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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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Chapter 5 behaviour assessment

Chapter 5:Behaviour Assessment

CBT Chapter 5


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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