Functional Analysis Of Behavior Research Articles

Current behavioral models of client and consultee resistance: A critical review.

Abstract Resistance is the phenomena that occurs in the therapeutic relationship when the patient refuses to complete tasks assigned by the therapist which would benefit the patient in improving their psychological situation. Resistance is also used to describe situations in the consulting relationship where the consultee does not do what the consultant suggests. Often resistance leads to poor treatment integrity and/or staff burn out. As a result, this resistance is a factor that warrants a behavioral interpretation and investigation. Currently several behavioral models of resistance exist. In this paper, we explore each of these models and critique the logical and empirical support. Future research directions will be discussed. Keywords: Resistance, Behavioral Models, Functional Assessment, Consultation ********** Introduction functional analysis of verbal behavior began in 1945, with the publication of the Harvard Symposium on Operationalism in Psychological Review. In paper by B.F. Skinner entitled The Operational Analysis of Psychological Terms it was argued that by observing the contingencies and setting conditions under which a verbal community typically used the ordinary language terms, the interpreter could interpret the terms in a descriptive functional assessment. This approach is critical to the scientific investigation of events that on the surface may not appear to be readily available to a behavioral interpretation or behavioral research (Leigland, 1996). Leigland lamented that behaviorally oriented clinicians have done little research on terms that have been important to non-behavioral clinicians. One term, which appears to have importance to traditional clinicians and consultants, is resistance. Resistance can be defined as anything that a client or consultee does that impedes progress (Wickstrom & Witt, 1983). What is termed resistance in consultation can have serious implications for treatment integrity (Wickstrom, Jones, LaFleur & Witt, 1998). Resistance to change in verbal therapies and consultation is a phenomenon that has substantial representation (Cautilli & SantilliConnor, 2000; Patterson & Chamberlain, 1994) with some early discussion within the behavioral literature (e.g., DeVoge & Beck, 1978; Skinner, 1957). Resistance appears to interest a broad spectrum of clinicians both behavioral (e.g., DeVoge & Beck, 1978; Lazurus & Fay, 1982) and non-behavioral (e.g., Mandanes, 1981) in orientation. However, supporting data are lacking to most of the theoretical conceptualizations including behavioral interpretations (Patterson & Chamberlain, 1994). In deconstructing resistance or conducting an analysis of its use, behavioral psychologists find therapists and consultants use the word in the context of therapeutic failure. For example, Dougherty (2000) refers to resistance as a consultee's failure to participate constructively in the process of consultation. Resistance can occur in the treatment relationship, where the client does not improve or, in the consulting relationship, where the consultee fails to implement the treatment. clinical literature is replete with examples from different traditions of techniques to manage this problem if it arises in the therapeutic context (e.g., Spinks & Birchler, 1982). In one study using regression analysis, Patterson and Chamberlain (1994) showed that parental resistance to parent training reduced therapist effectiveness and these parents showed fewer improvements in discipline. As pointed out by Cautilli and Santilli-Connor (2000), the term resistance is often used to describe a relationship in which the client, or in the case of consultation, the consultee, does not comply with the tasks that the therapist or consultant suggests. A review of the literature shows that many factors increase the probability that a consultee will be resistant. …

Toward a comprehensive functional analysis of depressive behavior: Five environmental factors and a possible sixth and seventh.

