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Clinical Applications

Clinical Applications. Justin Daigle, MA , BCBA, LBA Program Director. introduction. Focus of internship has been using behavior analysis in traditional Autism Treatment It has been hinted that behavior analysis can have additional applications: Animal Training Pizza Delivery Article

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Clinical Applications

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  1. Clinical Applications Justin Daigle, MA, BCBA, LBA Program Director

  2. introduction Focus of internship has been using behavior analysis in traditional Autism Treatment It has been hinted that behavior analysis can have additional applications: Animal Training Pizza Delivery Article Acceptance and Commitment Therapy

  3. introduction Here are some areas we will discuss today: Sleep Drug Addiction Gambling Phobia Public Safety Organizational Behavior Management (OBM) There are other areas that will not be covered

  4. Sleep “We may conveniently regard sleep as a special form of behavior.” - B.F. Skinner (1953)

  5. Sleep Skinner never defined “special behavior”. Researchers (Blumberg & Lucas, 1996; Thoman, 1990) suggest that conceptualizing sleep as a “state” is more constructive. “Being alert” is a state, that requires many behaviors leading up to it. “Being pregnant” is a state, that requires many behavior leading up to it.

  6. conceptual Can sleep be reinforced?

  7. Sleep If sleep is not a behavior, why is behavior analysis interested in it? How do we work around the biological factors of sleep? “Sleep” may be a state, but it takes several behaviors to achieve this state.

  8. Sleep “Falling asleep is conceptualized as an instrumental act (i.e., it is not a reflex response) emitted to produce reinforcement (i.e., sleep). Thus, stimuli associated with sleep become discriminative stimuli for the occurrence of reinforcement. Difficulty in falling asleep, then, may be due to inadequate stimulus control.” - Bootzin (1977)

  9. Sleep Stimulus Response Postcedant Let’s conceptualize sleep in the 3-Term Contingency: Biological (tired) and Environmental Falling Asleep State of Sleep

  10. Sleep Stimulus Response Postcedant We cannot systematically manipulate the response nor the postcedant. Biological (tired) and Environmental Falling Asleep State of Sleep

  11. Sleep Some stimulus control suggestions: Lie down to go to sleep only when you are sleepy. Do not use your bed for anything except sleep and sexual activity. If you can’t fall asleep, get up, and go to another room. Repeat as necessary. Get up at the same time no matter what. Do not nap during the day.

  12. Sleep Every human HAS to sleep. The behavior will occur (though the individual may not like the process). The goal becomes to place “falling asleep” behavior under stimulus control (when in the bedroom and lying in bed). Several complex interventions which will not be discussed in this presentation.

  13. Sleep Study Kaston Anderson Sleep Apnea C-PAP Compliance Token Economy and Sleep Journal Very effective, but generalization was not observed.

  14. Drugs “Almost 18% of the U.S. population will experience an [Substance use disorder] at some point in their lifetime.” - Galanter & Kleber, (2008)

  15. Drugs Stimulus Response Postcedant Let’s conceptualize drug use in the 3-Term Contingency: Private Events (sad) and Environmental Taking Drug Biology and Social

  16. Drugs Stimulus Response Postcedant Let’s highlight what we CANNOT systematically manipulate in Purple: Private Events (sad) and Environmental Taking Drug Biology and Social

  17. Drugs Stimulus Response Postcedant Let’s highlight what we CAN systematically manipulate in Red: Private Events (sad) and Environmental Taking Drug Biology and Social

  18. Drugs This leaves us at a disadvantage. We can use a Stimulus Control Intervention. We can use a Social Intervention (often times causing the power of the social reinforcer to diminish in favor of just the biological reinforcer – ‘social isolation’).

  19. Drugs Or, we have to get creative Aversion Therapy Reinforcement of Alternative Behaviors Non-Contingent Reinforcement (NCR)

  20. Stim. Control 1. Identify the discriminative stimuli (location, time of day, social situation, etc). 2. Systematically break the association between the stimulus and the behavior (diminish stimulus control).

  21. Stim. Control Example: Timmy smokes when the follow SDs are presented: Lunch Break In a Bar When Stressed At a party How do we break these associations?

  22. Aversion Usually an in-patient procedure. Usually as a “last resort” Usually under the supervision of a physician. Drug of choice is presented laced with an emetic Soon the drug becomes paired with the state of sickness. (Can be overcome by common use of the drug with no continued treatment).

  23. Reinforce Reinforcement is provided for an alternative behavior either in situation (i.e., free sodas for designated drivers) or on a modified DRO schedule. It is difficult because you have to find a reinforcer that is powerful enough to combat with the biological reinforcement of the drug. Often use a token economy with a menu of reinforcers.

  24. NCR Constant biological reinforcement breaks the association between the stimuli and the need for the drug. “The patch”

  25. Gambling

  26. Gambling Gambling treatment is becoming more behavioral. Gambling is now treated like an addiction, because it has the same characteristics of a drug addition when put into the 3-term contingency. Treatment is similar to drug treatments Stimulus Control Reinforcement of Alternative Behaviors

  27. Gambling Slot machines tend to be the worst. They are on a variable response schedule (designed like that). XXXXXXXXXXXXWXXXXXXXXXXXXXXXXXWXXXXXXXXXXXXXXXXXXXXXXXXXXXW. It will keep the player waiting for the “big win” which often times will not come before the player runs out of money.

  28. Phobia

  29. Phobia The most common treatment for phobia is called Systematic Desensitization.

  30. Public Safety

  31. Safety Dr. Van Houtten Crosswalk Safety “Pizza Delivery Driver”

  32. OBM

  33. OBM Skinner first outlined the concept of using behavior modification in the workplace in his 1953 book “Science and human behavior”. Since then, OBM has become a growing field alongside Autism treatment. It is the second most popular use of behavioral principles in an applied setting.

  34. OBM The useof behavioral principles in a office or business setting. In a workplace, results should be measured Reinforcement and punishment can be used Feedback is key. Amounts should be predetermined Not “let’s see who can sell the most”, but rather “your personal goal is 5 cars”.

  35. sources Blumberg, M.S., & Lucas, D.E. (1996). A developmental and component analysis of active sleep. Developmental Psychology, 29, 1-22. Bootzin, R. (1977). Stimulus control treatment for insomnia. In R. Stuart (Ed.), Behavioral self-management strategies and outcomes (pp. 176-195). New York, NY: Brunner-Mazel.

  36. sources Galanter, M., & Kleber, H.D. (Eds.). (2008). Textbook of substance abuse treatment (4th ed.) Washington, DC: American Psychiatric Press.

  37. sources Skinner, B.F. (1953). Science and human behavior. New York, NY: Macmillan. Thoman, E.B. (1990). Sleeping and waking states in infants: A functional perspective. Neuroscience and Biobehavioral Reviews, 14, 93-107.

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