PSYCH 282_ Textbook Notes

- Behavior modification procedures are developed by professionals but are often implemented by people such as teachers, parents, or others to help people change their behavior - People who implement behavior modification procedures should do so only after sufficient training - Measurement of Behaviour Change - Emphasis on measuring the behavior before and after intervention to document the behavior change resulting from the behavior modification procedures - Ongoing assessment of the behavior is done well beyond the point of intervention to determine whether the behavior change maintained - De-Emphasis on Past Events as the Causes of Behaviour - Knowledge of the past also provides useful information about environmental events related to the current behavior - Understanding learning experiences can be valuable in analyzing current behavior and choosing behavior modification procedures - Knowledge of current controlling variables however is most relevant to developing effective behavior modification interventions because those variables, unlike past events, can still be changes - Rejection of Hypothetical Underlying Causes of Behaviour - Skinner called hypothetical explanations of behavior explanatory fictions because they can never be proved or disproved, and are thus unscientific - Supposed underlying causes can never be measured or manipulated to demonstrate a functional relationship to the behavior they are intended to explain Historical Roots of Behaviour Modification (32 - 35) - Ivan Pavlov - Conducted experiments that uncovered the basic processes of respondent conditioning - Demonstrated that a reflex (salivation in response to food) could be conditioned to a neutral stimulus (the sound of a metronome); called a conditioned reflex - Edward L. Thorndike - Described the law of effect - A behavior that produces a favorable effect on the environment is more likely to be repeated in the future - Put a cat in a cage and set food outside the cage where the cat could see, to open the cage door the cat had to hit a lever with its paw - John Watson - Asserted that observable behavior was controlled by environmental events - Described a stimulus-response psychology in which environmental events (stimuli) elicited responses - Started the movement in psychology called behaviorism - B. F. Skinner

- Used to promote health-related behaviors by increasing healthy lifestyle behaviors and decreasing unhealthy behaviors - Applying behavior modifications to health-related behaviors is also called behavioral medicine or health psychology - Gerontology - Behavior modification procedures are applied in nursing homes and other care facilities to help manage the behavior of older adults Professional Practice, Certification, and Ethics (39) - The Behaviour Analyst Certification Board (BACB) was established to provide certification for individuals to practice behavior analysis as a profession - The BACB established education and training standards and developed an examination that individuals had to pass to become a Board Certified Behaviour Analyst - The Association for Behaviour Analysis International developed a set of ethical guidelines for the practice of behavior analysis Chapter 2: Observing & Recording Behaviour Behavioural Assessment (43 - 44) - Measurement of the target behavior(s) in behavior modification is called behavioral assessment - Behavioral assessment is important for a number of reasons: - Measuring the behavior for treatment provides information that can help you determine whether treatment is necessary - Can provide information that helps you choose the best treatment - Measuring the target behavior before and after the treatment allows you to determine whether the behavior changed after the treatment was implemented Direction & Indirect Assessment (44 - 45) - Indirect Assessment - Using interviews, questionnaires, and rating scales to obtain information on the target behavior from the person exhibiting the behavior or from others (ex: parents, teachers, etc.) - Does not occur when the target behavior occurs but relies on an individual’s recall of the target behavior - Direct Assessment - A person observes and records the target behavior as it occurs - The observer (or a video camera) must be in close proximity to the person exhibiting the behavior so that the target behavior can be seen (or heard) - Observer must have a precise definition of the target behavior - Observer must register the occurrence of the behavior when it is observed - Preferred Method: Usually more accurate Defining the Target Behaviour (45 - 47)

- Intensity (Magnitude) of a behavior is the amount of force, energy, or exertion involved in it - More difficult to measure than frequency or duration - Latency of the behavior is the time from some stimulus or event to the onset of the behavior - Percentage of Opportunities is when the observer records the occurrence of a behavior in relation to some other event and reports the results as the percentage of opportunities in which the behavior occurred - Product Recording (Permanent Product Reasoning) is an indirect assessment method that can be used when a behavior results in a certain tangible outcome - Indirect because you are not observing and recording the behavior as it occurs - Interval Recording - Record whether the behavior occurred during consecutive time periods - Observer divides the observation period into a number of smaller time periods or intervals, observes the client throughout each consecutive interval, and then records whether the behavior occurred in that interval - At the end of the observation period, the observer reports the percentage of intervals in which the behavior was observed - Partial-Interval Recording - Observer scores the interval if the behavior occurred during any part of the interval - Not interested in the number of times the behavior occurred or how long it lasts - Takes less time and effort - Whole-Interval Recording - Occurrence of the behavior is marked in an interval only when the behavior occurs throughout the entire interval - Typically used for behaviors that are expected to have a long duration of occurrence - Frequency-Within-Interval Recording - Observer records the frequency of the target behavior but does so within consecutive intervals of time in the observation period - Time Sample Recording - Divide the observation period into intervals of time, but you observe and record the behavior only during part of each interval - Observation periods separated by periods without observation - Momentary Time Sample Recording - Behavior is recorded only if it occurs at the exact instant the interval ends - Level of behavior is reported as the percentage of intervals in which the behavior occurred

- Compare baseline and treatment to determine whether the behavior changed in the expected way after treatment - Does not demonstrate a functional relationship because treatment is not replicated - Does not rule out the possibility of extraneous variables being responsible for the behavior change - Rarely used by behavior modification researchers - A-B-A-B Reversal Design - Extension of the simple A-B design - Baseline and treatment phases implemented twice - Researcher removes treatment after first treatment phase and reverse back to the baseline - Second baseline is followed by replication of the treatment - Variations of this design may be used in which more than one treatment is evaluated - Considerations - May not be ethical to remove the treatment in the second baseline if the behavior is dangerous - Must be fairly certain that the level of the behavior will reverse when treatment is withdrawn - If behavior fails to change when treatment is withdrawn, functional relationship not demonstrated - Can you even remove the treatment after it’s implemented - Multiple-Baseline Design - Multiple-Baseline-Across-Subjects Design - Baseline and treatment phase for the same target behavior of two or more subjects - Multiple-Baseline-Across-Behaviors Design - Baseline and treatment phase for two or more behaviors of the same subject - Multiple-Baseline-Across-Settings Design - Baseline and treatment for two or more settings in which the same behavior of the same subject is measured - Different baseline and treatment phases occur for different subjects, behaviors, or settings - May be used: - When interested in the same target behavior exhibited by multiple subjects - When you have targeted more than one behavior of the same subject - When measuring a subject’s behavior across two or more settings - Useful when you cannot use an A-B-A-B design - When treatment is implemented at different times, the treatment is staggered over time - Alternating-Treatments Design (ATD)

- Time between occurrence of a behaviour and the reinforcing consequence - An effective reinforcer should occur immediately after the response occurs - Longer delay between behavior and reinforcer = less effective - Contingency - When a contingency exists, the consequence is more likely to reinforce the response - A behavior is strengthened when a reinforcer is content on the behavior - Reinforcer only occurs if the behavior occurs - Motivating Operations (MO) - Antecedent events that alter the value of a reinforcer - Establishing Operation (EO) - Makes a reinforcer more potent - Establishes the effectiveness of a reinforcer - Makes a reinforcer more potent and makes a behavior that produces the reinforcer more likely - Deprivation - Increases effectiveness of most unconditioned reinforcers - A particularly reinforcer is more powerful if a person has gone without it for some time - Abolishing Operation (AO) - Makes a reinforcer less potent - Abolishes or decreases the effectiveness of a reinforcer - Makes a reinforcer less potent and makes a behavior that produces the reinforcer less likely - Satiation - When a person has recently consumed a large amount of a particular reinforcer or has had substantial exposure to a reinforcing stimulus - Reinforcers less potent at the time - Individual Differences - Likelihood of a consequence being a reinforcer varies from person to person - Magnitude - Generally the effectiveness of a stimulus as a reinforcer is greater if the amount or magnitude of the stimulus is greater - True for both positive and negative reinforcement Schedules of Reinforcement (105 - 110) - Specifies whether every response is followed by a reinforcer or whether only some responses are followed by a reinforcer - Continuous Reinforcement Schedule (CRF Schedule) - Each occurrence of a response is reinforced - Acquisition: Person acquiring a new behavior with CRF - Intermittent Reinforcement Schedule

- A particular behavior occurs and a consequence immediately follows the behavior; as a result, the behavior is less likely to occur again in the future - A punisher (aversive stimulus) is a consequence that makes a particular behavior less likely to occur in the future - You can conclude that a particular consequence is punishing only if the behavior decreases in the future Positive & Negative Punishment (133 - 137) - Positive Punishment - The occurrence of a behavior is followed by the presentation of an aversive stimulus and as a result, the behavior is less likely to occur in the future - Negative Punishment - The occurrence of a behavior is followed by the removal of a reinforcing stimulus and as a result, the behavior is less likely to occur in the future - Time-Out from Positive Reinforcement & Response Cost - Loss of a reinforcing stimulus or activity after the occurrence of a problem behavior - Reinforcer that is removed is one the individual has already acquired and is not necessarily the same reinforcer that was maintaining the behavior - Punishment Based on the Premack Principle - Premack Principle: When a person is made to engage in a low-probability behavior contingent on a high-probability behavior, the high-probability behavior will decrease in frequency - If after engaging in a problem behavior, a person is made to do something they don’t want to do, they will be less likely to engage in the problem behavior later Unconditioned & Conditioned Punishers (137 - 139) - Unconditioned Punishers - Painful stimuli or extreme levels of stimulation have biological importance - Through the process of evolution, humans have developed the capacity for their behavior to be punished by these naturally aversive events without any prior training or experience - Conditioned Punishers - Stimuli or events that function as punishers only after being paired with unconditioned punishers or other existing conditioned punishers - Any stimulus may become a conditioned punisher if it is paired with an established punisher - Generalized Conditioned Punishers - Stimulus that has been paired with a variety of unconditioned and conditioned punishers over the course of a person’s life - Stimuli associated with the loss of reinforcers may become conditioned punishers Contrasting Reinforcement & Punishment (139 - 141)

