Case 1: The Case of Emily
Introduction . When there are indications of anxiety in a child's behavior, often, we think that it is a normal behavior of nervousness or being shy and we expect that it will disappear in due course. However, the behavior intensifies, it significantly affects the child's development and it alters the lives of the family members. At this point, it is important to seek help because the anxiety tends to worsen with time if untreated. It gets worse because the child's coping mechanism develop automatically into avoidance because it helps quell the existing fears in the short term, not knowing that avoidance of triggers tends to strengthen the anxiety ( Coelho et al., 2015). This is the case for Emily.
Case Background . Emily is 6 years old and came as a referral from her pediatric psychologist. At first grade, she would refuse to go to school saying it was no longer fun. However, this has escalated and she throws a tantrum to insist she does not want to go to school. She also refuses to sleep in her own bed and insists on sleeping with the parents and would scream if she woke up and found herself in her bed. However, at school, she does not exhibit any of the signs that she displays at home.
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Diagnosis. The first notable observation is the escalation of Emily's deviant and defiant ways. From plainly refusing to go to school, giving an excuse, to the point of throwing a tantrum. The second notable observation is Emily's behavior at school. At school, her teacher notes that her behavior is normal and her academic performance is also average. From these two observations, it can be deduced that Emily's behavior at home escalated because the parents were rewarding her negative behavior and that in school the environment for perpetuating her actions are withdrawn hence the difference in behavior. Therefore, a double approach of response cost and token economies should be able to be effective tools for behavior modification.
Treatment. Response cost will target the refusal to go to school and tantrums because it will rely on withdrawing privileges to discourage unwanted behavior. The parents will be expected to play a big role in the actuation of this strategy. This is being highlighted because as parents, they are prone to emotional manipulation by the child and hence they may willingly give in to the child’s short-term demands at the family’s cost of long-term treatment. Therefore, a great level of assertive discipline is required. This might hurt the parents s they deny their child what looks like is readily available. Assertive disciple in fundamental in response costs because it is unlikely that the patient (Emily) will take it lying down. Therefore, when withdrawing the privileges, the parents have to make to make it clear that they are in charge and that they are whatever actions they are taking are for the benefit of the child and the family.
On the other hand, the token economies will be used to encourage positive behavior in the child’s sleeping behavior. The primary goal of token economies as a behavioral modification tool is to offer a consistent reminder about the goals that have to be obtained. The ensuing promise of a reward that is achieved cumulatively is described as the learned association. Essentially, earning the token is not an end but what the tokens can offer is the driving force. In other words, the token economy operates like a money economy whereby money is not valuable, but what money can get you is the value of the money itself. Tokens act as the reminder of accomplishment and a promise for future benefits that are tied to the choices of the subject and the expectations that are set. Therefore, this act of positive reinforcement will also be an important accompaniment of the negative reinforcement that is channeled by the response cost approach. Emily is therefore expected to aspire to earn the tokens repeatedly so as to get a reward and while at it she will pick up desired behavior.
Assessment: The progress of the patient can be monitored through the use of various metrics including frequency, intensity, and latency in the problem and effect of the intervention as applied to the patient. Data collection is, therefore, a core component of the entire activity because it will form the basis for assessing progress. It is important to note that assessment should be made by the parents and reported to the specialist using a standardized reporting mechanism. For example, during the assessment, some of the data that will be collected will include the number of occurrences of the undesired behavior. This will be monitored progressively and the frequency of occurrence noted over a specific period. Consequently, the duration of the tantrums will be noted over a specific time and the latency will be determined. From this data, the parents can observe the progress of their child. The specialist will also be able to utilize this data to recommend the appropriate actions that can be taken to solidify the gains or to change approach if the initial intervention is yielding the desired results.
