Chapter 14 Flashcards
Step 3:
Goal
Setting
Reframe
Reframe focus on undesired target behaviours, and focus on desired behaviours
(what they want to increase)
set
After behavioural change goal is established, set initial and intermediate goals
(successive approximation)
Discuss
Discuss context here:
*Gender Roles
*Cultural Expectations
*Settings where the goals are needed
*Ethical issues associated with the goals
*With client’s consent and collaboration
SMART goals
specific
measurable
attainable
relevant
time-bound
Step 4:
Intervention
Planning
A strategy for systematically carrying out the
behaviour change program to attain the client’s
goals.
Specifies:
The behaviour change technique to be used
Procedures for implementing them
The individuals to be involved
Plan for
generalization and maintenance
Treatment contract
Verbal Written Signed
Behaviour
Change
Techniques
Can be used separately or in “treatment
packages”
- Consider multiple factors:
- Effectiveness
- Comfort
- Obstacles
- Community norms
- Ethical considerations
- For example: punishment using aversive
stimuli may be more immediately
effective and efficient, but positive
reinforcement and shaping may have
greater long-term effectiveness and less
determinantal side effects
Table 14.1
Evidence-Based Treatments (EBT)
Evidence-Based Treatments (EBT)
Empirically Supported Treatments (EST)
Empirically-Validated Treatments
The strength of the scientific evidence showing this
treatment works
Randomized
Control Trials
(RCTs)
Demonstrates efficacy (how well it does under controlled
conditions)
* Random assignment of participants to treatment vs control
groups
* Often use manualized treatment protocols
Critiques:
* May not be as robust as the researchers suggest
* Biased researchers and “file drawer” effects
Evidence-Based Practice
(EBP)
“the integration of the best available research with clinical expertise in the
context of patient characteristics, culture, and preferences” (APA, 2005)
Guides professional ethics codes, insurance coverage
Evidence-Based Behavioural Practice (EBBP) – for Behavioural Research &
Practice
Critiques:
*Many clients do not receive treatment based on the best available science in mental health
*Efficacy alone is not enough; we need more studies about effectiveness in clinical settings that
combine both evidence-based and culture-based approaches
*Evidence-Informed Practice (EIP) may be a better term: guided by research and evaluation, clinical
expertise of the practitioner, and judgement of both the practitioner and client
Step 5:
Implementation
of
Behaviour
Change Plan
Canadian Code of Ethics for Psychologists
Vulnerable populations:
* Children
* Individuals with developmental disabilities
* elderly persons in long-term care settings
* those with severe mental health issues
* correctional settings
* pregnant women
* court-ordered treatment
Informed
Consent
- The client understands the nature proposed interventions
- Voluntarily agrees after knowing the risks/benefits
- Given alternatives to the procedures
- Has had their questions answered
- Competent to understand, communicate, appreciate, and
explain the treatment (or else get the client’s legal
guardian’s informed consent)
Step 6: Evaluation of the
Effectiveness
- Compare the target behaviour data
before, during, and after - Usually n-of-1
If not achieved: - Reassess the target behaviour
- Reformulate the behaviour change
goal - Select and implement alternative
intervention procedures - Re-evaluate the effects
Evaluation of Behaviour
Change Plan
- If not changed in a reasonable amount of time (4-6
weeks), then reassess and alter it - May be satiated on reinforcer
- May not be an effective reinforcer
- Need to monitor and record regularly
Record Keeping
Outlines the following (each problem listed
separately):
* Target behaviours
* Behaviour change goals
* Controlling antecedents and consequences
* Environmental resources and barriers for each
goal
* Specific behaviour change techniques and
procedures used
* Monitors the client’s progress toward goal
attainment
* After goals are attained, writes up summary of
termination of treatment plan
* Treatment evaluation by the client over time
(post-treatment and follow-up)
Client Satisfaction
- Patient-reported outcomes (PROs)
- Their level of satisfaction with the
treatment - Their level of satisfaction with
achievement of behaviour change goals - May or may not correlate with
objective measures of behaviour
change - Use real-time in sessions
