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Chapter 5: Behaviour Assessment. Purpose of Assessment. Clarify the problem Set initial goals Select/define target behaviours Identify maintaining conditions Design treatment plan Monitor client’s progress. Test Results and Interpretation.

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Presentation Transcript
purpose of assessment
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

test results and interpretation
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

standards for assessment
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

standards for assessment1
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

validity
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

standards for assessment2
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

how do you reduce assessment error
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

a behavioural interviews
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

persecutory ideation questionnaire piq
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

persecutory ideation questionnaire piq1
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

b self report inventories1
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

c self recording
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

limitations
Limitations
  • Accuracy of recording
  • Interruption of ongoing activity
  • Reactivity--self recording changes the behaviour itself

CBT Chapter 5

reactivity
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

d checklists rating scales
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

e naturalistic observation
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

limitations1
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

f simulated observation
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

g role playing
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

h physiological measures
H. Physiological Measures
  • Measure processes that readily measures of behaviour

Heart rate, respiration rate, blood pressure, muscle tension, skin conductivity

CBT Chapter 5

role of dsm iv diagnosis
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

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