The Evidence-Based Practice of Applied Behavior Analysis

Evidence-based practice (EBP) is a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients. This framework provides behavior analysts with a structure for pervasive use of the best available evidence in the complex settings in which they work. This structure recognizes the need for clear and explicit understanding of the strength of evidence supporting intervention options, the important contextual factors including client values that contribute to decision making, and the key role of clinical expertise in the conceptualization, intervention, and evaluation of cases. Opening the discussion of EBP in this journal, Smith (The Behavior Analyst, 36, 7–33, 2013) raised several key issues related to EBP and applied behavior analysis (ABA). The purpose of this paper is to respond to Smith’s arguments and extend the discussion of the relevant issues. Although we support many of Smith’s (The Behavior Analyst, 36, 7–33, 2013) points, we contend that Smith’s definition of EBP is significantly narrower than definitions that are used in professions with long histories of EBP and that this narrowness conflicts with the principles that drive applied behavior analytic practice. We offer a definition and framework for EBP that aligns with the foundations of ABA and is consistent with well-established definitions of EBP in medicine, psychology, and other professions. In addition to supporting the systematic use of research evidence in behavior analytic decision making, this definition can promote clear communication about treatment decisions across disciplines and with important outside institutions such as insurance companies and granting agencies.     

Factors Influencing Military Personnel Utilizing Chaplains: A Literature Scoping Review

Journal of Religion and Health - Chaplains have been embedded in military settings for over a millennium. In recent years however, the decline in spiritual/religious (S/R) affiliation of military...     

Night Eating and Loss of Control over Eating in Bariatric Surgery Candidates

The goal was to examine the relationship between loss of control over eating (LOC_E) and other variables, including eating pathology, in bariatric candidates. Two hundred and twenty-six participants completed measures of depressive symptoms, eating pathology, health-related quality of life (HRQOL), and alcohol use. Participants were divided into those who did (n = 123) and did not (n = 103) report subjective LOC_E. Participants with LOC_E had significantly higher levels of night eating, depressive symptoms, and eating disorder psychopathology and lower mental HRQOL. There were no observed differences in alcohol use, dietary restraint, or physical HRQOL. This study highlights eating and mental health-related correlates of LOC_E, providing evidence that it is associated with increased psychological burden in bariatric candidates. This is one of the first studies to report the relationship between LOC_E and night eating in this group and future research could elaborate on these variables to determine their importance in long-term weight loss.     

The Relationship Between the Supervisory Working Alliance and Student Self-Efficacy in Genetic Counseling Training

The purpose of this study was to determine if a genetic counseling student’s perception of the supervisory working alliance (SWA) is related to their self-efficacy on select clinical practice-based competencies (PBCs), evaluating the second tenet of the Reciprocal Engagement Model of Supervision (REM-S) from a student perspective. Second year genetic counseling students (N?=?168) completed a survey containing demographic and clinical rotation experience questions, the Supervisory Working Alliance Inventory-Trainee Form (SWAI-T), and the Genetic Counseling Self-Efficacy Scale (GCSES). Overall, the SWAI-T was significantly associated with all factors of the GCSES. Additionally, the relationship between the SWAI-T and self-efficacy was specific to those who had only one supervisor, thus highlighting the SWA may be most important under these circumstances. This serves as an important step in being able to guide supervisors toward effective methods in supervision, which may include encouraging supervisors to build a strong relationship with their supervisee in order to help strengthen the student’s confidence in their clinical skills.     

Parenting a Child with Phenylketonuria (PKU): an Interpretative Phenomenological Analysis (IPA) of the Experience of Parents

Phenylketonuria (PKU) is a rare inherited metabolic disorder which can cause neurological damage if left untreated. PKU is identified through newborn screening in developed countries, and treatment begins immediately to prevent these severe consequences. When a child is diagnosed, parents must assume immediate responsibility for the management of PKU and prevention of neurological damage. Quantitative studies have identified significant psychosocial stressors for parents, but little is known about how the parents experience this process. This study aimed to explore the experiences of parents of children with PKU under the age of two. It is the first study to examine these experiences in this way. Seven parents were interviewed about their experiences, and interpretative phenomenological analysis was used to analyse the data. Three main themes were identified: control, striving for normality and acceptance of PKU as a continuum. Links between the themes and processes underpinning the results were explored with relation to existing literature and theories from a clinical psychology perspective. The role of acceptance of PKU was central to the parent’s experiences. Clinical implications and suggestions for further research are discussed.     

Let Black People Be: A Plea for Racial Specificity in the Afterlife of Africanized Slavery

This article introduces a new term, “anti‐blackness supremacy,” in order to supplement existing theological discourse about the ethical life of racism. To a much greater extent than the terms “racism, ” “white privilege” or even “white supremacy,” this term also better positions scholars to address what I identify as the two most pressing problems in anti‐racist discourse: first, the inability to diagnose the relation between classism and racism without reducing one into the other; and second, the tendency to treat racism as a monolithic evil that falls upon all people of color equally and in the same way. The former error has distorted political discourse for decades; the latter misconception intensifies as the United States undergoes demographic shifts in the wake of immigration from Asia, Latin America, and Africa. Both of these errors arise from a pervasive misunderstanding of the slave regime that has set our current racial system in motion. In truth, slavery primarily represents not a mechanism of profit extraction, but a relation of a unique type of power. The term “anti‐blackness supremacy,” I contend, corrects both of these misperceptions, affirming both the singularity of black oppression and its fundamental connection to enslaving power. In so doing, it enables ethicists to disarm an older racial foe while thwarting the ascension of a newer one.