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| New Wine for an Old Bottle: Innovative Solutions for Common Clinical Challenges |
| Monday, May 31, 2004 |
| 10:30 AM–11:50 AM |
| Fairfax B |
| Area: EAB/TBA; Domain: Applied Research |
| Chair: Clinton E. Field (Girls and Boys Town) |
| Discussant: Patrick C. Friman (Girls and Boys Town) |
| Abstract: . |
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| Evaluating a Clinical Application of an In-vivo, Exposure-based Anger Management Intervention for Adolescents in Residential Care |
| MICHAEL I. AXELROD (Girls and Boys Town), Tonya Butler (Girls and Boys Town), Michael L. Handwerk (Girls and Boys Town) |
| Abstract: The clinical treatment of reactive anger in adolescents typically involves some combination of cognitive-behavioral strategies (e.g., contingency management, social skills training, rehearsal strategies). While research examining the effectiveness of these strategies for aggressive behavior has found them to be more effective than non-behavioral approaches, traditional cognitive-behavioral interventions are not without their limitations. For example, rehearsal strategies are often implemented by professionals far removed from the environment that provokes the anger reaction. In response to these limitations, several recent studies have expanded upon Kauffmann and Wagner’s (1972) “Barbing” technique for aggressive adolescents. In these studies, aggressive adolescents in residential care were exposed to anger-provoking situations in as natural an environment as possible and rewarded for appropriate responding.The purpose of this study was to evaluate the effectiveness of similar procedures for three adolescent females living in a family style residential program. This study differs from previous studies in that it applies the intervention to three youth living in the same family style home. Results provide further evidence supporting the use of an in-vivo, exposure-based anger management intervention for youth in residential care. Discussion focuses on the value of such findings in advancing empirical support for this intervention approach, especially applied to different target samples. |
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| Have We Been Wrong? Time-out for Escape Maintained Behaviors |
| NANCY L. FOSTER (Girls and Boys Town), T. Steuart Watson (Private Practice), Clint Field (Girls and Boys Town) |
| Abstract: Time-out from reinforcement is an empirically supported intervention for a variety of disruptive behaviors exhibited by children. Although the data are voluminous on specific techniques and applications of time-out, one major limitation in the current literature is that time-out is often contraindicated for behaviors maintained by escape. The present study demonstrates that time-out can be effective for behaviors that function to avoid or escape situations. First, functional assessment and analyses were conducted with typically developing children referred to a behavioral pediatric clinic to identify disruptive behaviors maintained by escape. The components of the current time-out procedure utilized empirically-based techniques and were implemented in the clinic (to ensure treatment integrity) and by parents (to promote generalization). Treatment integrity data were collected on all phases of the functional analyses and time-out procedures. The results support the use of specific time-out procedures for behaviors maintained by escape or avoidance. Discussion focuses on implications for research and applied clinical practice with typically developing children. |
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| A Preliminary Investigation of the Vibrating Urine Alarm |
| CLINT FIELD (Girls and Boys Town), Michael I. Axelrod (Girls and Boys Town), Nancy L. Foster (Girls and Boys Town), Tonya Butler (Girls and Boys Town), Michael L. Handwerk (Girls and Boys Town) |
| Abstract: Nocturnal enuresis is a relatively prevalent condition among children that is often mistreated despite the availability of empirically supported behavioral interventions. The urine alarm has often been described as the most effective intervention available for treating this condition. It works by emitting an auditory signal when a child urinates while asleep. A variation of this, the vibrating alarm, emits a vigorous vibration as opposed to an auditory cue. A benefit of the vibrating alarm is the increased privacy and decreased disruption that occurs when the alarm signals during sleeping hours. This may be especially attractive to older youth who suffer social consequences as a result of wetting. However, the vibrating alarm has not been sufficiently evaluated as a substitute for the urine alarm.
This study evaluated the effectiveness of the vibrating alarm under two conditions: independently and within a standardized treatment package that included self-awareness training and reinforcement for dry nights. Multiple baseline data were collected for several subjects across conditions. Results provide preliminary support for the use of the vibrating alarm despite identification of some apparent limitations in use. Discussion emphasizes treatment implications for adolescents and the practicality of alarm use while highlighting variables that remain in need of investigation. |
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