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Functional Analysis in Clinical Treatment Second Edition Edited by Peter Sturmey Professor of Psychology at Queens College and the Graduate Center, City University New York, United States AcademicPressisanimprintofElsevier 125LondonWall,LondonEC2Y5AS,UnitedKingdom 525BStreet,Suite1650,SanDiego,CA92101,UnitedStates 50HampshireStreet,5thFloor,Cambridge,MA02139,UnitedStates TheBoulevard,LangfordLane,Kidlington,OxfordOX51GB,UnitedKingdom Copyright(cid:1)2020ElsevierInc.Allrightsreserved. Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans, electronicormechanical,includingphotocopying,recording,oranyinformationstorage andretrievalsystem,withoutpermissioninwritingfromthepublisher.Detailsonhowto seekpermission,furtherinformationaboutthePublisher’spermissionspoliciesandour arrangementswithorganizationssuchastheCopyrightClearanceCenterandtheCopyright LicensingAgency,canbefoundatourwebsite:www.elsevier.com/permissions. Thisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightby thePublisher(otherthanasmaybenotedherein). Notices Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchand experiencebroadenourunderstanding,changesinresearchmethods,professional practices,ormedicaltreatmentmaybecomenecessary. Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgein evaluatingandusinganyinformation,methods,compounds,orexperimentsdescribed herein.Inusingsuchinformationormethodstheyshouldbemindfuloftheirownsafety andthesafetyofothers,includingpartiesforwhomtheyhaveaprofessionalresponsibility. Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,or editors,assumeanyliabilityforanyinjuryand/ordamagetopersonsorpropertyasamatter ofproductsliability,negligenceorotherwise,orfromanyuseoroperationofanymethods, products,instructions,orideascontainedinthematerialherein. LibraryofCongressCataloging-in-PublicationData AcatalogrecordforthisbookisavailablefromtheLibraryofCongress BritishLibraryCataloguing-in-PublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary ISBN:978-0-12-805469-7 ForinformationonallAcademicPresspublicationsvisitourwebsiteat https://www.elsevier.com/books-and-journals Publisher:NikkiLevy EditorialProjectManager:BarbaraMakinster ProductionProjectManager:PaulPrasadChandramohan CoverDesigner:MilesHitchen TypesetbyTNQTechnologies Contributors Holly L. Bihler, SouthernIllinois University,Center for Autism Spectrum Disorders, Carbondale,IL,UnitedStates ConnorA.Burrows,HealthandBehavioralIntegratedTreatments(HABIT)Research Unit, DepartmentofPsychology,RowanUniversity,Glassboro,NJ, UnitedStates Adrienne K. Chong, Department of Psychology, University of Nevada, Reno, Reno, NV,UnitedStates JaimeG.Crowley,MayInstitute,Randolph,MA, UnitedStates PrudenceCuper,CognitiveBehavioralTherapyCenteroftheTriangle,Durham,NC, UnitedStates Jeffrey S. Danforth, Eastern Connecticut State University, Willimantic, CT, United States DanielleR.Davis,VermontCenteronBehaviorandHealth,DepartmentsofPsychiatry and PsychologicalScience,UniversityofVermont, Burlington,VT,UnitedStates Robert Didden, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands JamesW.Diller,EasternConnecticutStateUniversity,Willimantic,CT,UnitedStates MarkR.Dixon,SouthernIllinoisUniversity,CenterforAutismSpectrumDisorders, Carbondale,IL,UnitedStates EricaDoran,QueensCollegeandTheGraduateCenter,CityUniversityofNewYork, NewYork,NY,UnitedStates Matthew J. Dwyer,Health and BehavioralIntegratedTreatments (HABIT) Research Unit, DepartmentofPsychology,RowanUniversity,Glassboro,NJ, UnitedStates Simon Dymond, Department of Psychology, Swansea University, Swansea, Wales, UnitedKingdom;Reykjav´ıkUniversity,Reykjav´ık,Iceland HallieM.Ertel,NimoursChildren’sHospital,Orlando,FL,UnitedStates Jane E. Fisher, Department of Psychology, University of Nevada, Reno, Reno, NV, UnitedStates Patrick C. Friman, Center for Behavioral Health, Boys Town, NE, United States; UniversityofNevada, Reno,NV,UnitedStates Ata Ghaderi, Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet,Stockholm,Sweden Sarah D. Haney, University of Nebraska Medical Center’s Munroe-Meyer Institute, Omaha,NE,UnitedStates xvii