Behavioral Assessment

History
Behaviorism beginning in 1930s Pavlov: Pavlovian or classical conditioning B.F. Skinner (most noteworthy work 1953)

Skinner

box for rat learning research Operant or response-stimulus (RS) conditioning

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

Differences from traditional assessment

1.

2.

3.

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 clinicians mind, as in other types of treatment)

1.

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

2.

Functional Behavioral Analysis (also called Functional Analysis)

Derived from Skinners 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

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

Elaboration of O
Organismic Physical / medical / physiological, cognitive / psychological aspects of the client that are relevant to treating the target behavior

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

Similar to SORC: ABC

A = Antecedent similar to situation B = Behavior similar to response C = Consequence outcome

3.

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 its almost always in the back of clinicians mind. Ex: Hmm, I thought Mr. Z had depression, but now hes 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

Behavioral Assessment Methods

Behavioral Interviews Observational methods

Naturalistic

Observation Controlled Observation

Controlled Performance Techniques Self-Monitoring Role-playing Inventories, Checklists Cognitive-Behavioral Assessments

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.

Observation: a primary technique

Observational methods (as opposed to selfreport) 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

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

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

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

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 its practice in a safe setting plus provides ongoing assessment

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!

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.

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