Clinical Behavior Therapy with Children

361 Pages·1982·10.964 MB·English

by  Thomas H. Ollendick, Jerome A. Cerny (auth.)

CLINICAL
BEHAVIOR THERAPY
WITH CHILDREN
APPLIED CLINICAL PSYCHOLOGY
Series Editors: Alan S. Bellack and Michel Hersen
Ul1iuersi~1 of Pittsburgh, Pittsburgh, Pemlsyiutlllill
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Robert P. Liberman, Eugenie G. Wheeler, Louis A.J.M. DeVisser, Julie
Kuehnel, and Timothy Kuehnel
PERFECTING SOCIAL SKILLS: A Guide to Interpersonal Behavior
Development
Richard M. Eisler and Lee W. Frederiksen
HANDBOOKOE BEHAVIOR MODIFICATION WITH THE MENTALLY
RETARDED
Edited by Johnny L Matson and John R. McCartney
THE UTILIZATION OF CLASSROOM PEERS AS BEHAVIOR CHANGE
AGENTS
Edited by Phillip S. Strain
FUTURE PERSPECTIVES IN BEHAVIOR THERAPY
Edited by Larry Michelson, Michel Hersen, and Samuel M. Turner
CLINICAL BEHAVIOR THERAPY WITH CHILDREN
Thomas Ollendick and Jerome A. Cerny
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CLINICAL
BEHAVIOR THERAPY
WITH CHILDREN
Thomas H. Ollendick
Virginia Polytechnic Institute and State University
Blacksburg, Virginia
AND
Jerome A. Cerny
Indiana State University
Terre Haute, Indiana
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Ollendick, Thomas H.
Clinical behavior therapy with children.
(Applied clinical psychology)
Includes bibliographies and index.
1. Behavior therapy. 2. Child psychotherapy. I. Cerny, Jerome A. II. Title. III. Series.
IDNLM: 1. Behavior therapy-In infancy and childhood. WS 350.6 049c)
RJ505.B4044 618.92'89142 81-17891
ISBN-13: 978-1-4684-1106-5 e-ISBN-13: 978-1-4684-1104-1 AACR2
DOl: 10.1007/978-1-4684-1104-1
© 1981 Plenum Press, New York
Softcover reprint of the hardcover 1s t edition 1981
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
To
MARY, LAURIE AND KATIE
and
JOANNE AND DEREK
PREFACE
As noted by its title, the focus of this book is centered on an examination
of behavior therapy with children in clinical settings. Throughout, our
goal has been to examine theoretical underpinnings, review empirical
research, and illustrate clinical utility for a variety of behavioral proce
dures with children. In pursuing this goal, we have described child
behavior therapy as an approach based on empirical methodology, de
rived from behavioral principles, and focused upon adjustment disor
ders of children. The hallmark of such an approach is its accountability
the extent to which the procedures and techniques presented in this
text are demonstrably accountable must be determined at least partially
by the reader.
As students of child behavior, we have become sensitized to two
trends in behavior therapy with children during the preparation of this
book. First, we have been concerned with the simple application of
behavioral procedures to children, irrespective of developmental con
siderations. All too frequently, assessment strategies and treatment pro
cedures found to be useful with adults have been applied to children
in an indiscriminate fashion. For example, some recent studies have
examined and assessed the very same social skill deficits in children as
in adults (e.g., lack of eye contact, delayed latency of response, and
absence of positive commendatory responses). Surely, skill deficits differ
from age to age just as they differ from situation to situation. Similarly,
other recent studies have reported use of self-instructional training and
cue-controlled relaxation procedures with 2- to 4-year-old children. It
seems highly improbable that these procedures are developmentally
appropriate for such children. While the resolution of this concern must
rest on empirical grounds, rather than developmental speculations such
as those presented here, we caution against the indiscriminate use of
procedures which appear to ignore developmental aspects of the child.
vii
viii PREFACE
Throughout our text, we acknowledge such developmental features and
attempt to examine various procedures with these developmental char
acteristics in mind.
Second, we have been concerned about the growing inclination to
view behavior therapy as apart from, or divorced from, psychology in
general. In our opinion, this trend has oftentimes resulted in myopic
vision and simplistic and naIve "solutions" to complex clinical problems.
We have become acutely aware of the limitations of our current pro
cedures and our behavioral principles for understanding and predicting
child behavior. We suggest that a partial resolution to this concern might
be found in other areas of psychology, most notably developmental,
clinical, and social psychology. By expanding our behavioral horizon,
we might be better able to account for complexities in child behavior
and, at the same time, better determine the scope and limitations of our
procedures.
Lest the above comments be misconstrued, we wish to restate that
we embrace the principles and procedures of behavior therapy. Clearly,
procedures derived from these principles are the most empirically based
and accountable procedures available to us. We do, however, wish to
suggest a "functional analysis" of our current status so that behavior
therapy with children can continue to prosper. It is our expectation that
the present text will serve as a meaningful step toward the continuance
of this growth.
In a project such as this, many persons are to be thanked. Among
them are our mentors from graduate school who served as role models
and who, in most instances, reinforced us for our budding efforts. Sub
sequently, a number of colleagues and students from Indiana State
University, the University of Pittsburgh, and Virginia Polytechnic In
stitute and State University were instrumental in helping us focus our
efforts and in reviewing various chapters of the project. To them, we
extend our appreciation and thanks. Gratitude is also extended to several
secretaries at these universities who typed and re-typed various chapters
and to the many children who, perhaps unknowingly, contributed to
the germination and fruition of this project. Finally, our foremost thanks