xviii Contributors Sarah H. Heil, Vermont Center on Behavior and Health, Departments of Psychiatry andPsychologicalScience,UniversityofVermont, Burlington,VT,UnitedStates Stephen T. Higgins, Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT, UnitedStates MichaelB.Himle,UniversityofUtah,Salt LakeCity,UT,UnitedStates Jessica M. Hinman, Southern Illinois University, Center for Autism Spectrum Disorders,Carbondale,IL,UnitedStates AnsleyC.Hodges,NimoursChildren’sHospital,Orlando,FL, UnitedStates Derek R.Hopko,TheUniversityofTennessee,Knoxville,TN,UnitedStates VivianF.Iban˜ez,Children’sSpecializedHospital,Somerset,NJ, UnitedStates MarianneL. Jackson,CaliforniaState University,Fresno,CA,UnitedStates Taylor E. Johnson, Southern Illinois University, Center for Autism Spectrum Disorders,Carbondale,IL,UnitedStates Craig H. Kennedy, Educational Psychology, University of Connecticut, Storrs, CT, UnitedStates Caitlin A. Kirkwood, Center for Pediatric Behavioral Health, University of North CarolinaWilmington,Wilmington,NC,UnitedStates CarlW.Lejuez,UniversityofKansas,Lawrence, KS,UnitedStates ThomasLynch,UniversityofSouthampton,Southampton,UnitedKingdom JessicaF.Magidson,TheUniversityofMaryland,CollegePark,MD, UnitedStates Michael E. May, Applied Behavior Analysis, The Chicago School of Professional Psychology,Dallas,TX,UnitedStates KibbyMcMahon,DukeUniversity,Durham,NC,UnitedStates RhondaMerwin,DukeUniversity,Durham,NC,UnitedStates Raymond G. Miltenberger, Department of Child and Family Studies, University of SouthFlorida,Tampa,FL,UnitedStates Ali M. Molaie, Department of Psychology, University of Nevada, Reno, Reno, NV, UnitedStates Jessica A. Nastasi, Health and Behavioral Integrated Treatments (HABIT) Research Unit,Department ofPsychology,RowanUniversity,Glassboro,NJ, UnitedStates Nancy A. Neef, Educational Studies, The Ohio State University, Columbus, OH, UnitedStates John Northup, University of Iowa, Department of Psychological and Quantitative Foundations,IowaCity,IA, UnitedStates Christopher J. Perrin, Psychology & Counseling, Georgian Court University, Lake- wood,NJ,UnitedStates Nienke Peters-Scheffer, Behavioural Science Institute, Radboud University, Nijme- gen,theNetherlands Contributors xix CathleenC.Piazza,RutgersGraduateSchoolofAppliedandProfessionalPsychology and Children’sSpecializedHospital,Piscataway,NJ,UnitedStates JosephJ.Plaud,AppliedBehavioralConsultants,LLC,Boston,MA, UnitedStates SharletD.Rafacz,UniversityofNevada,Reno,NV,UnitedStates Bethany R. Raiff, Health and Behavioral Integrated Treatments (HABIT) Research Unit, DepartmentofPsychology,RowanUniversity,Glassboro,NJ, UnitedStates CatalinaN.Rey,VermontCenteronBehaviorandHealth,DepartmentsofPsychiatry and PsychologicalScience,UniversityofVermont, Burlington,VT,UnitedStates AlexandraL.Rose,The UniversityofMaryland,CollegePark,MD, UnitedStates JordanT.Stiede,MarquetteUniversity,Milwaukee,WI,UnitedStates Peter Sturmey, Queens College and The Graduate Center, City University of New York,NewYork,NY,UnitedStates Caitlyn R. Upton, Health and Behavioral Integrated Treatments (HABIT) Research Unit, DepartmentofPsychology,RowanUniversity,Glassboro,NJ, UnitedStates JohnWard-Horner,CambridgeCollege,Boston,MA, UnitedStates DavidA.Wilder,FloridaInstituteofTechnology,Melbourne,FL,UnitedStates W. Larry Williams, Center for Behavioral Health, Boys Town, Boys Town, NE, UnitedStates StephenE.Wong,SchoolofSocialWorkFloridaInternationalUniversity,Miami,FL, UnitedStates DouglasW.Woods,Marquette University,Milwaukee,WI,UnitedStates Preface to the First Edition Behaviorismhaslong considered explanations andtreatmentofpsychopathol- ogy.MillerandDoUard(1941)begantotranslatepsychoanalyticintobehavioral concepts.Skinner’sWaldenTwo(1948),ScienceandHumanBehavior(1953), andBeyondFreedomandDignity(1971)developedthatapproachandaddressed the conceptualization of psychopathology andits implications for case formu- lation and treatment. Skinner also expanded on earlier work by offering func- tionalanalyticapproachestoexplainingbehaviorchangethatmightoccurduring classicpsychotherapyandRogeriantherapy.Functionalanalyticapproachesto