- Discriminative Stimulus ( ): Antecedent stimulus that is present when a behavior is 𝑆 𝐷 reinforced - The process of reinforcing a behavior only when a specific antecedent stimulus ( ) is 𝑆 𝐷 present is called stimulus discrimination training - When the is present, the behavior is reinforced 𝑆 𝐷 - When any other antecedent stimuli except the are present, the behavior is not 𝑆 𝐷 reinforced; any antecedent stimulus that is presented when the behavior is not reinforced is called an s-delta ( ) 𝑆 ∆ - A behavior is more likely to occur in the future when an is present, but less likely to 𝑆 𝐷 occur when an is present 𝑆 ∆ - The presence of an does not cause a behavior to occur nor does it strengthen a 𝑆 𝐷 behavior, it only increases the likelihood of the behavior in the present situation because it was associated with reinforcement of the behavior in the past - Reinforcement is what causes the behavior to occur when the is present 𝑆 𝐷 The Three-Term Contingency (158 - 159) - The consequence (reinforcer or punisher) is contingent on the occurrence of the behavior only in the presence of the specific antecedent stimulus ( ) 𝑆 𝐷 - → R → where R = response and = reinforcer 𝑆 𝐷 𝑆 𝑅 𝑆 𝑅 - → R → where = punisher 𝑆 𝐷 𝑆 𝑃 𝑆 𝑃 Generalization (160 - 166) - Takes place when a behavior occurs in the presence of stimuli that are similar in some ways to the that was present during stimulus discrimination training 𝑆 𝐷 - The more similar another stimulus it to the , the more likely it is that the behavior will 𝑆 𝐷 occur in the presence of that stimulus - Stimulus generalization has also occurred when a response occurs in different circumstances– in a different context, at a different time, or with different people– from those in which it was originally learned Chapter 8: Respondent Conditioning Introduction (169) - Operant behaviors are controlled by their consequences - Operant conditioning involves the manipulation of consequences - Respondent behaviors are controlled (elicited) by antecedent stimuli - Respondent conditioning involves the manipulation of antecedent stimuli Defining Respondent Conditioning (170 - 173)

- Certain types of stimuli typically elicit specific types of bodily responses, known as unconditioned responses (URs) - Responses elicited by antecedent stimuli even though no conditioning or learning has occurred - Occurs in all health people when an unconditioned stimulus (US) is presented - An unconditioned stimulus (US) elicits an unconditioned response (UR) - Humans have evolved to respond to USs because the URs have survival value - A UR is a natural reflexive action of the body that occurs when a US is present - URs are common to all people - Respondent conditioning occurs when a previously neutral stimulus (NS) is paired with a US (the NS and the US are presented together) - As a result of this pairing, the NS becomes a conditioned stimulus (CS) and elicits a conditioned response (CR) similar to the UR - A UR or CR is called a respondent behavior - Respondent conditioning is also called classical conditioning or pavlovian conditioning Timing of the Neutral Stimulus & Unconditioned Stimulus (173 - 174) - Ideally, the US should occur immediately after the onset of the NS - Trace Conditioning - NS precedes the US, but the NS ends before the US is presented - Delay Conditioning - NS presented and then the US is presented before the NS ends - Simultaneous Conditioning - The NS and the US are presented at the same time - Backward Conditioning - US presented before the NS - Trace and delay conditioning (in which NS presented first) generally are most effective - Backward conditioning is least likely to be effective - Only case in which respondent conditioning can occur without close temporal proximity of the NS and the US is taste aversion Higher-Order Conditioning (175) - Occurs when a NS is paired with an already established CS and the NS becomes a CS - Depends on how well established the CS is when it is paired with the NS Conditioned Emotional Responses (175 - 177) - First proposed by Watson (little Albert dude) - The process of respondent conditioning can develop CSs for positive (desirable) CERs or negative (undesirable) CERs - Fear developed by Albert was a negative CER - Can be difficulty in operationalizing or measuring the emotional responses

- Some emotional responses are overt and easily observable - Physiological responses, although covert, are measurable with appropriate instruments - Other reported emotional reactions are not observable or measurable; cannot be observed independently, it is not clear what responses are involved in the emotions people report - Most likely, people’s reports of emotional responses are a joint function of the actual CER, the situation in which is occurs, their interpretation of events, and the ways in which they have learned to label overt and covert events Extinction of Conditioned Responses (177 - 178) - Respondent Extinction - Extinction of a CR - Involves the repeated presentation of the CS without presenting the US - If the CS continues to occur in the absence of the US, the CR eventually decreases in intensity and stops - Spontaneous Recovery - After a period of respondent extinction, in which the CS is repeatedly presented in the absence of the US, the CS doesn’t elicit the CR - However, if the CS is presented at a later time, the CR might occur again - When the CS elicits the CR after respondent extinction has taken place, spontaneous recovery has occurred - Magnitude of the CR is usually smaller during spontaneous recovery - CR should again disappear if the US is not presented with the CS during spontaneous recovery Discrimination & Generalization of Respondent Behaviour (178 - 179) - Discrimination in respondent conditioning is the situation in which the CR is elicited by a single CS or a narrow range of CSs - Generalization has occurred when a number of similar CSs or a broader range of CSs elicit the same CR - Discrimination Training - When a particular stimulus is paired with the US, but similar stimuli are presented without the US, only the particular stimulus elicits a CR - Generalization - Tendency for the CR to occur in the presence of stimuli similar to the CS that was initially paired with the US in respondent conditioning - If a particular stimulus is paired with the US, but similar stimuli are never presented in the absence of the US, the CR is more likely to generalize to these other stimuli - Can be enhanced if a number of similar stimuli are paired initially with the US during respondent conditioning Factors That Influence Respondent Conditioning (179 - 181)

- The Nature of the US and CS - Intensity of a stimulus influences the effectiveness of the stimulus as a CS or US - In general, a more intense stimulus is more effective as a US - A more intense stimulus also functions more effectively as a CS - More intense stimuli are more salient - The Temporal Relationship Between the CS and US - For conditioning to be effective, the NS should precede the US - Delay conditioning and trace conditioning most effective - Interval should be short (exception being taste aversion) - Contingency Between the CS and US - NS and US should be presented together on every trial - Number of Pairings - More pairings of the NS and US produce stronger conditioning in general - Previous Exposure to the CS - A stimulus is less likely to become a CS when paired with a US if the person has been exposed to that stimulus in the past without the US Distinguishing Between Operant & Respondent Conditioning (181 - 184) - A respondent behavior is a UR or CR elicited by an antecedent stimulus - Bodily responses that have a biological basis - Operant behavior is controlled by its consequences - Although it may be under the stimulus control of a discriminative stimulus, an operant response is not elicited by an antecedent stimulus - An operant response is emitted by the individual in specific antecedent situations because it has been reinforced in the same or similar situations - Respondent Conditioning - Occurs when a NS acquires the power to elicit a CR because the NS has been paired with a US - Involves pairing two stimuli (NS & US) - Outcome is the development of a CS from a previously neutral stimulus - Operant Conditioning - Occurs when a specific response in a particular stimulus situation is followed reliably by a reinforcing consequence - Involves a contingency between a response and a reinforcer in specific circumstances - Result is that the behavior is more likely to occur in the future in circumstances similar to hose in which the behavior was reinforced - Circumstances in which the behavior was reinforced develop stimulus control over the behavior or evoke the behavior - Respondent Extinction - Occurs when the CS is no longer paired with the US - CS no longer elicits the CR - Operant Extinction

- Occurs when the behavior no longer results in a reinforcing consequence, and as a result, the behavior stops occurring in the future - Operant and respondent behaviors can occur together in the same situation Respondent Conditioning & Behaviour Modification (184) - Most behavior modification procedures are designed to change operant behaviors because operant behaviors make up the majority of behaviors that people target for change - Most often, the types of respondent behaviors that people want to change are CERs that interfere with normal functioning Chapter 9: Shaping Defining Shaping (188 - 190) - Shaping is used to develop a target behavior that a person does not currently exhibit - Differential reinforcement of successive approximations of a target behavior until the person exhibits the target behavior - Involves basic principles of reinforcement and extinction - Differential reinforcement occurs when one particular behavior is reinforced, and all other behaviors are not reinforced in a particular situation - The behavior that is reinforced increases - Behaviors that are not reinforced decrease through extinction - To begin shaping, you identify an existing behavior that is an approximation of the target behavior (the starting behavior/first approximation ) - You reinforce this behavior and as a result, the person starts to exhibit this behavior more often - You then stop reinforcing the behavior and as part of the subsequent extinction burst, novel behaviors typically begin to appear - Now you start reinforcing a novel behavior that is a closer approximation to the target behavior How to Use Shaping (197 - 198) - Define the target behavior - Determine whether shaping is the most appropriate procedure - If person already engages in the target behavior at least occasionally, you do not need to use shaping; you can simply use differential reinforcement to increase the frequency of the target behavior

- Shaping is used for the acquisition of a novel topography or a novel dimension of a behavior or to reinstate a behavior that the person does not currently exhibit - You do not need to use shaping if you can simply tell a person how to engage in the target behavior, if you can show the person the correct behavior, or if you can physically assist the person to engage in the correct behavior - Identify the starting behavior - Must have some relevance to the target behavior - Choose the shaping steps - Change in behavior from one step to the next must not be so large that the person’s progress stalls - If shaping steps are too small, progress will be slow and laborious - Choose the reinforcer to use in the shaping procedure - Trainer must be able to deliver the reinforcer immediately contingent on appropriate behavior - Amount of the reinforcer should be such that the person does not satiate easily - Conditioned reinforcers are often useful to avoid satiation - Differentially reinforce each successive approximation - Move through the shaping steps at a proper pace - Reinforcing one approximation too many times may make it difficult to move to the next step Shaping of Problem Behaviors (199 - 202) - Problem behaviors may be developed unintentionally through shaping - Successive approximations of a behavior that is not beneficial to the person are reinforced - Much anecdotal evidence exists that shaping can develop problem behaviors in people, but there is no research because of ethical reasons Chapter 10: Prompting & Transfer of Stimulus Control Prompting (207 - 208) - Prompts are used to increase the likelihood that a person will engage in the correct behavior at the correct time - Prompts used during discrimination training to help the person engage in the correct behavior in the presence of the discriminative stimulus so that the behavior can be reinforced - The function of prompts is to produce an instance of the correct behavior so that it can be reinforced Fading (208 - 210) - The gradual elimination of the prompt as the behavior continues to occur in the presence of the discriminative stimulus - One way to transfer stimulus control from the prompts to the discriminative stimulus

- Engaging in the correct behavior without prompts is the goal of prompting and fading - Prompting gets the correct behavior to occur in the presence of the discriminative stimulus, fading transfers stimulus control to the discriminative stimulus Types of Prompts (210 - 214) - Response prompts - The behavior of another person that evokes the desired response in the presence of the discriminative stimulus - Verbal prompts - When the verbal behavior of another person results in the correct response in the presence of the discriminative stimulus - Any verbal statement from another person may act as a verbal prompt if it makes the correct behavior more likely to occur at the correct time - Instructions have stimulus control over instruction-following behavior - Gestural prompts - Any physical movement or gesture of another person that leads to the correct behavior in the presence of the discriminative stimulus - Gestural prompts have stimulus control over the behavior indicated by the gesture - Modeling Prompts - Any demonstration of the correct behavior by another person that makes it more likely that the correct behavior will occur at the right time - A person observes the model and imitates the modeled behavior in the presence of the discriminative stimulus - Can be effective because people have a history of reinforcement for imitating models, and as a result develop a generalized imitative response - Modeling prompts have stimulus control over imitative behavior - Physical Prompts - Another person physically helps a person to engage in the correct behavior at the right time - Often involves hand-over-hand guidance - Person using a physical prompt is executing all or part of the behavior with the learner - Appropriate when telling or showing the person the behavior is ineffective - Stimulus Prompts - Involves some change in a stimulus, or the addition or removal of a stimulus, to make the correct response more likely - May involves change in the discriminative stimulus or s-delta that makes the discriminative stimulus more salient and the s delta less salient - Within-Stimulus Prompts - Change the salience of a discriminative stimulus

