Behavioral skills workshop for staff and supervisor in a community residence for developmentally handicapped adults

A behavioral skills workshop for counselors and a supervisor in a community group home was developed and evaluated. The workshop included group skills training, individual supervised in vivo practice, and supervisor training. Supervisor training taught behavioral staff management skills that were delivered in a multiple baseline design across subjects. Positive changes in staff behavior occurred for each group only after supervisor intervention. Significant positive changes occurred by the end of the workshop and were maintained at follow-up for staff self-evaluations of expertise and confidence to resolve problems, severity of client problems, and behavioral observations of positive client behaviors.     

The efficacy of remote video-based behavioral skills training and awareness training on public speaking performance

This study evaluated the efficacy of (a) remote video-based behavioral skills training (BST) with added speech outlines on teaching public speaking behaviors and (b) remote video-based awareness training (AT) on speech-disfluency rates. A multiple-baseline design across speech behaviors was used to evaluate the training. Remote video-based BST and AT were effective at teaching public speaking behaviors and reducing speech disfluencies, respectively, for both participants. In addition, performance generalized to increased audience size. Although expert ratings of perceived public speaking effectiveness improved following BST, the ratings did not improve and some worsened following AT. Both participants reported satisfaction with video-based BST and AT. One participant reported greater comfort, confidence, overall ability, and less anxiety as a public speaker following BST. Both participants reported greater improvements in those categories following AT. Our results suggest that public speaking behaviors can be taught using remote video-based BST and speech disfluencies can be reduced using remote video-based AT.     

SOCIAL SKILLS TRAINING WITH CHILDREN: PROCEED WITH CAUTION

Three learning disabled children, selected on the basis of peer sociometric ratings and teacher referral, received social skills training. A group training procedure consisting of coaching, modeling, behavior rehearsal, and feedback was used to teach children the target behaviors of eye contact and appropriate verbal responses. A multiple baseline analysis across target behaviors was used to demonstrate treatment effectiveness on role-play scenes trained during treatment sessions. Duration of speech was measured as an untrained, corollary measure. The following measures were also obtained during baseline, posttreatment, and 1-mo follow-up for the experimental subjects and three control subjects: (a) performance on role-play scenes not trained during treatment sessions; (b) behavioral observations in a free play setting, and (c) sociometric ratings. In addition, the trained and untrained role-play scenes were administered by novel experimenters following treatment. The results indicated that socially unskilled, learning disabled children can be taught to respond appropriately to role-play situations. However, improved performance did not generalize to the natural school setting and treatment did not effect ratings of peer acceptance. The implications of these findings for future social skills training with children are discussed.     

A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes

This study examined the impact of a cognitive behavioral intervention for nonadherent adolescents with type 1 diabetes. Six youths having problems following the diabetes regimen received training in cognitive restructuring and problem solving during individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through 24-hr recall adherence interviews with adolescents and frequency of testing data was downloaded from glucose meters. Data was also collected for diabetes-specific stress. Five youths displayed improvement on at least one self-care behavior. Furthermore, the results suggest that the cognitive behavioral intervention was effective in diminishing diabetes-related stress in two participants. Cognitive behavioral interventions show promise for increasing self-care behaviors among nonadherent youths with type 1 diabetes. However, individual youths varied in their response to treatment. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.     

Clinical Behaviors for Addressing Religious/Spiritual Issues: Do We Practice What We Preach?

To determine if counselors integrate clinical behaviors for addressing religious/spiritual issues in counseling consistent with their ratings of the importance of such behaviors, the authors conducted a national survey of American Counseling Association (ACA) members. Seventy‐eight ACA members rated the importance of and frequency with which they engaged in a set of 30 clinical behaviors that were identified in the existing literature as addressing religious/spiritual issues within counseling. Results indicated possible disparities between importance and frequency ratings. Potential barriers to counselors' utilization of religious and spiritually directed clinical behaviors were identified.     

Fathers as Intervention Agents for Their Children with Developmental Disabilities

ABSTRACT

Parent training aimed at aiding children to overcome social and behavioral problems is an area that has continued to gain attention and support. Very little of the current research has been with developmentally disabled children, the focus of this study. Additionally, for most parent training programs, “parents” actually refers to mothers. In this study three fathers and their developmentally disabled children, who ranged in age from 2 years 10 months to 4 years 5 months, were studied. A multiple baseline across fathers' behaviors was utilized for participants to evaluate effects of parent training on fathers' target behaviors. Child compliance and inappropriate behaviors were also addressed. Parent training resulted in desirable changes on a range of target behaviors. The implications of these findings are discussed.     

