. It will illustrate how neurofeedback is used clinically to assess and train children (and adults) with ADHD. It will identify the most common conditions co-morbid with ADHD, such as anxiety, depression, obsessive compulsive disorder, specific learning and developmental disorders, autism spectrum disorder, and epilepsy as well as how neurofeedback may also be used to address the comorbid symptoms. Clinical outcome data will be presented on several cases of ADHD clients trained with EEG neurofeedback to reduce ADHD symptoms and medication need. |
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