ABA and Therapy?

Each one of my many vague career ideas involves working to improve the lives of people with mental health problems. Whether this will involve working for a charity or training as a therapist, only time will tell…

Let’s imagine the work of a therapist or counsellor. In such an instance, I may be faced with a client suffering with Obsessive Compulsive Disorder (OCD). This particularly client has a persistent fear of contracting illness through contact with any person who has the disease or places associated with it, thus avoids visiting most public places. Perhaps I could consider the use of Applied Behavioural Analysis in an attempt to help this client. If I were to apply the ABA approach, I would begin with a behavioural assessment. This involves three stages:

1.  Defining the target behaviour – in this instance, the target behaviour is visiting public places, a behaviour which the therapist aims to increase.

      2. Identifying functional relations between the behaviour and its antecedents and consequences across episodes of the target behaviour.

     

      3.   Identifying an effective intervention for changing the target behaviour –CBT, DBT, [insert letter] BT.

This plan would be discussed and tested with the client, and observe if we can reduce or increase the frequency of the target behaviour. If I were to continue approaching this client’s treatment from an ABA perspective, I may consider the role of reinforcement when considering an intervention.

According to Thorndike’s Law of Effect (1927) the probability of a behaviour occurring is a function of the consequences that the behaviour has had in the past.  The law of effect highlights the importance of environmental consequences and role of reinforcement, i.e.  the procedure of providing consequences for a behaviour that determine the frequency of that behaviour reoccurring. In this instance, a favourable outcome should follow the act of visiting a place outside of their comfort zone and it is more likely to reoccur (positive reinforcement.)

Given the difficultly of providing a direct physical reinforcer in this scenario, covert positive reinforcement may be a preferable intervention. Covert reinforcement intends to increase behaviour by imagining a reinforcing experience in connection with it. Essentially, get the client to imagine a positive outcome from an encounter in a place they usually avoid. This approach to mental health treatment uses principles of behaviour modification base on ABA.

Bistline, Jaremko and Sobleman (1980) tested the relative contributions of two possibly active test anxiety treatment components, one of which was covert reinforcement.  The covert modeling consisted of imagining (a) the feared situations; (b) handling the stress in a coping manner; and (c) feeling good for having coped. Results showed that the covert modelling was somewhat improved anxiety scores than the cognitive restructuring group.

In light of research, ABA is unlikely to be the most effective approach to apply as a therapist in this scenario but with a little stretch of the imagination, it is certainly possible to try!

Bistline, J. L., Jaremko, M. E., & Sobleman, S. (1980). The relative contributions of covert reinforcement and cognitive restructuring to test anxiety reduction. Journal of clinical psychology, 36(3), 723-728.

Thorndike, E. L. (1927). The law of effect. The American Journal of Psychology.

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