psychopathologytookoffinthe1950sinareassuchasmentalretardation(Fuller, 1949; Lindsley, 1964a; Risley & Wolf, 1964, 1967; Wolf, Risley, Johnston, Harris, & Allen,1967; Wolf, Risley, & Mees,1964),schizophrenia (Ayllon& Michael,1959; Lindsley, 1956, 1959, 1960, 1963; Lindsley & Skinner, 1954), tics (Barret, 1962), and geriatrics (Lindsley, 1964b) and influenced the devel- opmentofbehaviortherapy(Kalish,1981;Kanfer&Phillips,1970;Ullmann& Krasner, 1965; Wilson & Franks, 1982). Turkat’s (1985) volume. Behavioral CaseFormulation,wasnotableinillustratingtheapplicationofbehavioranalytic concepts to individual case formulation and in addressing its application to a widerangeofclinicalproblems,suchasfear,depression,personalitydisorders, substanceabuse,andproblemsoflaterlife.Thisearlyworkformedthebasisof subsequentdevelopmentoffunctionalapproachedtopsychopathology. Functionalapproachestothispsychopathologyarecharacterizedbyfocusing on current context; environmental variables that have a large impact on the presenting problem and that can be readily manipulated; operationalization of behavior and reliable measurement of its relationship to the environment; and case formulation and idiographic treatment that are grounded in behavioral conceptsandaimtoproducelarge,socially,andpersonallymeaningfulchanges (Baer, Wolf, & Risley, 1968) that address goals that society recognizes as important,thatusemethodsandachieveoutcomesthatarevalued(Wolf,1978). Thisvolumeshowsthatthisapproachhasnowbeenappliedtothefullrangeof psychopathology. Overview of this volume Thefirst3chaptersreviewbasicphilosophicalunderpinningsoffunctionalan- alyticapproaches.Thesefirstchaptersdescribethecommonlearningprocesses thatareinvolvedinallbehaviorchangeprocessesandillustratetheirapplication xxi xxii PrefacetotheFirstEdition tocaseformulationandinterventionwithawiderangeofpopulations.Thenext 17chaptersreviewtheapplicationoffunctionalanalysistothemajorDiagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV; American Psychiatric Association, 1994) categories of psychopathology using the following standard format: Each of these chapters briefly reviews the current diagnosticcriteriaandthenmovesontodescribeafunctionalanalyticmodelof that disorder, its functional assessment and analysis, and functional analytic- based interventions. Finally, each chapter illustrates these concepts and inter- vention methods with a case study, which includes functional assessment or analysis, development of a treatment plan, and evaluation of outcome. Cindy Anderson’s final chapter provides an overview of these chapters andidentifies commonthemes,emergingissues,andfuturedirections. The contributors The contributors have made my job as editor an easy one. I selected them because they had established track records of empirical research in functional approaches to psychopathology and extensive professional experience in the hopethattheywouldproduceauthoritativeoverviewsoftheirareasofexpertise andinform practitioners of how to conceptualize andtreat psychopathology:I wasnotdisappointed. References AmericanPsychiatricAssociation.(1994).Diagnosticandstatisticalmanualofmentaldisorders (4thed.).Washington,DC:Author. Ayllon,T.,&Michael,J.(1959).Thepsychiatricnurseasabehavioralengineer.Journalofthe ExperimentalAnalysisofBehavior,2,323e333. Baer,D.M.,Wolf,M.M.,&Risley,T.R.(1968).Somecurrentdimensionsofappliedbehavior analysis.JournalofAppliedBehaviorAnalysis,1,91e97. Barret, B. H. (1962). Reduction in rate of multiple tics by free operant conditioning methods. JournalofNervousandMentalDiseases,135,187e195. Fuller,R.R.(1949).Operantconditioningofavegetativehumanorganism.AmericanJournalof Psychology,62,587e590. Kalish,H.I.(1981).Frombehavioralsciencetobehaviormodification.NewYork,NY:McGraw- Hill. Kanfer,F.H.,&Phillips,J.S.(1970).Learningfoundationsofbehaviortherapy.NewYork,NY: Wiley. Lindsley, O. R. (1956). Feeding a kittendA social reinforcer. In Annual technical report #5, November,ContractN5-Ori-07662.OfficeofNavalResearch.Waltham,MA:HarvardMed- icalSchool,BehaviorResearchLaboratory. Lindsley, O. R. (1959). Reduction in rate of vocal psychotic symptoms by differential positive reinforcement.JournaloftheExperimentalAnalysisofBehavior,2,269. Lindsley,O.R.