With recent advances in the behavioral treatment of depression and growing dissatisfaction with medical and cognitive interventions, a resurgence of interest in behavior analytic treatment of depression has occurred. Currently, several behavioral and cognitive behavioral models of depression exist. In reviewing these models, certain agreed upon environmental factors emerge. In this paper, we explore five factors related to a behavioral treatment of depression. Three of these factors view depressive behavior as a bi-product of person-behavior-environment interaction. These are (1) lack of response contingent reinforcement of behavior, (2) too much punishment of behavioral responses, and (3) loss of effective operant behavior. In addition, two models view depressive behavior as operant behavior as controlled by (4) positive reinforcement and/or (5) negative reinforcement. Two final factors to consider are (1) depressive behavior develops as a failure to develop or an over reliance on rule governed behavior and (2) environmental factors that precipitate depression may be viewed as establishing operations. Each of these factors will be explored as well as multiple combinations of these factors in the generation and continuation of depression. Key words: Depression, Functional Assessment, Clinical Behavior Analysis, & Behavioral Models of Depression. ********** In the 1990's, a resurgence of interest in behavioral theories of depression occurred. This resurgence derived from the establishment of clinical behavior analysis as a vibrant adjunct to applied behavior analysis (Dougher, 1993; 1994; 2000) with active theoretical and empirical investigations and treatment developments relevant to outpatient psychotherapeutic treatment of depression. In addition, a component analysis of cognitive-behavior therapy for depression showed that the behavioral component (behavioral activity scheduling was referred to as behavioral activation) was sufficient to explain recovery from initial depression (Jacobson et al., 1996) and at follow up (Gortner, Gollan, Dobson, & Jacobson, 1998). The cognitive component of treatment appeared to add little to the overall outcome. These findings renewed interest in behavioral approaches to depression treatment (Hollon, 2001; Jacobson & Gortner, 2000) and sparked development of a complete Behavioral Activation approach (Martell, Addis, & Jacobson, 2001; also see Kanter, Callaghan, Landes, Busch, & Brown, 2004). Other clinical behavior analytic approaches to depression have also been evaluated, including Acceptance and Commitment Therapy (Zettle & Hayes, 1986; Zettle & Rains, 1989) and Functional Analytic Psychotherapy (Kanter, Schildcrout, & Kohlenberg, in press; Kohlenberg, Kanter, Bolling, Parker, & Tsai, 2002). The above sets the stage for a re-analysis of behavioral theories of depressive behavior (e.g., Bolling, Kohlenberg, & Parker, 2000; Dougher & Hackbert, 1994; 2000; Ferster, 1973; Hoberman & Clarke, 1993; Kanter et al., 2004; Lewinsohn, 1974). In review of current behavioral models of depression, we found that several factors were highlighted. First, early models incorporated Skinner's (1953; 1974) stance that feelings such as depression are respondent bi-products of behavior-environment interactions. For example, failure to achieve sleep as a reinforcer for insomniacs might produce depressive symptoms. Subsequent models focused on direct functional aspects of depression. While many of the early pioneers of behavioral approaches to depression became focused on cognitive phenomena after initial investigations, this behavioral work remains an excellent starting point for current theory exploration. In particular these models emphasized depression as a function of positive reinforcement deprivatio n, either in terms of low density of positive reinforcement (Ferster, 1973) or low rates of response-contingent positive reinforcement (Hoberson & Lewinsohn, 1985; Lewinsohn, 1974, 1975). …

Exploring Unique Roles for Psychologists.

Presents a comment on "Psychological Treatments" by D. H. Barlow. Barlow highlighted unique roles that psychologists can play in mental health service delivery by providing psychological treatments--treatments that psychologists would be uniquely qualified to design and deliver. In support of Barlow's position, the authors draw from their own clinical practice with special psychiatric populations, such as adults with severe and persistent mental illness and behaviorally disordered youths, to illustrate some potential unique roles for psychologists. The authors believe psychologists are uniquely trained to design such individualized functional behavioral analysis protocols because of their training in research design, behavior analysis, learning theory, and behavior change. Psychologists may also be uniquely qualified to design, implement, and evaluate many specialized therapy techniques, as Barlow has outlined and suggested.

