A History of the Behavioral Therapies 2002

Transcription

1 A History of the Behavioral Therapies 2002 Knowing where we came from allows us to assess whether we have lost something; whether we have drifted away from some of the strengths that allowed us to be where we are today. A valuable lesson may be that some of what made behavior therapy successful has been lost across generations.

2 They say the older you get, the more you become like your parents. It s a little scary! I AM BECOMING JUST LIKE HIM!!!

3 CONTROVERSIAL There are more brains in this salad, than in the people seated at this table. Psychology Today January 1974

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5 SENSE and NONSENSE: It HAS to be Ronald Leaf, John McEachin & Mitch Taubman SAID!

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7 JOHN B. WATSON Psychology as Behavior was Published in 1913 Contrasting Behaviorism with Psychoanalysis

8 WATSON S CONTRIBUTIONS Father of Behaviorism Asserted that Psychology was a Science Tabula Rasa Demonstrated the Application of Behaviorism Tremendously Influential in Psychology

9 HE WAS KINDA OF A BIG DEAL!

10 MARY COVER JONES Nationality: American Influences: Pavlov & Watson Mother of Behavior Therapy Piloted Systematic Desensitization (Peter and the Rabbit) Pioneer in the Use of Social Imitation Researched the Developmental Antecedents of Problem Drinking Comprehensive Study of Development Across the Lifespan

11 JOSEPH WOLPE Nationality: South African Influences: Hull, Masserman, Pavlov, Spence Trained in Psychoanalysis Treated Soldiers with War Neurosis Found Psychoanalytic Treatment to be Ineffective Hypothesized Fears & Phobias were Learned Demonstrated that Fears Could Be Counter Conditioned Developed Systematic Desensitization Later Developed Assertion Training

12 TED ALLYON Nationality: Bolivian Influences: Azrin, Lindsley, Michael Worked with Chronically Mentally Ill Adults Didn t Accept the Common Beliefs of Expectations & Interventions Innovative ( Just Fooling Around ) Developed the Token Economy Went on to Work with: Hyperactivity, General Education Students, Tennis Players, Ballet Dancers and Burn Victims

13 SANDY HARRIS Trained in Psychoanalysis Founded the Douglass Developmental Disabilities Center-- Premier Clinic for Treatment of ASD Coauthored a Seminal Article Demonstrating the Effectiveness of ABA Pioneer in Working with Parents and Siblings Mentored 100 s of the Top Professionals in the Field of ASD

14 DON BAER Nationality: American (Immigrant Parents from Belorussia) Influences: Bijou, Guthrie, Spence, Tolman Father of Applied Behavior Analysis Instrumental in Forming the MECA of ABA Doctoral Programs at the University of Kansas Illustrated that the Principles of ABA were Applicable to Child Development Helped Establish a Technology for Promoting Generalization Mentored Over 150 Graduate Students Who Are Leaders in the Field

15 IVAR LOVAAS Nationality: Norwegian Influences: Baer, Bijou, Risley, Sherman, Wolf Trained in Psychoanalysis Worked with Chronically Mentally Ill Adults Didn t Adhere to the Common Belief that Children with Autism had a Grave Prognosis Seminal Outcome Studies Demonstrating the Efficacy of ABA Treated Hyperactivity, Gender Identity & Intellectual Disability Controversial Not Protocol Driven Flexible Approach

16 STRIDENTLY OUTSPOKEN If I had gotten Hitler here at U.C.L.A. at the age of 4 or 5, I could have raised him to be a nice person. A humanitarian! Los Angeles Magazine March 2004

17 FLEXIBILITY If a child cannot learn in the way we teach, then we must teach in the way the child can learn.

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20 A History of the Behavioral Therapies 2002 Can a therapist do better achieve greater improvement or do it more quickly by adjusting therapy to what is perceived as the individual needs of the patient as opposed to doing it by the book?

21 COMMONALITIES? Challenged Conventional Thinking Grounded in Learning Theory & General Psychology Variety of Experiences Psychological Orientations Populations Ages Settings Innovative Not Protocol Driven

22 A History of the Behavioral Therapies 2002 We have lost the iconoclastic value of the first generation: they were questioners; they were radical; they had the courage to fight the power structure. As the discipline has matured it has come to be more conventional, less revolutionary. Our goals have become more modest-we seek no longer to change institutions or society but rather to make a living.

