Behavioral consultation is described as a multi-step problem-solving process that provides indirect service delivery to a client. This triadic relationship is facilitated through a consultant-consultee relationship in which the consultant works to change the client’s behavior by empowering the consultee with skills for future problem-solving. A Behavioral Consultation happens when one or more of the child’s parents/caregivers discuss family dynamics. The conversation is usually focused around one or more children’s challenging behaviors and the way that they affect the family’s ability to function. The Consultant makes suggestions and develops a plan of action from a toolbox of methods that they have been trained in, or previously seen evidence-based success in. At Psychtegrity, everything we do is a person centered-based and individualized.
Behavioral consultation encompasses three levels of intervention:
On a tertiary level, the concern is instructing consultees in how to intervene with a child, adolescent, or adult who presents with learning and behavior challenges. Using feeding as an example, a focus of tertiary intervention might be a child who displays selective eating, food refusal, or liquid avoidance, which causes the child to be malnourished and underweight. In this example, the child demonstrates a presenting problem, with clear negative outcomes, and requires systematic intervention.
Secondary intervention is not directed at an existing learning or behavior challenges but instead an existing condition that places a child or adult at-risk for developing a problem. With feeding, an example would be a child who displays a tendency toward preferential eating or a parent who mismanages meals. Effective consultation in such cases would target these risk factors through prevention-focused intervention.
Finally, the emphasis on primary intervention is preventing the emergence of risk factors. Using the feeding example again, the concern for consultation might be training parents and care-providers to select nutritionally sound food choices and use positive approaches to making mealtimes enjoyable, apply procedures that support a child’s self-feeding, and implement antecedent strategies which deter the child from acquiring disruptive mealtime behaviors.
What is ABA?
ABA is an evidence-based treatment method, which has been proven especially effective in teaching individuals with autism and other developmental disabilities. ABA is based on B.F. Skinner’s theory of operant conditioning. Behavior-environment interactions are analyzed to determine why individuals engage in certain behaviors and how best to teach them new behaviors. This includes decreasing inappropriate behaviors, such as tantrums and aggression, and increasing appropriate behaviors, such as communication, socialization, and instruction following. ABA programs are data-driven and individualized. ABA is used to increase independence and teach socially important behaviors. Data is taken on all goals so that progress can be monitored and changes to the teaching strategies can be made if needed. ABA uses a number of techniques, including
Psychtegrity Behavioral Center offers two main service steps. Each step is set to provide the best possible service for each family and their child. adolescents and/or adults. We provide both a direct therapy model and a consultation model based on the specific needs of your child, adolescent, and/or adults.
In our direct therapy model, we provide one or more therapists to work directly one-on-one with the individual on skill acquisition and behavior management goals. An assessment will be completed by one of our supervisors to access the specific needs of the child.
Each program is supervised by one of our Board Certified Behavior Analysts (BCBA), Board Certified Assistant Behavior Analysts (BCaBA), and Behavioral Specialist. Play therapists and Registered Behavioral Technicians (RBTs) are utilized in this step.
A parent training component will be provided to each case as this is a crucial part of an ABA program. Parents will gain the essential knowledge needed to help their child generalize acquired skills and behavioral goals.
The use of a consultation model generally incorporates both psychotherapeutic and educational elements. Consultative activities range from providing mental health or behavioral consultation to another professional about a specific child to providing organizational consultation to a system involved with a child, such as a school. The system usually has recognized that a problem exists and invites the ABA clinician to assess the problem and suggest potential intervention strategies. However, if the clinician has a client whose problems are adversely impacted because of the way the client is being handled in another system (e.g., school), then the therapist and/or analyst may initiate the offer to consult with individuals in the system. Usually, the clinician does not implement the interventions him- or herself. Instead, the system intervenes in the problem from within, with the information and guidance provided by the play therapist as a consultant.
Our consultation model is provided for parents in-home or community setting, or for teachers/school aides in an in-school setting. Each consultation will provide education and the implementation of behavior management strategies based on the principles of ABA (Applied Behavior Analysis). We demonstrate how to deal with challenging behaviors most effectively in order to decrease the occurrence of these behaviors in the future. Challenging behaviors may include aggression, temper tantrums, self-injury, property destruction, or non-compliance. Based on antecedent and consequence strategies, we will teach you how to reduce your child’s motivation to engage in select problem behaviors and we will help you teach your child a more appropriate way to communicate his/her needs. Each set of interventions provided will be modified to each child’s and family’s needs.
What does the initial consultation look like?
A certified clinician comes to the family’s house and observes the children in their natural environment as well as observe the individual in the community (Psychtegrity's clinic, school, and other social environments). The clinician makes time to spend with the children, then sits down with the parents for the consultation. Depending on the situation and ages of the children, we like to involve the entire family in the initial consultation.
The first session is spent observing existing contingencies (motivating factors and current consequences), which helps us to determine the function of the behavior. Based on this observation, we will provide you with recommendations and train you on how to implement them. The training consists of a teaching and modeling component. After that, our level of involvement depends on the needs of your family. We do not require a minimum number of sessions. However, based on our experience, families whom we see on a regular basis (at least short-term) tend to make more progress. If desired, we are also available to accompany you on community outings, such as to stores, restaurants, or anywhere else where you see the most problematic behavior.
Consultations will be provided by a Board Certified Behavior Analyst, a Board Certified Assistant Behavior Analyst, a Behavioral Specialist, or a Senior Therapist.
How often do families see Behavior Clinicians?
It is recommended that in the first few weeks of the intervention that the clinician visits the family on a weekly basis, to check in with how everything is going. It is likely that there will be a few “teething problems” with some strategies, and these kinks can be worked out during the treatment. The clinicians and therapist can help families to start a culture of meeting regularly which can then be sustained without being present. The consultant is involved for as long as the family requires assistance. One of the biggest advantages of having a third party involved in a family behavioral intervention is that the clinicians helps to keep the parents accountable for reinforcing the strategies that will lead to change.