Chapter 5: Behaviour Assessment

1. Chapter 5:Behaviour Assessment CBT Chapter 5

2. Purpose of Assessment • Clarify the problem • Set initial goals • Select/define target behaviours • Identify maintaining conditions • Design treatment plan • Monitor client’s progress CBT Chapter 5

3. Test Results and Interpretation • Test score are approximations to actual phenomena. • Any type of assessment method is subject to error. • Systematic error or bias. CBT Chapter 5

4. Standards for Assessment 1. Reliability: repeatability; comparable scores each time a test is administered When is a test unreliable? • Ambiguous assessment procedures • Poorly trained evaluators • Varying behaviour of the patient • Growth and development • Varying assessment conditions • Learning effects CBT Chapter 5

5. Standards for Assessment 2. Validity: Is test accurately assessing what is was designed to assess? • Concurrent: vary with other measures of the same phenomenon • Content: how comprehensive the measure is • Predictive: future outcomes (GRE, LSAT, MCAT) CBT Chapter 5

6. Validity What can affect validity? • Sampling the wrong or irrelevant content area • The measure’s reactivity – extent to which the measure makes the patient want to respond a certain way • A mismatch between test difficulty and developmental level (ceiling or floor effects). • Low reliability = lowers validity CBT Chapter 5

7. Standards for Assessment 3. Utility: usefulness, impact on appropriate placement and treatment • issues of time and money. Three Questions of Utility • What is the percentage of correct decisions made using this instrument? • What are the costs involved in getting the assessment information? • What are the values or costs associated with making a correct decision? CBT Chapter 5

8. How do you reduce assessment error? Rule of Multiples: • Multiple Tests – use more than one test • Multiple Evaluators • Multiple Times –more than once, if possible CBT Chapter 5

9. A. Behavioural Interviews • Establish rapport • Understanding problem, selecting target behaviour(s) • Identifying maintaining conditions • Educating the client on the behavioural approach, confidentiality • No “why” questions allowed ! CBT Chapter 5

10. B. Self Report Inventories CBT Chapter 5

11. Persecutory Ideation Questionnaire (PIQ): 1. I sometimes feel as if there is a conspiracy against me. 2. I feel at times that I am deliberately ill-treated by others. 3. I often feel that others have it in for me. 4. People mean to do and say things to annoy me. 5. I sometimes feel that people are plotting against me. CBT Chapter 5

12. Persecutory Ideation Questionnaire (PIQ): 6. I sometimes feel that people are laughing at me behind my back. 7. Some people try to steal my ideas and take credit for them. 8. I sometimes feel that I am being persecuted in some way. 9. I often pick up hidden threats or put-downs from what people say or do. 10. Some people harass me persistently. McKay et al. (2006) CBT Chapter 5

13. B. Self Report Inventories • Questionnaire format • Usually address a particular type of problem behaviour (covert or overt) • Highly efficient, easy to score • However, more specialized follow-up assessments are typically required CBT Chapter 5

14. C. Self Recording • Client observing and recording own behaviours • Efficient, especially for infrequent behaviours • Appropriate for overt and covert behaviours • Record number of times targer behaviour is performed CBT Chapter 5

15. Limitations • Accuracy of recording • Interruption of ongoing activity • Reactivity--self recording changes the behaviour itself CBT Chapter 5

16. Reactivity • Awareness of recording own behaviours affects their frequency • Especially with deceleration target behaviours • With acceleration target behaviours, may be used as a component of therapy CBT Chapter 5

17. D. Checklists, Rating Scales • Completed by someone other than the client retrospectively • Usually a list of problem behaviours, and maintaining conditions • Especially useful for children’s behaviours • scored by parents or teachers • Child Behaviour Checklist (CBCL) CBT Chapter 5

18. E. Naturalistic Observation • Observing and recording specific and predetermined behaviours • Usually involves considerable investment on the part of observer • Training nonprofessional agents • “Time Sampling”: Observation during limited intervals CBT Chapter 5

19. Limitations • Reactivity from being observed • Counter this with inclusion of adaptation period • Observer error/bias • Cultural factors • Practicality • May require a simulated environment CBT Chapter 5

20. F. Simulated Observation • Study conditions resemble natural environment • Use of-one way mirror and intercom • Ideally is near-identical to natural observation • Limited by generalizability: How similar is it to natural conditions? CBT Chapter 5

21. G. Role Playing • Enacting problem situation • Imagining physical arrangements and events • Limited by generalizability and awkwardness of client • Reactivity may also be a concern CBT Chapter 5

22. H. Physiological Measures • Measure processes that readily measures of behaviour Heart rate, respiration rate, blood pressure, muscle tension, skin conductivity CBT Chapter 5

23. Role of DSM-IV Diagnosis • Is a diagnosis really necessary if all we are looking at are specific, individualized behaviours? • DSM is “trait” based. • Other than for insurance or health care reasons, is there any need for these labels? CBT Chapter 5