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| #341 Poster Session - CBM |
| Monday, May 31, 2004 |
| 12:00 PM–1:30 PM |
| Exhibit Hall D (Hynes) |
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| 35. Can Blind Faith in the "New Biological Psychiatry" be Reined In? Update on the Marshall Project |
| Area: CBM; Domain: Applied Research |
| W. JOSEPH WYATT (Marshall University), Donna Midkiff (Marshall University) |
| Abstract: In the past thirty or forty years the biological causation model of behavioral difficulties has emerged in surprisingly strong form, despite the relative paucity of supporting data for biological causation of many clinical problems. The financial interests of entities such as organized psychiatry, the pharmaceutical industry and the insurance industry have played major roles in the resurgance (Wyatt, 2003). This ongoing project will expose professionals (physicians, medical students, psychology graduate students) and laypersons to a training session designed to educate them about the data that support biological causation of several classes of disorders (depression, anxiety, schizophrenia, ADHD) and the variables that have influenced the model's resurgence. The training session is modeled after a three CE presentation at ABA 2002 (Wyatt, 2002). Pre-post assessment of participants' strength of belief in the biological causation model will be done. Data collection is underway. |
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| 38. An Internet-Based Voucher Program for Smoking Abstinence |
| Area: CBM; Domain: Applied Research |
| IRENE M. GLENN (University of Florida), Taryn M. Manders (University of Florida), Matthew L. Locey (University of Florida), Bethany R. Raiff (University of Florida), Jesse Dallery (University of Florida) |
| Abstract: Abstinence reinforcement therapy is effective in promoting drug abstinence. Few studies, however, have extended this treatment to smokers. The current study is a preliminary investigation of an internet-based voucher program for initiating smoking abstinence. Two carbon monoxide (CO) samples were obtained daily for all conditions. Participants recorded the sampling procedure by using a web cam, and they emailed the video clip from their home to research staff. The effects of the program were evaluated by using an ABCBC design. During the baseline (A) condition, carbon monoxide (CO) samples were obtained twice per day. During treatment (B) conditions, participants could earn vouchers contingent on 10% reductions from the mean baseline CO. After the first negative sample (CO<7ppm), all subsequent samples had to be negative for voucher delivery. During yoked (C) conditions, the vouchers earned in B were “played back” to the participant. The voucher intervention included a progressively increasing schedule of voucher values, bonus vouchers for consecutive negative samples, and a reset contingency for positive samples. Preliminary results suggest that participants initiated abstinence only when vouchers were contingent on reduced or negative CO samples. |
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| 39. The Use of Behavioral Interventions to Decrease the Frequency of Inappropriate Behavior in an Adult Male with Paranoid Schizophrenia |
| Area: CBM; Domain: Applied Research |
| PATRICIA RIVERA (Judge Rotenberg Educational Center), Robert Von Heyn (Judge Rotenberg Educational Center), Matthew L. Israel (Judge Rotenberg Educational Center) |
| Abstract: This extensive case study will present a review of behavioral interventions used to decrease the frequency of inappropriate behavior in a 44 y.o. male with paranoid schizophrenia. A history which includes severe aggressive behavior, multiple suicide attempts and other health dangerous behavior will be discussed. Prior interventions included the use of at least 15 different psychotropic medications, more than 25 psychiatric hospitalizations, months of electroconvulsive shock therapy and placements in adult residential facilities failed to produce significant behavioral change. Strict behavioral programming was implemented upon his admission to the Judge Rotenberg Center and he was slowely weaned off of his medications. The use of positive programming included a standardized token system, DRO contracts of varied lengths, and an extensive reward program. After nearly 6 months of treatment, punishment in the form of a contingent skin shock was also implemented to decelerate his most problematic behaviors. Following the reduction of his major behaviors to near zero rates, Risperdal and Zyprexa were started to reduce his bizarre verbalizations and allowed for the weaning of the skin shock device. Standard celeration charts showing significant deceleration in aggressive, health dangerous, destructive, major disruptive and non-compliant behaviors will also be presented. |
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| 40. Using Precision Teaching to Increase Social Skills Fluency in an Adult Diagnosed with Paranoid Schizophrenia |
| Area: CBM; Domain: Applied Research |
| STACI L. SAYLORS (University of the Pacific), Lauren C. Wasano (University of the Pacific), Cynthia J. Lopez (University of the Pacific), Adrienne F. Granadosin-Deanes (University of the Pacific) |
| Abstract: The consumer for this study was an adult diagnosed with Paranoid Schizophrenia who was receiving Community Behavioral Intervention Services. When referred for services, the consumer demonstrated specific social skills deficits in the areas of initiating conversations and maintaining conversations. According to both care provider and consumer reports, he had limited social interaction with peers, particularly those outside of the mental health system. Precision teaching was used to increase his rate of responding and to train his specific social skills deficits. Timing occurred from 1 – 3 times a week. The consumer showed significant improvement after training. |
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| 41. A Behavioral Account of Stages of Change |
| Area: CBM; Domain: Applied Research |
