Behavioral Assessment

1. Behavioral Assessment

2. History • Behaviorism beginning in 1930’s • Pavlov: Pavlovian or classical conditioning • B.F. Skinner (most noteworthy work 1953) • Skinner box for rat learning research • Operant or response-stimulus (RS) conditioning

3. Behavioral Assessment Context in Clinical Psych • Grows from Behavior Theory / Learning Theory • Aspects of it can be easily combined with other forms of assessment – very common to do so • Differs from traditional assessment (clinical interview and testing) in 3 ways

4. Differences from traditional assessment • Interested in samples of behavior, not behavior as a sign of internal processes • Functional Analysis, a very concrete method, is employed to understand behavior • Assessment is an ongoing, active part of all phases of treatment (not just always in the back of clinician’s mind, as in other types of treatment)

5. Sample vs. Sign • In behavioral assessment, test / interview responses are interpreted as “samples” of behavior that are thought to generalize to other situations • In traditional assessment (even psychodynamic), we interpret test data as “signs” of internal processes

6. Functional Behavioral Analysis (also called Functional Analysis) • Derived from Skinner’s work with SR (stimulus-response) learning • SORC model • ABC model (very similar) • Isolates a target behavior for analysis and understanding in a very concrete, prescripted manor

7. SORC model for conceptualizing a behavior • S = stimulus or “antecedent” factors which occur before target behavior • O = organismic variables relevant to target behavior • R = the response = the target behavior • C = consequences of target behavior

8. Elaboration of “O” • Organismic • Physical / medical / physiological, cognitive / psychological aspects of the client • …that are relevant to treating the target behavior

9. Example of SORC model • S – Stimulus: a child is ignored by her peers in class • (O – Organismic: the child has previously been diagnosed with ADHD) • R – Response: She increases the volume of her voice (i.e., yells) • C – Consequences: her peers pay attention to her, some role their eyes

10. Similar to SORC: ABC • A = Antecedent – similar to “situation” • B = Behavior – similar to “response” • C = Consequence – outcome

11. Is an ongoing & active process, through all points of behavioral therapy: initial assessment, therapy, and evaluation of improvement • Assessment is an ongoing process in almost all clinical orientations, in that it’s almost always in the “back” of clinician’s mind. • Ex: Hmm, I thought Mr. Z had depression, but now he’s exhibiting more anxious symptoms; I wonder if this is more a mixed anxiety-depression sydrome. • In behavioral assessment, is a planned & integral part of entire therapeutic process

12. Behavioral Assessment Methods • Behavioral Interviews • Observational methods • Naturalistic Observation • Controlled Observation • Controlled Performance Techniques • Self-Monitoring • Role-playing • Inventories, Checklists • Cognitive-Behavioral Assessments

13. Behavioral Interviews • Behavioral interviews: ask questions focused on target behaviors • Goal: help clinician gain general perspective of problem behavior and the variables that perpetuate it • Understand antecedent factors • May use structured diagnostic interview (relatively new development) • Not different from traditional interview in format, only in focus.

14. Observation: a primary technique • Observational methods (as opposed to self-report) provide a sample of behavior in naturalistic OR controlled conditions • Fewer problems in research than therapy • Naturalistic: at home or school, in a hospital, or in therapy • Controlled: situational tests that approximate real life

15. Controlled Performance Techniques • Similar to controlled observational methods, except that the observer interferes more • do not approximate real life, but may be analogous to or heighten aspects of real life (pressure, interpersonal challenges, presence of phobic stimuli) • Contrived situations • Potential for standardization across individuals

16. Self-monitoring techniques • Have client observe their own behaviors, thoughts, and emotions • chance of bias? • Typically more part of treatment than assessment for this reason • Clients keep list of observations in similar fashion as SORC or ABC • Dysfunctional Thought Record DTR is most common of self-monitoring in clinical setting

17. EMA • Special kind of self-monitoring • Ecological Momentary Assessment • Real-time assessment using a PDA • Increasingly used in research • Example: for assessment of emotions & cognitions associated with eating habits, participants may be asked to answer questions on the PDA each time it beeps (set randomly ~3x day), and before and after all meals and snacks

18. Role Playing • Controlled-setting for “safety” • Provide a scenario for client to act out, possibly with a clinical assistant or the therapist • Benefit: therapeutic since it’s practice in a safe setting plus provides ongoing assessment

19. Inventories, checklists • E.g., child behavior checklist CBCL • Parent, peer, self, teacher rate on a list of behaviors • Usually multiple raters • Questionnaire format • Often have multiple “factors” in checklist • E.g., aggressive, depressed, anxious behaviors • Benefit: they offer a quantitative measure!

20. Cognitive-Behavioral Assessments • Add component of conscious & remembered “thoughts” as an additional type of behavior to assess • Example: Beck Depression Inventory • Asks questions about behaviors such as sleep, appetite, decision making related to decision • But also thoughts: negative thoughts about self, thoughts about death, etc.

21. Challenges to validity and reliability • Reliability & validity influenced by • complexity of behavior observed • level of training, experience of observer(s) • unit of analysis chosen & coding system used • influence of observation on target (problematic) behavior • generalizability of observations to other settings/situations