Autism spectrum disorder ASD has always been my passion and I strive to continue making a difference in the lives of these children and creating a positive impact in the lives of the families. My goal is to advocate for families with ASD. In recent reports, it is noted that “1 in 68” children are diagnosed with autism every year. While reportedly more common among boys (1 in 42), 1 in 189 girls are diagnosed (Christensen, et al, 2012). My topic of interest as it pertains to creating my blog for social change is incorporating behavior therapy and advocacy for autistic families. The goals I plan to achieve as it relates to social change includes: Connecting families with autistic children with available community resources, linking families to share and support each other with effective tools, educating families on autistic symptoms and how to cope, helping autistic children deal with symptoms and to understand adaptive skills, encouraging research and ideas to help such families, organizing events and facilitating treatment procedures, speaking for autistic children and families before agencies and parastatals that may assist. Is there awareness relating to behavior therapy and advocacy to autistic families? I plan to structure that my blog includes educative research whereby people can gain information that will be beneficial. In addition, there would be different sections with vital information that will help guide the visitors to the blog.
Derived from the work of leading psychologists such as Ivan Pavlov; behavior therapy emerged as a way to examine human behavior and how it is directly impacted by environmental conditions (Pearson, 2010). According to the American Psychological Association (2016), behavior is “the actions by which an organism adapts to its environment”. In other words, human behavior is directed by the environment. The difference between positive and negative (maladaptive) behavior(s) lies in how we respond to an environmental stimuli. Stimuliis any “event that [provokes] a response” (Psychology Dictionary, n.d.). Furthermore, as viewed through Skinner’s technique of operant conditioning; a subject will continue a behavior if that behavior has previously been reinforced (will be discussed in more detail later). Thus, pioneered by Joseph Wolpe during the late 1950s, and further developed by psychologists such as B.F. Skinner and Albert Bandura during the 60s and well into the 90s; behavior therapy focuses on systematically “changing negative behavior through the use of behavioral techniques and principles” (Autism Speaks, 2016; Disorders.org, 2016).
Used to treat a variety of symptom-based disorders, such as obsessive-compulsive disorder (OCD), specific phobias as well as other behavior disorders like autism behavior therapy has emerged from the work of Joseph Wolpe, B.F. Skinner, and Albert Bandura (Disorders.org, 2016). Having merged into what is referred to as cognitive behavior therapy, the counseling practice arouse out of efforts to examine and define behavior in relation to environmental stimuli (Corey, 2009, p. 237). However, speaking in terms of traditional behavior therapy in order to define specific determinants of the behavior for change; the behavior must first be able to be observable and measurable. Some examples of observable (able to be seen/heard) and measurable (how often it occurs) behaviors include: screaming and stomping feet versus unobservable or unmeasurable behaviors such as anger. Since measurable behavior is defined as behavior that is characterized by how often it occurs; one of the ways behavior is measured through frequency recording (University of Minnesota, 2007). Throughout the process of behavioral therapy, the goal is to “eliminate or change specific behaviors”. According to theoretical principles, behavioral therapy focuses on the questions what, when, and how (Disorders.org, 2016).
The ‘What’ Question
There are five essential steps to changing a behavior. First, as many know; in order for any change to occur you must identify the problem (target behavior) in which change needs to happen (Counseling Connection, 2016). What is it that needs changing? You cannot change that which you are not aware. Through therapy, the therapist can help determine which behaviors are hindering you from progressing towards your goal using interviews, observations, and other behavioral practices. In behavioral analysis, behavior is talked about in terms of an ABC model. The A stands for antecedent. In other words, what happened before the behavior occurred? B…what was the behavior that resulted in response to the antecedent, and C…what was the consequence for the behavior? It is one thing to have identified the target behavior, but what does the behavior look like; and what purpose does engaging in the behavior serve for the client (Cormier, Nurius & Osborn, 2009)?
The ‘When’ Question
When? A majority of people have probably asked this question at some point during their life. When am I going to have kids? When am I going to win the lottery? When am I going to get my breakthrough? When are things going to change? However, if you are like many of the other individuals in the world; you have learned that despite what you would like, change does not occur immediately. Rather, change is a process.
The ‘How’ Question
The problem behavior has been identified (first step), and now the question has shifted to how…how am I going to change this behavior? How is changing this behavior going to benefit me. The second step is to develop a plan. However, just as everyone is not the same, the same solution will not work for everyone. I liken this to going to the doctor. The doctor’s job is to determine how to get you well, right? While the doctor has probably seen the same symptoms you have in someone else, and may prescribe the same medication as he did to the other individual; it does not necessarily mean you are going to respond the exact same way to the same medication. Therefore, the plan may be different for everyone or even different for each target behavior. Third, I have seen a lot of individuals develop a plan for change. For example, New Year’s resolutions. The time of year where a lot of people pick something they want to change or accomplish. They have a plan, that is wonderful; but what good is a plan if you do not implement the plan (implement…the third step)? As previously mentioned, not everyone is the same which results in differences among individual responses to therapeutic practices and methods which stresses the need to periodically assess the client’s progress (fourth step) and make changes to the plan as needed. Finally, continue the process (Counseling Connection, 2016).