Brain-based mechanisms underlying complex causal thinking

We use functional magnetic resonance imaging (fMRI) and behavioral analyses to study the neural roots of biases in causal reasoning. Fourteen participants were given a task requiring them to interpret data relative to plausible and implausible causal theories. Encountering covariation-based data during the evaluation of a plausible theory as opposed to an implausible theory selectively recruited neural tissue in the prefrontal and occipital cortices. In addition, the plausibility of a causal theory modulated the recruitment of distinct neural tissue depending on the extent to which the data were consistent versus inconsistent with the theory provided. Specifically, evaluation of data consistent with a plausible causal theory recruited neural tissue in the parahippocampal gyrus, whereas evaluating data inconsistent with a plausible theory recruited neural tissue in the anterior cingulate, left dorsolateral prefrontal cortex, and precuneus. We suggest that these findings provide a neural instantiation of the mechanisms by which working hypotheses and evidence are integrated in the brain.

Skinner and the Rise of Behavior Modification and Behavior Therapy

Skinner is, without a doubt, one of the most predominant figures in the development of Behavior Modification and Behavior Therapy. Skinners' work is essential to the development of Behavior Modification and Behavior Therapy. Beginning with the social need for efficient psychotherapy, and after having generated a solid theoretical body of behavioral laws, Skinner indicated and also developed the appropriate path towards efficient interventions for unadaptive behavior. He developed a new theory regarding abnormal behavior (psychopathology), as well as a procedural model for evaluation (diagnosis) and intervention: "The functional analysis of behavior". His applications for this kind of work are pioneering and at the same time, he is the agglutinant figure of what we today call "Behavior Modification and/or Therapy". It is remarkable that a scientist could change the theories and practices of a discipline as radically as Skinner and his work did. His work, however, still has its limitations. The best way to acknowledge and pay tribute to Skinners' work is to overcome these limitations.

Functional analysis and treatment of low rate problem behavior in individuals with developmental disabilities

AbstractExtensive research has validated the standard functional analysis as a useful technology for identifying the function of problem behavior in individuals with developmental disabilities. The assessment of low rate problem behavior is one area that has yet to receive a significant amount of research. Some problem behaviors may occur at rates too low to be observed during a standard functional analysis, despite the fact that they may be highly destructive behaviors. The current study evaluated the effectiveness of initiating functional analysis sessions contingent on the occurrence of bursts of problem behavior for producing interpretable functional analysis results. While a standard functional analysis did not produce definitive results with respect to behavioral function, the ‘low rate’ functional analysis produced interpretable results for all three participants. Two of the three participants were available for the evaluation of treatments based on their functional analysis results. Function‐based treatments suppressed rates of problem behavior for both participants. Copyright © 2004 John Wiley & Sons, Ltd.

Determining the influence of tangible items on screaming and handmouthing following an inconclusive functional analysis

AbstractA brief experimental analysis was used to compare the effects of the presence of tangible objects in an alone condition following an inconclusive functional analysis of screaming and handmouthing behavior of an 8‐year‐old boy. The alone condition with tangibles involved having toys available throughout the session with no interaction from the therapist and produced a higher percentage of intervals with screaming and handmouthing. The study demonstrates the importance of evaluating the effects of the presence of tangible items during a functional analysis. Copyright © 2004 John Wiley & Sons, Ltd.

Weight survey on adult persons with mental retardation living in the community

Prevalence of underweight and obesity were investigated in 282 mentally retarded persons living on the West Coast of Norway. Data collected in this survey suggest that people with severe mental retardation were more likely to be underweight and people with mild mental retardation were more likely to be obese. Compared to persons of average intellectual levels, persons with mental retardation were found to be over-represented with both underweight and obesity. Food refusal and self-induced vomiting was more present among persons regarded as underweight and reduced control of food intake was related to obesity. Findings suggest that behavioral variables may have explanatory value with respect to both underweight and obesity. Further investigation using functional analysis of behavior is recommended.

