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Compassionate Care, Cultural Humility, and Psychological Flexibility: Examining the Potential for Consilience in Applied Behavior Analysis 同情关怀、文化谦逊和心理灵活性:考察应用行为分析中的韧性潜力
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-06-21 DOI: 10.1007/s40617-024-00950-0
Donna M. West, Kian Assemi, Swathi Ragulan, Ramona A. Houmanfar

Taylor et al. Behavior Analysis in Practice, 12, 654–666, (2019) recommended that applied behavior analysts develop more collaborative relationships with their clients' caregivers by researching, training, and providing compassionate care in applied behavior analysis (ABA). A behavior analytic interpretation of compassionate care could support the development of such training and support collaborative relationships with not only caregivers, but all participants in ABA services (e.g., clients, stakeholders, providers, supervisees, and other professionals). The present article will review a relational frame theory account of compassionate care and discuss the possibility of expanding the concept of compassionate care by discussing its similarities with two other middle level terms: cultural humility and psychological flexibility. Given these similarities and the evidence that Acceptance and Commitment Training (ACT) supports several self-management skills including psychological flexibility, we will discuss ways practicing ACT could facilitate compassionate care, cultural humility, and collaborative relationships in human service organizations. The ACT Matrix will be presented to elaborate on how ACT, as a viable and comprehensive technology, may support behavior analysts’ training and practice of psychologically flexible skills which might bolster a compassionate care repertoire. Given this review, a possible consilience of compassionate care, including the proposed component of cultural humility, as facilitated by psychological flexibility will be offered. Finally, implications of this approach to practitioners, clients, and ABA as a whole will be discussed in conjunction with recommendations for future research and how ABA leadership can support the development and sustainability of compassionate care in ABA organizations.

泰勒等人(Taylor et al. Behavior Analysis in Practice, 12, 654-666,2019)建议应用行为分析师通过研究、培训和提供应用行为分析(ABA)中的同情关怀,与客户的照顾者建立更多的合作关系。行为分析对同情关怀的诠释可以支持此类培训的开展,并支持不仅与照顾者,而且与所有参与 ABA 服务的人员(如客户、利益相关者、提供者、被督导者和其他专业人员)建立合作关系。本文将回顾体恤关怀的关系框架理论,并通过讨论体恤关怀与其他两个中级术语:文化谦逊和心理灵活性的相似性,讨论扩展体恤关怀概念的可能性。鉴于这些相似之处,以及接纳与承诺训练(ACT)支持包括心理灵活性在内的几种自我管理技能的证据,我们将讨论如何通过实践接纳与承诺训练来促进人类服务组织中的同情关怀、文化谦逊和协作关系。我们将介绍 ACT 矩阵,以详细说明 ACT 作为一种可行的综合技术,可以如何支持行为分析师培训和实践心理灵活技能,从而增强同情心关怀的能力。根据上述回顾,我们将提出一种可能的同情关怀的一致性,包括所建议的文化谦逊的组成部分,并通过心理灵活性加以促进。最后,我们将讨论这种方法对从业人员、客户和整个美国心理辅导协会的影响,并对未来的研究和美国心理辅导协会领导层如何支持美国心理辅导协会组织中同情关怀的发展和可持续性提出建议。
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引用次数: 0
Constructional Parent Coaching: A Collaborative Approach to Improve the Lives of Parents of Children with Autism 建构式家长辅导:改善自闭症儿童家长生活的合作方法
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-06-21 DOI: 10.1007/s40617-024-00944-y
Timothy Allen Liden, Jesús Rosales-Ruiz

Parents of children diagnosed with autism face enormous stressors, which may interfere with achieving personal and family goals. The typical approach for reducing stress is often pathological; the individual attempts to directly eliminate the stress through counseling, behavioral therapy, or medication. As an alternative, the constructional approach builds repertoires for accessing important reinforcers. In this study, a mentoring program based on the constructional approach was used to teach three parents of children diagnosed with autism how to analyze their lives, formulate goals, and implement programs to reach these goals. A mentor’s support was gradually reduced until each participant could implement these steps independently. After the implementation of this program, events that each participant wanted to keep as part of their life encompassed a larger proportion of their total weekly events, as compared to before the program. In addition, time spent working on chosen goals increased as each goal was targeted for intervention. This mentoring program offers a promising approach for teaching people to manage their own lives by cultivating skills that help them get what they want, without dwelling on the problems interfering with their happiness.

