Association for Behavior Analysis International

Individuals with serious mental illness (SMI) experience behavioral excesses and skills deficits that significantly impact their daily functioning. Individuals with SMI are in high need for receiving psychological treatment, making them frequent utilizers of healthcare. Interventions for this population are commonly being implemented within prison, emergency care, and underfunded community mental health settings. Interventions in these environments can be ineffective because providers in these locations may not have appropriate training or access to sufficient resources to provide treatment to this complex population. Due to the frequent and inappropriate utilization of these systems for psychological treatment, these settings incur a high cost for individuals for SMI and the healthcare system. To address this issue, we will discuss underutilized and often forgotten behavior analytic interventions that have a history of effectively reducing behavioral excesses and providing skills training for individuals with SMI. We suggest that by revisiting these interventions and considering newly developed behavioral treatments, behavior analysis may be the solution to effectively treating this population.

In response to the increasing demand on pediatricians to screen and treat depression in primary care, a 90-minute curriculum was developed to train pediatricians to conduct a suicide risk assessment and deliver a brief behavior activation (BA) protocol to adolescents who screen positive for depression in primary care. Prior research demonstrates increased confidence among professionals who receive active, hands-on training (Fallucco, Conlon, Gale, Constantino, & Glowinski, 2012). Thus, the curriculum was developed using Behavioral Skills Training (BST), involving instruction, modeling, rehearsal, and feedback to promote mastery (Ward-Horner & Sturmey, 2012). A total of 54 providers participated in the training and completed pre-training and post-training surveys. Results from paired sample t-tests indicated significant increases in provider-reported comfort managing depression (t (53) = -5.40, p<.001), perceptions of feasibility in managing depression during medical visits (t (53) = -4.50, p<.001), and knowledge about depression management (t (53) = -6.31, p<.001). Providers strongly agreed the training provided information they will apply to patient care (M = 5.52, SD = .64) and that feedback during roleplays was helpful (M = 5.48, SD = .75). BST was found to be an effective and acceptable strategy for training medical professionals in primary care.

Depression is a highly prevalent condition with proportionally higher rates shown among university students than the general population. Research supports that engaging in physical activity improves symptoms associated with depression. Self-management techniques offer an effective, economical approach to teaching individuals to engage in increased physical activity. This study evaluated the effects of a self-management treatment package (i.e., goal setting, self-monitoring, feedback) on walking behaviour for four adults with chronic depressive symptoms. The extent to which increased physical activity affects self-reported depressive symptoms and sleep duration and quality were examined. All data were collected using the Fitbit FlexTM. A changing-criterion design embedded within a concurrent multiple baseline across four participants design was used in which each successive criterion was increased above the mean performance frequency in the previous phase by a value between 5-15%. After a stable decrease in walking was observed during follow-up for one participant, the treatment package was re-implemented. Overall, the results demonstrate that the treatment package was efficacious at increasing walking across participants (i.e., 31% increase in average mean shift from baseline to treatment). Findings also suggest that increased walking may be associated with increased sleep duration. A blind clinician is analyzing collateral effects on depressive symptoms.