| GARETH I. HOLMAN (University of Washington), Robert J. Kohlenberg (University of Washington), Madelon Y. Bolling (University of Washington) |
| Abstract: We provide a behavioral account of the Stages of Change (SOC) model, a popular construct for studying behavior change which posits four stages - precontemplation, contemplation, action, and maintenance - and provides a reliable measure for assessing which stage a client is in (McConnaughy et al., 1983 and 1989). Recent research has related SOC to treatment outcome in clinical populations with the implication that modulation of the therapeutic relationship and intervention style to match client SOC would improve outcomes (Prochaska and Norcross, 2001). The rationale for SOC was originally based on a 'transtheoretical perspective' incorporating aspects of various theories. Its analysis is similar to the analysis of context that occurs in functional analysis. We evaluate the advantages of this functional conception for understanding client history and movement through Stages of Change and its broader implications for improving outcome. We explore the role of behavioral interventions such as FAP (Kohlenberg and Tsai, 1991) and ACT (Hayes, Strosahl, and Wilson, 1999) in relation to SOC. Data obtained from a sample of clients (n=40) enrolled in a study evaluating talk-therapy treatments of depression is used to illustrate the functional re-conceptualization. |
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| 42. Dual Diagnosis: The Behavioral Treatment of Traumatic Brain Injury and Pre-morbid Chronic Dur and Alcohol Abuse |
| Area: CBM; Domain: Applied Research |
| DANIEL D. KNITTEL (Florida Institute for Neurologic Rehabilitation, Inc.), Bridget A. Shore (Florida Institute for Neurologic Rehabilitation, Inc.), Claudia L. Dozier (Florida Institute for Neurologic Rehabilitation, Inc.), Shannon L. Root (Florida Institute for Neurologic Rehabilitation, Inc.) |
| Abstract: Alcohol use shortly before injury is the most commonly cited predisposing factor in traumatic brain injury, and pre-injury substance abuse has been documented in 40-66% of traumatic brain injury survivors. This poster’s purpose is to outline a behavioral contract intervention for patients with traumatic brain injury and histories of drug and/or alcohol abuse. Behavioral contracts consisting of reinforcement for the absence of drug/alcohol use, participation in therapy and vocational activities, compliance with program rules, and the absence of other inappropriate behaviors, and response cost were implemented for all three participants. Response cost consisted of increased levels of supervision, decreased community privileges, and more restrictive living environments contingent on drug or alcohol use or other targeted inappropriate behavior. Reinforcement also included participant-selected community activities, decreases in staff supervision, and increased community participation (e.g., community employment, community college). All participants showed initial noncompliance with drug/alcohol abstinence and subsequent compliance with the behavioral contracts. All three met criteria for independent living, community employment and/or college participation. Reliability for target behaviors was obtained for at least one-third of admission days, and showed 80% or greater inter-observer agreement. Results suggest that behavioral contracts may facilitate drug and alcohol rehabilitation for patients with traumatic brain injury. |
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| 43. Treatment of Compulsive Gambling |
| Area: CBM; Domain: Applied Research |
| THOMAS ZIMMERMANN (Lienveien), Jørn Stensvold (Lienveien), Erik Arntzen (Akershus University College, Norway) |
| Abstract: A program for treatment of compulsive gambling is presented. The participant in the study was a 27-year old teacher, which is actually the first author of this presentation. Before the treatment started he spent about $3.000 a month. The treatment included training of alternative types of behavior. After the start of the treatment he has not spent any money on gambling for nearly two years. |
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| 44. Treatment of Chronic Aphasia with Errorless Learning Procedures: A Direct Replication |
| Area: CBM; Domain: Applied Research |
| MAGNUS SIGHVATSSON BLONDAHL (University of Iceland), Z. Gabriela Sigurdardottir (University of Iceland) |
| Abstract: One male, aged 67, with chronic broca’s aphasia as a result of stroke received treatment based on errorless learning procedures and operant conditioning for almost seven months. Treatment effects were evaluated with a multiple-baseline design across behaviors. Treatment was applied to making sentences and sequencing stimuli (e.g., months). Treatment variables were clearly defined and systematically used in standard ways across tasks using clearly defined criteria for fading prompts in or out depending on performance. Prompts were faded out as performances improved. Mean inter-scorer agreement for both dependent variables was 95.5%, however, inter-scorer agreement ranged from 87-100 percent in one variable (making sentences) but was always 100 percent in the other variable (sequencing stimuli). Mean inter-scorer agreement for experimenter’s use of correct prompt in the first task was 100 percent but was 94.5% for the latter task, range 67-100 percent. Low reliability is due to number of opportunities to respond in the task, i.e, only three, thus, scores could only be 33, 67 and 100. Participant’s performances improved significantly in both tasks, his performance in sequencing reached 100% correct performance without any prompts from the experimenter and has not deteriorated. Generalization across stimuli and settings is presently being assessed. |
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| 45. Assessing Mental Health Outcomes with a Frequency-based Activity Measure |
| Area: CBM; Domain: Applied Research |
| JENNIFER L. ZINKE (Illinois Institute of Technology), Charles T. Merbitz (Illinois Institute of Technology) |