被诊断为自闭症儿童的家长面临着巨大的压力,这些压力可能会影响个人和家庭目标的实现。减轻压力的典型方法往往是病态的;个人试图通过咨询、行为疗法或药物直接消除压力。作为一种替代方法,建构法可以建立获取重要强化物的再现。在这项研究中,基于建构法的指导计划被用于教导三位被诊断为自闭症儿童的家长如何分析他们的生活、制定目标并实施计划以实现这些目标。导师的支持逐渐减少,直到每位参与者都能独立完成这些步骤。与计划实施前相比,计划实施后,每位参与者希望保留的活动在其每周总活动中所占的比例增加了。此外,由于每个目标都有针对性地进行干预,用于实现所选目标的时间也有所增加。这项指导计划提供了一种很有前景的方法,通过培养技能,帮助人们获得他们想要的东西,而不是纠缠于干扰他们幸福的问题,从而教会他们管理自己的生活。
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引用次数: 0
Response Allocation of Board-Certified Behavior Analysts toward Categories of Evidence-Based Practice 经委员会认证的行为分析师对循证实践类别的响应分配
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-06-21 DOI: 10.1007/s40617-024-00953-x
Jennifer L. Posey, Craig A. Marrer, Natalie M. Driscoll, Alan J. Kinsella, Mark R. Dixon

Board certified behavior analysts (BCBAs) are often called upon to recommend treatments while working with autistic individuals. As practitioners of the science of human behavior, behavior analysts must make recommendations supported by scientific evidence. However, at times, individual practitioners may inadvertently recommend interventions that are not evidence-based. This study sought to examine if the severity level of the present symptoms of autism impacted the recommendations made by behavior analysts. A survey of 122 BCBAs gathered information about how they allocated resources toward interventions across three categories: evidence-based, emergent, and nonevidence-based. The results indicate that up to 62% of BCBAs allocated resources toward nonevidence-based or emergent practices and that these resource allocations were affected by the autism severity of hypothetical client presentations. There were statistically significant differences between allocations to resources between individuals with the lowest symptom severity and those maximally affected for both evidence-based practice (p < 0.0009) and nonevidence practice (p < 0.0011).

行为分析师(BCBA)在为自闭症患者提供服务时,经常被要求提出治疗建议。作为人类行为科学的实践者,行为分析师必须提出有科学证据支持的建议。然而,有时个别从业人员可能会不经意地推荐一些并非以证据为基础的干预措施。本研究旨在探讨自闭症现有症状的严重程度是否会影响行为分析师提出的建议。我们对 122 名 BCBA 进行了调查,收集了他们如何分配资源进行干预的信息,包括三个类别:循证干预、紧急干预和非循证干预。调查结果表明,多达 62% 的行为分析师将资源分配给了非循证或紧急干预措施,而且这些资源分配受到假设客户自闭症严重程度的影响。在循证实践(p <0.0009)和非循证实践(p <0.0011)方面,症状严重程度最低的个体和受影响最大的个体之间的资源分配差异具有统计学意义。
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引用次数: 0
The Use of Technology and Telehealth to Improve Behavioral Sleep Assessment and Intervention 利用技术和远程医疗改进行为睡眠评估和干预
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-06-19 DOI: 10.1007/s40617-024-00942-0
Julie Koudys, Catherine McConnell, Angeline Savard, Krysten Spottiswood, Alyssa Treszl, Paige O’Neill, Kaitlyn Harrison, Michelle Guzman Ratko, Aman-preet Randhawa

Children diagnosed with autism spectrum disorder (ASD) are likely to experience sleep disturbance. Evidence supports the effectiveness of functional analysis and behavioral sleep interventions to address sleep problems. However, these approaches are resource intensive in terms of assessment and measurement of target sleep behaviors, intervention implementation, and progress monitoring. Recent advances in the use of technology and telehealth in behavioral services may improve the efficiency and effectiveness of behavioral intervention. We evaluated the effectiveness of a hybrid (face-to-face and telehealth) model of behavioral sleep assessment and intervention as implemented by community-based behavior analysts. We used motion/sound detection cameras and various “apps,” for remote viewing, caregiver coaching, data collection, and treatment decision making. We explored the agreement between various data sources. Three autistic children, who engaged in caregiver reported unwanted co-sleeping or behavioral sleep challenges, participated in the study along with their caregivers. A nonconcurrent multiple baseline design across participants was used to evaluate the effects of the intervention on sleep onset delay, sleep interfering behavior, and total sleep duration. For two participants, caregiver co-sleeping was eliminated, target bedtimes were achieved, and child participants regularly achieved an age-appropriate amount of sleep. Caregivers rated the intervention and child outcomes positively. The results provide preliminary evidence for the use of telehealth technology to provide caregiver coaching, monitor child progress, and make timely data-based treatment decisions. Results of this study may be used to increase the efficiency of––and access to––behavioral sleep assessment and intervention.

