Chapter 8
Putting Techniques Together to
Design a Program
Combining Techniques for a
Behavior Change Program
• treatment programs are often more effective when
they address several dimensions of a problem
• multidimensional approaches concurrently focus
treatments on different elements of antecedents,
behavior, and consequences
• problem CERs are often dealt with using both
operant and respondent procedures
Combining Techniques for a
Behavior Change Program
(continued)
• self-management programs are served well by
applying a multidimensional approach
Identifying Possible Techniques
to Use
• conduct a functional analysis
• determine whether the behavior problem is
maintained by operant control, respondent control,
or a combination of both
• determine whether the problem involves a
behavioral excess or deficit
• use brainstorming techniques to generate possible
therapy solutions
Multidimensional Programs:
Azrin's CommunityReinforcement Approach
Azrin's community-reinforcement approach to treat
alcoholism is an example of a broad, communitybased, multidimensional program
• aversion conditioning is used to suppress drinking
• reinforcement is used to maintain treatment
• relaxation training helps reduce stress
• cognitive training is used to teach how to refuse
drinks
Multidimensional Programs:
Rasing and Duker's Social
Skills Program
Rasing and Duker's multidimensional program
improved social skills of deaf children
• prompting encouraged appropriate social behavior
• verbal and modeled instruction guided behavior
• feedback and reinforcement followed behavior
Multidimensional Programs:
Dahlquist and Gil's Dental
Program
Dahlquist and Gil's multidimensional program
improved dental flossing
• prompts reminded children to floss
• self-monitoring was used to provide feedback
about behavior
• praise and tangible reinforcers were provided for
appropriate responses
What Makes a Behavior Change
Program Good?
• begin with a good functional analysis
• generate appropriate treatments for each problem
• clearly specify target behaviors and all
contingencies
• involve client as an active participant
• provide training for anyone assisting in treatment
What Makes a Behavior Change
Program Good? (continued)
• insure accuracy of data collection
• use data to provide feedback to client and anyone
assisting in treatment
• modify treatment if goals are not being met
• introduce procedures to insure generalization
• maximize client commitment to the program
Deciding Which
Techniques to Use
• choose procedures that are most effective for the
problem addressed
• evaluate the practicality (or cost per benefit) of the
treatment
• use aversive control procedures as a last resort
• scrutinize ethics of treatment procedures
• evaluate drawbacks of procedures
Motivational Factors to Consider
• those who are more motivated to change tend to
be more successful in changing
• evaluate motivation using the Scale of Motivation
to Change Behavior
• seek methods to enhance motivation to change
Readiness to Change
stages of change model suggests five levels of
motivation for change:
• precontemplation involves minimal
consideration of change
• contemplation involves some thought about a
problem and the possibility of change but no
commitment to immediate change
• preparation involves a more concrete
commitment
Readiness to Change (continued)
• action involves active pursuit of the change
• maintenance involves activities to sustain change
Enhancing Motivation:
Realistic Expectations
• one should have realistic expectations about
treatment procedures, goals, and what it will take
to succeed
• understand that lapses are possible but that they
can be overcome
• develop and apply methods that can be used to
resist temptation
• establish rule-release procedures early on to allow
occasional planned outs
Enhancing Motivation:
Sense of Commitment
one must have a sense of commitment to change
• develop both written and verbal commitment
statements
• list long- and short-term advantages and
disadvantages of change
• invest significant time or money into the change
program
Enhancing Motivation:
Social Support
social support can increase motivation and
commitment
• encourage pairs or groups with similar behavior
problems to work together
• provide a consultant
Behavioral Contracts
behavioral contracts are agreements that clearly
specify target behaviors, monitoring procedures,
goals, and treatment procedures
• contracts should be signed by the person who will
change and by a mediator
• loopholes should be anticipated
• rule-release procedures should be clearly defined
Behavioral Contracts (continued)
• contracts should be negotiated, not imposed
• responsibilities of all parties should be negotiated
and made clear
Tips on Designing a Program
• techniques should address behavior, antecedents,
and consequences
• develop separate programs for each target
behavior
• use at least six but usually no more than ten
intervention techniques
• confirm the accuracy of data, preferably by having
an independent observer
Tips on Designing a Program
(continued)
• early on, immediately reinforce every instance of
behavior
• vary consequences to maintain strength
• reinforce self-management exercises
• make programs cost-effective
• identify responsibilities of all involved and
conduct periodic review