Behavior Modification最新文献

Building on studies of preferences for social interaction in children with autism spectrum disorder (ASD) we sought to provide a way for siblings with ASD to express their perspective about the quality of their sibling relationships. We developed a behavioral assessment of sibling relationship preference (Sibling Relationship Assessment [SRA]) and examined the psychometric properties of test-retest reliability, inter-rater reliability, and convergent validity. The SRA was feasible to administer and revealed expected differences between sibling dyads with one sibling with ASD compared to typically-developing sibling dyads. We found strong positive correlations for inter-rater reliability and test-retest reliability and convergent validity. The SRA provides a way to assess the perspective of the sibling with ASD that taps one characteristic, preference for spending time with one's sibling, of the quality of sibling relationships.

Applied behavior analysts have traditionally relied on visual analysis of graphic data displays to determine the extent of functional relations between variables and guide treatment implementation. The present study assessed the influence of graph type on behavior analysts' (n = 51) ratings of trend magnitude, treatment decisions based on changes in trend, and their confidence in decision making. Participants examined simulated data presented on linear graphs featuring equal-interval scales as well as graphs with ratio scales (i.e., multiply/divide or logarithmic vertical axis) and numeric indicators of celeration. Standard rules for interpreting trends using each display accompanied the assessment items. Results suggested participants maintained significantly higher levels of agreement on evaluations of trend magnitude and treatment decisions and reported higher levels of confidence in making decisions when using ratio graphs. Furthermore, decision making occurred most efficiently with ratio charts and a celeration value. The findings have implications for research and practice.

Video feedback following social anxiety exposures improves self-perceptions. Clinical studies have not examined whether feedback from group members has incremental benefit beyond that of viewing the tape itself. Sixty-seven individuals with social anxiety disorder completed videotaped exposure during group based cognitive behavior therapy (CBT). After participants viewed their taped exposure, group members and therapists gave feedback. Participants completed ratings of anxiety and performance before and after taping their exposure, after viewing the video themselves, and after receiving group feedback. Appraisal of social concerns were assessed after taping, viewing, and group feedback. There were significant improvements in anxiety, performance, and decreased social concerns across time points. Comparing only the time points of after viewing and after receiving group feedback, the same pattern emerged for anxiety, performance, and appraisal of social concerns, with moderate to large effect sizes. Group feedback led to ratings that exceeded their own initial evaluation of their video. Video feedback in group CBT that also includes feedback from others may improve clinical outcomes.

The Caught Being Good Game (CBGG) is a classroom management intervention which is described as a variation of the classic Good Behavior Game (GBG). It is based on the principle of positive reinforcement, such that teams of students can earn points for following the class rules during the game. Points are awarded by the teacher at different intervals during the game and these intervals were the focus of the current study. We aimed to determine if the CBGG is effective with an initially dense schedule of reinforcement which is progressively thinned. The efficacy of the CBGG in targeting academic engagement and disruptive behavior was demonstrated for one primary school class and for two target students in that class. The game remained effective when the reinforcement schedule was thinned from 2 minutes, up to 5 minutes. This has potential implications for teacher time saving while playing the game.

Cognitive Behavior Therapy (CBT) for bulimia nervosa (BN) requires patient skill utilization (use of treatment skills) and skill acquisition (successful skill use) for symptom improvement. Treatment outcomes are unsatisfactory, possibly due to poor skill acquisition and utilization by post-treatment. Just-in-time adaptive interventions (JITAIs), momentary interventions delivered at opportunities for skill practice, may improve skill acquisition and utilization. Participants (N = 56 individuals with bulimia-spectrum eating disorders) completed electronic self-monitoring in CBT+ and received JITAIs or no JITAIs alongside 16 sessions of CBT. Feasibility, acceptability, target engagement, and treatment outcomes were evaluated. JITAIs demonstrated feasibility and acceptability. Treatment outcomes and target engagement did not differ between conditions. The lack of group differences in target engagement and treatment outcomes may be explained by skill use self-monitoring promoting skill utilization and acquisition or low statistical power. Our findings suggest that JITAIs are feasible and acceptable during CBT for BN and warrant additional study.

