Behavioral Analysis, Essay Example

There are many different types of behavior that requires attention for necessary modification. A big part of the solution is understanding the problem. Behavior is how a person acts in a specific situation; this is shown in what they say and what they do. Identifying the target behavior for the individual that is socially significant or meaningful is an essential part in the solution. Designing a behavior modifying procedure will also aid in the patient’s ability to essentially learn new behaviors. Behavior analysis varies from person to person, but taking the necessary steps to identify the problem, specifies the behavior, and create a plan for modification will allow the individual to change the actions that were unfavorable.

Marla, a 24-year old college graduate suffers from fear of social situations. As she has progressed in her career it is virtually impossible for her to successfully be able to avoid social situations. The target behavior that appears to be affecting Marla is social phobia. She has had ongoing issues with large groups, and this was made clear by her continual avoidance of social functions. As defined, “social phobia refers to persistent fears of situations involving social interaction or social performance or situations in where there is the potential for scrutiny by others.” (American Psychiatric Association, 1994) The fear does not seem to extend outside of social situations. Her avoidance of such gatherings is consistent with anxiety characterizations that are also connected with this disorder. Marla is afraid of social situations and the conditioned stimuli are parties or large social gatherings which she does not want any part of.

Respondent behavior is involved in the development of Marla’s anxiety problem. It is necessary to identify the CS and CR in her case. Fear consists of both a respondent behavior and an operant. Her fear or anxiety of social settings is characterized by a combination of respondent behaviors in which avoidance and escape remove unpleasant situations. The conditioned stimulus (CS) was the social setting and interacting with large groups of people. The conditioned response (CR) for Marla was complete and total avoidance. The CR was also anxiety that she would be put into a social situation without being given an option.

There is a difference between in-vivo and systematic desensitization. They have advantages and disadvantages of each procedure. Defined, “Systematic desensitization is a procedure developed by Joseph Wolpe in which the person with a phobia practices relaxation while imagining.” (Miltenberger, 2012) “In vivo desensitization is similar to systematic desensitization, except that the client gradually approaches or is gradually exposed to the actual fear-producing stimulus.” (Walker, Hedberg, Clement, & Wright, 1981) An advantage of systematic desensitization is that fear is essentially conditions; therefore by exposing to the same fear it can be unconditioned. Disadvantage would be that it may require an excessive amount of sessions because some phobias are just difficult to treat. It has been suggested that only a minimal amount of individuals actually benefited from short-term therapeutic intervention to treat such disorders.

The desensitization techniques in real life situations opposed to simulations are called in vivo desensitization. An advantage of this treatment is that Marla is exposed to the social situation in which she actually fears, and may benefit from such a treatment. On the other hand, a disadvantage is that real life (in vivo) desensitization may not benefit a chronic phobia primarily because of the time necessary to address such phobias. Similar to systematic desensitization, if long term treatment is necessary this may not be the best option for treatment.

Designing a behavior modification procedure for Marla with a rationale for the selection is important. There are also a behavior of hierarchy relaxation procedures and desensitization procedures. For Marla, she will have 30 minute training in relaxation techniques which involve relaxing and tensing muscles for several weeks duration. There will be a hierarch created that is most like the CS of social situations to least feared, being alone. Marla will be asked to explain the occasions in which her anxiety was heightened. The relaxation technique would then be implemented while she is imagining her feared stimuli during this hierarchy. Marla would first imagine a small crowd, and then the desensitization training would start. This technique will be repeated again and again till no anxiety exists. The treatment will progress from the least feared to the most feared. If at any stage the anxiety presented again, the process would revert to the previously completed stage. This is done until Marla is able to overcome her fear and advance in her future desires.

Lastly, compare specific ABA-based treatment that can be applied to assist Marla with her fear and anxiety. Marla will be eased into social setting. It will start with a few individuals, and it will be an inviting friendly setting where she can interact in a non-threatening manner. The feedback will be positive and it will encourage her to enter into another small social setting. The next step, a few more people will be added to the group repeating the same process until the anxiety subsided. The positive reinforcement will be in place until Marla is able to comfortably enter into a social setting without anxiety.