- Extra Stimulus Prompts - Adding a stimulus to help a person make a correct discrimination Transfer of Stimulus Control (214 - 219) - Prompt Fading - Most commonly used method of transferring stimulus control - Response prompt is removed gradually across learning trials until the prompt is no longer provided - Prompt Delay - Present the discriminative stimulus, wait a certain number of seconds, and then, if the correct response is not made, you provide the prompt - Time delay between presentation and the prompt maybe constant or progressive - Stimulus Fading - Stimulus prompts removed through stimuli fading to transfer stimulus control the the natural discriminative stimulus - Also used when the stimulus prompt involves a change in some aspect of the discriminative stimulus itself (within-stimulus prompt) - Stimulus fading involves gradually change the discriminative stimulus from its altered form to its natural form How to Use Prompting & Transfer of Stimulus Control (219 - 221) - Choose the most appropriate prompting strategy - If a novel behavior is being taught, response prompts are most appropriate because they can be used to generate a new behavior in the appropriate situation - For learners with limited abilities, stronger or more intrusive prompts are more appropriate - Less intrusive or weaker prompts can be used if the learner is capable of benefiting from them - May also use graduated prompt strategies - Stimulus prompts are most appropriate when you want to help a person make a correct discrimination - Get the learners attention - Before you present the instructional stimuli (the discriminative stimulus or the prompts), be sure that the learner is paying attention - Present the discriminative stimulus - The learning trial always starts with the presentation of the discriminative stimulus - If learner makes correct response in the presence of the discriminative stimulus, prompts are not necessary - Prompt the correct response - Reinforce the correct behavior, whether it was prompted or unprompted

- Increase magnitude of reinforcement for unprompted responses - Transfer stimulus control - If response prompts being used, transfer stimulus control with fading or prompt delay procedures - If stimulus prompts being used, transfer by means of stimulus fading procedures - If a fading step is too big, the behavior may be lost; go back to a previous fading step and provide more of the prompt or a stronger prompt - Continue to reinforce unprompted responses - As learner continues to engage in the correct behavior, switch from continuous schedule of reinforcement to intermittent reinforcement schedule - Goal is for the behavior to eventually come under the control of natural contingencies of reinforcement Chapter 11: Chaining Introduction (225) - A complex behavior consisting of many component behaviors that occur together in a sequence is called a behavioral chain Analyzing Stimulus-Response Chains (226 - 228) - Each behavioral chain consists of a number of individual stimulus-response components that occur together in a sequence - Behavioral chain is often called a stimulus-response chain - Each behavior or response in the chain produces a stimulus change that acts as a discriminative stimulus for the next response in the chain - The whole stimulus-response chain is under stimulus control - First response in the chain occurs when a particular discriminative stimulus is presented Task Analysis (228 - 230) - The process of analyzing a behavioral chain by breaking it down into its individual stimulus-response components - Identify all the behaviors necessary to perform the task and write them down in order, then identify the discriminative stimulus associated with each behavior in the task - Can be done in a number of ways - Observe a person engaging in the task and record each of the stimulus-response components - Ask a person who performs the task well (an expert) to explain all the components in the task - Develop a task analysis by performing the task yourself and recording the sequence of discriminative stimuli and responses in the task - Once the task analysis has been developed, the next step is to choose a strategy for teaching the skill

- Strategies for teaching complex tasks (behavioral chains) are called chaining procedures - Involve systematic application of prompting and fading strategies to each stimulus-response component in the chain Backward Chaining (231 - 233) - Intensive training procedure typically used with learners with limited abilities - Use prompting and fading to teach the last behavior in the chain first - Learner completes the chain on every learning trial - Once the last behavior is mastered, you teach the next to last behavior Forward Chaining (233 - 235) - Teach one component of the chain at a time and then chain the component together - Use prompting and fading to teach the behavior associated with the discriminative stimulus at each step in the chain - Teach the first component, then the second component, etc. - Present the first discriminative stimulus, prompt the correct response, and provide a reinforcer after the response, then fade your prompts until the person is engaging in the first response without any prompts when the first discriminative stimulus is presented - Because you provide a reinforcer after each response in the chain during training, the outcome of each response (the discriminative stimulus for the next response) becomes a conditioned reinforcer Total Task Presentation (235 - 238) - Complex chain of behaviors is taught as a single unit - Total task is completed in each learning trial - Use prompting to get the learner to engage in the entire chain of behaviors from start to finish - Once the learner successfully completes the task with prompts, you fade the prompts over learning trials - Provide reinforcer every time the learner completes the task, with or without prompts - Graduated guidance - Hand over hand guidance to lead the learner through the task - Over trials, gradually provide less and less assistance and shadow the learner’s hand as the learner completes the tasks Other Strategies for Teaching Behavioural Chains (239 - 242) - Written Task Analysis - Trainer presents the learner with a list of the component behaviors in their proper sequence, and the learner uses this list to perform the task correctly - Picture Prompts - Take pictures of the outcome of each behavior or of someone engaging in each behavior in the task

- Pictures are then used to prompt the learner to engage in the behaviors in the proper sequence - Learner has to look at the pictures in the proper sequence and each picture must have stimulus control over the behavior that is depicted - Video Modeling - Learner watches a video of someone engaging in the chain of behaviors immediately before engaging in the same task - Can be conducted in two different ways: - Learner watches the entire video just before attempting to complete the task - Learner watches one step of the task on video, completes that task, then watches the next step, etc. - Self-Instructions - Teach the learners how to give themselves verbal prompts or instructions to engage in the correct sequence of behaviors in the chain - Learners must be able to remember the self-instruction, say them at the appropriate time, and correctly follow the self-instructions - Learner first learns to recite self-instructions out loud as a prompt for the correct behavior, may then recite them covertly How to Use Chaining Procedures (242 - 243) - Determine whether a chaining procedure is appropriate - Not to be used in cases of noncompliance - Develop a task analysis - Get a baseline assessment of the learner’s ability - Single-opportunity method: Present the learner with the opportunity to complete the task and record which component the learner completes without assistance in the correct sequence - First error typically results in errors on all subsequent steps - Multiple-opportunity method: Assess the learner’s ability to complete each individual component in the chain - Choose the chaining method you will use - Limited abilities: forward or backward chaining - Implement the chaining procedure - Continue reinforcement after the task has been learned Chapter 13: Functional Assessment Introduction (267) - The process of identifying variables before treating a problem behavior is called functional assessment

Defining Functional Assessment (270 - 271) - Regardless of whether a behavior is desirable or undesirable, its occurrence is controlled by environmental variables - The behavior occurs as a function of environmental variables - Functional Assessment is the process of gathering information about the antecedents and consequences that are functionally related to the occurrence of a problem behavior - Provides information that helps you determine why a problem behavior is occurring - Provides detailed information about antecedent stimuli - Provides information about the existence of alternative behaviors that may be functionally equivalent to the problem behavior - Identifies motivational variables : establishing and abolishing operations that influence the effectiveness of stimuli as reinforcers and punishers Functions of Problem Behaviors (271 - 273) - Social Positive Reinforcement - When a positively reinforcing consequence is delivered by another person after the target behavior, and as a result, the behavior is more likely to occur - May involve attention, access to activities, or tangibles provided by another person - Social Negative Reinforcement - When another person terminates an aversive interaction, task, or activity after the occurrence of a target behavior, and as a result, the behavior is more likely to occur - Automatic Positive Reinforcement - When the behavior produces a positively reinforcing consequence automatically, and the behavior is strengthened - Some behaviors produce sensory stimulation that reinforces behavior - Automatic Negative Reinforcement - Occurs when the target behavior automatically reduces or eliminates an aversive stimulus as a consequence of the behavior and the behavior is strengthened Functional Assessment Methods (273 - 285) - Indirect Methods (Informant Assessment Methods) - Behavioral interviews or questionnaires are used to gather information from the person exhibiting the problem behavior or from others who know the person well - Easy to conduct and do not take much time - Informants must rely on their memory of the events; information may therefore be incorrect as a result of forgetting or bias - Interview is the most common assessment method used by psychologists - Goal of a behavioral interview is to generate information on the problem behaviors, antecedents, consequences, and other variables that will permit you to form a hypothesis about the controlling variables for the problem - Direct Observation Methods (ABC Observation)

- When conducting a functional assessment using direct observation methods, a person observes and records the antecedents and consequences each time the problem behavior occurs - Antecedents and consequences observed and recorded in the natural environment where the problem behavior typically takes place - Assessment information more likely to be accurate than indirect observation - ABC observations are reliably associated with the problem behavior - Do not demonstrate a functional relationship , only a correlation - Development of a hypothesis about the antecedents and consequences is the desired outcome of conducting ABC observations - Descriptive Method - Observer writes a brief description of the behavior and of each antecedent and consequent event each time the behavior occurs - Open ended and results in descriptions of all events that were contiguous to the behavior - Checklist Method - Typically developed after the problem behaviors and potential antecedents and consequences are identified in an interview or through observation - Observer records the particular problem behavior each time it occurs, together with its antecedents and consequences, by putting a check mark in each of the relevant columns - Interval (Real-Time) Recording Method - Identify and define specific events that may serve as antecedents and consequences and record these events, as well as the behavior, with an interval or real time recording - Identify the specific events to record from an interview or direct observation - Indirect and direct functional assessment methods categorized as descriptive assessments - Do not prove that variables are functionally related to the behavior - Experimental Methods (Functional Analysis) - Experimentally demonstrates a functional relationship between the antecedents and consequences and the problem behavior - Follow the problem behavior with potential reinforcers to see which consequences increase/strengthen the behavior and/or you present different antecedent events (possible EOs) to see which ones evoke the behavior - Typical functional analysis manipulates both antecedents and consequences - Exploratory functional analysis is designed to evaluate a range of possible functions for the problem behavior; the behavior analyst may not have a hypothesis about the reinforcing consequence maintaining the problem behavior and is exploring a range of possibilities - In each test condition , you present an EO and a possible reinforcer for the problem behavior

