Outcomes Driven Model
Good, Gruba, & Kaminski (2002)
-Based on problem solving model (originally tied to early literacy skills)
-Provides a prevention-orientated assessment and intervention decision making system
Components of Outcomes Driven Model
-Identify Need for Support
-Validate Need for Support
-Plan Instructional Support (Implement Instructional Support)
-Evaluate Support (Implement Instructional
Support)
-Review Outcomes
Multi-Method Assessment-- Merrell (2003)- Chapter 1
Multimethod, Multisource, Multisetting Assessment
-Methods (direct observation, behavior rating scales, interviews, records review, sociometric assessment, self-report)
-Sources (student, parents, teachers, peers, school staff, other family members, community informants)
-Settings (home, school, clinic, play, community)
Multi-Method Assessment--McConaughy & Ritter (2008)
Assessment of emotional and behavior disorders- Use a three-tiered model:
Tier 1 (universal condition): examine what universal conditions were already in place
Tier 2 (targeted interventions)
Tier 3 (Individual/intense intervention)
-Parent, teacher, student rating scales and interviews
-Direct observations, social skills, academic achievement
Functional Assessment for problem behavior
O'Neil, et al. (1997)
-Get a clear description of the problem behaviors
-Identify events, times, and situations that predict behavior (antecedents)
-Identify consequences that maintain problem behavior
-Develop summary statements/hypothesis of problem behavior
-Collect direct observation data to support summary statements
--get this info through interviews (FAI) and direct observations
Consequences- Obtaining Desired Events
Positive Reinforcement
-Obtain internal stimulation (Automatic)
-Obtain attention (Social)
-Obtain Activities or Objects (Tangible/activity)
Consequences- Escape/Avoid Undesirable Events
Negative Reinforcement
-Escape/Avoid internal stimulation (automatic)
-Escape/Avoid attention (Social)
-Escape/Avoid tasks or activities (Task)
When and why to use a Functional Analysis
- Use when info obtained from functional assessment fails to reveal consistent patterns of behavior or if summary statements cannot be clearly confirmed
- Designed to test summary statements/hypothesis regarding variables or events most strongly related to the occurance of problem behaviors
Four Considerations for building behavior support plans
O'Neil, et al. (1997)
-Describe our behavior (teacher, staff, etc.)
-Should build from functional assessment results
-Should be technically sound (Reinforcement, punishment, generalization, stimulus control)
-Should fit the setting where they will be implemented
--Make problem behaviors irrelevant, inefficient, ineffective
Competing pathways behavior model
O'Neil (1997)
-Diagram functional assessment summary statements (setting events, antecedents, problem behaviors, maintaining consequences)
-Define alternative behaviors and contingencies associated with those behaviors (desired behavior, equivalent/replacement behavior)
-Select intervention procedures (setting event, predictor, teaching, consequence strategies
Assessment of Internalizing Problems
Merrell (2003)- chapter 10
- Use normal assessment methods (behavioral observation, rating scales, interviewing, narrow band assessments: CDI, RCMA, etc.)
-Student interviews and self-report measures weigh more heavily (due to cognitive and emotional disturbances that are not always visually present)
Weisz & Hawley (2002)
-Focus on psycho-social treatments not medication for adolescents
-Depression= CBT
-Anxiety= CBT, modeling, desensitization
-ADHD- behavioral parent training
-Conduct disorder= behavioral parent training, anger management, problem solving skills, assertiveness training, multisystemic therapy, rational emotive therapy
Medication can be less predictable for adolescents given developmental factors
Compton, Burns, Egger & Robertson (2002)
- evidence-based treatment for children (internalizing)
-depression= CBT (not enough research for meds)
-anxiety= systematic desensitization, CBT (not enough research for meds)
-OCD= lack of research for psychosocial treatment- medication appears promising
Spielsmans, Pasek & McFall (2005)
Anxiety and depression in children= CBT is more efficacious
-adding on parent training adds no benefit for this population
-CBT and bona-fide treatments (graduate level therapist, individual sessions, psychologically valid components, manual, research, etc.) are equivalent
-thus, CBT critical ingredients are not specifically helpful for depression or anxiety
McCarty & Weisz (2007)
Psychotherapy for depression in children and adolecents
-treatment techniques that have been found in the most effective treatments: achieving measurable goals/promoting competency, self-monitoring, addressing relationship skills, communication training, cognitive restructuring, problem solving, behavioral activation, therapist indicating drepression is treatable, assigning homework
Weisz, Weiss, et al. (1995)
Effectiveness of psychotherapies
-Behavioral methods are more effective than non-behavioral methods
-studies with adolescents showed larger effects
-larger effect sizes for females- adolescents
-paraprofessionals have larger effect sizes
-larger treatment effects when outcome measure is matched to problem
Assessment of Externalizing problems
Merrell (2003)- chapter 9
- Use normal assessment methods (behavioral observation, rating scales, interviewing, narrow band assessments: Conners, etc.)