Effects of differential reinforcement on the behavior and self-esteem of children with emotional and behavioral disorders

Students in a residential special school for children with emotional and behavioral disorders participated in a study designed to reduce their levels of inappropriate behavior. The residential care staff rated the students' behavioral problems and their class teachers rated their overt self-esteem pre and post intervention. In addition, the students completed self-ratings of their self-esteem. The students were divided into two groups, experimental and control. A multiple baseline across behaviors design was used to assess behavioral changes in the experimental group. Both groups received tangible rewards to the same level but only the experimental group received them contingent upon behaving appropriately. Results showed that the experimental group students made substantial reductions in their levels of inappropriate behavior, which were maintained at a three-month followup. Also, ratings of their behavioral problems by residential child care staff suggested that this improvement in behavior had generalized beyond the classroom to the residential setting. However, no significant differences were found between the pre- and post-intervention ratings of their self-esteem or teacher ratings of their overt self-esteem.     

The effect of social skills training procedures on the acquisition of appropriate interpersonal skills for mentally retarded adults

A pretest/posttest control group design was utilized to examine the effect of social skills training on social interactions with peers, conversational interactions with a novel partner, and ratings of overall social functioning. The results failed to support the hypothesis that social skills training could increase the generalization of overall conversational responding of mentally retarded adults. The results showed that social skills training augmented with self-monitored videotape feedback could not optimize the effects of social skills training alone. The subjects did demonstrate acquisition of the targeted behaviors during training by meeting preestablished criteria for all of the training sessions. However, the subjects failed to generalize those behaviors across settings to in vivosocial situations.     

Impact of social problem-solving training on aggressive boys: Skill acquisition,behavior change,and generalization

This study examined the impact of social problem-solving training on the behavior of five aggressive boys. Acquisition of problem-solving skills and changes in classroom behavior were evaluated using multiple-baseline designs within and across subjects. A generalization-programming procedure to promote the use of problem-solving skills in the natural environment was introduced across children in multiple-baseline fashion. Direct observation and behavior ratings were used to evaluate the treatment. Results indicated that each subject acquired the problem-solving skills at levels comparable to well-adjusted peers. Only one child showed behavioral improvement coincident with problem-solving skill acquisition. Three others showed moderate behavior change after the generalization-programming procedure was introduced. Only one child's gains on teacher ratings were maintained at the 6-month followup. The results suggest that cognitive-behavioral treatment of childrens' aggressive behavior may produce changes of limited magnitude and durability.This paper was based on a doctoral dissertation by the first author in partial fulfillment of the requirements of West Virginia University. The authors wish to thank Lianne Willis for her participation as a therapist. Appreciation is also extended to Barry Edelstein, David Hansen, Daniel Hursh, and Mark Cummings for their constructive comments.     

Situation Taxonomy and Behavioral Diagnosis Using Prospective Self-Monitoring Data: Application to Dietary Adherence in Patients with Type 1 Diabetes

The goals of this study were to create a taxonomy of problem situations for diet adherence in persons with insulin-dependent diabetes mellitus (Type 1 diabetes) and a behavioral diagnosis by grouping patients together who have similar adherence problems. In study one, 29 patients with Type 1 diabetes kept food diaries for 4 weeks. Adherence was assessed using eight behavioral measures: (1) compliance with a meal plan, (2) energy intake, (3) protein, (4) carbohydrates, (5) fat, (6) self-reported overeating, (7) self-reported undereating, and (8) ratings of impulsive eating. The occurrence of each behavior was quantified in a wide range of situational contexts including meal, social context, physical location, and mood. Cluster analysis of behaviors, situations, and behaviors-in-situations was used to create a hierarchical classification model consisting of five major categories of adherence problems: (1) compliance with meal plan, (2) undereating, (3) overeating, (4) impulsive eating, and (5) lifestyle differences. Within each category, situations were associated with everyday eating habits and special circumstances such as social events, and meals in restaurants. Grouping patients based on the similarity of their adherence problems resulted in five diagnostic groups: (1) emotional binge eaters, (2) restrained eaters, (3) unrestrained eaters, (4) undereaters, and (5) cyclical diet bingers. In study two, 28 subjects kept diaries during an intervention program designed to enhance dietary adherence. Study two results were similar to study one. Situation taxonomy and behavioral diagnosis are potentially useful ways to understand the intervention needs of those attempting maintaining dietary behavior changes.     

