Paradoxical intention in the treatment of obsessional flatulence ruminations

A case study of the paradoxical treatment of long standing obsessional ruminations about flatulence in a 33-year old female respiratory therapist is described. Self- reported estimates of the frequency and intensity of flatulence were unaffected by a misconception correction procedure that entailed the presentation of scientific data disconfirming the bases of her concerns. Paradoxical instructions to intensify flatus emissions were then employed. These instructions resulted in a rapid elimination of the obsessional ruminations; this improvement was enhanced at 1 yr follow-up.     

Flooding or systematic exposure in the treatment of extreme social withdrawal in children

Several children provided social stimuli for treating the extreme social withdrawal of two young boys, one treated by flooding, the other by systematic exposure. To assess the effectiveness of the treatment procedures, within-subject designs were used, consisting of multiple baselines across settings. The results showed that when flooding was introduced in the first setting for the first child, a dramatic increase in interaction from 0 to 60% resulted, with an accompanying decrease in self-talk from 70 to 20%. These behavioral changes did not occur in the second setting until flooding was introduced, when interaction increased form 10 to 40% and self-talk decreased from 85 to 20%. Similar results were obtained with systematic exposure in the second child. Follow-ups of 5 months in the first child and 9 months in the second indicated that the therapeutic gains were maintained. Thus, in treating anxiety-related problems in children in their natural environment either flooding or systematic exposure can be effective.     

Instructions and reinforcement in the elimination of encopresis: A case study

A 7-yr-old boy was reported by school officials and his mother to exhibit chronic fecal soiling (encopresis). A reinforcer sampling procedure was used to expose the boy to potential reinforcers to be used in a home-based motivation system. The mother provided instructions which served to make explicit a contingency between appropriate toileting and reinforcement. Within 10 days fecal soiling was eliminated, and a token system was added to maintain this positive change. An 11-month follow-up indicated no evidence of remission or symptom substitution. Pre- and post-psychodiagnostic evaluations were at variance with the child's behavior.     

The effects of varying schedules of time-out on aggressive behavior of a retarded girl

Three schedules of time-out were compared for suppressing aggressive behavior in a 7-yr-old retarded girl. The schedules (FR5, FR2, CRF) were time-out after every 5th, 2nd or every aggressive act. The FR5 schedule had no effect on rate of aggressive behavior while the FR2 and CRF schedules both produced significant reductions, the CRF being more effective. This reduction was maintained at follow-up after 5 weeks. It appears that time-out may be effective proportionate to the percentage of target behaviors it follows, and that some success can be achieved with less than continuous application.     

Teaching an autistic child pedestrian skills

An autistic child was taught pedestrian skills in a classroom by use of a model of the streets and the intersection she most often frequented. She manipulated a doll and verbalized what the doll was doing to get to the designated location. After mastering the pedestrian skills on the model, video recordings familiarized her with traffic at local intersections. She successfully generalized the pedestrian skills to the natural environment.     

Accountability in psychotherapy: A test case

An attempt was made to determine empirically the feasibility of therapy on a contract basis between therapist and client. The case was a 9-yr-old autistic child whose major problems were temper tantrums and refusal to obey adults' requests. Therapeutic goals and criteria were defined to the satisfaction of therapist and client (the parents) as was the duration of the treatment. An important feature of the intervention was the decision to develop social behaviors outside and not inside the clinic, thus obviating the problem of transfer.     

Teaching and generalization of instruction-following in an “autistic” child

A 4-yr-old boy, diagnosed as “autistic”, very seldom followed instructions. A program, utilizing operant reinforcement procedures designed to increase instruction-following, succeeded dramatically and the behavior generalized across people and novel instructions, and persisted when the primary treatment intervention was withdrawn.     

Automated direct deconditioning of a childhood phobia

The authors present a procedure for the treatment of childhood phobias. Involving aspects of deconditioning, systematic desensitization and reinforced practice, it is referred to as automated direct deconditioning. The application of the procedure to a fear of loud noises in an 11-yr-old boy is described. Treatment was self-administered by the child in his home. Following relaxation in a darkened room, he listened to increasingly longer portions of a tape recording in which feared sounds were systematically superimposed upon selections of his favorite music. Participation in the sessions was reinforced by the child's parents. Within 24 sessions, over an 8-day period, the phobia was eliminated. The advantages of the procedure and its possibilities for other childhood phobias are discussed.     

