Descriptive analysis of the verbal behavior of a therapist: a known-group validity analysis of the putative behavioral functions involved in clinical interaction

Accuracy of paper-and-pencil systematic observation versus computer-aided systems

Computer-aided behavior observation is gradually supplanting paper-and-pencil approaches to behavior observation, but there is a dearth of evidence on the relative accuracy of paper-and-pencil versus computer-aided behavior observation formats in the literature. The current study evaluated the accuracy resulting from paper-and-pencil observation and from two computer-aided behavior observation methods: The Observer XT® desktop software and the Big Eye Observer® smartphone application. Twelve postgraduate students without behavior observation experience underwent a behavior observation training protocol. As part of a multi-element design, participants recorded 60 real clinical sessions randomly assigned to one of the three observation methods. All three methods produced high levels of accuracy (paper-and-pencil, .88 ± .01; The Observer XT, .84 ± .01; Big Eye Observer, .84 ± .01). A mixed linear model analysis indicated that paper-and-pencil observation produced marginally superior accuracy values, whereas the accuracy produced by The Observer XT and Big Eye Observer did not differ. The analysis suggests that accuracy of recording was mediated by the number of recordable events in the observation videos. The implications of these findings for research and practice are discussed.

Measuring parent strategy use in early intervention: Reliability and validity of the Naturalistic Developmental Behavioral Intervention Fidelity Rating Scale across strategy types

LAY ABSTRACT

Children with autism spectrum disorder benefit from early intervention to improve social communication, and parent-implemented interventions are a feasible and family-centered way to increase the amount of treatment they receive. For these treatments to be effective, it is important for the parent to implement the strategies as intended. However, measurement of parent strategy use is inconsistent across studies of parent-implemented interventions. This study evaluates the quality of the NDBI-Fi, an efficient measure, compared to a more time-consuming measure that is known to be precise. Videos of parents playing with their children were used to compare these two measurement methods. Results demonstrated that the NDBI-Fi was of good quality: scorers had high levels of agreement, the NDBI-Fi was similar to the more precise measure in rating parents after intervention, it detected changes from before to after intervention, and it detected differences when parents learned different types of intervention strategies. The NDBI-Fi was not as precise as the other measure across all strategies before parents learned intervention. Taken together, the findings of this study support the use of the NDBI-Fi as a high-quality outcome measure.

A translational approach to the functional analysis of language in psychotherapy

The functional analysis of verbal behavior has been successful in establishing basic and advanced forms of language in individuals with developmental disabilities. The development of behavioral approaches to psychotherapy, such as the functional-analytic psychotherapy, have advanced the implementation of operant analyses of verbal behavior among typical adults. The field of behavior-analytic approaches to psychotherapy departs from the applied experimental research in behavior analysis in various ways: (a) minimal use of molecular analyses of behavioral processes using single-subject experimentation, (b) confined use of functional analysis and function-driven intervention, and (c) metaphoric use of mainstream behavioral concepts and methods. The breakthroughs brought about by behavioral approaches to psychotherapy may be supplemented by way of translating some of the findings of the applied experimental literature. The present analysis illustrates how behavioral processes demonstrated in the context of experimental research, often with individuals with developmental and intellectual disabilities, may be relevant to psychotherapy with typically-developed adults. This translational approach is discussed with reference to basic language processes: echoics, mands, tacts, and intraverbal dynamics. This approach could prompt programmatic translational research in the field of behavioral psychotherapies.

Studying the Therapeutic Process by Observing Clinicians' In-Session Behaviour

This paper presents a further step in the use and validation of a systematic, functional-analytic method of describing psychologists' verbal behaviour during therapy. We observed recordings from 92 clinical sessions of 19 adults (14 women and 5 men of Caucasian origin, with ages ranging from 19 to 51 years) treated by nine cognitive-behavioural therapists (eight women and one man, Caucasian as well, with ages ranging from 25 to 48 years). The therapists' verbal behaviour was codified and then classified according to its possible functionality. A cluster analysis of the data, followed by a discriminant analysis, showed that the therapists' verbal behaviour tended to aggregate around four types of session differentiated by their clinical objective (assessment, explanation, treatment and consolidation). These results confirm the validity of our method and enable us to further describe clinical phenomena by distinguishing psychologists' classes of clinically relevant activities. Specific learning mechanisms may be responsible for clinical change within each class. These issues should be analysed more closely when explaining therapeutic phenomena and when developing more effective forms of clinical intervention.

KEY PRACTITIONER MESSAGE

We described therapists' verbal behaviour in a focused fashion so as to develop new research methods that evaluate psychological work moment by moment. We performed a cluster analysis in order to evaluate how the therapists' verbal behaviour was distributed throughout the intervention. A discriminant analysis gave us further information about the statistical significance and possible nature of the clusters we observed. The therapists' verbal behaviour depended on current clinical objectives and could be classified into four classes of clinically relevant activities: evaluation, explanation, treatment and consolidation. Some of the therapist's verbalizations were more important than others when carrying out these clinically relevant activities. The distribution of the therapists' verbal behaviour across classes may provide us with clues regarding the functionality of their in-session verbal behaviour.

Descriptive study of the Socratic method: evidence for verbal shaping

In this study we analyzed 65 fragments of session recordings in which a cognitive behavioral therapist employed the Socratic method with her patients. Specialized coding instruments were used to categorize the verbal behavior of the psychologist and the patients. First the fragments were classified as more or less successful depending on the overall degree of concordance between the patient's verbal behavior and the therapeutic objectives. Then the fragments were submitted to sequential analysis so as to discover regularities linking the patient's verbal behavior and the therapist's responses to it. Important differences between the more and the less successful fragments involved the therapist's approval or disapproval of verbalizations that approximated therapeutic goals. These approvals and disapprovals were associated with increases and decreases, respectively, in the patient's behavior. These results are consistent with the existence, in this particular case, of a process of shaping through which the therapist modifies the patient's verbal behavior in the overall direction of his or her chosen therapeutic objectives.