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Behavior modification

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Behavior modification is the use of empirically demonstrated behavior change techniques to improve behavior, such as altering an individual's behaviors and reactions to stimuli through positive and negative reinforcement of adaptive behavior and/or the reduction of maladaptive behavior through its extinction, punishment and/or therapy.

Description

The first use of the term behavior modification appears to have been by Edward Thorndike in 1911. His article Provisional Laws of Acquired Behavior or Learning makes frequent use of the term "modifying behavior".[1] Through early research in the 1940s and the 1950s the term was used by Joseph Wolpe's research group.[2] The experimental tradition in clinical psychology[3] used it to refer to psychotherapeutic techniques derived from empirical research. It has since come to refer mainly to techniques for increasing adaptive behavior through reinforcement and decreasing maladaptive behavior through extinction or punishment (with emphasis on the former). Two related terms are behavior therapy and applied behavior analysis. Emphasizing the empirical roots of behavior modification, some authors[4] consider it to be broader in scope and to subsume the other two categories of behavior change methods. Since techniques derived from behavioral psychology tend to be the most effective in altering behavior, most practitioners consider behavior modification along with behavior therapy and applied behavior analysis to be founded in behaviorism. While behavior modification encompasses applied behavior analysis and typically uses interventions based on the same behavioral principles, many behavior modifiers who are not applied behavior analysts tend to use packages of interventions and do not conduct functional assessments before intervening.

In recent years, the concept of punishment has had many critics, though these criticisms tend not to apply to negative punishment (time-outs) and usually apply to the addition of some aversive event. The use of positive punishment by board-certified behavior analysts is restricted to extreme circumstances when all other forms of treatment have failed and when the behavior to be modified is a danger to the person or to others (see professional practice of behavior analysis). In clinical settings positive punishment is usually restricted to using a spray bottle filled with water as an aversive event. When misused, more aversive punishment can lead to affective (emotional) disorders, as well as to the receiver of the punishment increasingly trying to avoid the punishment (i.e., "not get caught").

Martin and Pear indicate that there are seven characteristics to behavior modification,[4] They are:

  • There is a strong emphasis on defining problems in terms of behavior that can be measured in some way.
  • The treatment techniques are ways of altering an individual's current environment to help that individual function more fully.
  • The methods and rationales can be described precisely.
  • The techniques are often applied in everyday life.
  • The techniques are based largely on principles of learning – specifically operant conditioning and respondent conditioning
  • There is a strong emphasis on scientific demonstration that a particular technique was responsible for a particular behavior change.
  • There is a strong emphasis on accountability for everyone involved in a behavior modification program.

Techniques

Therapy and consultation cannot be effective unless the behaviors to be changed are understood within a specific context.[5][6] The process of understanding behavior in context is called functional behavioral assessment.[7] Therefore, a functional behavioral assessment is needed before performing behavior modification. One of the most simple yet effective methods of functional behavioral assessment is called the "ABC" approach, where observations are made on Antecedents, Behaviors, and Consequences. In other words, "What comes directly before the behavior?", "What does the behavior look like?", and "What comes directly after the behavior?" Once enough observations are made, the data are analyzed and patterns are identified. If there are consistent antecedents and/or consequences, an intervention should target those to increase or decrease the target behavior. This method forms the core of positive behavior support for schoolchildren in both regular and special education.

Behavior modifiers like to employ a variety of evidenced-based techniques. These techniques intervene at all levels of context. For example, given specific setting events for a behavior, a behavior modifier may develop a neutralizing routine to eliminate that setting. If a behavior pattern has a specific antecedent, or trigger, then an antecedent control strategy can be developed to train new behavior in the presence of the trigger. If a problem behavior readily occurs because it achieves some function, then an alternative behavior can be instructed and trained to occur in the context of the trigger.[5][6] If a behavior is particularly complex it may be task-analyzed and broken into its component parts to be taught through chaining. While all these methods are effective, when the behavior problem gets difficult or when all else fails many turn to contingency management systems.[8] Complex and comprehensive contingency management systems have been developed and represent effective ways to eliminate many problem behaviors (see applied behavior analysis and positive behavior support). Collaborative goal setting with the client enhances treatment effects.[4]

Some areas of effectiveness

Functional behavior assessment forms the core of applied behavior analysis and thus forms the core of behavior modification. Many techniques in this therapy are specific techniques aimed at specific issues. Interventions based on behavior analytic/modification principles have been extremely effective in developing evidence-based treatments.[9]