Multisource Feedback and Leaders' Goal Performance: Moderating effects of rating purpose,rater perspective,and performance dimension

The main purposes of this study are to examine whether multisource feedback ratings predict leaders' organizational goal performance, and whether the relationships are consistent across the two rating purposes (developmental, administrative), two leadership dimensions behaviors (Consideration, Initiating Structure), and three rating perspectives (supervisor, self, and ‘other’ raters, i.e., peers and subordinates). Leaders (n=396) in a large organization in the transportation industry participated in two multisource feedback programs, the first for developmental purposes and the second 8 months later for administrative purposes. Approximately 1 month later, they were rated by their supervisor on their effectiveness in attaining five organizational performance goals (financial, safety, customer satisfaction, employee satisfaction, diversity). Results revealed that both developmental ratings and administrative ratings uniquely predicted leaders' goal performance. However, both leadership dimension and rater perspective moderated these relationships. Leadership behaviors associated with Consideration were stronger predictors of goal performance for supervisor ratings, whereas behaviors associated with Initiating Structure were stronger predictors of goal performance for self and other ratings.     

Attitudes and action: The effects of behavioral intent and perceived effectiveness of acts

Based on the assumption that an individual's behavioral intentions mediate the relationship between his attitudes and behaviors, an attempt was made to obtain a direct assessment of (a) subjects' intentions with regard to a series of acts varying in behavioral thresholds and (b) the perceived instrumentality of these acts for achieving one's goals After the reliability of the Intentions Scale was established, it was combined multiplicatively with ratings of perceived effectiveness to form a combined Action Potential Index (AP) The index resulted in significantly greater predictive validity than a conventional attitude assessment instrument. A second study was undertaken to determine the consistency of the AP-index across issues. The high correlations obtained for the AP-index across three issues suggested the operation of an “activism” personality dimension     

Psychostimulant medication and perceived intensity in hyperactive children

Adult ratings of children's activity, based on impressionistic scales, are good indicators of psychostimulant medication effects. These ratings seldom correlate with objective indicators, however, and their behavioral referents are poorly understood. Two separate studies tested the hypothesis that intensity of child behavior, as perceived by others, would differentiate medicated and unmedicated states. College student subjects assessed randomized videotaped segments of children's behaviors. The perceived intensity of hyperactive children's responses decreased with medication, while there were no medicationrelated changes in either gross motor locomotion or off-task behaviors. In a test for observer sensitization or expectancy, the results for subjects who were looking for medication effects did not differ from those for uninformed subjects.This research was supported in part by NIMH grant 29475 and NIDA grant 01070. We thank Andy Christensen and Carol Whalen for helpful comments.     

Training teachers in behavioral consultation and therapy: An analysis of verbal behaviors

This study evaluated the relative effectiveness of two teacher-training packages under two analogue consultation conditions in a 2 × 2 completely randomized factorial design. The subjects were 56 elementary school teachers in an urban school district in Arizona. The conditions included a training package of classroom behavior modification and consultation, a training package of consultative service procedures, and general multidisciplinary team processes (a nonspecific control). The consultation conditions included one variant in which very specific consultant questions were presented, and a second in which much more general, somewhat vague, consultant elicitors were presented to subjects in problem-identification, problem-analysis, and problem-evaluation behavioral consultation analogue interviews. The effectiveness of these training packages was evaluated in respect to knowledge of behavior modification principles and concepts, and the frequency of specific categories of consultee verbal behaviors. The results indicated that the experimental training package was effective in increasing teachers' knowledge of behavioral procedures and in increasing the frequency of teacher verbalization regarding overt child behaviors and behavioral intervention plans during the problem identification and problem analysis phases of consultation. It was also found that even after training, specific consultant questions were important in eliciting consultee statements related to environmental conditions surrounding behavior. The use of more general consultant verbal behaviors resulted in significantly more vague, unspecified, and irrelevant types of consultee verbalizations. Implications for future research are discussed.     