Therapeutic Goals and Therapist-Client Relationship
As previously mentioned, the goal of behavior therapy is to “change or eliminate specific behavior” (Disorders.org, 2016). Possibly one of the most critical components necessary for behavior change to occur, outside of identifying the target behavior, is the relationship between the therapist and the client. During therapy, the therapist and the client collaborate together to determine specific treatment goals in order “to increase personal choice, and create new conditions for learning”. Furthermore, due to the collaborative nature of the therapeutic process; in order for change to occur, goals must be “concrete, [providing a clear expectation] and understood by each person involved in the treatment” (Corey, 2009).
Client’s Therapeutic Experience
In years past, up until about the last sixty, not a lot was known about human behavior. According to Kappel, Drufresne and Mayer (2012), “it was thought that individuals with disabilities could not learn”. However, over the past half-century “much has been learned about human behavior” and while known to be used among individuals with developmental disabilities, those in the field have come to understand that “all kinds of behaviors can be changed” (p. 2). It is important to remember, that while behavioral therapy is a joint effort in order to maximize the effectiveness of therapy, the client may not be willing to participate. Lack of client participation can possibly occur for a variety of reasons. For instance, Corey (2009) suggest that motivation plays an integral part in client participation. If a client is not motivated towards the change, the therapist must think about what is causing the lack of motivation (p. 241). Is it that the client is just not putting forth the effort, or does the client not know how to perform the new; more desirable behavior? If the latter is true, then the therapist may need to implore a variety of techniques in order to teach the new behavior (Kappel et al, 2012). It may be safe to say that, you only get out of therapy what you put in to therapy.
Methods of Behavioral Therapy
While there are many different techniques that can be applied throughout a behavioral therapy session…some which you may use simultaneously with others, there are a few prominent methods of behavioral therapy that I find to be an essential part of every behavior therapists tool belt. Possibly one of the most widely known techniques of behavioral therapy, “operant conditioning, was coined by psychologist B.F. Skinner in 1938”. By definition, operant conditioning utilizes the concept of reinforcement to change behavior. In theory, this technique contends that “when a desirable behavior is reinforced; the likelihood that the behavior will be repeated increases while behavior that is not reinforced will decrease and hopefully the undesirable, or maladaptive, behavior will become nonexistent (extinct). For example, in his experiment Skinner examined the behavior of lab rats and their response to pushing a lever. Every time a rat produced the desired response, it was reinforced with food. So, if we stick with the principle of Skinner’s model; we would find that the behavior of pressing the lever would increase through the addition of a pleasant reinforcer (positive reinforcement). Correspondingly, based on Skinner’s model of reinforcement; “behavior can also be strengthened through the removal of an unpleasant reinforcer, or stimulus” (McLeod, 2007).
Another technique that can be applied within behavioral therapy sessions is known as modeling. Based on the contributions of Albert Bandura to the field of behavioral therapy, modeling is a part of the social-learning theory that “[utilizes] live or symbolic symbols to demonstrate [the desired] behavior”. Based on the premise of modeling, a therapist would generally use the technique when teaching the client, a new behavior. Modeling can also be referred to as “observational learning, or imitation”. In addition, it is suggested that “the client does not actually need to perform the behavior in order to learn it”. Some conditions or disorders known to be modified through the use of modeling, include:
- Post-Traumatic Stress Disorder
- Specific phobias and
- Obsessive Compulsive Disorder (Modeling, 2016).
A third method that can be used by behavioral therapist is known as systematic desensitization. According to McLeod (2008), systematic desensitization was “developed by Joseph Wolpe in the 1950s and is based off of the model of classical conditioning”. Conceptually, systematic desensitization is used to treat specific phobias, and ultimately “remove the fear response to an aversive event or stimulus” by introducing a stimulus that is viewed as positive. For example, working in the behavioral therapy field (with children diagnosed with autism) I have utilized this technique with a child who displayed a fear of going outside after associating one experience with a negative stimulus (loud sounds). During the implementation and process of systematic desensitization, myself along with our lead behavioral analyst gradually reintroduced going outside by pairing the negative stimulus with activities that are highly reinforcing to the child (i.e. favorite videos, toys).
Through the process of research and work experience, I have learned that behavioral therapy can be applied with clients who are facing a variety of situations ranging from autism (or other developmental disorders), to obsessive compulsive disorder and specific phobias. In addition, while I mentioned that the relationship between the therapist and the client is collaborative in nature; I find it evident to be that the therapist plays a huge role within the therapy process because the therapist should initially be striving towards building a positive rapport with the client as they will be an integral part of helping their client become aware of behaviors for possible change through the collection and review of observable and measurable data. Therapists may also need to teach new behaviors where a behavior is not known (Cormier, Nurius & Osborn, 2009 & Wilson, 2008). To implement positive social change, my goal is to advocate to these families and possibility of creating awareness.
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