Case of Emily
Recap the Case
Emily is a 6-year old girl who was referred by her pediatric psychologist. When she reached her first grade year she started having behavioral issues. She began to express her dislike for school and resisted going. What started as being reluctant turned into screaming tantrums when being faced with attending school. Emily also refused to sleep alone and wanted to sleep with her parents. Her parents tried to move her to her own bed when she fell asleep and often she would wake up screaming, waking up her whole family. Tired of the battle, the parents let her sleep with them and even tried keeping her home from school while they were trying to figure out her issues. Emily behaves well at school and is up to her academic grade level.
There are several areas that draw concern in this case study, however the primary concern is that Emily is suffering from separation anxiety from her parents. Her fear of being separated from her parents is creating an environment that allows Emily to react so negatively. Depression associated with the anxiety may play a role as well. Ensuring there are no physical factors that are creating this reaction is important to move forward with the anxiety diagnosis.
Identify Important Target Behavior
The behavioral issues that Emily is exerting occurs at both home and school. Emily’s target behavior is tantrumming. The behavioral definition of tantrumming is ”when Bobby cries and sobs, lies on the floor and kicks the floor or walls, or pounds toys or other objects on the floor, it is defined as a tantrum.” (Miltenberger, 2011) It is essential to define this behavior because without targeting it there is no way to create a clear solution to the problem. Emily depends on tantrums to express herself and to get a point across regarding her likes and dislikes. Behavior modification procedures is a means to aid in helping people change their overall behavior. Choosing the target behavior that is socially significant is important too. This is behavior that the individuals agree are essential targets to alter for change. “One way to make sure you are choosing important (socially significant) target behaviors are to assess the opinions of the client or other important individuals (parents, teachers, etc.). When such individuals agree that the target behaviors are important and acceptable, they are establishing the social validity of the target behaviors.” (Miltenberger, 2011)
Inadvertent Reinforcement Strategy May Have Contributed to Emily’s School Refusal
The inadvertent reinforcement strategy that is contributing to Emily’s behavior is the acceptance of this behavior. Emily’s parents allow her to sleep in their bed and miss school because she exerts an excessive amount of anger and tears. Because Emily knows that her parents will eventually give into her tantrums, this can cause significant distress for Emily’s parents as well as Emily herself and it will continue to worsen because it has been allowed. Her separation anxiety allows Emily to sleep with her parents and not have to sleep in her bed. In the long run, this inadvertent reinforcement strategy will only make Emily’s separation anxiety excessively worse. Emily will not be ready to attend school or sleep in her own bed anytime soon.
A Hypothesis Regarding what Intervention will Result in a Specific Level and Direction of Desired Change in the Target Behavior
The desired intervention is to get Emily to go to school and sleep in her own bed without any resistance from her. By getting Emily to sleep in her own bed and to desire to go to school the separation anxiety and tantrums may completely stop on their own. However the likelihood of her anxiety, tantrums, or depression going away on their own immediately is highly unlikely. But this is the first step. Perhaps taking smaller steps to make Emily comfortable in her bed is a great starting point. One parent laying with her so she is choosing to go to bed on her own free will. This transformation will not be easy, she will resist and the parents will want to give in, but they have to start the transition at home. Emily may not understand the issue with her clinging to her parents so she needs know it is not ok. Discussing what she is afraid of and what issues she is having will also help with rectifying the problem. Allowing Emily to discuss the problem and the solution will help Emily with overcoming her issues.
An Effective Behavior Modification Program to Help Emily’s Parents to help her Improve her Target Behavior and to Test Your Previously Stated Hypothesis
“Reinforcement is the process in which a behavior is strengthened by the immediate consequence that reliably follows its occurrence.” (Miltenberger, 2011) Medication is often used as part of the solution for disorders. In the case of separation anxiety the main treatment is psychotherapy. The therapy will allow the child to be ok with separating from her parents on a regular basis for an extended period of time. Emily should be able to function void of her parents. The type of psychotherapy that would be utilized is cognitive-behavioral therapy. This will allow Emily to express her actions and feelings to become more independent. The anxiety of separation will be able to be controlled and the family can work with Emily on a daily basis as well.
The important thing to remember about positive reinforcement and negative reinforcement is that both have the same impact on the behavior: They strengthen it. Reinforcement is always defined by the effect it has on the behavior (Skinner, 1958). Praising Emily for her good behavior will keep her wanting to try harder. Letting her know she did good by going to bed alone will make her want to repeat the behavior. By her parents enforcing the expectations over an extended period of time, along with external help, they will be able to break Emily of her separation anxiety actions and replace them with the desired actions. Soon it will be normal for her to be away from her parents without anxiety issues.
How you will Monitor the Program and Analyze the Results
The way that this program will be monitored will be how Emily reacts herself. Start the program to work with Emily on positively being able to separate from her parents. A month later reevaluate the behavior modification process and make revisions as necessary to support the necessary progress. Tracking the number of nights Emily is able to leave for school without a breakdown and the number of nights she successfully sleeps in her bed. Each week the goal will be to increase and improve the numbers over the previous week. There will be obvious regression at points because separation anxiety is a difficult disorder for children.