Parting Reflections on Education of Children with Emotional or Behavioral Disorders

There are three areas that to me seem not only critical for the future of our field but to which we also need to pay more attention, as we enter a new era of evidence-based practice. These involve topics that may serve to move us beyond our traditional behavioral approaches into interdisciplinary collaboration in the larger enterprise of school mental health. They are (1) developmental psychopathology, (2) psychiatric comorbidity, and (3) psychopharmacology. What follows are brief reflections on each. As special educators, we usually care for children already referred for emotional or behavioral disorders. These disorders, however, have usually been long evident to their families through expression of mild functional impairments and/or early symptoms (Forness & Kavale, 2001a). Such disorders, in their earliest stages, however, are not always recognized as such. Developmental psychopathology holds that the trajectory of such disorders is determined by a variety of early genetic, biologic, and/ or environmental etiologies (Pennington, 2002). Parents and even professionals may have been concerned by these earlier signs yet did not necessarily view them as prodromal, as early symptoms of a possible psychiatric diagnosis. Inherent in the concept of developmental psychology is the need for early detection, instead of just early identification or diagnosis, and primary prevention, instead of just early intervention. Also inherent is the implication that, as special educators, we are back-loading most of our efforts, long after the diagnosis is fully realized, as opposed to front loading at the earliest signs of difficulty. We thus need to focus much more on this concept of developmental psychopathology since it puts a much greater emphasis on early trajectories of psychopathology and on the diffuse nature of symptoms of very early risk. My colleagues and I have been extremely interested in this concept and have shown how early emotional or behavioral disorders have not only been significantly underidentified in special education but also misidentified as learning disabilities or related disorders (Duncan, Forness & Hartsough, 1995; Lopez et al., 1996; Redden et al., 1999; 2002). We have also shown how primary prevention or classroom-wide interventions in preschool can not only significantly improve both functional behavior and symptoms in children at risk (Serna, Lambros, et al., 2000; Serna et al, in press) but also possibly forestall actual psychopathology in those youngsters at highest risk (Serna et al., 2003). Such preventative approaches, as well as our usual functional behavioral analyses and positive behavioral supports, may not be entirely adequate, however, if such disorders are accompanied or even preceded by significant psychiatric comorbidity. The gradual emergence of such comorbidity may not always be readily apparent, unless we are prepared to recognize its developmental trajectory as well. One interesting example is children with disruptive disorders who also have comorbid depression or anxiety disorders. In sequential behavioral observations of adult-child interactions, children with such a mixed pattern are often significantly less likely to pursue adaptive responses and much more likely to revert to impulsive responding without regard to consequences of their actions than children with just disruptive behavior disorders (Granic & Lamey; 2002). They simply do not respond to our usual behavioral approaches. Both prospective and retrospective follow-up of children with mixed disorders also suggests very different developmental patterns of adjustment, with implications for differential treatment involving much more emphasis on cognitive-behavioral and emotional-regulation approaches than needed for children with simple disruptive behavioral disorders (Capaldi & Stoolmiller, 1999; Jaffee, et al., 2002). Finally, it is becoming clear that children with such mixed disorders (externalizing and internalizing) may show very different patterns of perturbation on neuroimaging in the anterior cingulate gyrus (governing some aspects of emotion or motivation) and the orbitofrontal cortex (governing some aspects of impulse control) than children with pure externalizing disorders (Luu, Collins & Tucker, 2000). …

Behavioral assessment in mentally retarded and developmentally disabled patients with epilepsy

Behavioral disturbance is common in many individuals with mental retardation. Its presence in those with coexisting epilepsy provides a further challenge to the individual, caretakers, and family members. In particular, concerns that antiepileptic medication is causing such behavioral disturbances are often raised. For the clinician, assessment is crucial to minimize morbidity by appropriately identifying the cause of the behavioral disturbance. The assessment should aim to delineate whether the disturbance is due to a direct effect of epilepsy, its treatment, social impact, or factors unrelated to the epilepsy. However, before being able to make this differentiation, the clinician needs to understand the behavior itself. Assessing behavior in people with mental retardation requires a multifactorial approach. These factors include an objective and reliable description of the behavior and an assessment of its function. Detailed description requires a functional analysis of behavior. Such analysis may indicate the behavior is associated with epilepsy treatment or represents a seizure disorder in itself. In the majority of cases, though, it is likely that any disturbance seen is independent of epilepsy or its management.