- In a control condition , you present an AO and withhold the possible reinforcers for the problem behavior - Hypothesis-Testing Functional Analysis: Goal of the functional analysis is not to evaluate all possible functions, but to confirm or disconfirm the hypothesis - One test condition and one control condition - Test condition presents hypothesized EO, and when the problem behaviour occurs, presents the hypothesized reinforcer - Control condition presents the hypothesized AO, and if the problem behavior occurs, does not provide the hypothesized reinforcer Functional Analysis Research (285 - 288) - The functional analysis provides the standard scientific evidence that a particular type of antecedent evokes the behaviour and a particular type of reinforcing consequence maintains the behaviour Conducting a Functional Assessment (289 - 291) - Start with a behavioural interview - Develop a hypothesis about the ABCs of the problem behaviour - Conduct a direct observation assessment - May be conducted by the client, a behaviour analyst, or people in the client’s environment who are trained by the behaviour analyst to conduct observations - Reactivity can be reduced through unobtrusive observation, by participant observation, or by allowing a period of time for habituation - Confirm your initial hypothesis about the ABCs of the problem behaviour - Conduct further assessments if needed - Conduct a functional analysis if needed Functional Interventions (291) - Once you have conducted the functional assessment process, you use the information on antecedents and consequences of the problem behaviour to develop interventions - Interventions should be designed to alter the antecedents and consequences of the problem behaviour to decrease the problem behaviour and increase desirable alternative behaviours - Functional interventions include extinction, differential reinforcement, and antecedent manipulations - Interventions are considered functional because they address the antecedents and consequences identified in the functional assessment - Nonaversive because they do not rely on punishment Chapter 14: Applying Extinction Using Extinction to Decrease a Problem Behaviour (300 - 309) - You must identify the specific reinforcer for the problem behaviour so that you can eliminate it in an extinction procedure

- Success of an extinction procedure depends on whether the particular reinforcer maintaining the problem behaviour as been identified - If the change agent has no control over reinforcer, extinction cannot be implemented - Extinction can be implemented only if the change agent can prevent the reinforcing consequence each time the problem behaviour occurs - When using an extinction procedure, you must take a number of steps: - Inform the change agent of the escalation that is likely to occur during an extinction burst - Instruct the change agent to persist in withhold the reinforcer as the problem behaviour escalates - If escalation of the behaviour is likely to harm the person with the problem behaviour or other people, you must devise a plan to eliminate or minimize the harm - For extinction to be implemented correctly, the reinforcer must never follow the problem behaviour Taking Account of the Schedule of Reinforcement Before Extinction (309 - 311) - Continuous schedule = More rapid extinction Reinforcing Alternative Behaviours (311) - Extinction procedure decreases the frequency of the problem behaviour, and the reinforcement procedure increases an alternative behaviour to replace the problem behaviour - Reinforcement procedure will increase a desirable behaviour that serves the same function or results in the same consequence Promoting Generalization & Maintenance (311 - 312) - Promote generalization and maintenance of the behaviour change - Generalization: Extinction must be implemented consistently by all changes agents and must be implemented in all circumstances in which behaviour change is expected - Consistent reinforcement of an alternative behaviour that is functionally equivalent to the problem behaviour promotes generalization and maintenance Chapter 15: Differential Reinforcement Differential Reinforcement of Alternative Behaviour (322 - 333) - Behavioural procedure used to increase the frequency of a desirable behaviour and to decrease the frequency of undesirable behaviours - Desirable behaviour reinforced each time it occurs - Results in an increase in the future probability of the desired behaviour - At the same time, any undesirable behaviours that may interfere with the desirable behaviour are not reinforced - Results in a decrease in the future probability of the undesirable behaviours

- DRA involves combining reinforcement for a desirable behaviour and extinction of undesirable behaviours - When to Use DRA - Decide whether it is the right procedure in a particular situation - Desirable behaviour must be occurring at least occasionally if you are to reinforce it - If the behaviour is not occurring at all, DRA by itself is not an appropriate procedure - However, if procedures such as shaping or prompting are used initially to evoke the behaviour, DRA may then be used to strengthen and maintain the behaviour - Must be able to identify a reinforcer that you can control/use each time the behaviour occurs - How to Use DRA - Define the desirable behaviour - Clear behavioural definition of the desired behaviour helps ensure that you are reinforcing the correct behaviour - Allows you to record the behaviour to determine whether treatment is successful - Define the undesirable behaviour - Identify the reinforcer - Important to determine a reinforcer specific to the person with whom you are working - One possibility is to use the reinforcer that is currently maintaining the undesirable behaviour, as you already know this reinforcer is effective - Could also observe the person and note which interests he or she pursues - Ask people questions about what they like - Try out a variety of different stimuli and see which ones the person prefers - Preference Assessment - Can be carried out in at least 3 different ways: - Single stimulus assessment - Paired stimulus assessment - Multiple stimulus assessment - Research identifies a number of potential reinforcers, presents the potential reinforcers to the person, and records which ones they approach - To determine that the item did in fact function as a reinforcer, you would deliver it contingent on a behaviour and show that the behaviour increased (process known as reinforcer assessment ) - Single Stimulus Assessment - Each potential reinforcer presented one at a time - Paired Stimulus Assessment (Forced Choice Procedure) - Two potential reinforcers are presented and researcher records which stimulus the individual approaches

- Multiple Stimulus Assessment - Array of potential reinforcers is presented to the individual and the researcher records which potential reinforcer the individual approaches or chooses first - Stimulus then removed and the researcher records what the individual chooses next - Array of stimuli presented a number of times with stimuli in different locations each time to identify the order in which the stimuli are chosen - Also called a multiple stimulus without replacement (MSWO) procedure - Another technique is to make each potential reinforcer contingent on an operant response - Reinforce the desirable behaviour immediately and consistently - Eliminate reinforcement for the undesirable behaviours - If reinforcer for undesirable behaviours cannot be eliminated completely, it at least must be minimized so that the contrast between the reinforcement of the desirable and undesirable behaviours is maximized - Use intermittent reinforcement to maintain the target behaviour - Continuous reinforcement for the desirable behaviour is used in the early stages of DRA - Once the desirable behaviour is occurring consistently and the undesirable behaviours occur rarely, start to thin the schedule of reinforcement and reinforce the desirable behaviour intermittently - Makes the desired behaviour more resistant to extinction - Program for generalization - Target behaviour should occur outside the training situation in all relevant stimulus situations - Target behaviour should be differentially reinforcer in as many relevant situations as possible, by as many relevant people as possible - Use differential negative reinforcement of alternative behaviours - When differential reinforcement is used successfully, the desirable behaviour should increase and the undesirable behaviour should decrease - Variations of DRA - Differential Reinforcement of an Incompatible Behaviour (DRI) - Alternative behaviour is physically incompatible with the problem behaviour and therefore the two behaviours cannot occur at the same time - Differential Reinforcement of Communication (DRC)/Functional Communication Training - Alternative behaviour that is reinforced to replace the problem behaviour is a communication response

- Communication response reinforced in this variation of DRA is more efficient than the problem behaviour

Differential Reinforcement of Other Behaviour (333 - 340) - Reinforcer is contingent on the absence of the problem behaviour - Reinforcer is no longer delivered after the problem behaviour (extinction), but the reinforcer is delivered after an interval of time in which the problem behaviour does not occur - Problem behaviour decreases through extinction - Implementing DRO - Identify the reinforcer for the problem behaviour - Identify the reinforcer to use in the DRO procedure - Choose the initial DRO time interval - Length of the interval should be tied to the baseline rate of the problem behaviour - As the frequency of the problem behaviour decreases, the DRO intervals can be lengthened gradually - Eliminate the reinforcer for the problem behaviour and deliver the reinforcer for the absence of the problem behaviour - Reset the interval if the problem behaviour occurs - Gradually increase the interval length - Whole-Interval DRO - Problem behaviour must be absent for the whole interval for the reinforcer to be delivered - More effective than momentary DRO - Momentary DRO - Problem behaviour must be absent at the end of the interval for the reinforcer to be delivered Differential Reinforcement of Low Rates of Responding (340 - 346) - Reinforcer is delivered contingent on a lower rate of responding during a period of time - Not reinforcing the absence of the behaviour as in DRO, but rather reinforcing a lower rate of the problem behaviour - Used when a low rate of the problem behavior can be tolerated or when the behaviour is a problem only because of its high rate - Full-Session DRL - Reinforcement is delivered if fewer than a specified number of responses occur in a period of time - Spaced-Responding DRL - Must be a specific amount of time between responses for the reinforcer to be delivered - Objective is to pace the behaviour - When the behaviour occurs at the end of the DRL interval, the behaviour is reinforced - However, if the behaviour occurs before the end of the DRL interval, the behaviour is not reinforced, and the interval is reset

- Interval DRL - Involves dividing a session into intervals and providing the reinforcer if no more than one response occurred in each interval - Entails an average time between each response - Implementing DRL Procedures - Determine whether DRL is the appropriate procedure to use - If goal is to decrease the rate of a behaviour but not to eliminate it, DRL is appropriate - Determine an acceptable level of behaviour - Decide whether to implement full session DRL or space-responding DRL - If timing of the behaviour is important and it is necessary to have an interval of time between responses, spaced-responding DRL - If timing of each response is less important and you simply want to decrease the overall rate of the behaviour in a session, full-session DRL - Inform the client about the procedure so they know the criterion for reinforcement - Give client feedback on their performance Chapter 16: Antecedent Control Procedures Introduction (351) - Antecedent control procedures also called antecedent manipulating - Antecedent stimuli are manipulated to evoke desirable behaviours, so that they can be differentially reinforced, and to decrease undesirable behaviors that interfere with the desirable behaviors Defining Antecedent Control Procedures (353 - 362) - Desired behaviour and undesirable (problem) behaviours are viewed in a competing responses framework - Involve manipulating some aspect of the physical or social environment to make a desired behaviour more likely or to make a competing, undesirable behaviour less likely - Used to evoke desired behaviours and prevent undesirable behaviours - Presenting the Discriminative Stimulus or Cues for Desired Behaviour - One reason that a desirable behaviour may not occur often is that the discriminative stimuli for the behaviour are not present in the person’s environment - By presenting the discriminative stimuli or cues for the behaviour, you are arranging the right conditions for the behaviour to occur - Arranging Establishing Operations for the Desirable Behaviour - Decreasing Response Effort for the Desirable Behaviour - Arrange antecedent conditions such that less effort is needed to engage in the behavior - Behaviours that require less effort are more likely to occur if both result in fairly equal reinforcers