Modification of aggression through modelling: An experimental probe

Hyperactive impulsive boys were asked to play a game involving verbal assault. Baseline observations indicated a marked inability to cope with verbal aggression. Subjects subsequently viewed a videotape depicting a young boy coping with similar verbal aggression by means of covert coping self-statements. Following coaching and practice in these coping skills, all subjects demonstrated marked improvement. Classroom assessments of disruptiveness prior to and following treatment also reflected performance improvement. The interpretation of these results is qualified as tentative due to the methodological limitations of the study.     

Indirect modification of adolescent drug abuse using contingency contracting

Contingency contracting was used to modify the relationship between a poly-drug abusing adolescent and his family. Concomitant with improvement in the family relationship there was a marked decrease in drug use. Implications for the indirect modification of drug abuse and the importance of negotiation in contingency contracting are discussed.     

Response-contingent time out: Important parameters in behavior modification with children

The present paper delineates and discusses eight parameters of response-contingent time out (TO) procedures that need to be considered in treating children and conducting research. In general, the parameters have not been systematically controlled or investigated.     

Treatment on a severe bird phobia by participant modeling

The use of participant mod.ling in the treatment of a bird phobia of 18 years' duration is described. The case illustrates how self-directed performance and naturally occuring situations were included to enhance the generality of the treatment effect. A one year follow-up indicated that the improvement was maintained. Failure to recognize the role of participant modeling in other case reports is discussed.     

Generalization training and the transfer of prosocial behavior in delinquent adolescents

This study examines the role of generalization training in the transfer of behavior to extra-training settings. Four residents of a treatment center for delinquent adolescents participated in seven 30-min training sessions in which undergraduate students reinforced (praise and redeemable points) positive comments made to peers. For two subjects the same undergraduate trainers conducted all sessions which involved a single activity (ping-pong). For the other two subjects, new trainers and new activities were introducedduring each session. Observation in the residential home was carried out before, after, and during training. “Home” observations revealed that generalization-training subjects showed greater increases over baseline performance during training and post-training periods than constant-training subjects.     

A combination of orgasmic reconditioning and covert sensitization in the treatment of a fire fetish

A 20-year-old male reported a history of fire-setting behavior associated with masturbation as his sole means of obtaining sexual gratification. Physiological and subjective measures indicated sexual arousal to photographic slides of fire and lesser arousal to slides of nude females. Treatment included a new version of orgasmic reconditioning to increase heterosexual arousal and covert sensitization to decrease deviant arousal. At the end of treatment, sexual arousal was greater for heterosexual than for fire stimuli. Masturbatory fantasies were reported to be exclusively heterosexual and no further fire-setting incidents were reported. These changes were maintained at both 4 and 9 month follow-ups.     

The effects of a self-control weight loss program on an obese woman

Self-control techniques were taught to an obese, 55-yr-old woman to help modify overeating behavior. Self-reinforcement was employed in addition to systematic isolation of eating behaviors from associated stimulus situations. Chained eating responses were also broken down. She lost 15 lb in 4$\text{1}\text{2}$ weeks. However, mental and physical fatigue and low blood sugar caused hospitalization. Results are discussed in terms of too rapid a weight loss and the need for careful supervision of the nutritional intake. The problem of sufficient reinforcement is also discussed, and the great potential for self-control methods in treating obesity.     

Some laboratory paradigms for chemical aversion treatment of alcoholism

An extensive literature shows that animals can be trained to avoid a flavored substance if sickness follows consumption. These experiments parallel the chemical aversion therapy of alcoholism nearly exactly. The following suggestions are made for the improvement of this therapy. (1) Lithium appears to be the most effective agent with which to produce the sickness. (2) The alcoholic beverage (in small amounts) should actually be swallowed during treatment, not just tasted. (3) The sickness should be induced after the patient begins to drink even if the result is an appreciable delay between drinking and the peak of the sickness. (4) The patient should fast for a number of hours prior to treatment. (5) An individual treatment usually should involve only one alcoholic beverage.     

Minimizing therapist supervision in the treatment of enuresis

A response cost procedure which minimizes therapist and parent participation was successfully applied to two enuretic sisters. Results are discussed in terms of the type of child with whom this procedure would be most effective.     

Preference for immediate reinforcement in depression

In order to test predictions derived from Lewinsohn's behavioral analysis of depression, 92 undergraduates were given paper and pencil measures of depression, preference for immediate vs delayed reinforcement and value of social vs non-social reinforcements. Results indicated that more depressed Ss scored more in the direction of preferring immediate reinforcement and that this did not seem to be due to response bias. Depression was not related to social vs non-social reinforcer preference. Results were discussed in relation to the function of depressive behavior.