Dissociation and Sexual Addiction/Compulsivity: A Contextual Approach to Conceptualization and Treatment

SUMMARY The possible relationship of dissociation to sexual addiction/compulsivity (SAC) among childhood sexual abuse (CSA) survivors is explored. In applying a treatment procedure based on functional behavioral analysis to CSA survivors exhibiting SAC it was frequently observed that SAC patterns of behavior were not sexually gratifying, but that clients had been previously unaware of this. These clients often had poor recall of even recent instances of SAC and described a subjective sense of being in a daze, truncated awareness, and absence of a sense of agency during SAC episodes. Repeated detailed description of recent incidents of SAC in session helped clients become less dissociative when subsequently participating in SAC behaviors and gradually reduced the appeal of engaging in them. On the basis of these observations it is argued that recognition of the dissociative quality of SAC behavior in CSA survivors is essential to adequately understanding it, and that targeting the dissociative elements of SAC in treatment is crucial to disrupting it. It is also proposed that in this clinical population SAC can reflect the dissociative disconnectedness represented by re-enactment of CSA experiences, failure to integrate emotional intimacy with sexuality due to insecure or disorganized attachment, association of sexual activity with soothing and validation rather than sexual arousal, or a combination of these factors.

Behavioral effects of cocaine and dopaminergic strategies for preclinical medication development.

The illicit use of cocaine is a persistent health problem worldwide. Currently, there are no broadly effective pharmacotherapies to treat cocaine addiction. A prerequisite for development of useful anti-cocaine medications is an understanding of the pharmacological basis of cocaine's effects. The functional analysis of behavior in laboratory animals has allowed for the development of strategies identifying candidate medications to treat cocaine addiction. This review summarizes the current status of dopaminergic compounds as cocaine pharmacotherapies in animal models of cocaine addiction. Maintenance medications should share key subjective effects with cocaine, yet have limited abuse liability and side effects. However, maintenance medications often have reinforcing effects that could contribute to abuse potential and side effects that could deter patient compliance. Combined with cocaine, these drugs enhance cocaine's effects. Cocaine antagonists should block the effects of cocaine and have no cocaine-like effects or side effects on their own. However, the cocaine-modulating effects of candidate cocaine antagonists are often surmountable, and, on their own, these drugs produce severe motoric side effects. In contrast, dopamine (DA) partial agonists should exhibit reduced abuse potential relative to agonists, as well as less severe motoric effects relative to antagonists. Combined with cocaine, these drugs should antagonize cocaine's effects. DA partial agonists, in particular the D(3)-selective and the D1-like partial agonists, offer a more encouraging profile for novel anti-cocaine medications. Neither class of drug is self-administered, and side effects are often less severe and only observed at doses above those that antagonize the effects of cocaine.

Comportamento verbal na terapia analítico comportamental

Apenas recentemente a análise funcional do comportamento verbal vem ganhando importância na clínica comportamental, o que representa um paradoxo, uma vez que a terapia se dá quase que exclusivamente através da interação verbal terapeuta-cliente. Vários conceitos propostos por Skinner de análise do comportamento verbal podem ajudar a compreender o caráter disfuncional dos comportamentos verbais e sua influência sobre os comportamentos não verbais dos clientes. Dentre eles foram abordados no presente trabalho o conceito de audiência, audiência não punitiva, tatos distorcidos, mandos disfarçados, intraverbais, controle por regras, lapsos verbais, extensão metafórica do tato, significado pelo uso e treino em tatear o próprio comportamento e suas variáveis controladoras. A classificação do comportamento do cliente de acordo com tais conceitos fornece indícios relevantes acerca de suas variáveis controladoras, permitindo uma atuação do terapeuta no restabelecimento dos repertórios comportamentais dos clientes e do aperfeiçoamento dos repertórios verbais disfuncionais.

