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RUNNING HEAD: Practical Psychology

PRACTICAL PSYCHOLOGY WITH EVERYDAY CASES

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Often times, a clinical psychologist is called in to assist people grappling with serious emotional or behavioral issues. This professional is trained in the mitigation and treatment of various conditions, including the two mentioned in the following cases. The psychologist works with the patient or their guardian to improve the situation in which they find themselves. They identify the concerns as well as the target behaviors that need to be modified using a combination of different counseling and modification techniques.

1. Briefly recap the case, discussing your observations and clearly identifying a research question.

Six-year-old Emily has been experiencing significant emotional problems at home and in school. Her issues have lead to severe tantrums in the classroom, and she has lost interest in activities that she presumably used to enjoy. Her grades have begun to suffer, and one teacher has commented on her lack of desire to participate in classroom activities. Furthermore, these concerns have boiled over to her home life and she consistently experiences separation anxiety from her parents and demands to be let sleep in bed with them. As may be imagined, Emily’s parents are quite tired and frustrated with Emily’s behavior, and are seeking help developing a behavior modification program so that Emily will return to her own bed and both she and her parents get adequate and restful sleep.
After a thorough review of Emily’s case, I have several concerns that I feel need to be addressed. For one, I am concerned about Emily’s lack of regular sleeping habits; this could be contributing to her poor school behavior and unhappy mood. What’s more, I worry about Emily’s apparent feelings of separation anxiety from her parents. In addition, I think that a general anxiety disorder or depression may be causing these negative emotions. Lastly, I would like to rule out any organic causes for these symptoms, such as vision or hearing difficulties as well as an evaluation of her situation with friends and teachers at school. At the moment, my diagnostic hypothesis is separation anxiety coupled with permissive parenting.

2. Define and discuss the target behavior(s), providing background information regarding why it's important to address the behavior.

Emily is exhibiting obvious behavior problems at school and at home. She is throwing tantrums and refuses to sleep in her own bed at night. In some children, however, fears about separation seem to only intensify as time passes, or to resurface as a new situation. If anxieties are persistent and excessive enough to get interfere with school or other activities, it is possible that the child has separation anxiety disorder. Unlike normal separation anxiety, this condition may require the support of a professional—but there is also a lot that parents can do to mitigate the disorder.

Furthermore, separation anxiety is a normal stage of growing up, and it usually resolves on its own. However, what Emily appears to be experiencing is a bit more than simple separation anxiety, and may be more serious, such as separation anxiety disorder. This condition may become too overwhelming for the child to manage her own problems and may lead to more severe emotional issues down the road (ABA, 2011).

Target behavior:

6-year-old child is having difficulty with separation anxiety disorder that is causing disruption in her home and school lives. This information is relayed to the psychologist by her parents. The child and her parents should note an improvement within two months’ time.
3. Discuss which inadvertent reinforcement strategy may have contributed to Emily's school refusal and why.

Clearly, I believe that Emily’s parents have inadvertently reinforced the bad behavior of sleeping outside her own bed by letting her sleep with them at night. This is causing significant distress for both Emily as well as her parents and may only get worse with time. Emily now feels that it is acceptable to sleep with her parents and refuses to fall asleep in her own bed. This activity will only make the separation anxiety symptoms worse in the end, and Emily will not be willing to try her own bed at night.

4. Formulate a hypothesis regarding what intervention will result in a specific level and direction of desired change in the target behavior.

Obviously, the goal of therapy is to get Emily sleeping in her own bed once again. If this may be accomplished, the other issues Emily is experienced may go away on their own. Even if they do not, this is the key first step in this situation for Emily and her parents. The specific end point is to work up to Emily being comfortable to sleep in her own bed, and of her own free will. This may be difficult for her parents to manage at first, but must be started at the home. Emily may feel more open to this new behavior if her parents sit down and just talk with Emily about what her fears may be or what could be causing the issues at school and at home. Many children feel isolated when they experience these unfamiliar emotions, and the simple act of listening to her may help Emily feel more confident and safer.
5. Choose an effective modification program to test the hypothesis for your hypothetical experiment - such as a token economy, lottery, or positive reinforcement - and discuss how you would implement your program and the rationale for your choice, based upon current scientific literature.