- Removing the Discriminative Stimulus or Cues for Undesirable Behaviour - Presenting Abolishing Operations for Undesirable Behaviours - Increasing the Response Effort for Undesirable Behaviours Using Antecedent Control Strategies (370 - 373) - Appropriate to use one or more of the above strategies whenever the goal is to increase a desirable behaviour or decrease an undesirable behaviour - If the person is engaging in the behaviour at least occasionally, antecedent control strategies may be used to make it more likely that the person will engage in the behaviour at the appropriate time - Differential reinforcement procedures are used in conjunction with antecedent control procedures to increase desirable behaviour - Extinction and differential reinforcement often are used in conjunction with antecedent control procedures to decrease undesirable behaviour - Functional Interventions - Decrease problem behaviours and increase desirable behaviours by modifying the antecedent and consequent variables that control the behaviours - Nonaversive because they do not rely on the use of punishment - Should always be the first treatments used in an attempt to decrease a problem behaviour because they change the conditions that are maintaining the behaviour and invoking it - Extinction, differential reinforcement, and antecedent manipulations Chapter 17: Time-Out & Response Cost Introduction (377 - 378) - Punishment procedures typically are used only after functional interventions have been implemented or considered - When these procedures are implemented and result in a decrease in the problem behavior, punishment procedures are unnecessary - If functional procedures are ineffective or not completely effective, or if their use is limited or impossible for whatever reason, punishment procedures may be considered Time-Out (378 - 388) - The loss of access to positive reinforcers for a brief period contingent on the problem behaviour - Result in a decrease in future probability of the problem behaviour - Non-Exclusionary Time-Out - Most likely to be used when - The person can be removed from the reinforcing activities or interactions while still remaining in the room - The presence of the person in the room will not be disruptive to others in the environment

- Person must be removed from access to positive reinforcers - Exclusionary Time-Out - The person is removed from the room (the reinforcing environment) where the problem behaviour occurred and is taken to another room - Removes person from all sources of positive reinforcement - Using Reinforcement with Time-Out - When you use time-out (or any other punishment procedure), you should also use a differential reinforcement procedure - Time-out procedure decreases the rate of the problem behaviour, differential reinforcement procedure increases an alternative behaviour to replace the problem (DRA) or provides the reinforcer for the absence of the problem behaviour (DRO), while at the same time applying extinction - Because the time-out procedure eliminates access to positive reinforcers contingent on the problem behavior, it is important for the person to have access to positive reinforcers through a DRA or DRO procedure (or an NCR procedure) - If not used, there could be a net loss in reinforcement and the problem behaviour could be more likely to reemerge after treatment - Considerations in Using Time-Out - To use effectively, immediately following problem behaviour, get close to the child, tell child to go to time-out area while pointing in the direction of the time-out area, provide physical guidance if the child does not comply, and ignore problem behaviour occurring during time-out - Function of the problem behaviour - Appropriate to use with problem behaviours maintained by positive reinforcement involving social or tangible reinforcers - The time-in environment (environment where the problem behaviour occurs) must consist of positively reinforcing activities or interactions for timeout to be effective - Not appropriate to use with problem behaviours maintained by negative reinforcement or sensory stimulation (automatic reinforcement) - Timeout would negatively reinforce any behaviour that was maintained by escape - When a problem behaviour is maintained by sensory stimulation, time-out is not appropriate because it would not function as a time-out from positive reinforcement - Practicality of time-out - Practical when change agents can implement the procedure successfully and the physical environment is conductive to its use - Physical resistance or violence must be considered - Appropriate room or area to use for time-out? - Time-out area must be a place where the client does not have access to any positive reinforcers - Room should be safe, well-kighted, barren, have an observation window, and lock free

- Safety - Time-out room must not contain any objects that clients could use to hurt themselves - Although change agent should not interact with clients during time-out, they should observe them throughout the duration of time-out to ensure that they do not harm themselves - Time-out period - Client should be returned to the time-in environment as soon as possible and allowed to resume normal activities - If client is engaging in problem behaviours in the time out area at the end of the timeout period, time-out is extended for a brief time until the client is no longer engaging in problem behaviours - Absence of the problem behaviour is required at the end of the time out so that the termination of time-out does not negatively reinforce the problem behaviour - Extension called a contingent delay or a release contingency - Escape prevention - Change agents should be able to prevent client from leaving the timeout room or area before the end of the time-out interval - Interactions - Time-out must be implemented calmly and without any emotional response from the change agent - Change agent must not interact with the client - Reprimands, explanations, or any other form of attention must be avoided - Acceptability - Must be certain that the procedure is acceptable in the particular treatment environment Response Cost (388 - 394) - The removal of a specified amount of a reinforcer contingent on the occurrence of a problem behaviour - Negative punishment procedure when it results in a decrease in the future probability of the problem behaviour - Using Differential Reinforcement with Response Cost - If a response cost procedure is being used to decrease a problem behaviour, differential reinforcement should also be used to increase a desirable alternative behaviour (DRA) or to reinforce the absence of the problem behaviour (DRO) - Comparing Response Cost, Time-Out, and Extinction - With extinction , the problem behavior is no longer followed by the reinforcing event that previously maintained the behaviour - With time-out , the person is removed from access to all sources of reinforcement contingent on the problem behaviour

- With response cost , a specific amount of a reinforcer the person already possesses is removed after the problem behaviour - Considerations in Using Response Cost - Which reinforcer will be removed - Quantity of reinforcer must be large enough so that its loss will decrease the problem behaviour - Reinforcer Loss Immediacy - Although the reinforcer loss in response cost is typically delayed, the person is told about the loss immediately after the problem behaviour - In some cases, an immediate consequence occurs together with the delayed loss of the reinforcer - Ethics - Practicality & Acceptability - Change agent must be able to carry out the procedure - Response cost procedure must not embarrass or stigmatize the person with the problem behaviour Chapter 18: Positive Punishment Procedures Application of Aversive Activities (398 - 405) - Contingent on the problem behaviour, someone is made to engage in an aversive activity; as a result, the problem behaviour is less likely to occur in the future - An aversive activity is a low-probability behaviour the person typically would not choose to engage in - Based on the premack principle - When the requirements to engage in a low-probability behaviour (the aversive activity) is made contingent on the occurrence of a high-probability behaviour (the problem behaviour), the high-probability behaviour will decrease in the future - An aversive activity is a behaviour that can be a punisher for another behaviour - When applying an aversive activity as a positive punisher, the change agent instructs the client to engage in the aversive activity immediately contingent on the problem behaviour - If the client does not engage in the activity when instructed, the change agent then uses physical guidance to make the client engage in the behaviour - Overcorrection - Client is required to engage in an effortful behaviour for an extended period contingent on each instance of the problem behaviour - Positive Practice - Client has to engage in correct forms of relevant behaviour contingent on an instance of the problem behaviour - Client has to engage in the correct behaviour many times - Restitution - Contingent on each instance of the problem behaviour, the client must correct the environmental effects of the problem behaviour and restore

the environment to a condition better than that which existed before the problem behaviour - Contingent Exercise - Client is made to engage in some form of physical exercise contingent on an instance of the problem behaviour - Aversive activity involves physical exercise that is unrelated to the problem behaviour - Must be a physical activity that the client is capable of performing without harm - Guided Compliance - Person is guided physically through the requested activity contingent on the occurrence of the problem behaviour - Physical guidance is withdrawn if the person begins to comply with the requested activity - Compliance is negatively reinforced - Physical Restraint - Change agent holds immobile the part of the client’s body that is involved in the behaviour - Client physically restrained from continuing to engage in the problem behaviour - Response Blocking - Change agent prevents the occurrence of a problem behaviour by physically blocking the response - Cautions in the Application of Aversive Activities - Should only be used when the change agent can provide physical guidance - Change agent must anticipate that the client mat resist the physical guidance, at least initially, and must be certain that they can carry out the procedure if the client does resist physically - Change agent must be certain that the physical guidance involved in the procedure is not reinforcing to the client - Change agent must be certain that the procedure can be conducted with no harm to the client or change agent Application of Aversive Stimulation (405 - 408) - Delivering an aversive stimulus after the problem behaviour - When the problem behaviour results in the delivery of the aversive stimulus, the behaviour is less likely to occur in the future Considerations in Using Positive Punishment (409 - 410) - Use functional interventions first - Implement differential reinforcement with punishment - Consider the function of the problem behaviour - Choose the aversive stimulus with care - Aversive stimulus is always defined by its effect on the behaviour it follows - Collect data to make treatment decisions

- Address the ethical considerations in the use of punishment The Ethics of Punishment (410 - 412) - Informed Consent - Person must fully understand the punishment procedure, the rationale for its use, how and when it will be used, its intended effects and side effects, and possible treatment alternative - Person must be fully informed and must willingly agree - Only adults can give informed consent - Alternative Treatment - Reinforcement procedures always used in conjunction with punishment procedures - Recipient Safety - Should never cause harm to the client - Problem Severity - Punishment procedures should be reserved for more severe problem behaviours - Implementation Guidelines - Must be strict written guidelines for using the procedure to avoid ambiguity - Training & Supervision - Peer Review - Accessibility: Preventing Misuse & Overuse Chapter 19: Promoting Generalization Defining Generalization (419) - The occurrence of the behaviour in the presence of stimuli that are similar in some way to the discriminative stimulus that was present during training - A class of similar stimuli develops stimulus control over the behaviour - Generalization is defined as the occurrence of the behaviour in the presence of all relevant stimuli outside the training situation Strategies for Promoting Generalization of Behaviour Change (419 - 430) - Reinforcing Occurrences of Generalization - Reinforce the behaviour when generalization occurs - Reinforce the behaviour when it occurs outside the training situation in the presence of relevant stimuli - Drawback is that it is not always possible to provide reinforcement for the behaviour outside the training situation - If you cannot reinforce instances of generalization, use other strategies - Training Skills That Contact Natural Contingencies of Reinforcement - If you cannot provide reinforcement for the behaviour in relevant situations outside the training situation, it is important for natural reinforcers to be present

- May not always been possible - Modifying Contingencies of Reinforcement/Punishment in Natural Environment - Desirable behaviours will occur in relevant situations outside the training situation if the behaviour is reinforced in those situations (and if punishment contingencies are not operating in those situations) - When the trainer is not able to reinforce occurrences of generalization and there are no existing natural contingencies of reinforcement, generalization may be promoted by modifying the contingencies of reinforcement in the relevant situation - If the trainer cannot reinforce the behaviour in the natural environment, the trainer should teach others in the natural environment to reinforce the behaviour - Sometimes, natural punishment contingencies make generalization of the desirable behaviour less likely - Although a person might learn to perform a desirable behaviour in training, the behaviour is unlikely to generalize if it is punished outside the training situation - One way to promote generalization is to eliminate any punishment contingency that would suppress the desirable behaviour outside the training situation - All three of the above strategies have focused on reinforcing the behaviour outside the training situation - Generalization can also be promoted by arranging appropriate stimulus situations and response variations during training - Incorporating a Variety of Relevant Stimulus Situations in Training - Train the learner to respond to a sufficient number of stimulus exemplars until the behaviour generalizes - If the learner is trained to respond correctly to a range of relevant stimulus situations (stimulus exemplars), the behaviour is more likely to generalize to all relevant stimulus situations - Unfortunately, you cannot determine in advance how many exemplars are sufficient for generalization to occur - General Case Programming - Using multiple training examples (stimulus exemplars) that sample the range of relevant stimulus situations and response variations - Incorporating Common Stimuli - Incorporate stimuli from the generalization environment (target situation) into the training situation - If the training and generalization situations have some features or stimuli in common, generalization is more likely to occur - Some aspect of the target situation is used in training - Teaching a Range of Functionally Equivalent Responses

