|Introduction to Clinical Behavior Analysis for Common Mental Health Presentations: Part Two|
|Monday, May 27, 2019|
|3:00 PM–4:50 PM |
|Swissôtel, Event Center Second Floor, Vevey 3/4|
|Area: CBM; Domain: Theory|
|Chair: Robert Snyder (Eastern Michigan University)|
|Discussant: Thomas J. Waltz (Eastern Michigan University)|
|CE Instructor: Thomas J. Waltz, Ph.D.|
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 second 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 Behavioral Activation (BA), exposure therapies, Integrative Behavioral Couples Therapy (IBCT), and Contingency Management (CM). 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): anxiety, couples therapy, depression, substance use|
|Target Audience: |
Graduate students in behavior analysis and graduates from graduate programs in behavior analysis.
|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.|
|Behavioral Activation for Depression|
|TORI HUMISTON (Eastern Michigan University), Lillian Ellis (Eastern Michigan University), Thomas J. Waltz (Eastern Michigan University)|
|Abstract: Behavioral activation (BA) is a third-wave behavior therapy that is grounded Lewinsohn’s and Ferster’s frameworks for conceptualizing depression. Life events can put into motion a cascade of changes in contingencies that result in social withdrawal and decreases in the effectiveness of reinforcers. Behavioral activation takes steps to reverse this process through values clarification, problem solving, and the scheduling of meaningful activities. Rooted in behavioral principles, BA has a strong evidence base as a treatment for depression. This presentation will introduce behavior analysts to the treatment structure of BA while highlighting the role of a behavioral case formulation during implementation. Potential factors that could interfere with treatment such as interpersonal skills deficits and contexts with coercive contingencies will also be discussed. The evidence base of BA for depression will be briefly reviewed. Finally, guidance will be provided regarding the professional training required for BA to fall within one’s clinical scope of practice.|
Facing Fears: Exposure Therapy for Anxiety Disorders
|TOM BUQO (Hofstra University)|
Exposure therapy is an early behavioral intervention for anxiety disorders that continues to play a key role in a number of existing psychotherapies. Of note, it provides a powerful treatment method for phobias and panic (exposure therapy/graduated exposure), obsessive compulsive disorder (Exposure and Response Prevention [ERP]), and posttraumatic stress disorder (Prolonged Exposure [PE]). The method of exposure therapy involves repeated presentation of stimuli that are typically feared or avoided, while not allowing the individual to escape or avoid them. This presentation will discuss the current state of exposure therapy, including theoretical debates that highlight the behavioral principles underlying the treatment. Various models for conducting exposure therapy for a diverse array of presenting problems will be discussed, including recent advances in the area of Virtual Reality Exposure Therapy (VRET). Data regarding efficacy and effectiveness will also be presented. Future directions and current trends in exposure therapy will be elaborated, as will the steps and resources available to individual providers in learning the techniques, nuances, and technicalities of exposure therapy.
|Integrative Behavioral Couples Therapy|
|LILLIAN ELLIS (Eastern Michigan University), Qingqing Yin (Eastern Michigan University), Thomas J. Waltz (Eastern Michigan University)|
|Abstract: Integrative behavioral couples therapy is based on a functional contextual model that aims to bring about contingency-shaped changes in couples’ behaviors (Benson, Sevier, Christensen, 2014; Sevier, Atkins, Doss, Christensen, 2015). It is a third wave behavioral therapy, integrating change and acceptance strategies (Christensen & Jacobson, 1998). IBCT has evidence to suggest efficacy in increasing relationship satisfaction (Roddy, Nowlan, Doss, Christensen, 2016), with couples maintaining this increase over the next five years (Christensen, Atkins, Baucom, & Yi, 2010). A large-scale role-out of this treatment in the VA health system has demonstrated effectiveness within this healthcare system (Roddy et al., 2015). In contrast to emotion-focused couples therapy, traditional behavioral couple therapy, and cognitive behavioral couples therapy, IBCT emphasizes a cohesive behavioral framework, inclusive of overt behaviors and private events. This presentation provides a review of IBCT, with an emphasis on the behavioral principles embedded in the treatment model, discuss mechanisms of change, and direct listeners to further resources on this approach.|
Contingency Management for Substance Use
|Robert Snyder (Eastern Michigan University), BRANDON MILLER (Eastern Michigan University), Tori Humiston (Eastern Michigan University), Thomas J. Waltz (Eastern Michigan University)|
In the face of a nationwide opioid epidemic, there is an increased need for behavioral interventions for substance use disorders (SUD). Contingency Management (CM) is an efficacious, non-pharmacological, cost effective treatment for SUD. CM therapists provide individuals with monetary rewards or vouchers, which are then exchanged for tangible rewards upon verified negative drug or alcohol screenings on varying schedules of reinforcement. By increasing the response cost for using and providing competing reinforcers, the rate of substance decreases. CM has been shown to yield positive treatment outcomes across a number of substances, including cocaine, opioids, nicotine, and alcohol (Higgins, Heil, & Sigon, 2013). This presentation will first provide an overview of CM as an application of the differential reinforcement of other behavior and the matching law. A review the evidence base for CM and the contextual considerations for its use will be provided. Finally, the clinical settings and professional training required for using CM clinically will be characterized to identify how behavior analysts can include CM in their scope of practice.