Case 2: The Case of Mr. Smith
Background. Mr. Smith's employees are showing disinterest in committing to their employers business. Absenteeism among the 30 employees is getting rampant especially after the owner, Mr. Smith, decided to communicate his concerns to the employees. First, he indirectly tried to improve the morale of his employees by introducing coffee and donuts in the mornings. Later on, he directly tied to intervene by calling for a meeting and addressing the employees about the impact of their behavior on the company's future. From the description of the problem above, the employee's lack of morale is due to uncertainty about the impact of their effort and lack of accountability in terms of teamwork. An effective solution for this problem is to create reward schemes that offer collective rewards and punishment to a team.
Diagnosis . Teamwork can be reinforced through operant conditioning. Teamwork will be used as the framework for behavioral modification to increase the employee’s accountability to their fellow colleague. This different approach is drawn from the two cases of failed intervention where the employer failed to impress the employees. Therefore, to eliminate the absenteeism or to decrease the probability of its occurrence, Mr. Smith in the formation of the team should initiate team activities and implements criteria of punishment and reinforcement. Punishment in this instance will entail the removal of positive rewards after exhibiting discouraged behavior ( Cooper, Heron, and Heward, 2007 ).
Treatment . However, the positive reinforcement and punishment will be contextualized to ensure that the presence or absence of these stimuli can be linked to the undesired behavior to ensure that the exercise roots out or reduce the probability of reoccurrence. Consequently, to be effective, the reprimand will be contingent upon the employee's behavior and hence impersonal. It will also be consistent and timely. Lastly, the behavioral modification will be elaborative. Every action will be explained to the other employees and the effect will be communicated clearly. Therefore, the employees will be encouraged to refrain from undesired behavior as the negative effects will be directed to their colleagues. This is intended to enhance collaboration through team cognition. T eam cognition occurs at the organizational level, unit level but could be elusive at a team level. For example, whereas the tasks in the organization are highly specialized and hence workers and departments are independent, it is important that the teams update each other on the progress to ensure timely delivery. Therefore, despite being independent, planning should be conducted as a cognitive activity that entails collaborative planning among teams or individuals from different teams to enhance interaction among employees.
Assessment . Assessment for this exercise will be conducted at two levels. The first level will be at a group level, while the second level of assessment will be at an individualized level. At the group level, the assessment will include the use of peer reviews. This enables the team to follow-up on the individual member's contribution to the failure or success of their team. Peers would be expected to state how the exercise has impacted individual members to show up to work. Other metrics for measuring success will include the frequency of absenteeism and the latency of absenteeism before and after punishment or positive reinforcement. However, overall, independent observation will study the individual employees and their response to the exercise and how this affected their absenteeism rates.
Another critical component of assessment is measuring the impact of the intervention on the company’s productivity rates. Whereas the primary intention of the process is to stop or reduce absenteeism, the effects of the process will spill over into other areas that are directly affected by absenteeism. Therefore, the impact of the behavior modification can be measured individually using the productivity of the employees or collectively in either the team or the total output. Some of the questions that the assessment will be answering include; did the undesired behavior of the employees change? Did the intervention improve the overall organization team cognition?
Feedback is also essential in monitoring the effectiveness of the intervention. Whereas the overall expectation is that the employees would display desirable behavior over time, achieving this requires that specific conditions are met. The best way to understand the effectiveness of the process is to collect feedback from the participants and other stakeholders. For example, in a bid to discourage absenteeism and improve productivity, employee satisfaction is an area that the behavior modeling will inadvertently address. Therefore, a comprehensive collection and dispensation of individual employee information will be required. However, however well intended the process, there will arise cases of resented and maybe animosity whenever communication is not effectively conveyed. Therefore, the feedback has to be intentionally straightforward inspiring and positive. It should not be threatening or condescending because this type of feedback could make the entire process and its intentions to be unyielding of the desired outcomes. This is because feedback alone can be used as a tool for behavior modification procedure.
References
Coelho, L. F., Barbosa, D. L. F., Rizzutti, S., Muszkat, M., Bueno, O. F. A., & Miranda, M. C. (2015). Use of cognitive behavioral therapy and token economy to alleviate dysfunctional behavior in children with attention-deficit hyperactivity disorder. Frontiers in Psychiatry , 6 , 167.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis . Merrill Prentice Hall.