被诊断患有自闭症谱系障碍(ASD)的儿童很可能会出现睡眠障碍。有证据支持功能分析和行为睡眠干预对解决睡眠问题的有效性。然而,这些方法在目标睡眠行为的评估和测量、干预措施的实施和进展监测方面需要大量资源。最近在行为服务中使用技术和远程医疗的进步可能会提高行为干预的效率和效果。我们评估了由社区行为分析师实施的混合(面对面和远程医疗)睡眠行为评估和干预模式的有效性。我们使用运动/声音检测摄像头和各种 "应用程序 "进行远程观察、护理人员辅导、数据收集和治疗决策制定。我们探讨了各种数据源之间的一致性。三名自闭症儿童与他们的看护人一起参与了研究,据看护人报告,这些儿童不愿意与他人同睡或存在睡眠行为障碍。研究采用非同期多基线设计,评估干预措施对睡眠开始延迟、睡眠干扰行为和总睡眠时间的影响。有两名参与者取消了照顾者与他们同睡的情况,实现了目标就寝时间,而且儿童参与者定期获得了与年龄相适应的睡眠时间。照顾者对干预措施和儿童的结果给予了积极评价。研究结果为使用远程医疗技术提供护理人员指导、监控儿童进展以及及时做出基于数据的治疗决策提供了初步证据。这项研究的结果可用于提高行为睡眠评估和干预的效率,并增加获得这些评估和干预的机会。
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引用次数: 0
Empowering Mexican Women in Behavior Analysis 增强墨西哥妇女在行为分析领域的能力
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-06-18 DOI: 10.1007/s40617-024-00952-y
Rosalinda Arroyo, Isaac Camacho

Considering empowerment as a circumstance under which power is extended, this article describes the elements of a metacontingency that allow such a function transfer to occur. Particular interest is placed on the empowerment of Mexican women in higher education and its unsatisfactory state. Mentoring is proposed as a tool for the empowerment of women in behavior analysis. In particular, the article presents an outline of a 2-year mentoring program that will promote interlocked behavioral contingencies and their products, which can be selected by the proper academic environment. This program also promotes the development of the mentee's agency and a set of data related to the products being created. Finally, this article highlights the possibility that such a mentorship program can empower female behavior analysts in Mexico and begin to change the cultural practices that uphold inequality for women.

考虑到赋权是权力得以扩展的一种情况,本文描述了允许这种职能转移发生的元权变的要素。文章特别关注墨西哥妇女在高等教育中的赋权情况及其不尽如人意之处。文章建议将指导作为在行为分析领域增强妇女能力的一种工具。文章特别提出了一个为期两年的指导计划大纲,该计划将促进环环相扣的行为偶发事件及其产物,并可通过适当的学术环境进行选择。该计划还将促进被指导者机构的发展以及与正在创造的产品相关的一系列数据。最后,本文强调了这样一个导师计划能够增强墨西哥女性行为分析师的能力,并开始改变维护女性不平等的文化习俗的可能性。
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引用次数: 0
Training Behavior Analysis Graduate Students to Work with an Interpreter 培训行为分析专业研究生与口译员合作
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-30 DOI: 10.1007/s40617-024-00938-w
Danika J. Vazquez, Sarah A. Lechago, Morgan J. McCarville

There has been a substantial increase in the racial and ethnic diversity of the United States population in the past 10–12 years, with the second most prevalent racial or ethnic group being Hispanic or Latino (Jensen, 2021). As a result, it is crucial that behavior analysts are prepared to serve consumers from all backgrounds, including those who do not speak English fluently. One important component for service delivery for linguistically diverse consumers is the incorporation of an interpreter. Given that few peer-reviewed articles in behavior analysis have been published regarding working with interpreters, the current study evaluated the effectiveness of Behavioral Skills Training (Fleming et al., 1996 Journal of Organizational Behavior Management, 16(1), 3–25) to teach behavior analysis graduate students to work with an interpreter during behavior analytic service provision with Spanish-speaking families. The results of this study show that practitioners can be trained to work with an interpreter in a relatively short amount of time. However, training with an interpreter did not affect caregiver comprehension. The results of the satisfaction surveys suggest that the interpreters noted significant improvements in the practitioners’ responding following training, whereas the caregivers did not. The participants also completed satisfaction surveys following the study and indicated positive experiences with the training.

