The Behavioral Tradition

Sample vs. Sign

  • Behavioral Assessment: Assessment that focuses on the interaction between situations and behaviors for the purposes of creating behavioral change.
  • Focus on how well assessment device samples the behaviors and situations
  • Sample orientation: Parallels how a person behaves in a situation; as in a test.
  • Sign orientation: Inference about performance is indicative of some other characteristic.
  • Traditional research has used a sign as opposed to sample orientation. But behavioral research sample approach is used.

Functional Analysis

  • Exact analysis is made of the stimuli that precede a behavior and the consequences that occur from it.
  • Behaviors are learnt and maintained as a result of consequences that follow them. Identify stimulus that occurs beforehand and determine reinforcements that follow, to elicit change.
  • Behaviors that are monitored must be recorded in observable, measurable terms.
  • Antecedent Conditions: Stimulus conditions that lead up to the behavior of interest.
  • Consequent Events: Outcomes or events that follow the behavior of interest

o E.g. lack of attention (stimulus)^ taking pencil from another child (behavior) attention (consequence).

  • Organismic Variables: Physical, physiological or cognitive factors of the individual that are important to determine the client's problem.
  • SORC Model—Used to conceptualize a client's problem

o S—Stimulus or antecedent conditions that bring on a problem

o O—organic variables related to the problem

o R—response or problematic behavior

o C—consequences of the problematic behavior

Behavioral Assessment as an Ongoing Process

  • Behavioral assessment is an ongoing process that occurs before, during and after treatment.
  • Diagnostic formulations—potential targets for intervention
  • Patients context or environment—social support, physical environment, evaluation of skills.
  • Initial understand of client's behaviors, resources will lead to a treatment plan.
  • Treatment includes collaboration between therapist and client and feedback will lead to adjustment of treatment.

Behavioral Interviews

Behavioral interview allows therapist to assess the client's “hope” for end results.

  • Ultimate Outcomes: Happiness, life satisfaction, making the world better.
  • Behavioral Interviews: Clinician attempts to make sense of the problem and of the variables that seem to maintain the problem.
  • Basic goal is to identify the problem behaviors, situational factors that maintain those behaviors and consequences that result from the problem.

Naturalistic Observation

  • Observing individuals in their natural environment, will enable a clinician to better understand the problem.
  • Observation in a natural environment has limitations and is easier for children than adults who may be outpatients.
  • Clinicians need to ensure that clients are not observed without their knowledge or that family members are not drawn into the observation net—do not compromise privacy.
  • Due to the cumbersome nature of it, clinicians prefer to use traditional assessment.
  • Examples:

o Home Observation (Family mealtime routines)

o School Observation (school classroom, playground). Rate frequency, duration and intensity.

o Hospital Observation (mental retardation; open environments)

  • Unfiltered observation not contaminated by extraneous variables.

Controlled Observation or Analogue Behavioral Observation

  • Clinicians can exert certain amount of control over the events being observed, may be better in situations where behavior does not occur very often on its own.
  • The environment is “designed” for the clinician to observe the behavior occurring.
  • Situational Tests: Place individuals in situations similar to real life and observe how people behave.

Controlled Performance Techniques

  • Assessment procedure in which the clinician palces individuals in a controlled performance situation and collects data on their reaction, performance and behavior.
  • Approaches include:

o Behavioral Avoidance Tasks (Total number of steps/tasks completed)

o Fear Arousal Accompanying Responses (Total fear or distress ratings)

  • Behavior in this type of situation may not reflect real-life behavior.
  • Psychophysiological measures: To assess CNS, autonomic nervous system, skeletal motor activity.

o Complement other traditional assessments, can assess a process (e.g. emotional response). E.g.—Event Related Potentials (ERP's), Electroencephalographic activity (EEG).

Self-Monitoring

  • Individuals observe and record their own behaviors, thoughts and emotions.
  • Keep diaries, logs for some period of time—usually in terms of how often the behavior occurs (frequency, duration and intensity).
  • May lead to distortion or wrongful recordings, resistance.
  • Most effective in relation to other larger forms of therapy.
  • Other monitoring devices include personal digital assistants (PDA's), palmtop computers, phones

Variables Affecting Reliability of Observation

Complexity of Target Behavior

  • More complex behaviors, greater unreliability of observation so focus is usually on less- complex behaviors.

Training Observers

  • Training observer by bringing them into an inpatient facility and training them to look for specific signs of a disorder is most helpful. The goal should not be to please the supervisor or agree.
  • Observer Drift: Observers that work closely with each other began to subtly drift away from other observers in their ratings. To prevent this regularly scheduled reliability checks by an independent rater should be performed.

Variables Affecting Validity of Observations

  • Content Validity—Behavioral observation schema should include behaviors that are important/pertaining to the research or clinical purpose being measured.
  • Concurrent Validity—Whether one's obtained results of rating correspond to that found by other people (teachers, spouse, friends).
  • Construct Validity—Degree to which a test measures what it claims to measure.
  • Mechanics of Rating:

o Unit of Analysis: Length of time observations will be made along with the type and number of responses made.

o Scoring procedures must also be developed (ex: checklist, timers, laptop computers).

  • Observer Error: Observers need to be monitored and double checked to ensure that their work is not subject to bias, flattering or misidentification/attribution.
  • Reactivity: Patients or participants react to the fact that they are being observed and may change the way they behave. Can impact the validity of a study; and prevents the data from being generalizable.
  • Ecological Validity: In the context of behavior assessment, the extent to which behavior analyzed or observed are representative of a person's typical behavior. Is the sample large enough for the behavior to be truly representative?

Contemporary Trends in Data Acquisition

  • The use of laptops and handheld devices can be used to code observational data.
  • Devices like audio-recordings, diaries and logs can assist patients in self-monitoring by providing them questions at specific time-points.
  • Ecological Momentary Assessment (EMA): Devices for data collection in an individual's natural environment. E.g. electronic diaries.
  • EMA's have the potential to be ecological and moods of patients can be studied in their “natural habitat”.
  • Completing data entries using paper diaries—subjects neglect, threat to validity, forgetting, self-presentation bias.

Role Playing or Behavioral Rehearsal Methods

  • Can be used as a means of training new response patterns to get people to respond in a way they would typically respond in a given situation.
  • They have been used as therapeutic devices for many years in which the participant or patient responds out loud to a scenario.

Inventories and Checklists

  • Behavioral checklists like the Fear Questionnaire and the Fear Survey Schedule is used to assess a patients fear about specific situations.
  • Inventories asses a range of the patient's behaviors—physical activity, binge eating, alcohol use and other behaviors.
  • Behavioral assessors focused on specific deficits and behavioral assets and not psychiatric diagnostic criteria.

Cognitive-Behavioral Assessment

  • Cognitions relate to the development of pathological situation, its maintenance and changes.
  • Notion that client's thoughts play a vital role in behavior.
  • Cognitive Functional Approach: Functional analysis of the client's thinking process must be made to plan an intervention strategy. What underlying cognitions are aiding with lack of performance, and under what circumstances?
  • g.-think out loud, verbalize thoughts.

Strengths and Weaknesses of Behavioral Assessments

  • Behavioral assessors specify the behaviors targeted for intervention, treatments are provided before, after and during treatment and on this basis are modified as such.
  • Behavioral assessment like natural observation is time intensive and expensive.
  • Behavioral assessors now widely use DSM criteria to diagnose disorders.
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