Evaluation of behavioral group counseling for parents of learning-disabled children

The present study evaluated the effectiveness of a behavioral group counseling program for parent members of the Association for Children with Learning Disabilities. Twentytwo mothers were assigned to two treatment groups (N=5 and N=6) and a control group (N=11). Treatment-group mothers received a series of eight weekly 11/2-hour sessions in which they were taught basic principles and procedures of behavior modification which they could apply to specific childrearing problems. Multiplesuccess criteria (maternal reports, direct observation, frequency counts, and attitudinal measures) were employed to provide a broad-based measurement of outcome. Results indicated that treatment ratings of childrens' conduct and disruption and parental postbehavioral observations of mother-child interactions showed improvement for the behavioral-counseling groups while control-group ratings and behavior observations remained the same. All treatment-group changes were maintained at 3-month follow-up. Consistency of treatment-group data across measures and over time suggests the effectiveness of this approach as a training method. Implications for future research were discussed.     

Training behavioral technicians to implement naturalistic behavioral interventions using behavioral skills training

Training behavioral technicians mainly focuses on teaching accurate implementation of structured behavioral intervention programs. Often behavioral technicians are unable to adequately promote their clients' learning in less structured environments, which can limit opportunities for generalization of the clients' skills to the natural environment. The aim of the present study was to evaluate the effectiveness of using behavioral skills training to coach behavioral technicians on the implementation of naturalistic behavioral interventions. Naturalistic behavioral interventions take advantage of naturally occurring situations to teach new skills and practice mastered skills in natural settings, thus promoting generalization across environments and in the presence of natural contingencies. Five behavioral technicians were trained to implement a novel protocol based on play therapy. Specifically, they were coached to engage in well‐defined positive behaviors during their interactions with clients (e.g., labeled praise). All participants reached mastery criteria, maintained skills at follow‐up, and demonstrated generalization of skills with novel clients.     

The social validation and training of conversational skills

Three reliably measured components of conversation-questioning, providing positive feedback, and proportion of time spent talking-were identified and validated as to their social importance. The social validity of the three conversational behaviors was established with five female university students and five female junior-high students. Each was videotaped in conversations with previously unknown adults. The conversational ability of each girl was evaluated by a group of 13 adult judges who viewed each tape and rated each conversant "poor" to "excellent" on a seven-point rating scale. The average ratings of the girls correlated at r = 0.85 with the specified behavioral measures. These procedures were replicated with additional subjects and judges and yielded a correlation of r = 0.84. The high correlations between ratings and the objective measures suggested that the specified conversational behaviors were socially important aspects of conversational ability. Employing a multiple-baseline design across the behaviors of asking questions and providing positive feedback, an attempt was made to train four girls who used these behaviors minimally to engage in the behaviors in conversations with adults. Adult judges were again employed to rate randomly selected samples of the girls' skills in pre- and posttraining conversations. The average ratings of the girls before training were lower than both the university girls and the junior high-school girls. After training, the girls' conversational abilities were rated substantially higher than those of their junior high-school peers. These rating data validated the benefits of the training and the social importance of the behavioral components of questions and feedback in conversation. The authors suggest that it may be necessary for traditional behavior analysis measurement systems to be supplemented by social-validation procedures in order to establish the relationship between "objectively" measured behaviors and complex classes of behavior of interest to society.     

What do people think about changes in health behaviors? Differential perceptions of consequences of increases and decreases in health behaviors

Most health decision-making models posit that cost-benefit analyses underlie decisions to make changes in health-related behavioral practices. In a series of studies, participants imagined either increasing or decreasing the frequency of a variety of health behaviors and estimated the consequences of those changes. In Studies 1 and 2, individuals consistently estimated that increasing a health behavior produced greater consequences than did decreasing the behavior by an equivalent amount. The results of Study 3 demonstrated that this effect is due to differences in how individuals judge the impact of health behavior changes which involve not engaging in the behavior at all versus other types of changes. Taken together, these findings suggest that perceptions of the outcomes afforded by health behavior changes depend on both the behavioral frequency and direction of changes in behavior an individual is considering. This asymmetry has the potential to help explain patterns of behavior in a range of important health domains and may impact the effectiveness of behavior change interventions.     

The effects of safety behaviors on health anxiety: an experimental investigation

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n = 30) or control condition (n = 30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.