A 6-year-old boy, Jon, is normally intelligent but has a habit of pulling-hair or self-stimulatory behavior. This hair pulling takes place most often during times of inactivity like watching TV, quiet time in school, or waiting in line with his parents. Jon may have is a condition called Trichotillomania (TLM). According to the U.S. National Library of Medicine Trichotillomania is, “hair loss from repeated urges to pull or twist the hair until it breaks off. Patients are unable to stop this behavior, even as their hair becomes thinner.” (A.D.A.M. Medical Encyclopedia, 2012) The target behavior is inactivity because that seems to be what leads to the need for Jon to pull his hair.

There is behavioral excess or deficit involved with TLM. Also, there are some possible short and long-term implications of this behavior for Jon. TLM can be a single episode or it can happen excessively throughout the day depending on Jon’s daily activity. This need to pull hair out of the body is not just on the scalp, it can be eyebrows or other area of one’s body. Napolitano also found that Children with the disorder may present with a variety of co morbid conditions such as depression, anxiety-obsessive compulsive and disruptive behavior disorder. (Napolitano,1998) Jon’s behavioral excess is impulse control. He is not able to control his need to pull hair. Short-term implications can be patch spots, thinning hair, or balding areas depending on the severity of the situation. In cases where TLM takes place during the child’s early life, it maybe a habit and have a limited duration. However, in the event it is not simply a habit, there are long-term implications that have to be considered. There can be damage to the skin which exposed the flesh to potential infection. For older TLM patients, the location can change causing damage to other areas as well.

For Jon, a habit reversal procedure would include the use of differential reinforcements and identification of an appropriate competing response. In cases of TLM, one of the most effective treatments is habit reversal. The reversal techniques may be habit awareness training, self-monitoring strategies, or practice of competing motor responses. Other techniques may be habit inconvenience review and solicitation of social support. There will be a need to create a plan for Jon’s situation which includes habit awareness, responsive options, and social support. The reversal technique will be a series of drills that require Jon to move in a manner that he was going to pull his hair. This will heighten awareness to his actions and need to pull his hair. The movements will be associated with the need to pull his hair. After that is complete, there will be behavior that is not associated with the hair pulling. It will include the need to practice competing motor responses. What competing responses will do is show Jon that he has other movements to utilize outside of the ones that result in hair pulling. Jon would be sat in front of the television. Instead of giving him the option to pull his hair, he will be encouraged to reach for a book that is sitting on the table in front of him. This action will take his mind off of the need to pull his hair. This behavior will be repeated for a specified amount of time. Jon will participate in movement that simulates hair pulling, and then to the alternate movement for a specified time period. Jon’s positive behavior will rewarded or praised for his favorable behavior and will create an environment where he wants to receive the praise again.

If Jon had an intellectual disability, the habit reversal procedure would be changed to increase its effectiveness. The behavioral therapy that would be recommended in this situation is acceptance and commitment therapy (ACT). ACT suggests it is necessary to teach a person to accept their urges to pull their hair and learn to avoid the actions that coincide with the urges. An improved habit reversal treatment for TLM is ACT. ACT will create a reduction in the overall hair pulling severity. Dialectical behavior therapy DBT used in conjunction with TLM was successful as well. This emphasized the training for relapse prevention. The treatment would be to address the sensory, uncomfortable, and emotional experiences that Jon has associated with this disorder.

References:

A.D.A.M. Medical Encyclopedia. (2012) U.S. National Library of Medicine – The World’s Largest Medical Library. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002485/

American Psychiatric Association. (1994) Diagnostic and Statistical Manual of Mental Disorders (4^th ed.) Washington, DC: American Psychiatric Association.

Miltenberger, Raymond G. (2012) Behavior Modification Principles and Procedures (5^th ed.) Wadsworth, Cengage Learning.

Napolitano, Scott Adam; (1998). Trichotillomani (compulsive hair pulling) In: Health-related disorders in children and adolescents: A guidebook for understanding and educating. Phelps, LeAdelle (Ed.); Washington, DC, US: American Psychological Association.

Walker, C. E., Hedberg, A. G., Clement, P. W., & Wright, L. (1981). Clinical Procedures for Behavior Therapy. Upper Saddle River, NJ: Prentice Hall.