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Introduction to Clinical Behavior Analysis for Common Mental Health Presentations: Part One |
Sunday, May 26, 2019 |
3:00 PM–4:50 PM |
Swissôtel, Event Center Second Floor, Vevey 1/2 |
Area: CBM; Domain: Theory |
Chair: Emily Brennan (Eastern Michigan University) |
CE Instructor: Thomas J. Waltz, Ph.D. |
Abstract: Behavior analysis has been applied broadly and has been part of clinical psychology since the 1950’s. Behavior analysts have worked with a wide variety of clinical populations and several contemporary behavior therapies are deeply rooted in functional analytic thinking. This is the first of two symposiums aimed at introducing behavior analysts to clinical behavior analysis for common outpatient mental health presentations. In the service of workforce development, it is important that behavior analysts stay informed on the broad applications of behavioral principles in a wide variety of practice areas. This symposium covers Acceptance and Commitment Therapy (ACT), Functional Analytic Psychotherapy (FAP), Problem Solving Therapy (PST), and Dialectical Behavior Therapy (DBT). Each presentation will describe a therapy—its aims, techniques, and methods in functional terms. Outcome data for the treatments will be briefly reviewed. Finally, regulatory frameworks and professional training pathways will be discussed to inform behavior analysts of the training needed for these treatments to fall within their ethical scope of practice. |
Instruction Level: Basic |
Keyword(s): ACT, clinical, depression, extreme behavior |
Target Audience: Individual in graduate training programs in behavior analysis and graduates from such programs. |
Learning Objectives: Participants will be able to describe contemporary behavior therapies for mental health presentations in terms of behavioral principles. Participants will be able to describe the evidence base for these treatments. Participants will be able to describe training pathways for having these treatments ethically fall within ones scope of practice. |
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Acceptance and Commitment Therapy |
THOMAS J. WALTZ (Eastern Michigan University), Claudia Drossel (Eastern Michigan University) |
Abstract: Acceptance and commitment therapy (ACT) is a behavior therapy that takes a functional approach to verbal behavior and applies it to a wide variety of clinical presentations. ACT was developed to address verbal barriers to effective action. The dissemination of this treatment has involved a wide variety of techniques and the use of “middle level terms,” such as acceptance and mindfulness. This presentation will focus on characterizing ACT in terms of basic behavioral principles, molar functional relations, and a contemporary analysis of rule-governed behavior. A brief review of the outcome literature for ACT will be provided for a variety of clinical presentations including anxiety, depression, chronic pain, obsessive-compulsive disorder, and psychosis. ACT’s status as an evidence-based therapy and the evolving criteria used to categorize the evidentiary status of therapies will be presented. Finally, professional development pathways for having a professional scope of practice inclusive of ACT for clinical presentations will also be discussed. |
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Functional Analytic Psychotherapy for Interpersonal Repertoires |
EMILY BRENNAN (Eastern Michigan University), Kayla Rinna (Eastern Michigan University), Claudia Drossel (Eastern Michigan University) |
Abstract: Functional analytic psychotherapy (FAP) is a behavioral therapy that utilizes the client-therapist relationship as an environment for changing a client’s social repertoire and increasing the frequency of social reinforcers. This is achieved through the differential reinforcement of clinically relevant behaviors (CRBs); that is, ineffective CRBs (CRB1s) are discouraged, while more effective alternatives (CRB2s) are prompted and reinforced in session. Ideally, these behaviors then generalize to clients’ social environment outside of session, granting them the skills to identify and access social relationships of higher reinforcing value. A brief summary of the outcome data for FAP will be provided. Because of the reciprocal nature of client-therapist interactions in FAP, therapists must be aware of differences in dimensions of diversity between themselves and their clients that could impact intervention outcomes. This presentation will review the behavioral principles in FAP, discuss FAP with diverse populations, and the special considerations in this work. The presentation will conclude with a discussion of the pathways available to obtaining training in FAP. |
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Problem Solving Therapy for Depression |
CAITLYN UPTON (Rowan University), Tori Humiston (Eastern Michigan University), Thomas J. Waltz (Eastern Michigan University) |
Abstract: Problem Solving Therapy (PST) is a systematic approach to skills training. Across sessions, therapists coach clients to identify problematic areas, clearly define the problem(s) clients have, brainstorm solutions, implement, and evaluate them. A behavior analytic conceptualization of PST includes discrimination training (changeable versus unchangeable problems), identification of short-term contingencies that might be barriers to problem-solving (e.g., commiserating or other social reinforcement for maintaining the status quo), and reinforcement of a general active and experimental approach to problem-solving (approach versus avoidance). Of note, Division 12 of the American Psychological Association has listed the treatment as evidence-based for depression, particularly when impairments in planning and organizing are present (Alexopoulos, Raue, Kiosses, et al., 2011; Katon, Von Korff, Lin, et al., 2004; Nezu, Nezu & Perri, 1989). This presentation will introduce behavior analysts to the techniques of and the evidence base for PST, while highlighting the importance of contextualizing clients’ behavior. Finally, the appropriate clinical settings and professional training required for PST will be reviewed. |
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Dialectical Behavior Therapy for Severe Multi-Problem Outpatient Clients |
EFTHYMIA ORKOPOULOU (Eastern Michigan University), Rachel VanPutten (Eastern Michigan University), Claudia Drossel (Eastern Michigan University) |
Abstract: Behavior analytical principles constitute the foundation of many contemporary psychotherapies and can offer a comprehensive understanding of complex behavioral phenomena. Dialectical Behavior Therapy (DBT) is a behaviorally rooted therapy that replaces pervasive, long-standing, and ineffective behavior patterns with more effective alternatives. Division 12 of the American Psychological Association designated DBT an evidence-based treatment for severe problems, such as self-harming, therapy-interfering, or other impulsive behaviors. DBT conceptualizes these problems as behavioral deficits and/or excesses, and it addresses specific behaviors by contextualizing them, using descriptive functional analyses and systematic problem-solving. The strategies employed require a solid background on functional analytic methodology, termed within DBT as contingency management, skills training, and chain analysis. While DBT initially was a treatment for adult self-harm, studies have suggested efficacy with other clinical populations (e.g. adults with eating and substance abuse disorders). This presentation will provide an overview of DBT, the strategies used, and the clinical targets of the therapy. It will review the evidence and describe training pathways. |
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