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Class #7:
PBS Characteristics & Basic Concepts
Traditional Approach
Remediate problem behavior
Carr (2007)
Happiness
Happiness:
Centrality of QOL
vs
Social well-being
e.g., social networks (friends), clubs, religious groups
Emotional well-being
e.g., close relationships (love, intimacy, attachment), positive mood,
emotional stability
Autonomy
Autonomy
Being able to choose basic items: clothing, food,
personal belongings
Being able to make major life choices: living
arrangements, social relationships, recreation
and leisure, vocation, academic interests, religion
and spiritual preferences
Self-sufficiency: achieving a level of competence
that reduces the level of support required from
others (e.g., self-care, food preparation, safety in
the community, money management)
Impediments to QOL
Problem behavior
Skill deficits
Dysfunctional systems
The Problem With
Problem Behavior
Prevents full community integration
(home/school/employment)
Demoralizes family members (parents/siblings)
and teachers
Increases likelihood of institutionalization (loss of
choice/dignity)
Rejection by others (social isolation/no friends)
Damages self-esteem (shame/regret)
Summary: Destroys quality of life
Helpfulness
Support vs
Cause and Cure
Support: the use of educational procedures to enhance
personal competencies (e.g., skill development) &
systems-change procedures to create environments in
which those competencies can be used to promote a
good QOL
Medical disorders cant always be cured (e.g.,
diabetes, cancer, asthma, heart disease), but we can
give people a good QOL with treatment
Psychological disorders are the same; just because we
cant cure depression or autism, doesnt mean
treatment cant help people
Laboratory (Analog) Research as a
Prelude to Effective Support
Laboratory research is often an essential first
step
Ecological validity = can lab research be
translated into the real world?
Need to add more things to lab procedure to
make it work in the home, classroom, &
community
Support: Maintenance and
Sustainability
Maintenance: how durable are the effects of
treatment over time?
Maintenance is not a function of procedures;
maintenance is a function of systems
Sustainability: do the people in the home, school, &
community continue their treatment efforts over
time?
Gains are not maintained if efforts are not
sustained
What prevents us from being able to sustain
treatment?
Context 1 Bedtime:
Results
Multiple Baseline: TK's Bedtime Routine
Total Problem Behavior Per Night
Baseline Intervention
275
250
225
Total Problem Behavior
200
175
150
125
100
75
50
25
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Sessions
200
175
150
125
100
75
2/3 - 2/8
50
25
0
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 55 58 61 64 67 70 73 76 79 82 85 88 91
Sessions
8
Number of Voids In & Off-Toilet
p d dd pp d
1
0
1 7 13 19 25 31 37 43 49 55 61 67 73 79 85 91 97 103 109 115 121 127 133 139 145 151 157 163 169 175 181 187
Sessions
11/15/07 to 6/2/08
Toileting Intervention:
Barriers to Implementation
Difficult to constantly monitor & prevent accidents
Vision
Skills
Incentives
Resources
Action plan
Application of the Systems Change
Model
1) Vision (e.g., goodness-of-fit; person-centered
planning)
2) Skills (e.g., collaborative teaming and team
training)
3) Incentives (e.g., responsivity to social and
emotional needs)
4) Resources (e.g., life arrangement and life
coaching)
5) Action plan (e.g., group action planning)
1) Vision
Does everyone in the system have the same goal?
Unless people within a system share a common set of
goals or mission (e.g., everyone agrees that
community-based intervention must replace
intervention in segregated settings), they will be
working at cross-purposes with each other
Conflict often arises from people having different
visions
e.g., person-centered planning, goodness-of-fit
2) Skills
If there are too many people in the system who
lack the knowledge and expertise needed to
competently implement intervention
procedures, this will undermine sustainability
Many teachers are not equipped to deal with
problem behavior; they dont have the skills or
expertise to implement recommendations
E.g., Collaborative teaming & team training
3) Incentives
Motivation (an incentives issue) can derail efforts to
sustain an otherwise effective program if parents,
teachers, staff, administrators do not experience
relevant reinforcement for implementing the
program
E.g., for principal, motivation would be to not hear
from parents
E.g., from teacher, motivation would be class not
completely out of control so she can teach
E.g., for bus driver, motivation to have a safe trip
and not have to break up a fight
4) Resources
Resources become a factor impacting
sustainability when time, money, and the
material necessities required for proper
intervention implementation are lacking
Organizational management
Community / ecological psychology
Cultural psychology
Biomedical sciences
Positive psychology
Organizational Management: Systems
Change Themes
Models for effective service delivery
e.g., interagency collaboration, wraparound services
Models for effective training
e.g., trainer-of-trainer approach
Models for effective team building
e.g., integrate all staff in school into a unified team
Models for building motivation
to produce sustainability
Models for ensuring accountability
to ensure interventions applied with fidelity
Models for data management
basing decisions on evidence rather than opinion
Community / Ecological Psychology:
Illustrative Examples
A Focus on Prevention
Identification and analysis of environmental risk
factors
e.g., poverty, mental illness, marital conflict,
unemployment, racism, health issues
Proactively addressing the issue of scarce resources
e.g., not enough time, money, personnel
Preventive support plans that appeal to the broader
needs of settings and communities
Community / Ecological Psychology:
Illustrative Examples
Building Sources of Social Support
Support networks in the lifecycle (e.g., parenting,
childhood, adolescence, aging)
Self-help groups
Empowerment
Networking
Influencing policy formation
Effectively competing for resources
Building organizational coalitions
Cultural Psychology
Cultural relativism
Concepts of abnormality vary across cultures; therefore,
behavior needs to be assessed relative to its cultural
context
e.g., social phobia
Cultural values
Identifying acceptable goals is influenced by cultural
values
e.g., Autonomy & self-reliance vs. meeting
responsibilities/obligations to others
Cross-cultural competence
customs, rapport, cooperation
e.g., patriarchal, nuclear vs. extended family
Biomedical Science:
Some Possibilities
Knowledge of brain function influences how
to build competencies (e.g., TBI)
Biological factors as setting events for
problem behavior (e.g., pain, illness, fatigue,
hormonal states)
QOL and health psychology / behavioral
medicine
e.g., coping strategies for dealing with stress, pain
management, promotion of healthy behaviors &
wellness
Positive Psychology:
Our Greatest Scientific Ally?