-direct observation is more valid (easy to observe and be objective, can identify environmental variables that can be manipulated)
-self-report is less reliable- tend to underestimate their own behavior
Culturally competent behavioral assessment
-get cultural background info before conducting assessment
-always consider acculturation and language of student and parents
-multi-method multi-source
-make sure assessment instruments are reliable and valid for the population
-dont be afraid to ask questions (consult, or ask parents)
-be sensitive
Merrell (2003)- Chapter 14
Problems with rating scales
-bias response
--halo effects (rating positively or negatively)
--central tendency effects (rating in the middle)
-error variance
--source (different people may rate differently), setting (behavior may be different in different environments), temporal (behavior changes over time)
-recent behavior and events tend to weigh more for raters
-easier to remember unusual behavior than ordinary behavior
Merrell (2003)- Chapter 4
Interventions for internalizers
Depression: pleasant activity scheduling; social skills training; problem solving; self-monitoring
Anxiety: self-monitoring, relaxation, systematic desensitization, social skills, cognitive self-control techniques
Friedberg & McClure (2002)
interventions for externalizers
work with parents- behavior management training
-educate on ABC model of behavior, self-monitor, problem solving, time projection, social skills, empathy training, self instructional approaches (counting, self-talk, etc.)
Friedberg & McClure (2002)
Components of CBT
--Case Conceptualization (presenting problem, test data (self-reports, checklists, etc.), cultural variables, history and developmental milestones, cognitive variables, ABC data)
--Mood Check-In, homework review, agenda setting, session content, homework assignment, eliciting client feedback
Friedberg & McClure (2002)
Components of Microskills model
-Ethics, multicultural competence, wellness (consent, qualifications, etc.)
-Attending behavior (eye contact, body language, vocal tone and emphasis, verbal following)
-Basic listening skill sequence
-Interview (using basic listening sequence)'
-Confrontation (supportively challenge client- confront but support)
-Focusing (examine multiple persepctives)
-Reflection of meaning (find deeper meaning/values/direction)
-Influencing skills/strategies
-Skill integration
-Determine personal style and theory
Ivey, Ivey, & Zalaquett (2010)
Basic Listening skill sequence
-Open and closed questions
-Client observation skills
-Encouraging, paraphrasing, and summarizing
-Reflection of feeling
Ivey, Ivey, & Zalaquett (2010)
Influencing skills/strategies
-self-disclosure
-feedback (focus on strengths-things client can do something about)
-logical consequences
-information/psychoeducation
-directives (be explicit)
Ivey, Ivey, & Zalaquett (2010)
Sugai, et al (2000)
PBS: the application of positive behavioral interventions and systems to achieve socially important behavior change (behavioral science, practical interventions, social values, systems perspective)
-Behavioral RTI/PBS model:
--Primary prevention
---80-90% (students without serious problems)- universal interventions
--Secondary prevention
---5-15% (students at-risk for problem behaviors)- specialized group interventions
--Tertiary prevention
---1-7% (students with chronic/intense behavior problem)- specialized individualized intervention
Behavior Education Program (BEP)- Crone, Hawken, & Horner (2010)
-BEP addresses tier 2 of PBS (type of intervention)
-provides daily support and monitoring for at-risk students
Core Principles:
-clearly defined expectations
-social skills
-positive reinforcement
-contingent consequences for problem behavior
-positive contact with an adult in school
-opportunities for self-management
-increased home/school collaboration
*check in- check out
Scott & Eber (2003)
Argues for wrap-around services within PBS models
-elements of wrap-around services:
Community-based
Individualized, strength-based, needs driven
Culturally competent
Families as full and active partners
Team process
Balance of resources
Unconditional commitment
Collaborative process
Measurable outcomes monitored
**Research in this area is still needed*
Hawken & Horner (2003)
-study provided support for BEP (behavior education program)/ check-in check-out
-students showed decrease in problem behaviors and consistent appropriate participation in class
-BEP/check in check out works best with students who want adult attention
Rhodes, Ochoa, and Ortiz (2005)
issue about language and acculturation in psychoeducational assessment, goes into just test procedures
(1) the comparability of acculturation is crucial in determining whether a test is valid for an individual, and
(2) that acculturation differences can be based on any experiential differences, not just those attributable to culture
Hall (2001)
