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Workshop Preparation

Workshop Preparation. Get into groups of 4. Workshop 74 The Basic Behavior Analytic Principles of Psychotherapy. William C. Follette, Ph.D. Glenn M. Callaghan, Ph.D. Sabrina M. Darrow, M.A. Jordan T. Bonow, M.A. Workshop Preparation. Get into groups of 4 Pick an active, difficult client

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Workshop Preparation

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  1. Workshop Preparation • Get into groups of 4

  2. Workshop 74The Basic Behavior Analytic Principles of Psychotherapy William C. Follette, Ph.D. Glenn M. Callaghan, Ph.D. Sabrina M. Darrow, M.A. Jordan T. Bonow, M.A.

  3. Workshop Preparation • Get into groups of 4 • Pick an active, difficult client • General guidelines

  4. Outline • Introduction • Basics Principles [Short Break] • Therapist Repertoires • Noticing (Assessment) • Responding (Intervention)

  5. Introduction

  6. Learning Objectives • 1. Learn the basic principles of behavior analysis as they operate in psychotherapy • 2. Learn how to develop a client case conceptualization focusing on behavioral processes • 3. Learn how to develop intervention strategies based on a case conceptualization and behavioral processes

  7. Clinical Behavior Analysis (CBA) • “The application of the assumptions, principles, and methods of modern functional contextual behavior analysis to ‘traditional clinical issues’” (Dougher & Hayes, 1999; p. 11) • Modalities in CBA • Acceptance and Commitment Therapy (ACT) • Behavioral Activation (BA) • Functional Analytic Psychotherapy (FAP)

  8. CBA is All About Behavior • Targets behavioral repertoires • Establishing repertoires • Shaping more effective behavior from existing repertoires • Maintaining effective repertoires • Training discrimination of when to behave • The client is not the target • The cause of behavior is in the environment • People do what they do because it works • Do not blame person for what they have learned • We do not reinforce or punish clients

  9. Basic CBA Model In-Vivo Intervention Problematic Behavioral Repertoires Improved Behavioral Repertoires Problems in Broad Functioning Improvements in Broad Functioning

  10. Broad Tasks of Therapy • Establish therapist as an important stimulus for client • Assess the variables influencing client behavior • Change client’s environment in order to change client’s behavior • Promote continued behavior change outside the therapy environment • Assess for changes in client functioning

  11. The Basics

  12. The Behavioral Unit of Analysis • Behavior in context • The ABCs • Antecedent (A) • Behavior (B) • Consequence (C)

  13. Behavior (B) • More technically a “response” • Relatively self-explanatory • Any activity of an organism • Physical movement • Talking • Thinking • Feeling • Can be measured in multiple ways

  14. Consequence (C) • What happens in the environment following behavior of interest • An event temporally following behavior (immediately) • Consequences change and maintain behavior

  15. Two Types of Consequences • Reinforcer- A consequence that increases the probability of the behavior occurring in the future • Punisher- A consequence that decreases the probability of the behavior occurring in the future • Consequences can be “natural” or “arbitrary”

  16. Antecedent (A) • Condition in the environment that occurs before the behavior of interest • Another person’s behavior • Our own behavior, including thoughts and feelings • Motivational states: being hungry or tired • Temperature, noise level, location, etc. • Antecedents are the setting factors; they set the stage for behavior to occur • Signal the availability of reinforcement (technically referred to as a discriminative stimulus) • Directly elicit behavior (technically referred to as a conditioned stimulus) • Create motivation (technically referred to as establishing operations)

  17. How the ABC’s Go Together • Remember this is a unit • Referred to as a contingency (dependence) • In this situation/context (A) if I do (B), (C) will happen • Problems can occur at any point (A, B, or C) . B C A

  18. Video 1-Behavioral Chains

  19. Functional Classes • Behaviors should be grouped by function (i.e., those that demonstrate the same ABC contingency) • Some common basic functions • Attention • Escape/avoidance • Sensory/Automatic • Tangibles/Preferred activities • Behavior can be, and is, multiply controlled

  20. Function and Topography • Topography can be both helpful and misleading • The same topographical behavior can be maintained by different functional consequences • Widely different topographical behaviors can be part of the same functional class

  21. Video 2- A Functional Class

  22. Important Processes to Consider • Extinction • Shaping • Differential reinforcement • Schedule thinning • Generalization • Rule governance

  23. Extinction • The failure of the environment to present a functional reinforcer • The ABC contingency is broken • Eventually results in elimination of the behavior within a context • Also leads to “extinction bursts” in the shorter term

  24. Constructional Approach • Focus on building on a person’s existing repertoire • Different strategy than punishment or extinction • Differential reinforcement • Works particularly well when the behaviors are incompatible

