Behavioral Assessment

History

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

Skinner box for rat learning researchOperant 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. Interested in samples of behavior, not behavior as a sign of internal processes

2. Functional Analysis, a very concrete method, is employed to understand behavior

3. Assessment is an ongoing, active part of all phases of treatment (not just always in the back of clinician’s 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 Skinner’s 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 it’s almost always in the “back” of clinician’s mind.

Ex: Hmm, I thought Mr. Z had depression, but now he’s 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 self-report) 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 it’s 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 bycomplexity of behavior observed level of training, experience of observer(s)unit of analysis chosen & coding system used influence of observation on target

(problematic) behaviorgeneralizability of observations to other

settings/situations