-there is limited evidence that either ESTs (empirically supported therapies) that have been developed with nonminority populations or CSTs (culturally sensitive therapies) are efficacious with ethnic minority clients
-It is recommended that both clinicians and researchers
modify ESTs that have been developed with nonminority populations to become CSTs
Ivey, Ivey, & Zalaquett (2010)- Multicultural practice
- awareness of your own assumptions, values, and biases
-RESPECTFUL model (helps to develop multicultural competence..like ADDRESSING framework)
-understand the worldview of the culturally different client (the way your clients see themselves and the world around them)
Gudiño (2009)
- Greater disparities in mental health service were evident for internalizing problems, with non-Hispanic White youth more likely to receive services in response to internalizing symptoms than minority youth
- Fewer disparities in rates of unmet need emerged for externalizing problems, but minority youth were more
likely to have need for externalizing problems met and African American youth were particularly likely to receive services
in response to such problems
-Findings highlight the importance of considering problem type when examining racial disparities in mental health services and underscore concerns about the responsiveness of mental health services for minority youth with internalizing disorders.
Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists--- APA (2003)
(a) knowledge of self with a cultural heritage and varying social identities
(b) knowledge of other cultures
(c) employ the constructs of multiculturalism and diversity in psychological education
(d) recognize the importance of conducting culture-centered and ethical psychological research
(e) apply culturally-appropriate skills in clinical and other applied psychological practices
(f) use organizational change processes to support culturally informed organizational (policy) development and practices
Hays (1996)
- ADRESSING framework (model for organizing the systematically considering the cultural influences that therapists need to address
(1) Age
(2) Disability
(3) Religion
(4) Ethnicity
(5) Social Status
(6) Sexual Orientation
(7) Indigenous Heritage
(8) National Origin
(9) Gender
CBT- Definition and Foundation
- aims to change clients behavior by correcting his/her faulty thinking ans expose him/her to behavioral success by teaching and reinforcing behaviors
-Cognitive= change thinking errors
-Behavior= teach adaptive behaviors
--based on social learning theory
--5 inter-related elements (environment, individuals physiology, emotional functioning, behavior, cognition)
Treatment: Ethical Considerations
-Respect for person
-Beneficience (maximize good, minimize bad)
-Justice (client should not be negatively impacted by participating in therapy)
-Informed Consent
-Confidentiality
-Self and cultural awareness
-Competence
SEL
- learn to recognize and manage emotions, care about others, make good decisions, behave ethically and responsibly, develop positive relationships, and avoid negative behaviors
--Curriculum teaches: self-awareness, social awareness, responsible decision making, self-management, and relationship management (Casel, 2003)
First CBT meeting
define roles
define problem (allow client to identify)
identify goals (allow client to identify)
Anxiety assessment must always include...
- a medical evaluation...many physical conditions might mimic anxiety
CBT with children who have ASD must be...
- more behavioral than cognitive
- use more visual aides, social stories, relaxation, teach practical skills
School-wide SEL should...
-minimize number of students who need intensive services
-help support academic success of all students
Steps for effective implementation of SEL
-gain administrative support
-find time in schedule
-consider professional training
-enlist teacher support
-invite parents/community members
Behavioral Theory
behavior is learned
-learning takes place as a result of the consequences of out behavior
Function of problem behavior
humans engage in problematic behaviors in order to get or escape/avoid a given stimuli
- occur when the environment make them relevant, efficient, and effective
Goal of manipulating the environment is to make the problem behavior ....
- irrelevant (decrease or eliminate the need to engage in the behavior)
-inefficient (provide a replacement behavior that serves the same function as the inappropriate behavior)
-ineffective (stop providing desired consequence when engaging in inappropriate behavior)
...do this by manipulating setting events, triggering antecedents, behavior, and maintaining consequences
First steps towards PBS...
-establish leadership team
-review data (needs assessment)
-analyze, describe, issue/problem
-identify how to measure it
-select evidence based practice to achieve outcome
-provide supports for implementation (training)
-monitor progress
-modify implementation as needed