在过去的 10 到 12 年间,美国人口的种族和民族多样性有了大幅提高,第二大种族或民族群体是西班牙裔或拉丁裔(Jensen,2021 年)。因此,行为分析师必须做好准备,为来自各种背景的消费者提供服务,包括那些英语不流利的消费者。为语言不同的消费者提供服务的一个重要组成部分就是配备翻译人员。鉴于行为分析领域很少有关于与口译员合作的同行评审文章,本研究评估了行为技能培训(Fleming 等人,1996 年《组织行为管理杂志》,16(1),3-25)对行为分析研究生在为西班牙语家庭提供行为分析服务时与口译员合作的教学效果。研究结果表明,可以在较短的时间内对从业人员进行培训,使其能够与口译员一起工作。然而,使用口译员进行培训并不会影响照护者的理解能力。满意度调查的结果表明,口译员注意到从业人员在培训后的反应有了明显改善,而护理人员则没有。参与者也在研究结束后完成了满意度调查,并表示对培训有积极的体验。
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引用次数: 0
A Primer on Private Equity Ownership in ABA 美国律师协会私募股权投资所有权初探
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-05-28 DOI: 10.1007/s40617-024-00941-1
Cody Morris, Emma Grauerholz-Fisher, Megan E. Ellsworth, Caroline E. Crocker

The applied behavior analysis (ABA) service industry is currently estimated to be worth at least $4 billion. As a result of potential profits that can be made from ABA services, for-profit organizations have become more common in the field. One type of for-profit organization that has become especially prominent in the ABA service industry is private equity (PE)-owned ABA companies. As PE ownership has become more common in ABA and other human service industries, concerns about PE ownership have grown across disciplines. The current article focuses specifically on PE’s involvement in ABA services. The definition of PE and its fundamental components are discussed, along with their potential benefits and risks. The potential impacts of PE and opportunities for future research are also discussed.

据估计,应用行为分析(ABA)服务行业目前至少价值 40 亿美元。由于可以从 ABA 服务中获取潜在利润,营利性组织在该领域变得越来越普遍。在 ABA 服务行业中尤为突出的一种营利性组织是私募股权(PE)拥有的 ABA 公司。随着 PE 所有权在 ABA 和其他人类服务行业越来越普遍,各学科对 PE 所有权的关注也越来越多。本文特别关注 PE 参与 ABA 服务的情况。文章讨论了 PE 的定义及其基本组成部分,以及其潜在的好处和风险。文章还讨论了 PE 的潜在影响和未来研究的机会。
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引用次数: 0
Do Cultural Adaptations Matter? Comparing Caregiver Training in Different Language for Latino Caregivers of Autistic Children: A Telehealth-Based Evaluation 文化适应重要吗?比较针对拉丁裔自闭症儿童照护者的不同语言照护者培训:基于远程医疗的评估
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-04-17 DOI: 10.1007/s40617-024-00930-4
Fabiola Vargas Londono, Terry S. Falcomata, Nataly Lim, Andrea Ramirez-Cristoforo, Yuria Paez, Annabel Garza

Culturally and linguistically diverse (CLD) families of autistic children face unique challenges in accessing services that are appropriate for their cultures and languages. The purpose of the current study was to evaluate the impact of training language on caregiver skill acquisition. Using behavioral skills training (BST) through telehealth, three Latino caregivers whose first language is Spanish were taught to implement two different behavioral protocols with their autistic children. For one protocol, BST was done in Spanish; for the other, BST was done in English. Overall, the training in each family’s first language was (1) more efficient at promoting the skill acquisition of both caregivers and children; (2) rated by caregivers as more socially valid, and (3) associated with higher levels of caregivers’ indices of personalismo, involvement, and happiness. Findings suggest that cultural adaptations may be necessary to provide more effective and enjoyable training for CLD families.

自闭症儿童的文化和语言多元化(CLD)家庭在获得适合其文化和语言的服务方面面临着独特的挑战。本研究旨在评估语言培训对照顾者技能掌握的影响。通过远程医疗的行为技能培训 (BST),三名母语为西班牙语的拉丁裔照顾者学会了对自闭症儿童实施两种不同的行为方案。其中一个方案的 BST 用西班牙语进行,另一个方案的 BST 用英语进行。总体而言,以每个家庭的母语进行的培训(1)在促进照顾者和儿童掌握技能方面更有效;(2)照顾者认为更具有社会有效性;(3)与照顾者更高的个人主义、参与度和幸福感指数相关。研究结果表明,要想为中国儿童早期发展(CLD)家庭提供更有效、更愉快的培训,可能需要进行文化调整。
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引用次数: 0
Unrestricted Learning Opportunities for Trainees in Behavior Analysis: A Survey of Current Practices 行为分析受训人员的无限制学习机会:当前做法调查
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-04-11 DOI: 10.1007/s40617-024-00931-3
Clare J. Liddon, Madison Crandall, Regan Weston