23 IT IS THE BEST OF TIMES ABA is Commonly Recognized as Being the Most Effective Intervention for Children with ASD Children are Being Diagnosed at Younger Ages There are University and Online Programs Devoted to Teaching the Principles of ABA There is Increased Funding for Treatment

24 IT IS THE WORST OF TIMES ABA is Commonly Recognized as Being the Most Effective Intervention for Children with ASD Children are Being Diagnosed at Younger Ages There are University and Online Programs Devoted to Teaching the Principles of ABA There is Increased Funding for Treatment

25 PROGRESSION OR REGRESSION? CURRENTLY Operant Statistical Significance Prompting Positive Behavior Support Limited & Specific Training Protocol Driven Rigid ABA EARLY DAYS Operant & Respondent Clinical & Statistical Significance Prompting & Shaping Reinforcement & Punishment Extensive & Comprehensive Training Clinical Judgement Progressive ABA

26 Complexity of Teacher s Language Simple Moderate Complex Reinforcement Selection Therapist Selected Child Selected Reinforcement Effect Prompting Strategy Errorless No, No, Prompt Flexible Curriculum Targets Behavior Communication Social Data Collection Procedure CLINICAL JUDGEMENT In the Moment Assessment Continuous Sampling Estimation

27 Health Operant vs. Respondent Attentiveness Receptivity Interfering Behaviors Persistence Clinical Judgement Calm vs. Agitated Staff s Skill Level Non-Verbal Behavior Motivation Past Performance Recent Performance

28 WHY CLINICAL JUDGEMENT?

29 WHAT HAPPENED??? Specialization Reduced Emphasis in Understanding the Field of Psychology Training Primarily in ASD & Younger Children Operant Bigotry Not Willing to Fail! Contingencies Money over Science Supply & Demand Rigid Protocols Certification

30 What Do You Think About Board Certification? Donald Baer, 2002 In general, I don t like certification. I think it rigidifies practice and makes it more difficult to be innovative. I see certification as a way of making it a little more difficult for us to be innovative and to do research and to change what we do from what the pattern is now.

31 Unqualified Interventionists Providing Treatment High Functioning Children Are Brats Journals Reject Submissions Because They are Innovative Obedience to Set Protocols Research Should Not Be Based Upon Clinical Experience Operant Bigotry, Continuous Data, Prolonged FBAs, Reinforcement Preference Assessments, Four Functions of Behavior, Social Stories, Social Thinking, etc., etc.

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35 POSSIBLE REMEDIES Truly Understand the Potential of Children with ASD Conferences that Promote Enhancing the Field Heighten the Requirements for the RBT Credential Expand Graduate School Curriculum BCBA Exam Evaluates a Larger Breadth of Knowledge Make BCBA s Level of Expertise Clear Research Evaluating the Efficacy of Training Research on the Efficacy of Differing ABA Approaches Behaviorists Utilizing Best Practice Progressive ABA Journal Develop Training Programs that Teach Progressive ABA

36 POSSIBLE REMEDIES Truly Understand the Potential of Children with ASD Conferences that Promote Enhancing the Field Heighten the Requirements for the RBT Credential Expand Graduate School Curriculum BCBA Exam Evaluates a Larger Breadth of Knowledge Make BCBA s Level of Expertise Clear Research Evaluating the Efficacy of Training Research on the Efficacy of Differing ABA Approaches Behaviorists Utilizing Best Practice Progressive ABA Journal Develop Training Programs that Teach Progressive ABA

37 NOT ALL ABA IS ALIKE! RIGID CONTEMPORARY PROGRESSIVE Training One Week One Month Three + Months Focus of Intervention Instructional Format Behavior Speech Academics Discrete Trail Training Behavior Speech Play Social Academics Discrete Trail Teaching Observational Learning Learning How to Learn Communication Social Play Self Help Skills Discrete Trial Teaching Observational Learning Teaching Interactions Continuous Teaching Staffing Ratios 1:1 1:1 & Small Group 1:1, Small Group & Large Group Reinforcement Continuous: Primarily Food Variable: Tangibles & Socials Variable: Limited Tangibles, Socials & Intrinsic Data Continuous Continuous Representative Samples Behavior Triggers Operant & 4 Functions Operant & 4 Functions Respondent & Operant with Multiple Functions Structure Protocol Driven Protocol Driven w/ Some Flexibility Clinical Judgement

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