The Four-Term Contingency

The Four-Term Contingency

by John Wesenberg, M.S., BCBA, LBA

                                                                                         The Four-Term Contingency

Behavior analysis has long been known as a field studying the three-term contingency (antecedent-behavior-consequence). More specifically, behavior analysis has tended to focus on overt/ observable behavior and how idiosyncratic reinforcement schedules (i.e., fixed, ratio) and the immediacy of reinforcement impacts behavior. Skinner has written extensively about the conceptual underpinnings of private events, although, experimental analysis of covert behavior has had a difficult journey into the scientific literature. Due to this, behavior analysis has been come to be known as the field in psychology that has neglected the study of thoughts, emotions, and cognition. For this reason and a few others, behavior analysis has ultimately been pigeon-holed into a field known as “autism therapy.” For behavior analysis to persevere and account for thoughts, emotions, and cognition, they must go beyond the three-term contingency and account for contextual variables within a person’s environment.

Establishing operations (EOs) were described most specifically by Michael (1993) as environmental situations that momentarily establish or abolish the effectiveness of potential reinforcing events, people, things, etc. and discriminative stimuli that evoke behaviors most likely to gain access to those potential reinforcers. The three-term contingency, since then, has evolved into the four-term contingency (EOs-antecedent-behavior-consequence).

When a person is deprived (motivating operation) of attention, they will engage in behaviors that have been previously reinforced with attention (e.g., conversing about symptoms of distress). The evocative effect of a therapist (discriminative stimuli) has now been conditioned as a reinforcer because it is now associated with the availability of social attention. Being satiated (abolishing operation) on attention has the opposite impact on behavior. Behaviors previously associated with access to attention (e.g., conversing about symptoms of distress) will temporarily not be evoked by the same discriminative stimuli (therapist). In clinical practice, it is important for the clinician to consider what their role is in these terms with clients as they may find that they are conditioning a socially deprived person to talk about symptoms to maintain social connection – with the therapist. A therapist should keep in mind whether they are shaping skills that transfer well into the world and whether the therapeutic relationship is continuing for reasons best in the interest of the client.

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Reference

Micheal, J. (1993). Establishing operations. Behavior analysis. 16(2), 191-206.

 

Defusion, ACT and RFT

Defusion, ACT and RFT

by John Wesenberg, M.S., BCBA, LBA

                                                                                         Defusion, ACT and RFT

A core process of Acceptance and Commit Therapy (ACT) is defusion. ACT processes by nature are often confusing for behavior analysts as they are not described precisely, and often cannot be. Defusion is often described assisting client in “creating some distance”, though momentary, from their thoughts and feelings that function as ‘rules.’ Defusion is meant to help the client contact direct contingencies when relating to verbal symbolic stimuli has become more dominant. In terms of Relational Frame Theory – defusion occurs when we alter the form, function, or frequency of a stimuli such that histories of verbal relating fall away and direct contingencies are briefly contacted.

For example, a popular exercise demonstrating defusion is the ‘milk, milk, milk” exercise. In this exercise, the clinician brings up “milk” and asks participants to think about milk. The clinician may then ask if in the process of thinking about “milk” whether the client is able to in some sense contact the taste, texture, or experience of their previous history with milk. Most individuals will report that they can contact “milk” though not present in the room with them now. The clinician may then engage the client in an exercise where the word “milk” is repeated in rapid succession, out loud, for a minute. Following this exercise – the clinician may ask what the client may have noticed about their experience of “milk” during and directly after the exercise. When the exercise has functioned as intended, the client will often report that they noticed things they had not before – for example that “milk, milk, milk” said repeatedly and rapidly sounds like “quacking” or that during the exercise they briefly ‘lost’ connection with their previous ‘experience’ of the taste, feel, etc of “milk.” Thus – defusion is meant to use the properties of verbal symbolic behavior to alter briefly which contingencies the client can track.     

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Reference

Barnes-Holmes, Y., Barnes-Holmes, D., McHugh, L., & Hayes, S. C. (2004). Relational frame theory: some implications for understanding and treating human psychopathology. International Journal of Psychology and Psychological Therapy, 4, (2), 355-375).

 

Rule Governance and the use of Values to Facilitate Exposure for OCD

Rule Governance and the use of Values to Facilitate Exposure for OCD

by John Wesenberg, M.S., BCBA, LBA

Rule Governance and use of Values to Facilitate Exposure for OCD

Behavior is dynamic and influenced by many contingencies simultaneously. Relational Frame Theory (Hayes et al., 2001) is an extension of behavior analytic principles to the human ability to learn language/symbols and the affects of these over-riding behavioral repertoires on our behavior. This extension accounts for much of human psychopathology that had defied previous parsimonious behavior analytic explanations.

“Values” are verbal constructions of meaningful directions for our lives. For example, a person may value “being a warm father.” This is by nature something that can never be “completed” but we can also always act in accordance with this statement. Orienting to values can serve as a motivating augmental. That is, the stimulus functions of a particular stimulus may be augmented to make them more or less salient.  For example, changing a diaper may for most be a rather aversive experience but for the father who holds the value of “being a warm father” and brings this to the experience of changing diapers – diaper changing may be transformed to almost an enjoyable task!