Emily’s parents have expressed their desire to limit the use of medication for Emily’s problem. Fortunately, psychotherapy is the main treatment approach for separation anxiety disorder. The focus of therapy is to help the child tolerate being separated from the caregiver without the separation causing distress or interfering with normal activities or functions. A type of therapy called cognitive-behavioral therapy works to change the way Emily thinks about the condition and alter her behavior so that her behavior ultimately becomes more appropriate. Family therapy also may help teach the family about the disorder and help family members better support the child during periods of anxiety.

Positive reinforcement has shown reasonably good success with separation anxiety as well. Emily’s parents may help her develop positive expectations for an upcoming event or period away from home by writing them down before the event takes place. Furthermore, a nurturing attitude from the parents and expressed to Emily will help her feel more confident about leaving them for the day.

6. Make explicit how the proposed behavior plan will be monitored and outcomes analyzed, drawing clear conclusions.

The key actors in this intervention will be Emily’s parents as well as Emily herself. I would like to see the family again after a period of three weeks to evaluate the behavior modification strategy. My hope is to monitor the amount of times the family reports that Emily is sleeping in her own bed, with a decreasing goal for each week. In other words, she may be allowed 5 times out of bed the first week, followed by four times the next week, and so on, until she is sleeping in her own bed every night.

There may very well be backtracking in behavior over time, and so the parents need to be prepared for this to happen. Her parents should reassure Emily that she only experienced a set back and that she will try again the next night. The modification plan should not change or be altered in any way. I also want to get reports from Emily herself how she feels she is doing with the new plan, and what her experiences at school have been like.
7. Clearly communicate anticipated results, addressing any potential issues of response maintenance, response transfer and/or extinction.

I trust that following this plan will have significant impact on the entire family’s lives. If Emily refuses to participate in the plan, I would recommend a period of negative reinforcement or punishment, used judiciously, to discourage the behavior. Things like not being able to participate in fun or anticipated activities while she refuses to follow the plan should suffice. Emily’s parents may also use this technique for any time when Emily may revert to her old behavior.
8. How has the scientific method guided this experiment?

The scientific method is a way to state a hypothesis and then develop an experiment with which to test that hypothesis. There should be measurable goals and expected outcomes as well as ways to handle if the expected outcomes are not what were expected. All of these have been done here for Emily and her family, and I trust that this experiment will work beautifully for them.

1. Briefly recap the case, discussing your observations and clearly identifying a research question.

Mr. Smith is having trouble with his employees at a loc al manufacturing plant that makes ice skates. Specifically, Mr. Smith is having trouble with a very high rate of absenteeism among his workers. He has tried being kind to them and providing donuts, but that has not been effective. Furthermore, Mr. Smith has tried reasoning with his employees by utilizing the fear technique of explaining that the factory may have to close down secondary to the high rate of worker absenteeism. That also did not work as hoped, and Mr. Smith is getting quite frustrated.

2. Define and discuss the target behavior(s), providing background information regarding why it's important to address the behavior.

Unfortunately, many of Mr. Smith’s workers have been calling out of work, leaving him seriously short staffed. Mr. Smith is afraid he will have to close his plant if he is unable to encourage his employees to show up for work regularly, and to take an active interest in their jobs. Despite two attempts to try to cajole his staff to begin showing up for work, absenteeism is still unacceptably high. Mr. Smith must address this behavior or risk going out of business.

Target behaviors:

Mr. Smith is having problems with frequent absenteeism by his employees at his firm. Smith has been advised that he should try a behavioral modification program with the staff, including a token economy to award his workers if they follow it. Results should be expected within two months.