In addition to the above, a growing list of research-based interventions from the behavioral paradigm exists. With children with attention deficit hyperactivity disorder (ADHD), one study showed that over a several year period, children in the behavior modification group had half the number of felony arrests as children in the medication group.[10][11] These findings remain to be replicated but are considered encouraging for the use of behavior modification for children with ADHD. There is strong and consistent evidence that behavioral treatments are effective for treating ADHD. A recent meta-analysis found that the use of behavior modification for ADHD resulted in effect sizes in between group studies (.83), pre-post studies (.70), within group studies (2.64), and single subject studies (3.78) indicating behavioral treatments are highly effective.[12]

Behavior modification programs form the core of many residential treatment facility programs. They have shown success in reducing recidivism for adolescents with conduct problems and adult offenders. One particular program that is of interest is teaching-family homes (see Teaching Family Model), which is based on a social learning model that emerged from radical behaviorism. These particular homes use a family style approach to residential treatment, which has been carefully replicated over 700 times.[13] Recent efforts have seen a push for the inclusion of more behavior modification programs in residential re-entry programs in the U.S. to aid prisoners in re-adjusting after release.

One area that has repeatedly shown effectiveness has been the work of behaviorists working in the area of community reinforcement for addictions.[14] Another area of research that has been strongly supported has been behavioral activation for depression.[15]

One way of giving positive reinforcement in behavior modification is in providing compliments, approval, encouragement, and affirmation; a ratio of five compliments for every one complaint is generally seen as being effective in altering behavior in a desired manner[16] and even in producing stable marriages.[17]

Of notable interest is that the right behavioral intervention can have profound system effects. For example, Forgatch and DeGarmo (2007) found that with mothers who were recently divorced, a standard round of parent management training (a program based on social learning principles that teaches rewarding good behavior and punishing bad behavior combined with communication skills) could help elevate the divorced mother out of poverty.[18] In addition, parent management training programs, sometimes referred to as behavioral parent training programs, have shown relative cost effectiveness for their efforts[19] for the treatment of conduct disorder. Thus, such intervention can have profound effects on socializing the child in a relatively cost effective fashion and help get the parent out of poverty. This level of effect is often looked for and valued by those who practice behavioral engineering and results of this type have caused the Association for Behavior Analysis International to take a position that those receiving treatment have a right to effective treatment [20] and a right to effective education.[21]

Criticism

Behavior modification is critiqued in person-centered psychotherapeutic approaches such as Rogerian Counseling and Re-evaluation Counseling,[22] which involve "connecting with the human qualities of the person to promote healing", while behaviorism is "denigrating to the human spirit".[23] B.F. Skinner argues in Beyond Freedom and Dignity that unrestricted reinforcement is what led to the "feeling of freedom", thus removal of aversive events allows people to "feel freer".[24] Further criticism extends to the presumption that behavior increases only when it is reinforced. This premise is at odds with research conducted by Albert Bandura at Stanford University. His findings indicate that violent behavior is imitated, without being reinforced, in studies conducted with children watching films showing various individuals "beating the daylights out of Bobo". Bandura believes that human personality and learning is the result of the interaction between environment, behavior and psychological process. There is evidence, however, that imitation is a class of behavior that can be learned just like anything else. Children have been shown to imitate behavior that they have never displayed before and are never reinforced for, after being taught to imitate in general.[25]

Several people have criticized the level of training required to perform behavior modification procedures, especially those that are restrictive or use aversives, aversion therapy, or punishment protocols. Some desire to limit such restrictive procedures only to licensed psychologists or licensed counselors. Once licensed for this group, post licensed certification in behavior modification is sought to show scope of competence in the area through groups like the World Assocation for Behavior Analysis [6] Still others desire to create an independent practice of behavior analysis through licensure to offer consumers choices between proven techniques and unproven ones (see Professional practice of behavior analysis). Level of training and consumer protection remain of critical importance in applied behavior analysis and behavior modification.

While behavior analysis continues to grow as a science by including more environmental factors and behaviorism grows as a philosophy, some continue to criticize it for being reductionist.