Within the clinical context, treatment of Obsessive Compulsive Disorder may be facilitated through presenting stimuli that remind the individual of their values at key points during exposures. For example, an individual who engages in excessive washing/ cleaning compulsions due to contamination concerns may be ‘stuck’ in a loop of avoiding an aversive experience in the short term through compulsions (e.g., excessive bathing and grooming). If this individual values “being a warm father” as described above – this may be used to help facilitate new flexibility in his behavioral repertoire in the presence of normally aversive and avoided “contamination.” For example, in treatment the father may be asked to engage in exposures that involve changing mock or real diapers. The client may normally rate this as a “7” on a scale from “[not anxiety provoking at all] 0 to 10 [extremely anxiety provoking]” normally. The clinician can present the task in the context of conversation that prompts the client to attend to their values, for example “John, I know that you value being a warm father. Does loving your child and caring for them warmly mean that you will care for their basic needs?” “Can you bring your love for your child into this moment to help you move towards what matters most?” [Note: All examples are by nature topographical and function of these statements must be assessed and applied ideographically, rather than topographically.] If these statements function as a motivative augmental for the client – the client may report that their starting anxiety rating lowered, “I know that I said this was a ‘7’, but now it feels like a ‘5’ when I think of my son.” Additionally, you may see that the client is more willing to approach, maintain contact, or resist compulsions – as the aversive functions of ‘contamination’ are augmented to a more workable range for the client.

Sign up for our mailing list or check out our continuing education if you’d like to learn more about clinical behavior analysis or rule-governed behavior!

 

Reference

Barnes-Holmes, Y., Barnes-Holmes, D., McHugh, L., & Hayes, S. C. (2004). Relational frame theory: some implications for understanding and treating human psychopathology. International Journal of Psychology and Psychological Therapy, 4, (2), 355-375).

Hayes, C. S., Barnes-Holmes, D., & Roche, B. (2001). Relational Frame Theory: A Post- Skinnerian Account of Human Language and Cognition. New York, NY: Kluwer Academic/ Plenum Publishers

 

Function of Instructions in a Therapeutic context

Function of Instructions in a Therapeutic context

by John Wesenberg, M.S, BCBA, LBA.

The Function of Instructions in the Therapeutic Context

Instructions, both explicit and implicit, are important to providing the best care to an individual in the therapeutic context. The difficulty is determining the interlocking contingencies needing to be shaped and strengthened in a package treatment. For this analysis, exposure and response prevention (ERP) for individual’s diagnosed with obsessive-compulsive disorder (OCD) will be the exemplar of how and when to use instructions in clinical care. Detailed, explicit instructions and feedback are important to a client in clinical care for the following reasons:

  1. Therapeutic stimuli such as exposure assignments, practice and interoceptive forms, help with fluency and maintenance of expectations for a longer, and more consistent performance. These stimuli, when arranged and taught correctly, are easily accessible, readable, understandable, and sustained in the individual’s life in and out of treatment.
  2. Instructions and feedback can be communicated in clear contingencies of reinforcement to promote behavior momentum and consistency in responding. If… then… or first… then… statements indicate when to engage in activities that maintain responding. These contingencies are strengthened by incorporating values and personal preferences. Establishing operations (abolishing and motivating effects of stimuli) are accounted for and manipulated by communicating in clear and specific rules.
  3. Direct rules will create long-lasting maintenance of buy-in and momentum for responding correctly to stimuli that evoke fears. When the patient understands the contingencies that create the tools that allow them to respond differently to fear-evoking stimuli, there is a higher probability of effective maintenance and generalization.
  4. Rules can be used as augmentals, in that rules may serve to alter the reinforcing value or punishing value of consequences. Augmentals act as an establishing operation for increases in intensity or magnitude of an exposure or new stimulus class. For example, a therapist may say to a client, “If you are able to look at another person and respond with a one word answer when that person initiates a question 80% of opportunities for a week, you are able to play the Nintendo Switch at the end of the week,” will probably result in the client seeking feedback on their responses to others, which was previously a neutral stimulus, and attempting to meet the criterion.

Now, let’s specifically look at how indirect, implicit instructions and metaphorical feedback are important to effective clinical care.

  1. Metaphors and indirect instructions allow an individual to derive flexible instructions from mapping of contingencies onto previous experiences. This prevents client’s from over-following non-functional rules rather than responding appropriately to their context and contingencies as they occur. Therapists must always be aware that they are typically perceiving a client partially through their own verbal report and possibly biased rule-governed perceptions of themselves, others, and the world. Providing direct rules can dysfunction when therapists provide instruction based on how they believe behavior functions in contexts that they cannot directly observe and manipulate. Therapists must be mindful that providing metaphorical rules can assist a client in responding and learning effectively from contingencies as they occur; rather than responding by following what the therapist ‘says’ the client learns to track their environment better.
  2. Metaphors increase the variability of how an individual responds to stimuli. Variability in responding increases the possibility for accessing new contingencies of reinforcement when responding to stimuli in the natural environment.
  3. Metaphors are also most effective in reflecting complex instructions that require that the client begin to track the functions of their own behavior in context. For example, in explaining how exposures work to provide opportunities for learning, a therapist may let the client know that exposure therapy is ‘more like learning to ride a bike’ than attending ‘talk therapy’ – that the therapist’s role is much like ‘getting the client on the bike repeatedly and instructing on how best to improve performance.’ Further, the therapist may state that much like learning a bike – verbal instructions alone will not effectively produce the complex behavioral repertoire of sensing one’s weight shifting in motion and continuously correcting one’s behavior in reaction to felt positive and negative consequences.
  4. Metaphorical feedback evoke a context for an endless opportunity of possibilities. This is exciting to an individual because of the behavioral cusps they are currently contacting and could be contacting in the future.

Reference

Houmanfar, R., Rodrigues, J., & Smith, G., S. (2009). Role of communication networks in behavioral

systems analysis. Journal of organizational behavior management, 29, 257-275, DOI:                          10.1080/016086093092102

 

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