Behavior Analysis is different from other psychological therapies. First, it is considered a natural science, meaning that its interventions rely in manipulation of real world variables that can be observed. This removes some of the stereotypical therapeutic long talks on a couch for viable behavior analytic therapy, but don’t sell behavior analysis short just yet.
The best evidence based practices in applied behavior analysis can be found in the natural environment, both studying participants behavior across those environments. It looks at the patterns of either prosocial behavior that can be therapeutically reinforced , and identification and reduction of maladaptive behaviors which get in the way of a fulfilling life.
One of the founding psychologists of behavior analysis, B.F Skinner, wrote in “Science and Human Behavior” (1951) about both the experimental setting for behavior analysis, and the paramount importance of seeing behavior in the environment in which it behaves. Doing tests in a lab may be helpful to get behavior analysts some solid and clinically controlled data sets, but it could never tell them if those skills or patterns would generalize a certain way in the world outside. There’s an importance to that. One of the founding dimensions of behavioral analytic science demands that the products have Generality meaning that the effects of therapy occur across environments and time. The benefits of therapy must outlast the clinical visits. This is helpful to the clients and consumers of behavior analytic therapy (ABA) for obvious reasons; you want the therapy to work in the places you need it most.
ABA practitioners use two broad tools to shape the direction of therapy a Behavior Plan to identify maintaining factors for maladaptive behaviors, and a Skill Acquisition Plan to build up the better patterns, skills, and coping behaviors to replace them. It is all about identifying the problems fast, and implementing actionable change. To that end, they need all the information they can get. Location matters.
When it comes to the location of services, both for client/consumers, or perhaps the children of client/consumers, age becomes a factor in where this therapy takes place. In many cases this could happen in a school setting, or clinical center setting. This is a practical and commonplace service location for clients of therapy of younger ages. The school setting does have naturalistic opportunities that the clinical setting does not, and having the opportunity to receive therapy in both has its benefits. Clinical settings can focus on the skills that can be practiced with controllable conditions and stimuli that do not have the scheduling drawbacks of an academic setting. School settings have the benefit of natural peer environments, and natural contingencies for task demands if behaviors are dependent on those factors. What is often overlooked, however, is the home setting. I practiced as a School Counselor, and although certain types of therapy worked in the school setting and helped the students, once they walked out the door, the practitioner had no idea. It was all self-report from homes, and those can be misleading.
The benefits of having a house call from a behavior analyst (BCBA), and getting ABA therapy at a residence, is that the practitioner can see the conditions outside of the clinical and academic sphere that may be relevant to either stifling patterns of prosocial behavior, or feeding into the maladaptive behaviors. Sometimes the home environment is rich in information and reinforcement history that an analyst can work with. Routines, schedules, and practice can all be built into a home visit to work on the things that need the most work. Sometimes the privacy and comfort of the home also helps with going through dry runs of new skills without the social pressure of the outside world. When a Behavior Analyst comes in through the front door they are interested in getting to the bottom of the problem behaviors, teach socially relevant alternatives, and most of all, to help. I’ve seen first hand how just a change to familiar scenery can open up dialogue and planning for therapy directions that might be uncomfortable, or even embarrassing elsewhere, so never underestimate the power of an environment change on behavior.
Some Practitioners might not be able to deliver consistent services in the home, but even one occasional house call, one single visit, could open the lens on new conceptualizations on the therapeutic framework. I’ve experienced this countless times. As a practitioner, you think you know what’s going on, and then you’re in the client’s place of residence and a big piece of the puzzle falls into place. This is advice to any behavior analytic practitioner; if you have the opportunity to make that house call, don’t wait. It could change your entire idea of what is going on and save hours on dead end functional analysis hypotheses. House calls can also get the broader family involved with services that they might have otherwise been unfamiliar with. This opens up dialogue, and questions, which could lead to greater support both inside and outside of the home. There is a well known tenant in behavior analysis called dissemination. That means, this natural science works best when people know about it and understand it. Spreading the word, and being correct in the delivery of what ABA therapy is, is important. There is no short supply of misinformation out there. A home visit with the family, willing to participate, can break down the barriers of hesitancy, and show just how effective and useful this therapy can be.
So potential clients and consumers? If you can swing it, call for a home visit.
Behavior Analysts and ABA practitioners? Don’t be afraid of house-calls. You’ll be kicking yourself for not doing it sooner.
Questions? Comments? Thoughts? Leave them below.
Interest in ABA therapy for resources in getting services, or practicing? Feel free to email the address below.
Cooper, John O, Heron Timothy E.. Heward, William L.. (2018). APPLIED BEHAVIOR ANALYSIS. S.l.: PEARSON.
Skinner, B. F., & Skinner, B. F. (1951). Science And Human Behavior. Riverside: Free Press
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