Use of directed history and behavioral indicators in the assessment of the child with a developmental disability

It can be very difficult to get a complete history and review of systems for children with developmental disabilities and poor communication skills. In addition, many children with developmental disabilities may engage in self-injurious or aggressive behavior. Although the causes of inappropriate behavior are frequently environmental, physiologic components may exist as well, particularly pain or discomfort. History taking must be focused and specific and may need to focus on the child's behavioral patterns, because the child may not have sufficient communication skills to describe his or her problem and parents or guardians may not realize the relevance of certain behaviors. Gastrointestinal problems in particular may be a source of discomfort and should be reviewed with particular care. Referral to a psychologist who is able to perform a functional analysis of behavior may be necessary to treat problem behavior, especially if medical causes have been ruled out. J Pediatr Health Care. (2002). 16, 170-179.

Use of directed history and behavioral indicators in the assessment of the child with a developmental disability

It can be very difficult to get a complete history and review of systems for children with developmental disabilities and poor communication skills. In addition, many children with developmental disabilities may engage in self-injurious or aggressive behavior. Although the causes of inappropriate behavior are frequently environmental, physiologic components may exist as well, particularly pain or discomfort. History taking must be focused and specific and may need to focus on the child's behavioral patterns, because the child may not have sufficient communication skills to describe his or her problem and parents or guardians may not realize the relevance of certain behaviors. Gastrointestinal problems in particular may be a source of discomfort and should be reviewed with particular care. Referral to a psychologist who is able to perform a functional analysis of behavior may be necessary to treat problem behavior, especially if medical causes have been ruled out. J Pediatr Health Care. (2002). 16, 170-179.

An historical view of the clinical and research base of functional analysis

A functional analysis of behavior is of paramount importance in conducting a functional assessment. This paper reviews the historical clinical and empirical research bases of functional analysis of behavior. Specific landmark studies in the development of this assessment methodology are presented. Implications of functional analysis assessment methods for school settings are discussed

Functional analysis of problem behavior in children with mental retardation.

Pediatric nurses are frequently asked to give advice on behavior management. This can become considerably more difficult when the child in question has limited cognitive abilities and communication skills. It is especially complex when the behavior in question involves self-injury or aggression. Frequently used behavior modification strategies such as time-out may actually reinforce the inappropriate behavior in these children by allowing them to escape from an aversive task. Likewise, other common behavior management strategies such as discussion, saying "no," or yelling at the child, may reinforce the inappropriate behavior by providing attention for it. It is sometimes difficult to identify the antecedents of self-injurious or aggressive behavior, making appropriate behavior management plans elusive. However, functional analysis can be used to identify the functions that serve to maintain a child's inappropriate behavior, and may provide a basis for developing and implementing an individualized behavior management plan. The possibility that discomfort from an untreated or undertreated physiologic problem is exacerbating the behavior should not be overlooked.

Functional Analysis of Problem Behavior in Children With Mental Retardation

Functional Analysis of Problem Behavior in Children With Mental Retardation

The Case of Sam: Multidisciplinary Perspectives

The Case of Sam: Multidisciplinary Perspectives

Ignoring the Odds: Hazards of Not Adding the New Medical Model to Special Education Decisions

Although the traditional medical model has been vilified by special educators, new evidence on treatment and comorbidity of psychiatric disorders suggests a more relevant and effective version of this model. This evidence is reviewed briefly with the purpose of suggesting odds that a child with behavioral disorders may indeed have a disorder that is responsive to psychopharmacologic treatment. Merging the medical and behavioral models is suggested as critical to certain special education decisions in functional behavioral analyses and positive behavioral intervention.