1. Clinical Psychology Spring 2015 Kyle Stephenson

2. Overview – Day 7 Behavioral Assessment ▫Theory ▫Controlled observation/performance ▫Self-monitoring The clinical report ▫Content & samples

3. Concepts in behavioral assessment Sign ▫Inference about performance or response ▫Symbolic of other characteristics Sample ▫Identify characteristics of interest ▫Assume these traits carry over to non-test situation

4. Concepts in behavioral assessment Functional analysis ▫B.F. Skinner  Precise analysis of stimuli that precede behavior and consequences that follow  Learned behaviors  Influence of consequence  Precise description  Antecedent conditions  Consequent events  Can use this knowledge to understand motive and alter behavior

5. Concepts in behavioral assessment SORC method: a model for conceptualizing clinical problems from a behavioral perspective ▫Stimulus to behavior ▫Organismic variables ▫Response or problem ▫Consequence

6. Overview – Day 7 Behavioral Assessment ▫Theory ▫Controlled observation/performance ▫Self-monitoring The clinical report ▫Content & samples

7. Observational Method #1 Controlled observation ▫Clinical or natural settings ▫Environment is “designed” ▫Trigger specific behaviors so they can be observed ▫Situational testing

8. Example: Interaction Behavior Code

9. Observational Method #2 Controlled performance technique ▫Contrived situations that allow for control & standardization ▫Behavioral avoidance assessment  Series of tasks requiring increasingly threatening interactions  Fear arousal assessed in addition to behavior ▫Influence of researcher can be an issue (internal vs. external validity)

10. ExerciseSymptomsAnxiety (1-10)Similarity (1- 10) Run in placeHeart rate increase 22 SpinningDizzy99* OverbreathingShort of breath89* Straw-breathingSome shortness of breath 52 Stare @ self/spotUnreal1010* Lift head quicklyNothing much10 Tense bodyTingling, hot flash75 Other Interoceptive assessment

11. Overview – Day 7 Behavioral Assessment ▫Theory ▫Controlled observation/performance ▫Self-monitoring The clinical report ▫Content & samples

12. Observational Method #3 Self monitoring ▫Records of emotion, thought, behavior ▫Frequency, duration, intensity ▫Shows stimulus & triggers ▫Dysfunctional Thought Record: a compilation of the patient’s automatic thoughts ▫Can be inaccuracies in self-reports

13. Panic Attack Record Date: ______________________ Time began: ___________ Time ended: ___________ Triggers: ________________________________________________________________ ____Expected____Unexpected Maximum fear: 0---------1---------2---------3---------4---------5---------6---------7---------8 None Mild Moderate Strong Extreme Check all symptoms present to at least a mild degree: ___ Pounding heart___ Sweating ___ Hot/cold flush ___ Tight/pain in chest___ Choking___ Fear of dying ___ Shortness of breath___ Nausea/Diarrhea___ Fear going crazy ___ Dizzy___ Unreality___ Fear of losing control ___Trembling___ Numbing/tingling___ Other:_____________

14. Physiological Component Behavioral Component Cognitive Component The physical symptoms I experienced were…. Heart beat fast My hands shook Got sweaty The way I acted or things I did that were observable to others were…(Also indicate whether you escaped from situation or avoided it) The laser pointer was shaking in my hand My voice was shaky I didn’t come back on Tue for rest of training The thoughts I had were…. I am blowing this training My colleagues are bored stiff They can tell how nervous I am

15. Other Behavior Assessment Techniques Role-playing ▫A technique in which patients are directed to respond the way they would typically respond if they were in a given situation Inventories and checklists ▫Self-report techniques ▫Identify behaviors, emotional responses, and perceptions of environment

16. Overview – Day 7 Behavioral Assessment ▫Theory ▫Controlled observation/performance ▫Self-monitoring The clinical report ▫Content & samples

17. The Clinical Report Referral source: address the referral question! Aids to communication ▫Language ▫Individualize reports ▫Level of detail  Cite items and observations

18. Sample Psychological Report

19. Sample reports Therapy intake report Court-ordered report Neuropsychological report

20. Take-Home Behavioral assessment is typically the most time- intensive method, but often provides the best information regarding real-world problems of clients There are many types of clinical reports, but all share the goal of answering the referral question, providing appropriate context, and giving recommendations