The first thing you need to know is that the first appointment is for you to assess whether my support is right for you. Bobbi wants to be a good fit for your hopes and goals. There is no charge for the first meeting and no pressure. Meetings at the office are arranged for Monday or Wednesday, and after work hours are possible.
Within reason and your budget, we interact on an as-needed basis during business hours and I try to to deal with problems as soon as they arise. I can adjust our hours when possible to suit your needs and schedule. We also work using email, phone or video conferencing if that is convenient.
My involvement in the beginning is more intensive and over time we become less and less involved so you can prove to yourself and significant others, that you can reliably practice what you have learned.
Be prepared for working on strategies in your everyday life. Typically, you do independent practice work with or without help, for not more than 5-10 minutes at a time. Sometimes self-directed work is taking data (counting), sometimes it is study, and sometimes it is practice at doing something.
Throughout my work, I encourage you to take charge and direct your support, particularly if you have paid supporters. You need to know how to self-manage and self-advocate with reasonable and accountable behaviour. If you need others to see you differently or treat you differently, I will help you to know how to do a good job of saying what you mean, and to be confident enough to say it well. The people who care about you will see it for the progress it is.
Don’t worry (or hope) that I might try to turn you into someone you are not – we’ll work together to fit the skills you need, into your unique style.
Positive life change is not something that occurs overnight or just because you want it. There is no quick-fix, or magic pill. Analysis is an ongoing job in our partnership because you want solutions that last and permanently improve your quality of life. Typically, you can expect to be functioning at your desired capacity in 6 to 18 months, depending on the complexity of the issues.
You can expect me to keep you progressing at a pace that keeps you motivated and engaged, but not overwhelmed.
Just when you think everything is working well, challenging behaviour comfortably reappears when you least expect it. This is a good thing. I can’t possibly anticipate all the situations that you need alternate behaviour for. So when things don’t work as well as you might like, we are rewarded with a valuable learning opportunity.
In the beginning supports are more intensive and over time I become less and less involved so you can prove to yourself and significant others, that you can do it, without my help!
The treatment of depression and depressive disorders invariably includes some kind of behaviour change procedure. Often the treatment will be delivered in a “train and hope” model which can be effective for those persons who have demonstrated good behavioural skills in the past. Those skills include pro-social behaviours, self-soothing behaviours, and resilience behaviours. Eliciting those formerly practiced skill is an excellent solution for episodic depression due to life events or specific trauma – when it works.
Sometimes the helpless or hopelessness that accompanies depression is overwhelming, particularly if it is recurring or accompanies other disorders such as post-traumatic stress (PTSD). Depressed emotional behaviours disable the behaviours of initiation and motivation, and sometimes lead to collateral behaviours like anxiety. In those instances the typical treatments sometimes fail to offer relief for any length of time. That kind of failure can deepen the sense of helpless or hopelessness and create a chronic problem.
The rat race can be interrupted and individuals can get an effective kick-start with individualized behaviour support, based on a Functional Analysis of Behaviour. Targeting an individual’s depressed behaviour with behavioural activation, offers hope and optimism for long-term or chronic suffering from depression.
Behaviour change supports include the practice of replacement behaviours that appeal specifically to the person. Additionally, we support the building of new behaviours that prevent recurrence. All focused on the end goal of behavioural activation that is self-generated for recovery. Depressive episodes often reoccur but when the tools are effective and in the hands of the person suffering then the episodes decrease in intensity and duration, finally going away altogether.
You can read more evidence of the effectiveness of ABA as a treatment for depression in this research article on Behaviour Activation.
I can help.
Behaviour Consultants are not medically qualified to prescribe medications and therefore we can’t un-prescribed your medications. If you want to stop taking medications we help you to collect the data that your Doctor can use to justify medication withdrawal.
Because Behaviour Consultants continually collect and graph the evidence of stability and behaviour change, many Doctors appreciate our input and recommendations to work with you to withdraw medications.
Behaviour Analysis has solid research and evidence that ABA therapy and interventions support behaviour change and recovery. There is almost no evidence that medication therapy can change behaviour, and good evidence that medication inhibits or delays recovery. Furthermore, the paradoxical effects of drugs on individuals with neurological diagnoses is not well researched – meaning: if a person has a disability of brain functioning sometimes drugs have the opposite effect than they are meant to. You can find more information on the evidence at Mad in America
Withdrawal from medication is a difficult process that must be done gradually and monitored by a Doctor. Sometimes withdrawal can create a rebound effect that briefly is as bad as the original symptoms. Parley helps you and your supporters get through withdrawal with Positive Behaviour Supports that target the short-term difficulties from medication withdrawal.
If you want to refuse medication it is your right to do so, but I recommend that you do it because the evidence and your Doctor support it.
Anxiety takes many forms, it expresses differently in each Functional Behaviour Analysis with each person who lives with it. Some people feel it constantly, some anticipate it, others experience sudden panic attacks. With some individuals anxiety is created in specific places or only with certain people.
As a result of its many forms, anxiety can be resistant to treatment, and sadly the person living with anxiety can be blamed for that resistance. Medications provide some relief for short periods but little resolution. Long-term medication use has been found to increase anxiety over time.
Research tells us that the most effective therapies are behavioural. Because anxiety presents so uniquely in the person and personality, a Functional Analysis of Behaviour is the most efficient and effective approach. Other behavioural therapies include Acceptance and Commitment Therapy (ACT), which I integrate into most interventions where stress or anxiety are contributing behaviours. Cognitive Behavioural Therapy (CBT) can be effective when resistance or reactivity that are just emerging or not presenting strongly.