  25. Shaping • A completely generative strategy • The systematic building of a particular repertoire • Relies on the reinforcement of “successive approximations”

  26. Reinforcement Thinning • A strategy for maintaining a behavior • Involves fading out presentation of reinforcement (particularly from an FR1 schedule) • There is a fine balance between thinning and extinction

  27. Stimulus Generalization • Behaving with respect to a stimulus as if it were an established A • Can result from • Topographical similarity • Arbitrary verbal relations • Stimulus Discrimination • the opposite process • constricting the stimuli that will function as As

  28. Rule Governance • The functioning of verbal stimuli as As • Can be used to promote discrimination or generalization • Complete rules identify the As, Bs, and Cs • An individual does not need to be verbally aware of the ABCs in order for contingencies to influence his or her behavior

  29. Molar Functional Relations • The ABCs are a molecular, focused approach • Molar functional relations involve patterns of behavior occurring over time • Aggregates of multiple ABC instantiations over time • The unit of analysis is flexible

  30. Matching • The time spent engaging in a particular behavior (relative to other behavior) matches the rate of reinforcement for that activity (relative to the rate of reinforcement for other behavior) SR+ for SR+ for all activities

  31. Matching (cont.) • Implications • Have client monitor his or her behavior • Decrease reinforcement for the target behavior • Increase reinforcement for alternative behavior • Noncontingent reinforcement • Potential issues • Difficulty in overcoming the strong reinforcers maintaining the target behavior • Client skills deficits in alternative behavior • Client’s inaccurate labeling of potential reinforcers and alternative activities

  32. Discounting • Focuses on choice alternatives • Refers to the decrease in the value of a reinforcer resulting from some inconvenience • Delay • Risk • Cost • A way to characterize impulsivity

  33. Discounting (cont.) • Implications • Increase the reinforcing function of the stimulus maintaining a desired behavior • Shape approximations of the desired behavior • Establish rules that can occasion behavior • Decrease the punishing function of the inconvenience variable

  34. Momentum • A behavior’s persistence despite challenging circumstances • Determined by • Past levels of reinforcement for a behavior • Level of reinforcement currently provided • Reinforcement of the behavior • Reinforcement for other behavior

  35. Momentum (cont.) • Implications • Identify the reinforcers for a target behavior • Social community • Internalized rules • Importance of replicating outside contexts within therapy • Attend to response rate and rate of reinforcement • Fluency training • Differential reinforcement rather than simple noncontingent reinforcement

  36. Variability • Continuum of complete stereotypy to complete randomness • Functionality of variability is related to the context • Variability can be shaped

  37. Variability (cont.) • Implications • Watch for excesses and deficits in variability • Train variability directly after establishing a repertoire (but not too long after) • Vary your eliciting and responding behavior to increase client variability

  38. Break Time

  39. Steps of Therapy • Identify characteristics of client via assessment • Organize these characteristics into an analysis of the client’s problems in terms of behavioral principles • Devise an intervention based on assessment • Implement intervention • Assess outcome Successful- Assessment and intervention complete Unsuccessful- Reformulate functional case conceptualization

  40. Therapist Repertoires • Noticing • Responding

  41. Noticing (Assessment)

  42. Appropriate Therapy Targets(Haynes & O’Brien, 1990) • Therapy should target variables that are: • Causal- Actually influence client behavior • Controllable- Can be manipulated effectively • Important- Meaningful to client broad functioning • Assessment • Identifies these variables • Determines if their manipulation was successful

  43. The Case Conceptualization • Fundamental to doing CBA • Contains • Conceptualization of both strengths and weaknesses • Behavioral deficits and excesses • Examination of contingencies of client’s behavior • Functions • Helps guide therapy in the moment and over time • Allows measurement of targeted variables

  44. Layers of Conceptualization • Broad understanding of this client and his or her life • Understanding his or her goals for treatment • Understanding this session or series of sessions with focused goals • Understanding this interaction now and its impact on therapist

  45. Layers of Conceptualization (cont.) • All of these tie to each other • How does this strategy I am attempting now tie into my goals for this session given my intervention in the context of this client’s life? • The conceptualization applied to these levels will tell the therapist what to do next

  46. Layers of Conceptualization (cont.) CONTEXT

  47. Layers of Conceptualization (cont.) Context of Client’s Life Goals of Therapy Goals of Session NOW

  48. The Behavioral Approach is Pragmatic and Empirical • Tests competing hypotheses • Uses flexible analytic units

  49. Testing Competing Hypotheses • Your first idea may not always be correct • Always generate alternative hypotheses • Conduct critical tests • Methods for testing • Observation of ABCs over time • Mini functional analyses

  50. Using Flexible Analytic Units • Analytic unit becomes wider as therapy progresses • ABCs • Molar relations • Therapist may be involved in the unit

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