- It is often useful to teach a variety of responses that may all achieve the same outcome for the client - Different responses that achieve the same outcome called functionally equivalent responses - Each response serves the same function for the person - Providing Cues in the Natural Environment - Provide cues or reminders in the natural environment that can make the target behaviour more likely to occur in the correct circumstances - The behaviour analyst (or a supervisor) provides cues in the natural environment in the hope that the cue will evoke the behaviour when the circumstances in the natural environment do not have sufficient stimulus control over the behaviour - Although cues or reminders might evoke the correct behaviour and increase generalization of the target behaviour, for the behaviour to be maintained there must be some form of reinforcement for the target behaviour in the natural environment - Incorporating Self-Generated Mediators of Generalization - A mediator of generalization is a stimulus that is maintained and transported by the client as part of treatment - May be a physical stimulus or a behaviour exhibited by the person - Has stimulus control over the target behaviour, so the behaviour generalizes beyond the training situation when the mediator is present - Self-generated mediators of generalization - Self-recording - Self-instruction - Any behaviour in the target situation can be regarded as a self-generated mediator of generalization Implementing Strategies to Promote Generalization (430 - 431) - Identify the target stimulus situations for the behaviour - If you are establishing a new behavior or strengthening an existing behaviour, you want that behaviour to occur at the appropriate times and in the appropriate circumstances (the target stimulus situations) - To promote generalization of the behaviour to those situations, you must identify the target stimulus situations before the start of the training - Once you identify the relevant situations, you can implement generalization strategies to increase the likelihood that the behaviour will occur in those situations - If you do not identify the target stimulus situations before training, generalization will be left to chance - Identify natural contingencies of reinforcement for the behaviour - Once natural contingencies of reinforcement are identified, training can focus on strengthening the behaviours that will contact those existing contingencies - If contingencies are not analyzed in advance, you might target behaviours in training that are not functional for the person outside the training situation

- As a result, generalization would be much less likely to occur - Implement appropriate strategies to promote generalization - Analyzing the target stimulus situations allows you to incorporate a variety of these situations into training sessions - Permits you to choose common stimuli that might be incorporated into training or to choose mediators that facilitate generalization of the behaviour to those situations - Identify instances of generalization and provide reinforcers for the behaviour when it occurs in these situations - Analyzing existing reinforcement contingencies helps you choose the variations in the behaviour that are most likely to be reinforced - By training the skills that are most likely to contact natural reinforcement contingencies, you are enhancing the likelihood of generalization - You must understand the natural contingencies of reinforcement and punishment to determine when and how to modify those contingencies to promote generalization - Measure generalization of behaviour change - You must collect data on the occurrence of the behaviour in the target stimulus situations to determine whether your efforts to promote generalization have been successful - Assessment should include information on natural contingencies to determine whether the behaviour continues to be reinforced in the target situations Promoting Generalization Reductions in Problem Behaviours (431 - 433) - The outcome of treatment for problem behaviours should be an improvement in the client’s functioning - Improvement of functioning is defined not only by a decrease in or elimination of the problem behavior but, by the development and maintenance of new skills or the strengthening of existing alternative behaviours and an increase in the quantity of positive reinforcement - To achieve a generalized reduction in a problem behaviour, the focus of the intervention efforts should be on developing appropriate functionally equivalent alternative behaviours as replacements for the problem behaviours - When a person has developed functionally equivalent alternative behaviours, these behaviours can occur and receive reinforcement in all the situations in which the problem behaviour occurred previously - When the intervention consists only of an extinction or punishment procedure designed to eliminate the problem behaviour, a generalized reduction in the problem is unlikely

- Because the extinction or punishment procedure might not be used in all situations in which the problem behaviour occurs, so the behaviour will continue to be reinforced occasionally - In addition, without functionally equivalent behaviours to replace the problem, the problem behaviour is more likely to recur in situations in which it was previously reinforced - Focus on developing and increase appropriate replacement behaviours is known as the constitutional approach to treating problem behaviours - Objective is to develop the repertoires of more appropriate behaviour that are functional for the person - To develop a repertoire is to teach functional skills and reinforce the occurrence of those behaviours in natural contexts - Desirable alternative behaviours are more likely to replace the problematic behaviour if it is no longer reinforced - Attention must be paid to the following guidelines to achieve a generalized reduction in problem behaviours: - Conduct a functional assessment of the problem behaviour - Plan for generalization in advance - Focus on functionally equivalent alternative behaviours to replace the problem behaviours - Generalized reductions in problem behaviours are best achieved when there are generalized increases in appropriate alternative behaviours that serve the same function as the problem behaviour - Maintain extinction (or punishment) contingencies across situations and over time - If extinction or punishment procedures are discontinued prematurely, there is a risk that the problem behaviour may begin to occur more frequently Chapter 20: Self-Management Defining Self-Management Problems (440 - 442) - Goal of self-management strategies is to increase the current level of the deficit behaviour so that the positive outcome can be achieved for the person in the future - Can also attempt to decrease an undesirable behaviour - Behaviour is undesirable because it will have a negative impact on the person;s life in the future - Although it will have a negative outcome on a person’s life in the future, the undesirable behavior continues because it is immediately reinforced when it occurs or because alternative behaviors are not present to compete with its occurrence - Because the negative outcome is in the future, it does not influence the occurrence of the undesirable behavior in the present. The goal of self-management is to decrease or eliminate the behavioral excess so that the negative outcome does not occur in the future

Defining Self-Management (442) - In its basic form, self-management occurs when a person engages in a behaviour at one time to control the occurrence of another behavior (target behaviour) at a later time - The person engaged in the controlling behaviour to influence the future occurrence of the controlled behaviour - Controlling behaviour involves implementing self-management strategies in which the antecedent and consequences of the target behaviour or alternative behaviour are modified - These strategies make the controlled behaviour (target behaviour) more likely Types of Self-Management Strategies (442 - 448) - In self-management, a person identifies and defines a target behaviour and arranges for one or more behaviour modification procedures to influence the occurrence of that behaviour - Goal-Setting & Self-Monitoring - Goal-setting involves writing down the criterion level of the target behaviour and the time frame for the occurrence of the behaviour - Effective when implemented with self-monitoring and other self-management strategies - Set goals that are achievable - When a goal is achievable, you are more likely to be successful in exhibiting the desired level of the target behaviour - Achieving the goal is particularly important early in a self-management program because it is often the criterion for a reinforcement contingency to be implemented, and early reinforcement generally increases the likelihood that the person will preserve in the program - Goal achievement is a conditioned reinforcer for many people or may become a conditioned reinforcer if other reinforcers are delivered when the person achieves the goal - Goal-setting is implemented most often in conjunction with self-monitoring - Record each instance of the target behaviour as it occurs - Allows you to evaluate progress toward the goal - Self-monitoring is often reactive : the act of self-monitoring may result in a beneficial change in the target behaviour that is being recorded - Antecedent Manipulation - Antecedent manipulations often are used by people in self-management programs to influence their own behaviour

- All self-management procedures involve antecedent manipulations because the person engages in some controlling behaviours in advance of the target behaviour to be controlled - The person plans the self-management strategy and arranges for its occurrence before the incidence of the target behaviour - Behavioural Contracting - A behavioural contract is a written document in which you identify the target behaviour and arrange consequences contingent on a specified level of the target behaviour in a specific time period - Although another person (the contract manager) applies the consequences, a behavioural contract is considered to be a type of self-management strategy because the behaviour of entering into the contract is a controlling behaviour designed to influence the future occurrence of the target behaviour - Can also be done without a contract manager - Likely to be less effective - Might not implement the contingency as written - Short-Circuiting the Contingency - Failing to implement the contingency as written in your contract - Occurs when a person arranges a reinforcer for a target behaviour but then tales the reinforcer without first engaging in the target behaviour - May also occur when a person arranges a punisher for a target behaviour, but does not implement the punisher after engaging in the target behaviour - The benefit of having a contract manager is that the contract manager will implement the contingencies consistently and short-circuiting will be less likely to occur - Arranging Reinforcers & Punishers - You can arrange reinforcers or punishers to be implemented by yourself or another person - If the other person is implementing the contingency, short-circuiting is less likely to be a problem - Social Support - Occurs when significant others in a person’s life provide a natural context or cues for the occurrence of the target behaviour or when they naturally provide reinforcing consequences for the occurrence of he target behaviour - Self-management strategy specific when you arrange for social support to influence the target behaviour - Involvement of others increases the likelihood of success by helping to prevent the short-circuiting of contingencies - Self-Instructions & Self-Praise - In self-instruction , you are telling yourself what to do or how to do it in situations that call for a specific target behaviour

- Immediately after the appropriate behaviour occurs, you can recite self-praise statements in which you provide positive evaluations of your own behaviour - Self-instructions and self-praise and behaviours themselves, and they must be learned before they will occur in a criterion situation to influence other target behaviours - A person typically learns self-instructions and self-praise by rehearsing them in role-plays to simulate real problem situations - To use, you must: - Identify the self-statements - Determine the most appropriate time and place to use them - Rehearse them in a role-play as you imagine the problem situation - Plan to use theme only after they are well learned Steps in a Self-Management Plan (448 - 451) - Make the decision to engage in self-management - Define the target behaviour and competing behaviours - Set goals - Self-monitor - Conduct a functional assessment - Determine antecedents and consequences of the target behaviour - Determine competing alternative behaviours - Understand the variables that contribute to the occurrence or nonoccurrence of the target behaviour and alternative behaviours - Choose appropriate self-management strategies - Decrease an undesirable target behaviour: - Eliminate the reinforcer for the behaviour - Arrange punishers for the occurrence of the target behaviour - Provide reinforcers for the alternative behaviours - Eliminate punishment contingencies for the alternative behaviours, or use behaviour skills training procedures to teach the alternative behaviours - Increase a desirable behaviour: - Arrange reinforcers for the target behaviour - Eliminate any punishment contingencies operating for the target behaviour - Eliminate the reinforcers for the alternative behaviours - Provide punishers for the alternative behaviours - Choose antecedent and consequence manipulations that affect the target behaviour directly or antecedent and consequence manipulations that affect alternative behaviours as a way to influence the target behaviour indirectly - Evaluate change - Reevaluate self-management strategies if necessary, have you done something wrong - Incorrect implementation - Potentially chose inappropriate self-management strategies