See also

References

  1. ^ Thorndike, E.L. (1911), "Provisional Laws of Acquired Behavior or Learning", Animal Intelligence, New York: The McMillian Company
  2. ^ Wolpe (1958) Pyschotheraphy by Reciprocal Inhibition
  3. ^ In A.J. Bachrach (Ed.), Experimental foundations of clinical psychology (pp. 3–25). New York: Basic Books
  4. ^ a b c Martin, G.; Pear, J. (2007). Behavior modification: What it is and how to do it (Eighth Edition). Upper Saddle River, NJ: Pearson Prentice Hall, ISBN 978-0131942271 Cite error: The named reference "M&P" was defined multiple times with different content (see the help page).
  5. ^ a b McIntosh, K.; Av-Gay, H. (2007): Implications of Current Research on the Use of Functional Behavior Assessment and Behavior Support Planning in School Systems. IJBCT, 3.(1), pp. 38–49 BAO
  6. ^ a b Waguespack, A.; Vaccaro, T.; Continere, L. (2006). Functional Behavioral Assessment and Intervention with Emotional/Behaviorally Disordered Students: In Pursuit of State of the Art - IJBCT, 2.(4), pp. 463–480 BAO
  7. ^ Roberts, M. (2001). Research in Practice: Practical Approaches to Conducting Functional Analyses that all Educators Can Use. The Behavior Analyst Today, 3 (1), pp. 83–97 [1]
  8. ^ Walker, H. (1990). Acting Out Child. Soporis West
  9. ^ O'Donohue, W.; Ferguson, K.E. (2006). Evidence-Based Practice in Psychology and Behavior Analysis. The Behavior Analyst Today, 7(3) pp. 335–352 [2]
  10. ^ Satterfield, J.H.; Satterfield, B.T.; Schell, A.M. (1987). Therapeutic interventions to prevent delinquency in hyperactive boys. Journal of the American Academy of Child and Adolescent Psychiatry, pp. 26, 56–64
  11. ^ Satterfield, J.H.; Schell, A. (1997). A prospective study of hyperactive boys with conduct problems and normal boys: Adolescent and adult criminality. Journal of the American Academy of Child and Adolescent Psychiatry, 36, pp. 1726–1735
  12. ^ Fabianoa, G.A.; Pelham Jr., W.E.; Colesb, E.K.; Gnagya, E.M.; Chronis-Tuscanoc, A.; O'Connora, B.C. (2008). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129–140.
  13. ^ Dean L. Fixsen, Karen A. Blasé, Gary D. Timbers and Montrose M. Wolf (2007) In Search of Program Implementation: 792 Replications of the Teaching-Family Model. Behavior Analyst Today Volume 8, No. 1, pp. 96–106 Behavior Analyst Online
  14. ^ Milford, J.L.; Austin, J.L.; Smith, J.E. (2007). Community Reinforcement and the Dissemination of Evidence-based Practice: Implications for Public Policy. IJBCT, 3.(1), pp. 77–87 [3])
  15. ^ Spates, R.C.; Pagoto, S.; Kalata, A. (2006). A Qualitative and Quantitative Review of Behavioral Activation Treatment of Major Depressive Disorder. The Behavior Analyst Today, 7(4), pp. 508–517 [4]
  16. ^ Kirkhart, Robert and Evelyn, "The Bruised Self: Mending in the Early Years", in Kaoru Yamamoto (ed.), The Child and His Image: Self Concept in the Early Years. New York: Houghton Mifflin Company, 1972.
  17. ^ Gottman, J.M.; Levenson, R.W. (1999). "What predicts change in marital interaction over time? A study of alternative models." Family Process, 38 (2), pp. 143–158
  18. ^ Forgatch, M. & DeGarmo (2007). Accelerating recovery from poverty: Prevention effects for recently separated mothers. Journal of Early and Intensive Behavior Intervention, 4(4), pp. 681–72.BAO
  19. ^ Olchowski, A.E.; Foster, E.M.; Webster-Stratton, C.H. (2007). Implementing Behavioral Intervention Components in a Cost-Effective Manner: Analysis of the Incredible Years Program. Journal of Early and Intensive Behavior Intervention, Vol. 3,(4) and Vol 4(1) Combined Edition, pp. 284–304. BAO
  20. ^ ABA:I
  21. ^ ABA:I
  22. ^ [5]
  23. ^ Holland, J.L. (1976). A new synthesis for an old method and a new analysis of some old phenomena. The Counseling Psychologist, 6, pp. 12–15
  24. ^ B.F. Skinner, 1974, Beyond Freedom and Dignity
  25. ^ D. Baer, R.F. Peterson, J.A. Sherman Psychological Modeling: Conflicting Theories, 2006
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