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Behavioral Interventions to Facilitate Growth
Geriatric Long-Term Care continuing education addiction counselor CEUs

Module #1
Course Manual
Positive Reinforcement

Questions 1-3 found on this page
CE Test | Table of Contents
| Geriatric & Aging
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

An event is a positive reinforcer if a behavior or stimuli increases the probability of an action occurring. Many events can positively reinforce behavior. However, it is important to remember what is positively reinforcing for on person, may not be for another. Food, water, and warmth can all be positive reinforcers. Social attention, praise, grades, weight loss, weight gain, a smile, and money can also serve as positive reinforcers. Also, anything that a client or staff member engages in with any regularity can be used as a positive reinforcer, such as sugary foods, caffeine drinks, cigarettes, treats of various kinds, and so on.

Positive reinforcement procedure: There are usually four steps in the therapeutic application of positive reinforcement.

A. First an agreement with your client or staff member regarding the behavior to be developed needs to be precisely defined. Thus, changes in frequency of occurrence can be easily monitored. There should also be some way to observe or have reported whether or not measurable changes are taking place in the direction of the target behavior. This should be an ongoing measure, not one that happens at the end of a therapy or a staff member's evaluation.

(1) Write an example of a target behavior you might have for a client or for a staff member. For example "to show up on time (not after 8:00 a.m.) for work for four weeks."

B. Secondly, construct positive reinforcers. For example, in the case of hospitalized psychiatric patient's cigarettes, access to recreation, the opportunity to leave facility, and so on have been used. In the case of outpatients, praise from the therapist and patient arranged contingencies have been employed. An example of a contingency would be, "the patient may go bowling only if a certain behavior occurs at a certain frequency that week." On the tape, the "P" in the P-R-I-D-E Method stands for recognizing actions that the receiver of the reinforcement sees as worthy of praise. The "D" in the P-R-I-D-E Method stands for stating specifically what is being done right.

(2) Give an example of a contingency you might use with the target behavior you stated above in question #1. For example, "increase the employee's promptness evaluation rating, from "below average" to "average" for being on time for three months."

C. The third step is to arrange conditions encouraging the behavior to be strengthened. On the tape, the "E" in the P-R-I-D-E Method stands for expressing reinforcement often. The arrangement of conditions may be done, for example, by giving instructions, by demonstration, or by observation of other clients or staff members performing the behavior in question; or through a gradual shaping producer. Shaping, by means of the method of successive approximations, involve reinforcing in sequence those behaviors leading to the target behavior. Shaping and successive approximations will be covered in further detail later in this Course.

The target behaviors ideally should be ones that are likely to be maintained by the environment. This concept goes back to your first critical step of choosing of the target behavior to reinforce. As you know, however, if the client or staff member is in an environment that fails to reinforce the desirable behavior, then it may be beneficial to involve, for example, family members or other staff members in the intervention or employee counseling session.

Reinforcement Delay: Research has often shown that immediate reinforcers are more effective than delayed reinforcers. For example, infants who receive reinforcement of their vocalizations by lightly touching their stomach, smiling and saying, "That's a good baby," had more vocalizations. On the tape, the "I" in the P-R-I-D-E Method stands for giving reinforcement immediately.

Negative reinforcers: Observation shows that when negative reinforcers are removed the behavior will increase. Generally, painful stimuli such as excessive heat, blows, noise, or social criticism are negative reinforcers.

(3) Give one example of an object or event that acts as a negative reinforcer for yourself. State your proof or your resulting observable behavior.
a. Example
b. Proof

D. Fourth,
once the behavior has been generated, it must be strengthened through an appropriate reinforcement schedule. This schedule will reduce the likelihood of the behavior's disappearance. After the target behavior is established, this schedule should provide reinforcement intermittently, rather than after each occurrence of the desired behavior.

"Personal Reflection" Journaling Exercises
The Goal of this Home Study Course is to create a learning experience that enhances your clinical skills. We encourage you to discuss the Personal Reflection Journaling Activities, found at the end of each Section, with your colleagues. Thus, you are provided with an opportunity for a Group Discussion experience. Case Study examples might include: family background, socio-economic status, education, occupation, social/emotional issues, legal/financial issues, death/dying/health, home management, parenting, etc. as you deem appropriate. A Case Study is to be approximately 400 words in length. However, since the content of these “Personal Reflection” Journaling Exercises is intended for your future reference, they may contain confidential information and are to be applied as a “work in progress.” You will not be required to provide us with these Journaling Activities.

“Personal Reflection” Journaling Activity #1
The preceding section contained several Positive Reinforcement techniques. Write three case study examples regarding how you might use the content of this section of the Manual or the “Positive Reinforcement” section of the audio tape in your practice. Affix extra paper for your Journaling entries to the end of this Manual.

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