Individuals seeking certification as a board certified behavior analyst (BCBA) by the Behavior Analyst Certification Board (BACB) must meet certain eligibility requirements. In addition to passing the BCBA examination, such requirements include completion of a master’s degree, behavior-analytic coursework, and supervised practical fieldwork. In accruing fieldwork hours, trainees must be provided with the opportunity to complete unrestricted activities. The BACB defines unrestricted activities as “. . . those that are most likely to be performed by a BCBA,” and requires that 60% of fieldwork hours are comprised of these activities (BACB, 2022b). Fieldwork hours may be accrued across a number of different host sites (e.g., hospital units, schools, community locations), with each host site having different day-to-day responsibilities affecting how these opportunities are provided. Therefore, exploration of the provision of these opportunities and the barriers to providing these opportunities is warranted. The current study sought to determine the current practices involved in provision of opportunities to gain fieldwork experience hours towards BCBA certification; in particular, practices related to unrestricted fieldwork activities. Results indicate that, although unrestricted learning opportunities are often provided to trainees, contingencies present within the day-to-day operations of a clinical environment can be hampering. A discussion of the implications of these barriers and potential solutions are included.

申请行为分析师认证委员会(BACB)认证的行为分析师(BCBA)必须满足一定的资格要求。除通过 BCBA 考试外,这些要求还包括完成硕士学位、行为分析课程和有监督的实地实践。在积累实地工作时数时,学员必须有机会完成不受限制的活动。BACB 将非限制性活动定义为"......那些最有可能由 BCBA 执行的活动",并要求 60% 的实地工作时数由这些活动组成(BACB,2022b)。实地工作时数可在多个不同的接待场所(如医院、学校、社区)累积,每个接待场所的日常职责不同,会影响这些机会的提供方式。因此,有必要探讨这些机会的提供情况以及提供这些机会的障碍。目前的研究旨在确定目前在提供获得 BCBA 证书所需的实地工作经验小时数机会方面的做法;特别是与不受限制的实地工作活动有关的做法。结果表明,尽管经常向受训者提供不受限制的学习机会,但临床环境日常运作中存在的意外情况可能会阻碍学习。本文还讨论了这些障碍的影响和潜在的解决方案。
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引用次数: 0
Making Deception Fun: Teaching Autistic Individuals How to Play Friendly Tricks 让欺骗变得有趣:教自闭症患者如何玩友善的把戏
IF 2.2 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-04-10 DOI: 10.1007/s40617-024-00935-z
Megan St. Clair, Kacie Massoudi, Jonathan Tarbox, Adel Nadjowski, Lauri Simchoni, Marianne Jackson, Angela Persicke

Perspective taking is a critical repertoire for navigating social relationships and consists of a variety of complex verbal skills, including socially adaptive forms of deception. Detecting and being able to use socially adaptive deception likely has many practical uses, including defending oneself against bullying, telling white lies to avoid hurting others’ feelings, keeping secrets and bluffing during games, and playing friendly tricks on others. Previous research has documented that some Autistic1 children have challenges identifying deception and playfully deceiving others (Reinecke et al., 1997). The current study employed a multiple baseline across participants design to evaluate the use of multiple exemplar training, rules, modeling, practice, and feedback for teaching four Autistic children and adolescents to use deception to play friendly tricks on others. The procedure was successful for all participants, and generalization was achieved across novel, untrained tricks.

透视法是在社会关系中游刃有余的关键技巧,它由各种复杂的语言技能组成,包括适应社会的各种形式的欺骗。发现并善于使用社会适应性欺骗可能有很多实际用途,包括抵御欺凌、说白色谎言以避免伤害他人感情、保守秘密和在游戏中虚张声势,以及对他人进行友好的欺骗。先前的研究表明,一些自闭症1 儿童在识别欺骗和游戏性地欺骗他人方面存在困难(Reinecke 等人,1997 年)。目前的研究采用了跨参与者的多基线设计,以评估在教导四名自闭症儿童和青少年使用欺骗手段对他人进行友好的戏弄时,使用多重范例训练、规则、示范、练习和反馈的情况。该程序对所有参与者都是成功的,并在新颖的、未经训练的把戏中实现了泛化。
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引用次数: 0
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Behavior Analysis in Practice
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