In the analyses that the Behaviour Consultants do at Parley Services, we often see an element of stress or anxiety contributing to other behaviours that are causing challenges in a person’s life. The anxiety can be the underlying problem or sometimes just a symptom of the real problem. There are times when we discover that behaviour that has been labeled “Anxiety” is really just typical and productive stress, which can be easily managed in healthy ways. In youth we sometimes see challenges being labeled by them as anxiety, but after behaviour analysis we realize that it is a red herring or misleading information. Anxiety is reaching epidemic proportions in youth so it is not surprising that other challenges could take on a peer mediated label.
It is critical with Anxiety Disorders to figure out the precipitating factors, eliciting dynamics, target responses, visceral or physical responses, learning history, and the maintaining consequences. When we have that information through a functional analysis of the behaviour we can target positive supports for change that overcome resistance and reactivity.
Any disorder, including anxiety can be supported to good recovery. Anxiety Disorders may feel like a dead end, but in fact anxiety and overwhelming stress are a good reason to seek solutions for positive life change, your way.
The short answer to this question is yes. Applied Behaviour Analysis (ABA) and Cognitive Behavioural Therapy (CBT) are related. The difference between ABA and CBT is in the depth and types of services available.
Both therapies are behavioural approaches that evolved in the 1960’s as a result of advances in the research on human behaviour. In the 1980’s Cognitive Behaviour Therapy became popular because it was easy to use, solution-focused and there was evidence that it actually worked better than other psychotherapies.
The evidence regarding all therapies based on behavioural science continues to grow. However, CBT was immediately accessible to consumers because it could be used by any counsellor or psychologist who was interested in learning about it. Though there is a credentialing process, it is not necessarily used or required.
ABA on the other hand, has over the last 20 years developed a rigorous process for ensuring a much more extensive knowledge base, technology, and standards for using it. ABA is also claimed by people who are not credentialed, but that is becoming much more difficult to do as time goes on.
The CBT approach addresses cognitions as a means to change behaviour, and puts that together with simple behaviour change procedures as cognitions are modified. I used it to efficiently recover from a phobia of airplanes when I was young. It is, in my experience, very effective if the problem is understood, and if the individual already has some insight into the behaviour.
The ABA approach analyses behaviour (including cognitive behaviour) to identify the underlying function of the behaviour so I know what will work before we do anything. I then choose from a vast technology of behavioural approaches and keep data on each intervention’s success to ensure effective, efficient and reliable progress.
Some people do not respond to traditional therapies including CBT, for a world of reasons, each personality is unique. Additionally, if a behaviour is complex or resistant to change, if an individual’s brain function is compromised, or if they are missing some of the behaviours foundational to insight, Applied Behaviour Analysis has better data on effectiveness. Additionally ABA is preferred by people who are tired of talking about their issues and getting nowhere.
There’s more information on Cognitive Behaviour Therapy or CBT here.
The ABC’s of ABA after ABI – I couldn’t resist the alliteration.
Acquired Brain Injury (ABI) is a term that describes an insult to the brain whether it is from concussion, stroke, traumatic events or disease. Rehabilitation after any Acquired Brain Injury is a process of behavioural change. Survivors must successfully integrate new activities, habits, routines, expectations and attitudes that may be very different from their pre-ABI behaviours.
Applied Behaviour Analysis (ABA) has a unique opportunity to support survivors whose behaviours do not adapt to the new circumstances after an acquired brain injury. We analyse the function of pre-injury behaviours and how they combined with new brain functions to elicited the post injury adaptations. The new perspective leads to solutions for the post-injury functioning that has not adapted effectively to cope with new circumstances.
Positive Behaviour Supports draw on ABA technology, and when integrated into rehabilitation plans, improve rehabilitative success and greatly increase the likelihood of lasting behaviour change for recovery. Sohlberg and Mateer, in their landmark book, Cognitive Rehabilitation: an Integrative Neuropsychological Approach, recommend PBS strategies as best practice. Successful rehabilitation professionals including Occupational (OTs) Physical (PTs) and Physiatrists now routinely do their work with positive behaviour support techniques.
When the results of an accident or injury are neurologically based, seemingly new challenging behaviours can present obstacles to the rehabilitation process. The severity of physical impairment, memory loss, and age are typically the predictors of the capacity for return to work. Nevertheless, studies cite psychological problems and challenging behaviour as predictors of poor outcomes in rehabilitation, and whether, how, and when these factors emerge is unpredictable. When any type of rehabilitation with potential for positive outcomes fails to progress, behaviour challenges are frequently the factor cited as the barrier.
Collecting empirical evidence of progress and reporting data is increasingly recognized as necessary for the effective allocation of resources in rehabilitation. With Applied Behaviour Analysis data collection is an important aspect of treatment to ensure that progress is ongoing, or that intervention strategies are continuously measured and adjusted to ensure continuous positive growth. The ongoing collection of objective, observable and measurable information provides feedback to the survivor and their rehab team, as well as evidence of successful outcomes.
Complex behaviour or behaviour that is resistant to supportive change processes in rehabilitation for Acquired Brain Injuries, gain a huge cost benefit from the services of a Board Certified Behaviour Analyst (BCBA) to functionally analyze the contexts of the behaviour and provide a framework for professional supports for behaviour change.
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