- Implement maintenance strategies Chapter 21: Habit Reversal Procedures Introduction (455 - 456) - Habit reversal procedures used to decrease the frequency of undesirable habit behaviours - Habit behaviours often do not interfere to any great extent with the person’s social functioning - Tend to be more of an annoyance - When the habit behaviour occurs frequently or with high intensity, the person may seek treatment for the problem - In such cases, a habit behavior may be seen as a habit disorder Nervous Habits (457 - 458) - Involve repetitive, manipulative behaviours that are believed to be most likely to occur when the person experiences heightened nervous tension - Typically do not serve any social function - Believed that they diminish nervous tension; may serve a self-stimulatory function - Can occur while other voluntary functional activities are occurring - In most cases, nervous habits involve the use of the hands - Many nervous habits do not cause any problems for the person unless the frequency or the intensity of the behaviour becomes extreme - Body-focused repetitive behaviour problems refer to nervous habits that result in physical damage or negative social evaluations - Motor & Vocal Tics - Motor tics are repetitive, jerking movements of a particular muscle group in the body - Motor tics usually involve muscles in the neck or face - Motor tics believed to be associated with heightened muscle tension - A vocal tic is a repetitive vocal sound that does not serve a social function - May involve other sounds or words - Tourette’s Disorder - Tic disorder involving multiple motor and vocal tics - Believed to be caused by a complex interaction of genetic and neurobiological factors, as well as environmental events - Diagnosis when two or more tics (including at least one vocal tic) occur for at least 1 year - Considered a lifelong disorder with an onset in childhood

Stuttering (458 - 459) - Speech dysfluency in which the person repeats words or syllables, prolongs the sound or a word or syllable, or blocks on a word - May occur in young children as they are first learning to use language - Most children grow out of stutters Habit Reversal Procedures (459 - 460) - The habit reversal procedure is implemented in a therapy session with the client who exhibits the habit disorder - The client then implements the procedures that are taught in the session to control the habit as it occurs outside the session - Person is first taught to describe the behaviours that are involved in the habit - After learning the behavioural definition of the habit, the client learns to identify when the habit occurs or when it is about to occur - Above procedures constitute awareness training component of habit reversal - The client then learns competing response (behaviour incompatible with the habit behaviour) and practices the competing response in a session after each occurrence - Next, the client imagines the situations in which they will use the competing response outside the session to inhibit the habit - Finally, the client is instructed to use the competing response outside the session - These procedures constitute the competing response training - Significant others are instructed to prompt the client to use the competing response when the habit occurs outside the session - Instructed to also praise the client for not engaging in the habit and for using the competing response successfully - Involvement called social support - Finally, therapist reviews with the client all the situations in which the habit occurs and how the habit may have caused inconvenience or embarrassment - Review is a motivation strategy , which increases the likelihood that the client will use the competing response outside the session to control the habit - Client learns two basic skills: - To discriminate each occurrence of the habit ( awareness training ) - To use the competing response contingent on the occurrence of the habit or in anticipation of the occurrence of the habit ( competing response training ) - Typically an unobtrusive behaviour (not easily identified by others) that the person engages in for 1-3 minutes Applications of Habit Reversal (460 - 466) - When habit reversal is used with children, the parent might use physical guidance to get the child to engage in the competing response

- Because stuttering involves interrupted airflow through the vocal cords that interferes with the production of fluent speech, a competing response would involve relaxation and uninterrupted airflow over the vocal cords during speech - Competing response in stuttering called regulated breathing - Clients first taught to detect each instance of stuttering - First component is a quick relaxation procedure called diaphragmatic breathing - Client learns to breathe in a rhythmic pattern using the muscles of the diaphragm to pull air deep into the lungs - The use of the competing response serves two possible functions: - To inhibit the habit behaviour and provide an alternative behaviour to replace it - Competing response may serve as a punisher, as in the application of aversive activities such as overcorrection and contingent exercise Other Treatment Procedures for Habit Disorders (466 - 467) - Habit reversal may not be effective for habit behaviours exhibited by young children or people with intellectual disabilities Chapter 22: The Token Economy Defining a Token Economy (473) - A token economy is a reinforcement system in which conditioned reinforcers called tokens are delivered to people for desirable behaviours - Tokens later exchanged for backup reinforcers - Purpose of a token economy is to strengthen clients’ desirable behaviours that occur too infrequently and to decrease undesirable behaviours in a structured treatment environment or educational setting - A token is something delivered to a person immediately after a desirable behaviour, accumulated by the person, and later exchanged for backup reinforcers - Because the token is paired with other reinforcers, it becomes a conditioned reinforcer that strengthens the desirable behaviour it follows - Backup reinforcers can be obtained only by paying for them with tokens - Tokens can be obtained only by exhibiting desirable behaviours - Backup reinforcers chosen because they are known to be powerful reinforcers for the client in the treatment environment - Essential Components of a Token Economy - The desirable target behaviours to be strengthened - The tokens to be used as conditioned reinforcers - The backup reinforcers to be exchanged for the tokens - A reinforcement schedule for token delivery - The rate at which tokens are exchanged for the backup reinforcers - A time and place for exchanging tokens for backup reinforcers

- In some cases, a response cost component is added, in which the undesirable target behaviours to be eliminated are identified, together with the rate of token loss for each instance of these behaviours Implementing a Token Economy (473 - 480) - Defining the Target Behaviours - Target behaviors vary in a token economy depending on the people being treated and the nature of the treatment environment - Important to define target behaviours carefully - Identifying the Items to Use as Tokens - Token must be something tangible that the change agent can deliver immediately after each instance of the target behaviour - Must be practical and convenient for the change agent to carry and dispense - Must be in a form that clients can accumulate and (in most cases) carry with them - Tokens should not be available from any source other than the change agent - Identifying Backup Reinforcers - Tokens acquire their effectiveness as conditioned reinforcers because they are paired with the backup reinforcers - Effectiveness of a token economy depends on the backup reinforcers - Backup reinforcers are not available to clients except for purchase with tokens - Limiting access increases their reinforcing value because a relative state of deprivation is established - Deciding on the Appropriate Schedule of Reinforcement - In general, more important or more difficult behaviours receive more tokens than less important or less difficult behaviours - Often the program begins with continuous reinforcement, and later an intermittent reinforcement schedule is implemented - Establishing the Token Exchange Rate - Smaller items exchanged for fewer tokens - Change agents must determine the maximum number of tokens that the client can earn in a day and set the exchange rate accordingly - Exchange rate must be such that the client can acquire some backup reinforcers for exhibiting a reasonable level of desirable behaviour but does not acquire so much of the reinforcers that satiation occurs - Often the change agents may adjust the exchange rate after beginning a token economy to produce the best results - Establishing the Time & Place for Exchanging Tokens - Time and place for exchange planned in advance - In some cases, there is a token store - Creating a structure in advance results in more consistent implementation of the program

- Deciding Whether to Use Response Cost - If the goal of the token economy is to strengthen desirable behaviours and there are no competing problem behaviours, the token economy will not include a response cost element - When a response cost program is included, it should be introduced after the token economy has been in place for a period of time - The loss of tokens in the response cost component will be effective as a punisher only after the tokens have been firmly established as conditioned reinforcers for the participants - Response cost is used only if the change agent can get the tokens back - The loss of tokens in the response cost program must result in less opportunity to purchase backup reinforcers, but must not result in the loss of all tokens (except for serious problem behaviours) - Loss of all tokens through response cost would negate the positive reinforcement of the desirable behaviours because the client does not have tokens to exchange for backup reinforcers - If a client loses all of the accumulated tokens through response cost, problem behaviours may continue because the client has nothing left to lose - Staff Training & Management - Staff members mst receive proper training before implementation - Written instructions in all components of the program and behavioural skills training are needed to conduct the program as planned - Staff must fulfill the following responsibilities: - Discriminate each instance of all of the target behaviours - Deliver tokens immediately after the target behaviours, according to the correct schedule of reinforcement - Discriminate each instance of all identified problem behaviours - Implement response cost immediately when problem behaviours occur (if applicable) - Preserve the integrity of the tokens and prevent theft or counterfeiting - Know the exchange rates and times to adhere to the rules of exchange Practical Considerations (480 - 481) - Change agent should always deliver the tokens immediately - Change agent should praise the client while delivering the tokens - Praise is a natural conditioned reinforcer for most people - Once the token is discontinued, the change agents will continue to deliver praise as a reinforcer for the desirable behaviour - For young children or individuals with severe intellectual disabilities, early in the program, backup reinforcers should be given to the client at the same time the token is given so that the pairing is immediate and the token is more likely to become a conditioned reinforcer

- Token economies should always be faded out before the client leaves the treatment program Advantages & Disadvantages of a Token Economy (488) - Tokens can be used to reinforce the target behaviour immediately after it occurs - A token economy is highly structured; therefore, desirable target behaviours often are reinforced more consistently - Tokens are generalized conditioned reinforcers because they are paired with a variety of other reinforcers - As a result, tokens function as reinforcers regardless of any specific establishing operation that may exist for a client at any time - Tokens are easy to dispense and easy for the recipients to accumulate - Token reinforcement can be quantified easily, so different behaviours can receive a greater or lesser magnitude of reinforcement - Response cost is easier to implement in a token economy - Because the recipient has accumulated tokens that may be removed contingent on the occurrence of the problem behaviour - The recipient can learn the skills involved in planning for the future by saving tokens for larger purchases - Disadvantages - Time and effort involved in organizing and conducting the program - Cost of backup reinforcers - Potential staff training and management issues - When considering a token economy, consider: - Can the staff or other change agents be trained to career out the program consistently on a daily basis? - Are there sufficient financial resources to conduct the program? - Do the expected benefits justify the time, effort, and cost of conducting the program? Chapter 24: Fear & Anxiety Reduction Procedures Defining Fear & Anxiety Problems (514 - 516) - A fear is composed of both operant and respondent behaviour - Typically, a person is afraid of a particular stimulus or stimulus situation - When the stimulus is present, the person experiences unpleasant bodily responses (autonomic nervous system arousal) and engages in escape or avoidance behaviour - Bodily responses are respondent behaviours called anxiety - Autonomic nervous system arousal involved in anxiety is an establishing operation that makes it more likely the person will engage in escape or avoidance behaviour at that time - Most problems that we would label as fears or anxiety disorders are characterized by a combination of respondent behaviour, in which the bodily response of anxiety is elicited

by a particular CS, and operant behaviour in which escape or avoidance behaviours are reinforced by removal of the feared stimulus and reduction in the unpleasant anxiety - Because both operant and respondent behaviours are involved in the problem, most treatment approaches involve components that address both the operant and respondent behaviours - It may not always be known how the CS (the feared stimulus) became conditioned to elicit the CR of anxiety - Knowledge of how the fear was conditioned is not necessary to help the person overcome the fear - What is important is to identify all the stimuli that currently function as CSs and elicit the fear responses (the CRs) - Sometimes a problem that appears to be fear or anxiety is simply an operant behaviour with no respondent behaviour or fear component - It is important to conduct a functional assessment of the supposed fear behaviour to determine what function it serves for the person Relaxation Training (516 - 529) - Relaxation training procedures are strategies that people use to decrease the autonomic arousal that they experience as a component of fear and anxiety problems - Person engages in specific relaxation behaviours that result in bodily responses opposite to the autonomic arousal - Once the person produces these opposite bodily responses, they report a decrease in anxiety - Progressive Muscle Relaxation (PMR) - Person systematically tenses and relaxes each of the major muscle groups in the body - Tensing and relaxing the muscles leave them more relaxed than in their initial state - Person first learns how to tense and relax each of the major muscles of the body - Having learned how to tense each of the muscle groups, the client can begin: - Client gets into a comfortable position in a comfortable chair - Relaxation exercise should be conducted in a quiet room or some other place that has no major distractions - Client closes their eyes and tenses and relaxes each muscle group - Tense for about 5 seconds, then abruptly release the tension - Allows the client to feel the contrast between the tension and relaxation in that particular muscle group - Client focuses on the decreased level of tension in the muscle group for 5-10 seconds and then moves on - When the process is complete, the muscles of the body should be less tense or more relaxed than they were at the beginning of the exercise - Once people have practiced PMR many times, they can begin to relax themselves without tensing and relaxing each muscle group

