|Applied Behaviour Analysis and Mental Illness: Our Lost Roots|
|Sunday, May 28, 2017|
|4:00 PM–5:50 PM |
|Hyatt Regency, Capitol Ballroom 5-7|
|Area: CBM/PRA; Domain: Service Delivery|
|Chair: Louis Paul Alexander Busch (Centre for Addictions and Mental Health)|
|Discussant: Peter Sturmey (The Graduate Center and Queens College, City University of New York)|
|CE Instructor: David B. Lennox, Ph.D.|
According to the World Health Organization and the National Institute on Mental Health, mental disorders affect one in four people worldwide and have a global financial burden of approximately $2.5 trillion a year. In spite of the obvious social significance of this problem, the contribution of behavior analysis has been relatively absent for the better part of 40 years. This is not how it used to be however. The applied branch of our science is rooted in the pioneering work of behavior analysts that applied the technology in the treatment of chronic schizophrenia, depression, severe personality disorder, and other challenges commonly classified as mental disorders. This symposium will provide a brief history of Applied Behavior Analysis relationship with mental disorder, discuss ongoing obstacles to behavior analytic contributions in this area, and present several treatment models and case examples that demonstrate the efficacy of behaviour analytic technologies when applied to a variety of challenges associated with psychiatric diagnoses.
|Instruction Level: Intermediate|
Behavior Analysis' Broken Promise to Mental Health: A Brief Historical Review
|LISA ORSI (Forensic Consultation & Assessment Team: CAMH)|
B. F. Skinner and Odgden Lindsley first replicated the free operant paradigm in humans with individuals diagnosed with schizophrenia at the Metropolitan State Hospital in Waltham, Massachusetts. Although this experimental work was not intended to be therapeutic in nature, but rather demonstrate the generality of the laws of behavior to human beings, it was foundational to the development of behavioral interventions in applied settings. Over the following 20 years behavior analysts would demonstrate the effectiveness of behaviour analytic technologies such as the token economy, contingency contracting, reinforcement and shaping procedures to improve quality of life for those diagnosed with severe and chronic mental illness. The extent of this contribution waned beginning in the 1980s, currently entering a period of near obscurity. This presentation will provide a brief history of Applied Behavior Analysis’ relationship with mental disorder, discuss ongoing obstacles to behavior analytic contributions in this area and possible reasons for the decline in interest, and finally suggest that behaviour analysts revisit their lost roots.
|Behavior Analysis in an Inpatient Psychiatric Setting: Creating and Maintaining Behavioral Change Using Trauma-Informed Practices|
|JENNIFER MORRISON-DIALLO (Kings County Hospital Center)|
|Abstract: The Behavior Support Team (BST) as part of the Behavioral Health Department at Kings County Hospital Center in Brooklyn, NY has a unique team specialized in behavior analysis that decreases maladaptive target behaviors and increases adaptive replacement behaviors in adults and children with a variety of psychiatric diagnoses. Interventions used result in long-lasting behavioral change in both inpatient and outpatient settings including: comprehensive psychiatric emergency room (CPEP), acute adult inpatient, acute child inpatient, medical units, community residences, and home. This presentation will focus on our model of providing behavioral consultation and the positive effects such as: reduced length of stay, decreased restrictive interventions, increased days spent outside the hospital, and development of adaptive replacement behaviors in the community to support recovery. A special focus of this presentation will be how trauma-informed practices are incorporated into behavioral interventions implemented and how behavioral skills training was used to train staff how to view patients with a trauma-informed lens resulting in more effective, patient-centered care. Additionally, a case study using trauma-informed interventions will be presented about a patient who has an extensive history of trauma who engaged in extreme forms of self-injury.|
Addressing Self-Harm and Suicidality Related Behaviours in Youth With Trauma and Complex Needs
|MYLENA LIMA (Marymound)|
Aboriginal youth exposed to multiple traumatic childhood experiences are at higher risk for self-harm and suicide (Aboriginal Peoples Survey, 2012). The current study describes the effects of a behavioural analytical intervention on self-harm and suicidality related behaviours for a seventeen-year old Aboriginal-Canadian female diagnosed with Fetal Alcohol Spectrum Disorder (FASD). The youth participated in a 12-month residential program at the Marymound Mental Health and Complex Needs Centre. Following Functional Behavioural Assessment, an individualized treatment plan was implemented including the behavioural techniques: behavioural activation, behavioural contracting, token economy, functional communication training, and behavioural management of the target behaviours. During Baseline she presented with multiple suicide attempts, and daily self-harm behaviours. Results demonstrated that the youth met treatment criterion after nine months into treatment. During the course of treatment secondary behaviours such as aggressive behaviours towards others, property destruction, outbursts, and frequency of involvement with justice system all improved. Generalization and maintenance across setting have occurred. Findings of the current study have wide implications for the use of behavioural analytical intervention for self-harm and suicidality related behaviours for youth with FASD and suffering from Trauma and Stressed Related Disorder.
|Integrating Applied Behavior Analysis in the Forensic Mental Health System|
|LOUIS PAUL ALEXANDER BUSCH (Centre for Addictions and Mental Health)|
|Abstract: During the last century, western society has moved from conceptualizing the offenses committed by individuals diagnosed with mental illness as criminal behavior to a healthcare issue which requires a commitment to public safety. Still, individuals who live with mental disorders and who come into contact with the law face unique challenges in accessing effective treatment. Applied Behavior Analysis (ABA) offers strategies that can help reduce the risk of violence and treat behaviors commonly associated with severe mental illness while increasing the adaptive skills necessary for successful community reintegration. As part of the interprofessional care team, behavior analysts contribute an empirical approach to individual recovery which focuses on functional relationships between behavior and environment. This presentation will provide a brief overview of the forensic mental health system in Ontario, a description of a specialized inpatient rehabilitation program, and several case studies to provide the audience with an understanding of how behavior analysis can be effectively integrated into the forensic mental health system.|