Shame is considered central in body dysmorphic disorder (BDD) and empirical accounts highlight the link between shame and BDD symptoms as well as common negative psychosocial effects of the disorder, yet there is a lack of interventions addressing shame in this context. In the past decade, Acceptance and commitment therapy (ACT) and interventions that foster self-compassion have shown promise for reducing the negative effects of shame in a range of clinical problems. The aim of the present study was to develop and evaluate an acceptance and compassion-based treatment specifically targeting shame in BDD. Using a randomized nonconcurrent multiple baseline design, the 12-session intervention, ACT with Compassion (ACTwC), was examined in a psychiatric outpatient sample of five adults diagnosed with BDD. The daily ratings showed marked reductions in BDD-behaviors and self-criticism at posttreatment for four of five participants, while three participants demonstrated decreases in body shame compared to baseline. Improvements were maintained at 6-months follow-up. The intervention also led to reliable long-term improvements in general shame, overall BDD-symptoms, depressive symptoms, and quality of life for four of five participants. All treatment responders showed significant gains in psychological flexibility and self-compassion. Participants reported high credibility and satisfaction with the treatment. These preliminary results suggest that ACTwC may be a promising approach to treating shame in BDD, worthy of further investigation.

Behavioral technicians (BT) within the field of applied behavior analysis may be at greater risk for experiencing burnout and stress due to the nature of their clients, job demands, and work environments. Burnout and stress may negatively impact BT's work performances, more specifically, their treatment integrity. Acceptance and Commitment Training (ACT) may be a useful tool to address the private events as well as the covert and overt behaviors associated with burnout and stress. The purpose of this study was to investigate the effects of an ACT intervention on improving treatment integrity and reducing work-related burnout and stress amongst BTs. Four BTs participated in an ACT workshop, and their treatment integrity as well as their burnout and stress levels were measured prior to and following the ACT workshop. Treatment integrity increased for all participants, suggesting that ACT-based interventions may be an effective approach to improving work performance (i.e., treatment integrity) amongst BTs who may experience workplace burnout and stress.

Caregiver training is an important component of behavioral intervention; however, many barriers exist for in-person training. Alternatively, behavioral therapists may use telehealth as a service delivery method. To effectively train caregivers through telehealth, therapists should receive explicit training, but there has been limited research on effective methods for teaching this skill. The purpose of the current study was to evaluate video modeling with voice-over instruction (VMVO) to train therapists to implement 11 component skills of caregiver training through telehealth to teach confederate caregivers to implement a guided compliance procedure. We measured the therapist's implementation of the component skills during a scripted role-play before and after video-model training within a multiple baseline design across participants. We also conducted maintenance and generalization probes to a novel skill. All seven therapists learned the skill, but three therapists required a feedback component in addition to the VMVO. The results suggest that VMVO may be an efficient and effective method for training therapists to conduct caregiver training via telehealth. Furthermore, results indicate that component skill analyses may be valuable to monitor skills that require remediation.

Since the early 2000s, telehealth has been used to provide behavior analytic intervention to individuals with autism spectrum disorder (ASD). Evaluating evidence supporting telehealth remains valuable, especially as there has been increased accessibility since the COVID-19 pandemic. Although there is empirical support for telehealth as an effective service-delivery option, important variables (e.g., costs, implementer training) remain unknown. Despite potential roles in telehealth service-delivery models, a careful review of participant prerequisite skills, implementer characteristics (e.g., experience, education), technology variables (e.g., HIPAA compliance), and skill(s) targeted (i.e., mastered or untrained skills) have not been considered. Therefore, we aimed to extend prior telehealth literature reviews by evaluating current research across variables important for telehealth service-delivery involving individuals with ASD. We found thorough descriptions of participants and implementers, implementer training, and social validity evaluations. Limitations of telehealth literature include exclusion of teen and adult participants, limited description of prerequisite skills and evaluations of direct telehealth interventions. Future research areas were identified.