| Abstract: The Activity Importance Measure (AIM; Clorfene, 2000) asks individuals to report frequencies of 20 critical pro-social functional activities. With weekly administration it tracks changes in these behaviors over time. One key feature of the AIM is that goals are defined in terms of activities and positive functioning rather than deficits and symptoms. Changes over time are evaluated by reviewing the frequencies of activities; since goals are stated in these terms, participants can see progress (or the lack thereof) immediately, and treatment can be adjusted accordingly. Thus the AIM may be deployed as a formative (process) measure as well as a summative (outcome) measure. In this work 24 participants in an outpatient mental health setting used the AIM (English or Spanish version) over four months. In one of the two groups, the AIM responses and goals were reviewed by both the participant and clinician within each session; in the other responses and goals were collected and filed in the participant’s chart without participant-clinician review. Data are presented on Weekly Standard Celeration Charts (SCC) to illustrate change over time in a simple, easy to interpret format; English/Spanish and review/no review data are compared. |
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| 46. Functional Analysis in Clinical Applications of Behavior Analysis |
| Area: CBM; Domain: Applied Research |
| SIMONE NENO (Federal University of Para, Brazil), Emmanuel Z. Tourinho (Federal University of Para, Brazil) |
| Abstract: Clinical applications of behavior analysis have been discussed either with a focus on the use of “contingency management procedures” (applied behavior analysis), or with an emphasis on the use of “verbally based interventions” (clinical behavior analysis). Those two perspectives differ with respect to clinical problems or populations, and also to the context of intervention. Nevertheless, a link between both types of intervention is their commitment to functional analysis, though one finds little consensus in contemporary literature concerning its goals, limits or scope. The present work discusses the features of a clinical application of functional analysis consistent with behavior-analytic principles and suggests that these features may be seen as: a) selectionism as a causal model and functionalism as the principle for analysis; b) externalism as analytical orientation; c) the complexity, variability, and idiosyncrasy of behavioral relations; d) the pragmatic criteria for defining the intervention level; e) the distinction between assessment scope and intervention scope. Such features may provide a framework for a critical discussion of diagnostic criteria as well as for different models of intervention. |
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| 47. Effects of a Brief Exercise Program on Activity Patterns of Sedentary Hospital Health Care Workers |
| Area: CBM; Domain: Applied Research |
| PARSLA VINTERE (Queens College and The Graduate Center, City University of New York), Susan M. Schnall (Bellevue Hospital Center), Claire L. Poulson (Queens College and The Graduate Center, City University of New York) |
| Abstract: The effects of a brief exercise program on activity patterns of hospital health care workers with sedentary jobs during their 20-minute break period were experimentally analyzed. Three health care workers participated in the study. A multiple-baseline design across participants was used. Interobserver agreement was conducted on the two dependent variables (number of target movements and time allocation) during 30% of all sessions across all phases. The mean agreement was 96%. All participants chose to engage in the brief exercises instead of a more sedentary activity during their 20-minute break period. All participants reported an increase in perceived state of relaxation at the end of the 20-minute break period compared to the beginning of the break period regardless of the form of activity in which they engaged. Nevertheless, for all participants there was an increase in time allocation in “relaxation related” activities as opposed to “work related” activities during the last 5 minutes of the maintenance sessions compared to the baseline sessions. |
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| 48. Building the Treatment Program on a Children’s Emergency Psychiatric Unit |
| Area: CBM; Domain: Applied Research |
| DANA M. DAHMAN HARVEY (Project 12-Ways, Southern Illinois University), Elizabeth C. Nulty (Project 12-Ways, Southern Illinois University), David Griggs (Choate Mental Health Center), Paula K. Davis (Southern Illinois University), Brandon F. Greene (Southern Illinois University) |
| Abstract: This study was conducted on an emergency psychiatric unit for children and adolescents. A treatment program was designed to include, in part, a series of structured daily living (e.g., meal preparation) and leisure (e.g., board games) activities in which the children could participate. The children’s and staff’s participation in both types of activities was assessed using a time sampleing system during a 2-hour period surrounding dinner. During an alternating treatments phase the program supervisor was either absent or present on the unit gathering data and providing staff with feedback regarding their efforts to involve children in both types of activities. When present, the supervisor also publicly posted data reflecting the extent of staff and children’s engagement in these activites. During a withdrawal phase the supervisor was absent from the unit for an extended period. The results indicated children’s participatoin in leisure activities was not affected by staff. However, children’s engagement in activities of daily living was affected by the extent to which staff engaged them in such activities. Staff’s effort to engage children in daily living actiities was, in turn, affected by the degree to which the supervisor was present to provide immediate and posted feedback. |
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