Reassuring positive behavior will continue to improve the potential regressions that can and will occur. Allowing deviations from this plan is not an option. Emily will have difficulties with the change just like she has difficulties with separation in general. But by sticking to the plan and working with Emily the changes will happen. Monitoring the change will be easy because it will show in Emily’s actions.
The Scientific Method Guided this Experiment
The scientific method is to follow the theory stated by ruling out all other potential problems. Setting the expectations for each stage will allow the goals to be measurable and any changes necessary to be implemented. This experiment with helping Emily overcome her separation anxiety and depression will be successful because of the implementation.
Case of Mr. Smith
Recap the Case
Mr. Smith is a business owner of a company that manufactures custom figure skates. The company employees 30 employees who are trained to do the highly specialized work it takes to manufacture these skates. Absenteeism has grown to be a big problem. This has grown to become a productivity issue where deadlines are no longer being met. Obviously the health of the company is being challenged. The attempts of providing donuts and coffee for employee appreciation failed. This was unsuccessful. He held a meeting to explain the importance of attendance to the employees and that was unsuccessful as well. Mr. Smith is at the end of his rope worried the company will close and is need of guidance.
Identify Important Target Behavior
Mr. Smith’s target behavior is assertiveness. The behavioral definition of assertiveness is “when Pat says no to someone who asks her to do something that is not part of her job, when she asks coworkers not to smoke in her office, and when she asks coworkers to knock before entering her office, it is defined as assertiveness.” (Miltenberger, 2011) It is important for Mr. Smith to address his employee’s behavioral issues because his business is at risk. He needs to implement a behavioral modification program to change the negative actions that are taking place. Finally set a time frame for the modification program to be complete.
Why Mr. Smith’s Previous Intervention May Not Have Been Successful
Mr. Smith’s previous attempts to reach his staff has been unsuccessful because he has been approaching it in a nice manner. Meaning that they are not taking his request for change seriously. Their behavior has not changed because he has not implemented any medication procedures or repercussions. Rogers-Warren & Warren 1980 used behavior modification procedures to increase sharing in preschool children. They defined sharing as occurring “when one subject passed or handed a material to a second subject, when subjects exchanged materials, or when two or more subjects simultaneously used the same material (for example, two subjects coloring on the same piece of paper)” Obviously Mr. Smith is not addressing a situation with preschool children, but if they all share in the benefits and the repercussions of their actions, they will take ownership of their responsibilities.
Creating an environment that will allow workers to discuss issues that are preventing them from handling their responsibilities. If the workers are having grievances, they need a way to discuss it with Mr. Smith to prevent the poor performance and absenteeism. Mr. Smith’s attempts to make his staff understand the urgency was unsuccessful so he needs to find a new way to reach them. Loyalty and fear of losing their job was not a factor that helped Mr. Smith. Ownership and responsibility will make the employees responsible for their own personal input.
Formulate a Hypothesis Regarding what Intervention will Result in a Specific Level and Direction of Desired Change in the Target Behavior
Due to the visible lack of loyalty and ownership that Mr. Smith’s employees have, they need a way to feel empowered as employees. Providing kickbacks and benefits of their hard work and showing up to work every day, they may try harder to contribute more to their job. A reward system is a great way to reward the employees when they meet certain set goals and marks along the way. This can include addition time off or longer lunches, profit sharing; the reward is based on the contribution. The team will see the better the company does, the better they will do and work together to reach greater rewards.
An Effective Behavior Modification Program to Help Mr. Smith with His Company and to Test Your Previously Stated Hypothesis
Mr. Smith needs to implement a system that holds the employees responsible for poor performance. It absenteeism is the issue that is threatening the business, he needs to hold the employees accountable or he needs replace them. Positive reinforcement is the way that he will target and change the current behavior of his employees. The reinforces are awards, time off, and profit sharing that will be awarded based on the overall companies success. Creating a team atmosphere of competition will enable the employees to do more and to want to do more. This will increase productivity and attendance and the overall well-being of the company.
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. (Kazdin, 1982) Implementing consequences and positive enforcements will allow Mr. Smith to see the changes he desires.
How you will Monitor the Program and Analyze the Results.
The program will be monitored by the change in outcome and attendance. The company will begin to do better and the risk of going out of business will no longer be an issue. Tracking individual progress will allow Mr. Smith to eliminate the potential problems while rewarding the individuals who are making the necessary changes. The professional plan for modifying behaviors will be to change the employee’s actions by positive reinforcement. The necessary steps will be taking to ensure that all said goals are reached.
Miltenberger, Raymond G. (2011) Behavior Modification: Principles and Procedures. Cengage Learning.
Skinner, B.F. (1958). Teaching machines. Science, 128, 969-977.
Rogers-Warren, A., & Warren, S. F. (1980). Mands for verbalization. Behavior Modification, 4, 361-382.
Kazdin, A.E. (1982) Single-case Research Designs: Methods for Clinical and Applied Settings. New York: Oxford University Press.