Behavioral Interventions to Facilitate Growth

Motivation can be defined as a set of internal drives, needs, and interests, which create a behavior towards a particular target behavior. On the tape, the listener is asked to assess if the resident is alert enough to be aware of their behavior. Cognitive ability affects the resident's responsibility to change their behavior.Problematic behaviors are often the result of cognitive activities, such as thinking, fantasizing, imagining, or planning. Covert behaviors, such as these, are essentially inaccessible to direct observation. If your client or staff member, for example, possesses an adequate behavioral repertoire for acting on the basis of his or her thoughts, changing the cognitive response can become the primary task of a helping process. As you know, many of your clients seek assistance, but often they are motivated not so much to change, as to avoid discomfort. Here is an example of avoidance of discomfort. On the tape, to motivate a resident who is demanding a level of care higher than that provided by the facility, it is suggested staff state, "Hester, our home is only able to provide a certain level of care for its tenants. When that level of care increases beyond a certain point, you will no longer be an appropriate placement in this Assisted Living Community." Of course, client abandonment and prior notice issues also need to be addressed in such a situation.Extinction: It is sometimes necessary to eliminate undesirable behavior. One way to do this is to determine what reinforcers are maintaining the undesirable behavior. Your goal may then be to remove that reinforcer. This procedure is called extinction. Upon removal of reinforcement, the behavior often weakens and finally disappears. However, the behavior in question may initially increase before decreasing. On the tape, Joe's body odor bothered other residents, as well as being a health hazard to him. The reinforcer was staying in the facility. Staff informed Joe that his behavior may become inappropriate for the level of care provided.

(1) Give an example of extinction where the reinforcer is removed and the behavior decreases.
Time-Out: Often, socially disruptive behavior referred for therapy occurs with nonvoluntary clients. Such disruptive behavior in adults has also been treated with aversive therapy. In institutions, a time-out procedure of brief isolation is used for persistent yelling. Time-outs may also be used effectively with children.

(2) Give a brief example of a Time-Out.

Adverse procedures: Another way to reduce the frequency of unwanted behavior is to use aversive procedures. These procedures can be used in three main arrangements: escape procedures, avoidance training, and punishment.

A. In an escape procedure, the individual can turn off negative reinforcement by performing an action.

B. In an avoidance paradigm, the individual prevents the happening of a negative reinforcement by making his or her response. Both escape and avoidance arrangements lead to strengthening of the escape or strengthening of the avoidance behavior.

C. Punishment is the presentation of an aversive event or the removal of a positive event following a response. The result is a decrease in the frequency of the response. Punishment has the effect of reducing the frequency of behavior. This may happen very rapidly. This procedure is very useful when it is important to gain quick control of your client's unruly or aggressive behavior. However, it has three draw backs.

a. First, with punishment, behavior may only be temporarily suppressed. Often, when you remove the punishment, the behavior recurs. However, as you know, this can be overcome by adding a reinforcing behavior that is not compatible with the punished behavior. For example, aggressive behavior might be punished to prevent a yelling response, and cooperative, polite behavior might be reinforced as soon as it occurs. On the tape, an example of reinforcing behavior is illustrated by giving Mary encouragement and telling her to pretend she is pulling weeds as she reaches down to put the ointment on her toe.

b. The second draw back to punishment is the subject can learn an avoidance response that is just as undesirable as the behavior that was punished. For example, punishing stealing might lead to your client's learning how to hide his or her act more effectively to prevent being found out, and thus avoid punishment.

c. Third, punishment can also produce unwanted side effects. An example of unwanted side effects would be a general social withdrawal, a fear responses, and/or aggressive behavior.

(3) Give an example of a punishment.


Personal Reflection Exercise #6
The preceding section contained several Motivational techniques. Write three case study examples regarding how you might use the contents of this section of the Manual or the “Motivation” 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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