Behavior - Outcome-Informed Evidence

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Behavioral Observation
Behavior
“You can observe a lot by just watching.”
Yogi Berra
Behavior
 What people do
 How people move and what they say, think, and
feel
 Not what people have (e.g., depression,
anxiety, self-esteem)
Overt Behavior
 Can be observed by others, at least
theoretically

e.g., binge eating; bullying; illegal drug use;
spousal abuse; time spent with child or spouse;
time spent interacting by nursing home
residents number of completed Tx tasks;
number of times a parent compliments his or
her child
Covert Behavior
 Occurs within the individual and can not be
observed directly by others

e.g., positive, self-deprecating, or irrational
thoughts; time spent feeling anxious, under
stress, or overwhelmed; time spent craving
alcohol or drugs; time spent ruminating about
some concern
Direct Observation
Observation of overt behavior by outside
observers
Self-Monitoring
Systematic observation and recording by a
person of his or her behavior or other
experiences, either covert or overt
 Thought records and similar forms that you can
download and use in your practice:
http://www.getselfhelp.co.uk/freedownloads2.htm
Ideal Characteristics of
Behavioral Observation
 Conducted in real-time
 Conducted in the natural environment
 Conducted repeatedly over time
Purposes
 Pinpoint and define behaviors targeted for
intervention
 Explore and clarify the dynamic contexts in
which targeted behaviors occur
 Measure and monitor client progress
Decide What Dimension of
Behavior to Measure
 Counts (frequency)
 Number of times a behavior occurs, usually
within some time period (e.g., hour, day),
ignoring the duration of
the behavior
 Duration
 Length of time a behavior occurs
Counts
 Used when the number of times a behavior
occurs needs to be increased or decreased
 Behavior must have a clear beginning and
ending, and different occurrences must
last about the same duration
Count
Count
Rate
 Count per unit of time
 Rate used if observation times differ
 count / time
Duration
 Used when the time a behavior occurs
needs to be increased or decreased
 Behavior must have a clear beginning and
ending
Duration
Duration
Rate
 Duration per unit of time
 Rate used if observation times differ
 duration / time
Additional Dimensions of Behavior
 Response latency
 Time it takes for a behavior to occur in relation
to the occurrence of some stimulus
 Interresponse time
 Time between occurrence of two instances of
the same response
 Magnitude
 Strength, intensity, or force of a behavior
Behavior Products
 Effects or results of behaviors
 e.g., urine toxicology analysis for drugs;
completed school assignments; number of child
safety risks in a home
Decide Whether to Collect
Contextual Information
 Clarify environmental conditions that cause
or maintain behavior
 Develop interventions based on
environmental conditions that cause or
maintain behavior
Decide When and Where to
Observe Behavior
 Samples used when not practical or
efficient to observe continuously
 Samples provide estimates of the
frequency, duration, or other dimensions of
a behavior
 Accuracy of estimates depends on how
similar the sampled observations are to
observations made at other times and in
different circumstances
Time Samples
 Behavior observed during selected fixed or
random times believed to be
representative of the behavior
 Typically involves recording all instances of
a behavior, but only for selected periods of
time
 Useful when behavior occurs at a high
frequency, or observer only available at
limited times
 Samples can be fixed or random, but
should be consistent over time
Situation Samples
 Typically involves recording all instances of
a behavior, but only in selected situations
 Useful when behavior only occurs in a
limited number of situations
 Selected situations should be consistent
over time
Analog Situations
 Contrived situations designed to elicit
representative samples of behaviors



Paper-and-pencil
Role-play
Enactment
Paper-and-Pencil Analog
Client asked to respond orally or in writing to
a situation presented in written form
Role-Play
Client asked to visualize a situation in the
natural environment and his or her response
to it, or to act out situations with the
practitioner or others (e.g., in group therapy)
role-playing relevant people
Enactment Analog
Client interacts in the agency or clinical
setting with people he or she has difficulty
interacting with in the natural environment
Instruments for Recording
Behavior
 Keep it simple, unobtrusive, likely to be
used

e.g., golf score counters, pedometers, small
notebooks or cards, stopwatch
 Google “behavioral observation” and
“smartphone” to see what’s new
Ensure Accurate Observations
 Define target behaviors clearly and
specifically
 Select representative times and situations
if samples are used
 Record behavior immediately after its
occurrence
 Train and retrain observers
Ensure Accurate Observations
(cont’d)
 Monitor observers
 Make observers as inconspicuous as
possible to minimize reactivity
 Don’t inform relevant others or
independent observers of expected
changes in clients’ behavior, if possible
Verifying Reliability
Check interobserver reliability, if possible
and practical
Child’s Problems Rated by Mother
and Father
Reliability
 Counts
 smaller count / larger count
 Duration
 smaller duration / larger duration
Verifying Validity
 Compare observations to a standard
(criterion validity)
 Compare observations to other
measured variables, if predicted
relationships
Marital Conflict and Depression
Minimizing Reactivity in Direct
Observation
 Observers should be as unobtrusive as
possible
 Observers’ presence should be explained to
those being observed in simple, matter-offact language
 Observers should follow all formal and
informal rules of the observational setting
Minimizing Reactivity in Direct
Observation (cont’d)
 Observers should enter the setting during
the least disruptive time, such as before,
rather than during, a session
 Observers should spend time in the setting
before data collection, so that everyone is
accustomed to their presence
Set Goals and Objectives
 Relatively straightforward:
 e.g., eliminating self-injurious thoughts and
behaviors; smoking; enuresis; panic attacks;
binge eating or purging; bullying, migraine
headaches, truancy; theft; spousal abuse,
sexual abuse, animal abuse, or other forms of
violence; illegal drug use; binge drinking or
other forms of excessive alcohol consumption;
or driving while intoxicated
Set Goals and Objectives (cont’d)
 Matter of degree and need to be more
individualized:

e.g., time spent sleeping; exercising; reading or
talking with children; doing homework or
studying; interacting with family or friends;
feeling anxious, under stress, or overwhelmed;
or ruminating about some concern
Set Goals and Objectives (cont’d)
 Products of behavior change:
 e.g., maintaining a healthy blood glucose level or
blood pressure, avoiding psychiatric
hospitalization, losing or gaining weight, getting
good grades, having more friends, or getting a
full-time job
Advantages of Behavioral
Observation
 Sensitive measure of change
 Avoids recall biases associated with
retrospective reports
 Useful for measuring outcomes with young
children and others with limited verbal
ability
 Less subject to rater biases
Precautions in Using Behavioral
Observation
 Observer’s presence may produce an
unrepresentative sample of behavior
 Sometimes difficult to observe in the
natural environment
 Observation in the natural environment
may be costly and impractical
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