CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

An Ecological Approach to Enhancing Parenting Skills in Family Therapy

To increase the effectiveness of parent education interventions, family therapists can address those factors that shape the way in which parents interact with their children. This article presents ecological theory as a framework that can help clinicians expand the range of their parent training efforts. In order to assess the utility of ecological theory for clinical practice, the present study empirically explored the ways in which selected characteristics of parents, children, and the family context related to mothers' parenting behavior. Specific recommendations for family therapists who employ parent training techniques are offered.     

AUGMENTING SIMPLIFIED HABIT REVERSAL WITH AN AWARENESS ENHANCEMENT DEVICE: PRELIMINARY FINDINGS

The chronic hair pulling of a 36-year-old woman with moderate mental retardation was initially treated with a simplified habit-reversal (SHR) procedure that consisted of awareness training, competing response training, and social support. When SHR did not produce large and sustained reductions in hair pulling, an awareness enhancement device was added, and it reduced hair pulling to near-zero levels in two settings. The results are discussed, and directions for future research with this device are provided.     

Developing the matrix representation grid (MRG): A method for observing group processes. Findings from time-limited group psychotherapy for alcohol-dependent patients

The MRG was published 1988 in order to support developments in group psychotherapy methods as one of the all too few process observation research methods for studying group-as-a-whole. After 9 years of what pilot studies have labeled successful clinical trials, this study aims at validating the MRG against the established SAVI: Structural Analysis of Verbal Interaction (Agazarian & Simon 1989). Videotaped group sessions from short-term groups for alcohol dependent patients conducted along two therapy methods, one behaviorally oriented and the other group analytic, are used as material. The MRG is validated in the study, confirmed to be clinically valuable, and some interesting comparisons between the two treatment modalities are also made.     

Interpersonal conflict in group therapy: An object relations perspective

The aim of this paper is to demonstrate how object relations theory can be used to understand and regulate interpersonal conflict in group psychotherapy. Such concepts as projective identification, intersubjectivity and the analytic third are used to describe how conflict emerges in group psychotherapy and how it can be worked through. Case material is also provided to illustrate concepts and techniques in promoting a group's transition from a paranoid/schizoid to a depressive position. Positive aspects of the concept of projective identification are discussed including its use as a form of communication, a method of reducing anxiety and reintegrating previously dangerous and threatening aspects of the self.The paper was funded by Evan F. Lilly Memorial Trust Grant PV 13,067.     

TEACHING FOSTER GRANDPARENTS TO TRAIN SEVERELY HANDICAPPED PERSONS

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training.     

SEVERE CLASSROOM BEHAVIOR PROBLEMS: TEACHERS OR COUNSELLORS

This experiment was designed to determine the relative effectiveness of teacher and counselling approaches in the reduction of disruptive or inappropriate classroom behavior. Inappropriate classroom behavior frequencies of 12 academically low achieving, seventh-grade, black male students, with a reported high rate of inappropriate classroom behavior, were recorded. Three groups, with nearly equal mean inappropriate behaviors, were randomly assigned to one of three treatment conditions: behavioral counselling, client-centered counselling, or no counselling. Each counselling group received fifteen 30-minute counselling sessions, at a rate of two to three times a week. In addition to counselling, all students subsequently received teacher approval within the classroom. Results indicated that the teacher was able to reduce inappropriate behavior more than any counselling group. There were also indications that behavioral counselling, but not client-centered counselling, was moderately helpful in reducing inappropriate classroom behavior.     

THE EFFECTIVENESS OF INTERPERSONAL SKILLS TRAINING ON THE SOCIAL SKILL ACQUISITION OF MODERATELY AND MILDLY RETARDED ADULTS

Sixteen moderately and mildly retarded adults were selected from a group residential facility and randomly assigned to experimental and control groups. The experimental group received a 12-session interpersonal skills training program consisting of instruction in the following areas: (1) Introductions and Small Talk, (2) Asking for Help, (3) Differing with Others, and (4) Handling Criticism. The social skills instructional package included verbal instruction, modeling, role playing, feedback, contingent incentives, and homework. As a result of this training program, moderately and mildly retarded adults acquired new social skills as evidenced by performance on a situation role play assessment. These gains generalized to untrained role play situations but did not result in significant group differences when assessed in a more natural setting (i.e., local grocery store).