(1960).Characteristicsofthebehaviorofchronicpsychoticsasrevealedbyfree- operant conditioning methods. Diseases of the Nervous System, 21, 66e78. Monograph Supplement. PrefacetotheFirstEdition xxiii Lindsley, O. R. (1963). Direct measurement and functional definition of vocal hallucinatory symptoms.JournalofNervousandMentalDisease,136,293e297. Lindsley, O. R. (1964a). Direct measurement and prosthesis of retarded behavior. Journal of Education,147,62e81. Lindsley,O.R.(1964b).Geriatricbehavioralprosthesis.InR.Kastenbuam(Ed.),Newthoughtson oldage(pp.41e60).NewYork,NY:Springer. Lindsley,O.R.,&Skinner,B.F.(1954).Amethodfortheexperimentalanalysisofthebehaviorof psychoticpatients.AmericanPsychologist,9,419e420. Miller,N.,&Dollard,J.(1941).Sociallearningandimitation.NewHaven,NJ:YaleUniversity Press. Risley, T. R., & Wolf, M. M. (1964). Experimental manipulation of autistic behaviors and generalizationintothehome.InR.E.Ulrich,T.Stachnik,&J.Mabry(Eds.),Thecontrolof humanbehavior(pp.193e198).Glenview,IL:ScottForesman. Risley, T. R., & Wolf, M. M. (1967). Establishing functional speech in echolalic children. Behaviour,ResearchandTherapy,5,73e88. Skinner,B.F.(1948).Waldentwo.NewYork,NY:Macmillan. Skinner,B.F.(1953).Scienceandhumanbehavior.NewYork,NY:TheFreePress. Skinner,B.F.(1971).Beyondfreedomanddignity.NewYork,NY:Knopf. Turkat,I.(Ed.).(1985).Behavioralcaseformulation.NewYork,NY:Plenum. Ullmann,L.P.,&Krasner,L.(Eds.).(1965).Casestudiesinbehaviormodification.NewYork, NY:Holt,Rinehart&Winston. Wilson,G.T.,&Franks,C.M.(1982).Contemporarybehaviortherapy:Conceptualandempirical foundations.NewYork,NY:GuilfordPress. Wolf,M.M.(1978).Socialvalidity:Thecaseforsubjectivemeasurementorhowappliedbehavior analysisisfindingitsheart.JournalofAppliedBehaviorAnalysis,11,203e214. Wolf,M.M.,Risley,T.R.,Johnston,M.,Harris,F.,&Allen,E.(1967).Applicationofoperant conditioning procedures to the behavior problems of an autistic child: A followup and extension.Behaviour,Research&Therapy,5,103e111. Wolf,M.M.,Risley,T.,&Mees,H.(1964).Applicationofoperantconditioningprocedurestothe behaviorproblemsofanautisticchild.Behaviour,ResearchandTherapy,1,305e312. Preface to the Second Edition FunctionalAnalysisinClinicalTreatment(Secondedition)summarizesand updatestheuseandsuccessoffunctionalanalyticapproachesinthetreatmentof psychopathology. Functional analytic approaches focus on moderating the environmental variables that can have a large impact on the clinical problem. Behavior analytic concepts have been popular since the 1950s and are now regularly integrated into behavior therapy for both case formulation and treat- mentofawiderangeofclinicalproblems. Functional Analysis in Clinical Treatment (Second edition) begins with an updated review of the common learning processes involved in behavior change, and their relevance to case formulation and intervention with a wide rangeofproblems.Subsequentchaptersreviewtheuseoffunctionalassessment and analysis of each disorder, and intervention. Each chapter additionally in- cludes a case study to illustrate functional assessment development of a treat- mentplanandevaluationofoutcome. ThesecondeditionincludesupdatedresearchandareviewofDSM5diag- nostic criteria in every chapter. There are also new chapters on ODD, eating disordersandchronichealthproblemsandfuturedirectionsinthefield. Written by practitioners with extensive clinical experience and established trackrecordsofempiricalresearch,thisrevisedbookwillbeusefultoclinicians treatingawiderangeofdisorders.Chaptersdiscusstheuseoffunctionalanalysis in treatment developmental disabilities and pediatric disorders, ADHD, ODD, substance abuse, schizophrenia, mood disorders, anxiety, sexual disorders, easting disorders, personality disorders, impulse control disorders and chronic healthproblems. FunctionalAnalysisinClinicalTreatment Editedby PeterSturmey TheGraduateCenterandDepartmentandPsychology,QueensCollege CityUniversityofNewYork,Flushing,NewYorkCity,NY,UnitedStates xxv

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