and sentiments are extended to our own children and to our spouses
who supported, encouraged, and reinforced us throughout this project.
To them, we dedicate this book.
THOMAS H. OLLENDICK
JEROME A. CERNY
CONTENTS
Chapter 1. Foundations of Behavior Therapy ................ 1
Introduction ................................................. 1
Assumptions in Behavior Therapy................... 3
Determinants of Behavior .............................. 6
Behavior Therapy Models .............................. 10
The Classical Conditioning Model ............. 12
The Instrumental Conditioning Model ....... 13
The Operant Conditioning Model ............. 15
The Drive Reduction Models .................... 17
The Two-Factor Model of Learning ............ 19
Social Learning Theory ............................ 20
Summary ..................................................... 23
Chapter 2. Behavioral Assessment ............................. 25
Introduction ................................................. 25
Behavioral Interviews .................................... 30
Checklists and Rating Forms .......................... 35
Traditional Standardized Instruments .............. 40
Other Instruments ........................................ 47
Behavioral Observation .................................. 48
Summary ..................................................... 55
Chapter 3. Systematic Desensitization, Implosion, and
Flooding .......................................... 57
ix
x CONTENTS
Introduction ................................................. 57
Systematic Desensitization ............................. 58
Background ........................................... 58
Clinical Application ................................. 60
Clinical Application with Young Children .. 66
Implosive Therapy and Flooding ..................... 76
Background ........................................... 76
Clinical Application................................. 77
Summary ..................................................... 82
Chapter 4. Modeling and Social Skills Training .... ........ 84
Introduction ................................................. 84
Modeling ..................................................... 85
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 85
Clinical Application: Fears and Phobias ...... 88
Clinical Application: Social Withdrawal ...... 94
Social Skills Training ..................................... 99
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . 99
Clinical Application: Social Withdrawal ...... 102
Clinical Application: Aggressive Behavior .,. 109
Summary..................................................... 114
Chapter 5. Basic Operant Procedures ......................... 116
Introduction ................................................. 116
Shaping ... .......... ... .......... .......... ......... ......... 117
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Clinical Application ................................. 122
Chaining . ........ ....... ......... ................ ......... ... 126
Background ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Discrimination, Stimulus Control, and Fading ... 129
Background ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Clinical Application ................................. 132
Prompting ................................................... 136
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Clinical Application................................. 142
Summary ..................................................... 147
Chapter 6. Other Operant Procedures ........................ 149
Introduction ............. .......... ...... .................... 149
Contingency Contracting .... .......... ................. 149
CONTENTS xi
Background ........................................... 149
Clinical Application ................................. 153
Token Economy Programs ............................. 157
Background ........................................... 157
Clinical Application ................................. 168
Biofeedback Training ..................................... 172
Background ........................................... 172
Clinical Application...................... ........... 174
Summary ..................................................... 176
Chapter 7. Operant Reductive Procedures......... ........ ... 178
Introduction................................................. 178
Extinction .................................................... 180
Background ........................................... 180
Clinical Application................................. 182
Differential Reinforcement ............................. 187
Background ........................................... 187
Clinical Application................................. 189
Response Cost ............................................. 192
Background ........................................... 192
Clinical Application................................. 193
Timeout ........................ ............. .... ............. 198
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 198
Clinical Application................................. 200
Overcorrection ............................................. 205
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Clinical Application................................. 208
Physical Punishment ........ ............ ................. 213
Background ........................................... 213
Clinical Application ................................. 215
Summary..................................................... 217
Chapter 8. Cognitive Procedures and Self-Management... 219
Introduction.................. ............................... 219
Cognitive Behavior Therapy ........................... 220
Background ........................................... 220
Clinical Application................................. 224
Self-Management .......................................... 229
Background ........................................... 229
Clinical Application................................. 238
Summary ..................................................... 249