3. Speculate as to why Mr. Smith's previous interventions may not have been successful.

I believe that Mr. Smith’s earlier attempts have not worked because he is simply approaching the problem in the wrong way. For instance, providing sugary snacks to his workers likely did not succeed because this does not address the reason why many of his workers are calling out so often. There is no plan in place to consider worker grievances or to give them a forum to discuss inappropriate working conditions.

Mr. Smith’s second attempt was just as bad as his first, but for a different reason. He tried to appeal to his employees’ sense of loyalty and threatened that the firm may have to close, costing all of them their jobs. Fear and intimidation are never reasonable plans for trying to goad others in to doing anything. As was seen here, it will likely backfire.

4. Formulate a hypothesis regarding what intervention will result in a specific level and direction of desired change in the target behavior.

Mr. Smith’s employees do not feel empowered at their jobs. I addition, there is no sense of loyalty or pride among the workers at this firm. Mr. Smith should try a more balanced approach to allow his employees to feel they are contributing more significantly at the job. Smith could implement a reward system for meeting certain quotas, such as a number of days without an absence to earn a half or full day added to their vacation time for the upcoming year. This way the team will feel empowered to work together to achieve the goal as a team and not as individuals. A work sponsored athletic event may also help. A softball or soccer league will help the workers feel more camaraderie, but also encourage them to be active on and off the job.
5. Choose an effective modification program to test your hypothesis for your hypothetical experiment - such as a token economy, lottery, or positive reinforcement - and discuss how you would implement your program and the rationale for your choice, based upon current scientific literature.
Mr. Smith definitely needs to address the absenteeism issue at his business, or risk losing his firm altogether. A token economy is a great way to get started, and includes a system of behavior modification based on the systematic positive reinforcement of target behavior. The reinforcers are tokens that can be cashed in for other reinforcers or awards, as mentioned above. Employees may be encouraged to work in small groups or teams based on their function at the plant and try to outdo one another in friendly competition. Obviously the goal is to limit the overt absenteeism this plant has been experiencing, and it can be easily measured and recorded to help support each other coming in to work regularly.

Clearly specified behavioral criteria can facilitate the learning process. A token economy helps people experience the immediate consequences of their behavior and get a grip on their life. Their social environment becomes more predictable. While planning how many tokens can be earned by each target behavior some factors have to be considered: one has to assure that everyone can already earn a minimal amount of tokens for a minimal effort, and on the other hand one has to arrange that clients don’t earn too much too soon, making more effort useless. Sometimes the possibility of punishment by token loss is included, technically called 'response cost': disruptive behavior can be fined with the loss of tokens. This also should be clearly specified before the application starts. Clients can be involved in the specifying of the work satisfaction (Kazdin, 1982).

6. Make explicit how the proposed behavior plan will be monitored and outcomes analyzed, drawing clear conclusions.

This is definitely a challenging situation, but one that can surely be addressed. As previously mentioned, employees should be monitored using a clock in and clock out scenario that let’s Mr. Smith gage the effectiveness of his campaign (Hackenberg 2009). In addition, the token system will be very helpful in keeping track of who is coming in and who is not. While it is my hope that these techniques will be successful with Mr. Smith’s firm, there must be punishments ready and available for Smith to meter out as the situation warrants. As mentioned previously, some employees who do not follow the new guidelines may lose tokens, with an ultimate loss of job if the situation does not improve with time.

The cases above highlight some of the issues that a psychologist may be helpful with. They examine the case and make recommendations for modifying behaviors to help alleviate the troubling actions. The professional develops a behavior modification plan as outlined above and elucidates the quantifiable differences in behavior to be sought. They also clarify what steps are to be taken if the goals are not reached.

References

Applied Behavior Analysis (2011) Applied Behavioral Analysis. Last accessed September 3, 2011.

Hackenberg, T. (2009) Token reinforcement: a review and analysis. Journal of the Experimental Analysis of Behavior, 2009, 91, 257-286.

Kazdin, A. (1982) The token economy: a decade later. Journal of Applied Behavior Analysis, 1982, 15, 431-445.