- Because PMR procedure teaches people to control their own muscle tension, they can decrease muscle tension in situations where they are likely to experience more tension - To facilitate this process, people often use a cue word when practicing PMR and then later recite the cue word to help themselves relax - Reciting the cue word also helps the person avoid thoughts that might elicit anxiety - Diaphragmatic Breathing (Relaxed Breathing or Deep Breathing) - Person breathes deeply in a slow, rhythmic fashion - At each inhalation, the person uses the muscles of the diaphragm to pull oxygen deep into the lungs - Because anxiety or autonomic arousal most often involves shallow, rapid breathing, diaphragmatic breathing decreases anxiety by replacing this breathing pattern with a more relaxed pattern - To learn diaphragmatic breathing: - A person should get in a comfortable sitting position and place a hand on the abdomen, just below the rib cage (location of diaphragm muscle) - On inhaling, the person should feel the abdomen move outward as the diaphragm pulls the breath of air deep into the lungs - Shoulders should be motionless - Upward movement of the shoulders during inhalation indicates shallow breathing in the upper portion of the lungs rather than deep breathing into the lung - Abdomen moves outwards - Person sits, stands, or lies down in a comfortable position, with eyes closed, and inhales slowly for 3-5 seconds, then exhales for 3-5 seconds - It is best to inhale and exhale through the nose - On inhaling and exhaling, person should focus attention on the sensations involved in breathing - Makes them less likely to think anxiety provoking thoughts - Diaphragmatic breathing exercises are a component of most other relaxation procedures - Attention-Focusing Exercises - Produce relaxation by directing attention to a neutral or pleasant stimulus to remove the person’s attention from the anxiety-producing stimulus - Procedures such as meditation, guided imagery, and hypnosis all produce relaxation through a mechanism of attention focusing - Meditation: Person focuses attention on a visual, auditory, or kinesthetic stimulus, once focused, the person’s attention cannot be focused on stimuli that produce anxiety - Guided Imagery: Person visualizes or imagines pleasant scenes and images - Hypnosis: Person focuses attention on the hypnotic suggestions from the therapist or an audiotape

- In the hypnotic trance, attention is simply focused on the therapist’s words so that the person is less aware of external stimuli - A person can practice self-hypnosis by reciting hypnotic suggestions from a script to induce a state of relaxation - Attention focusing procedures typically are used as components of other relaxation procedures - Behavioural Relaxation Training - Person is taught to relax each muscle group in the body by assuming relaxed postures - Person does not tense and relax each muscle group as in PMR - Includes components of the other relaxation procedures - Systematic Desensitization - Person with a phobia practices relaxation while imagining scenes of the fear-producing stimulus - A phobia is a fear in which the level of anxiety or escape and avoidance behaviour is severe enough to disrupt the person’s life - A person can decrease fear response by learning to relax while imagining progressively greater anxiety-producing scenes - 3 important steps: - Client learns relaxation skills using one of the earlier procedures - The therapist and client develop a hierarchy of fear-producing stimuli - The client practices the relaxation skills while the therapist describes scenes from the hierarchy - Once the client can maintain the relaxation response while imaging every scene from the hierarchy, systematic desensitization is complete - Developing the Hierarchy - Client uses a fear-rating scale and identifies the amount of fear that is produced by a variety of situations related to the feared stimulus - Fear rating scale called a subjective units of discomfort scale - Hierarchy complete when client has identified 10-20 different situations that progressively cause more fear - Fear-producing situations should be identify across the range of fear levels so that the hierarchy is composed of situations with low, medium, and high fear scores - Progressing through the Hierarchy - At start of session, client practices relaxation techniques - After the client signals a state of relaxation, therapist describes first scene in the hierarchy, which produces little anxiety - Client imagines scene while continuing to relax - Once the client has successfully imagined this scene while maintaining relaxation, the client moves to the next step in the hierarchy - Therapist might repeat the scene a few times, to be sure that the client can imagine the scene while maintaining the relaxation response

- In Vivo Desensitization - Client gradually approaches or is gradually exposed to the actual fear-producing stimulus - To use in vivo desensitization procedure, the client: - Learns relaxation skills - Develops a hierarchy of situations involving the fear-producing stimulus - Experiences each situation in the hierarchy while maintaining relaxation as an alternative response to replace the fear response - Important for the client to advance through each step in the hierarchy without an increase in anxiety - Relaxation training not always used during in vivo desensitization - Therapist might simply provide reinforcement for approach behavior at each hierarchy step - Therapist might have the client engage in other reinforcing activities or in distracting activities at each hierarchy step - Therapist might provide reassuring physical contact known as contact desensitization - Advantages & Disadvantages of Systematic & In Vivo Desensitization - In Vivo - Client makes actual contact with the feared stimulus - Desirable behaviour in the presence of the feared stimulus is reinforced as an alternative behaviour to escape or avoidance - No problem with generalization from imagination to actual situation - More difficult and possibly more time-consuming and costly - When possible, in vivo preferred over systematic desensitization - Systematic - Easier and more convenient for the client - Results may not fully generalize to the actual fear-producing situation - Other Treatments - Flooding - Person is exposed to the feared stimulus at full intensity for a prolonged period until their anxiety subsides in the presence of the feared stimulus - Initially, person experiences heightened anxiety, but over time the level of anxiety decreases through a process of respondent extinction - Should only be conducted by a professional - Highly uncomfortable for the person - Modeling - Child observes another person approaching the feared stimulus or engaging in a feared activity, and the child is then more likely to engage in similar behaviour - Person with the fear can observe a live model or a film or video model

Chapter 25: Cognitive Behaviour Modification Defining Cognitive Behaviour Modification (537 - 538) - Cognitive behaviour modification procedures are used to help people changed behaviours that are labeled as cognitive - Defining Cognitive Behaviour - Verbal or imaginal responses made by the person that are covert - Not observable to others - To be able to work effectively with cognitive behaviors, we must work with the client to objectively define these behaviors - To be a behavioral definition of a cognitive behavior, the thought, image, or self-statement must be described clearly by the person engaging in the behavior - A label for the cognitive behaviour is not a behavioural definition - The cognitive behaviors that make up the target behaviors for cognitive behavior modification include behavioral excesses and behavioral deficits - A behavioral excess is an undesirable cognitive behavior the person would seek to decrease - A behavioral deficit is a desirable cognitive behavior the person would seek to increase - Functions of Cognitive Behaviour - Cognitive behaviour may be distressing to the person; it may function as a conditioned stimulus that elicits an unpleasant conditioned response (CR) - Cognitive behaviours can also function as discriminative stimuli for desirable behaviours - Cognitive behaviours may function as motivating operations that influence the power of consequences to function as reinforcers or punishers - Cognitive behaviours may also function as reinforcing or punishing consequences when they follow some other behaviour Cognitive Behaviour Modification Procedures (539 - 547) - Cognitive restructuring procedures are designed to replaced specific maladaptive cognitive behaviours with more adaptive ones - Used in the case of behavioural excess - Cognitive coping skills training procedures are designed to teach new cognitive behaviours that are then used to promote other desirable behaviours - Used in the case of behavioural deficits - Cognitive Restructuring - Therapist helps the client identify cognitive behaviors that are distressing and then helps the client get rid of these distressing thoughts or replace them with more desirable thoughts - Consists of 3 basic steps: - Helping the client identify the distressing thoughts and the situation in which they occur

- Can be done by asking clients to report what distressing thoughts they experience in specific situations - Relies on the clients’ memory - Can have client self-monitor - Helping the client identify the emotional response, unpleasant mood, or problem behaviour that follows the distressing thought - Client must report this information from memory or must engage in self-monitoring to record the responses as they occur - Helping the client stop thinking the distressing thoughts by helping the client think more rational or desirable thoughts - Therapist challenges the client’s distressing thoughts by asking questions that make the client analyze the logic or rationality of the thoughts or interpret the situation differently - Cognitive Therapy - Cognitive therapy for depression involves first getting the person to engage in more reinforcing activities - Next step is to use cognitive restructuring to help the person change their distorted thinking - When the person engages in more reinforcing activities and replaces the distorted self-talk with more rational or accurate self-talk, the person is less likely to report that they feel depressed - Cognitive distortions are negative evaluations or interpretations of life events or logical errors in thinking that lead to negative mood or depressed behaviour - Challenge a person’s distorted thinking by asking 3 questions: - Where is the evidence? - Are there any alternative suggestions? - What are the implications? - Cognitive Coping Skills Training - Therapist teaches clients specific self-statements that they can make in a problem situation to improve their performance or influence their behaviour in the situation - Self-Instructional Training - Identify the problem situation and define the desirable behaviour most appropriate to the situation - Also important to identify any competing behaviours - Identify the shelf-instructions that will be most helpful in the problem situation - Use behavioural skills training to teach the self-instruction - Person must practice the self-instructions in role-plays the simulate the problem situation so that the self-instructions generalize to the problem situation after behavioural skills training is completed - When conducting behavioral skills training, the therapist first models the self instructions and the desirable behavior in the context of the role-play

- Once the client learns the self-instructions in the context of role-plays that simulate the problem situation - The client is instructed to use the self-instructions in the actual problem situation - If self-instructional training is effective, the problem situation should be a discriminative stimulus for the self-instructions - Acceptance-Based Therapies - Goal of helping people accept their negative thoughts and feelings rather than change them - In acceptance and commitment therapy , the client learns that they have not been able to control troublesome thoughts and feelings in the past, and that attempts to control thoughts and feelings have made their problems worse - In the course of therapy, client learns to accept that the thoughts and feelings can continue to occur, but that they can still achieve meaningful behavior change goals - When client accepts the negative thoughts and feelings, they lose their ability to disrupt the client’s life, and then the client can commit to and work toward valued behaviour changes