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Counter-Control: Treatment Implications and Assent Considerations |
Sunday, May 28, 2023 |
8:00 AM–8:50 AM |
Hyatt Regency, Centennial Ballroom H |
Area: PCH/CSS; Domain: Service Delivery |
Chair: Dawn O'Neill (Judge Rotenberg Center; Contextual Behavioral Science Institute) |
Discussant: John O'Neill (Judge Rotenberg Educational Center) |
CE Instructor: Dawn O'Neill, Ph.D. |
Abstract: For over 70 years, the conceptual development of countercontrol in behavior analysis has focused on broad societal issues (e.g., public protests & social movements) with little attention to the behavior of individuals in clinical, residential treatment, and educational settings (see Delprato, 2002; Skinner, 1953, 1971, 1974; Spencer, King, Martone, & Houlihan, 2022). In fact, we are not aware of any interventions or experimental manipulations of countercontrol published in the applied behavior analytic literature. The purpose of this symposium is to first extend the conceptual literature by exploring dependent, independent, and extraneous variables associated with countercontrol in clinical, residential treatment, and educational settings. Next, we will discuss the treatment of countercontrol as a special example of the necessary risk/benefit analysis associated with client assent in applied behavior analysis. We propose that assent should be viewed on a continuum, be balanced with treatment effectiveness, and that assent (or lack thereof) can complicate applied behavior analytic treatment under certain conditions. |
Instruction Level: Intermediate |
Keyword(s): assent, choice, counter-control |
Target Audience: Behavior analysts interested in the clinical treatment of counter-control and associated assent considerations. |
Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) conceptualize and define counter-control at the individual level; (2) be able to identify counter-control in their clinical setting; (3) list considerations when obtaining assent to the treatment of counter-control. |
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Treatment of Counter-Control: A Clinical Case Study |
JOSEPH TACOSIK (Judge Rotenberg Education Center), Halle Apelgren (Judge Rotenberg Center ), John O'Neill (Judge Rotenberg Educational Center) |
Abstract: Skinner (1953, 1971, 1974) described countercontrol as a response to social aversive control that functions to escape/avoid control at the individual (e.g., noncompliance) or group (e.g., protest) level that is often multiply-maintained by the attention of peers. Delprato (2002) asserted that socially mediated controlling conditions (e.g., rules) often function as establishing operations for countercontrolling responses while Spencer, King, Martone, and Houlihan (2022) emphasized the role of rule-governed behavior. Although countercontrol has received conceptual attention in behavior analysis for over 70 years, no experimental manipulations or interventions for countercontrol exist in the behavioral literature. Given that all residential treatment and educational settings operate around rules of conduct, one might expect that behavior analysts experience some degree of countercontrolling responses in practice. The purpose of this presentation is to provide: (1) a review of the conceptual literature; (2) an overview of residential treatment and educational factors; and (3) recommendations for implementing function-based interventions and ways to address treatment challenges specific to countercontrol. |
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Assent Considerations in the Case of Counter-Control |
HALLE APELGREN (Judge Rotenberg Center ), Joseph Tacosik (Judge Rotenberg Education Center), John O'Neill (Judge Rotenberg Educational Center) |
Abstract: Behavior analysts are obligated to consider “obtaining assent from clients when applicable” as dictated by the ethics code - section 2.11 (Behavior Analyst Certification Board, 2020). Assent is broadly thought of as client agreement or approval of treatment procedures. The American Academy of Pediatrics advises that assent should include following elements: (1) helping the patient achieve a developmentally appropriate awareness of the nature of his or her condition; (2) telling the patient what he or she can expect with tests and treatments; (3) making a clinical assessment of the patient’s understanding of the situation and the factors influencing how he or she is responding; and (4) and soliciting an expression of the patient’s willingness to accept the proposed care. In behavior analysis, there is limited research describing assent procedures or studying the implications for treatment outcomes (Morris, Detrick, & Peterson, 2021). We will explore how factors such as court-mandated placements, regulatory guidelines, conservatorships, substituted judgement, and health related supports can impact client assent in function-based treatment. |
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