Papers by Stephen E . Wong
Behavior Therapy: First, Second, and Third Waves, 2022
If principles and techniques in this chapter can be described as the "first-wave of behavior ther... more If principles and techniques in this chapter can be described as the "first-wave of behavior therapy" for schizophrenia and psychotic disorders, then innovations of psychologists and other scientists leading to the development of behavioral psychology were impulses powering that wave. The roots of behavior therapy go back to twentieth century psychology and behaviorism. In A History of Experimental Psychology, Edwin G. Boring recounts that behaviorism emerged as an offshoot of American functional psychology, "… which has to do with success in living, with the adaptation of the organism to its environment, and with the organism's adaptation of its environment to itself…" (Boring, 1950, p. 551). The intellectual forebearers of this movement were illustrious. A profound influence was Darwin, whose theory of evolution explained animals' anatomical structures by the function they served in improving organisms' chances of survival and reproduction (Kimble, 1961). Behavior, an extension of an organism's anatomy and nervous system, might be similarly analyzed by looking at how it facilitated animals' successful adaption to their environment. This analysis would later provide invaluable clinical insights into how abnormal behavior could have formed and been functional in adverse or perverse environments. The leader of this new movement within psychology was John B. Watson (Keller & Schoenfeld, 1995), the nominal father of behaviorism. Watson rebelled against prevailing German structural psychology and its preoccupation with consciousness, sensation, imagery and other mental states. Structural psychology relied on introspection to study sensory processes and mental content, which were its primary subject matter. Watson criticized this approach as relying on subjective information that was beyond any means of independent verification. Watson also noted that during the preceding 50 years this approach had failed to produce a body of usable data or a related technology for improving human affairs. Watson argued that to become
Residential Treatment for Children & Youth, Jun 8, 2008
Summary Official state program reviews of 204 substitute care facilities were assessed for the ty... more Summary Official state program reviews of 204 substitute care facilities were assessed for the types of behavior management and behavioral interventions used and the extent to which agency practices were consistent with learning theory principles. Data were also collected on the type and number of professional staff available to implement and oversee these procedures, Results showed that a sizable portion of the agencies used restrictive procedures (e.g. “timeout") for response reduction purposes, but without incorporating positive reinforcement programs (e.g., token or point systems, contingent privileges) that would make the application of these procedures humane and therapeutically effective. Program reviews also indicated that relatively small numbers of professionally trained staff were available on‐site to supervise the use of behavior management procedures and behavioral interventions.
Journal of Applied Behavior Analysis, Mar 1, 1987
We evaluated the effects of minimally supervised, independent recreational activities on stereoty... more We evaluated the effects of minimally supervised, independent recreational activities on stereotypic vocal behavior in two chronic schizophrenic patients. In baseline sessions, subjects were observed during unstructured free time in the psychiatric ward. In treatment sessions, therapists presented preferred recreational materials (magazines, models, and art projects), verbally prompted on-task behavior every 20 min, and, in one condition, administered contingent tokens. Independent recreational activities reduced medium-rate self-talk in one subject and high-rate mumbling in a second subject by 60%-70%. Results were the same with or without contingent tokens. Apparent selfmaintaining characteristics of these vocal responses are discussed. DESCRIPTORS: independent recreational activities, hallucinatory behavior, stereotypic vocalizations, schizophrenic inpatients
This study was a component analysis o f several procedures commonly employed in behavioral vocati... more This study was a component analysis o f several procedures commonly employed in behavioral vocational re h a b ilita tio n programs. The work rate o f retarded subjects was assessed under four conditions: 1) base lin e ; 2) verbal prompts; 3) verbal prompts and social reinforcement; and 4) verbal prompts, social reinforcement, and monetary reinforcement. Subjects were fo u r, moderately retarded, male c lie n ts o f a sheltered workshop. The experimental task involved assembly o f a metal kn ife composed o f four separate pieces. Treatment e ffe c ts were analyzed w ith in a mixed multielement reversal design where each subject served as his own c o n tro l. Results showed th a t baseline sessions, a ll started w ith the simple in s tru c tio n , "Begin work," generated s u b s ta n tia l, steady work ra te s. Verbal prompts, given independent o f the sub ject's ongoing performance and uncorrelated w ith reinforcement, fa ile d to increase subject work rate above baseline le v e ls. Verbal prompts and social reinforcement produced a higher rate than verbal prompts alone in a ll four subjects. Verbal prompts, social reinforcement, and tangible reinforcement advanced work rate above th a t fo r verbal prompts and social reinforcement in only one out o f four subjects. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Journal of Teaching in Social Work, May 16, 2017
A course teaching graduate social work students to use an evidence-based model and to evaluate th... more A course teaching graduate social work students to use an evidence-based model and to evaluate their own practice was replicated and evaluated. Students conducted a project in which they reviewed published research to achieve a clinical goal, applied quantitative measures for ongoing assessment, implemented evidence-based interventions, and evaluated effects of their interventions with single-case designs. More than half of the students conducted self-improvement projects monitored with self-report measures, with widely varied goals and interventions. Approximately 48% of the projects showed statistically significant improvements, and an additional 10% showed statistically nonsignificant gains, suggesting the benefits of this instructional format.
Research on Social Work Practice, 1999
This study examined antisocial behavior and consumer satisfaction of 29 adolescents in a long-ter... more This study examined antisocial behavior and consumer satisfaction of 29 adolescents in a long-term psychiatric unit with a modified Achievement Place program. Unit staff recorded the daily frequency of 27 inappropriate behaviors exhibited by individual clients. Time-series data on specific problem behaviors were analyzed with change scores and graphic displays. Prior to discharge, clients also completed questionnaires that rated the helpfulness of program components. Change scores for severe behavior problems gradually declined to near zero levels for almost all clients. Scores for moderate and minor problem behaviors showed smaller declines, which were offset by concomitant increases within this same category. Off-unit activities and point store, individual and group therapy, and behavior reduction procedures received the highest, intermediate, and lowest ratings, respectively. Data indicate that long-term treatment within a structured behavioral program may be associated with substantial improvements in serious conduct problems, and that this intervention is generally acceptable to clients.
PubMed, Sep 1, 1977
Staff in 12 group homes for mentally retarded persons were randomly assigned to either an experim... more Staff in 12 group homes for mentally retarded persons were randomly assigned to either an experimental condition (N = 6), receiving eight 1.5-hour training sessions in behavior modification, or a waiting-list control condition (N = 6). Pre- to posttraining change scores showed that, compared to control home staff, experimental home staff increased significantly more in knowledge of behavioral techniques, had better evaluations of their residents, and indicated less decline in job satisfaction. Naturalistic observational data, collected with continuous real-time recording devices, showed trained staff superior in correctness and latency of their responses to residents. Trained homes also had significantly greater increases in the frequency and duration of positive staff and resident behavior.
Journal of education for social work, 1981
ABSTRACT
Springer eBooks, 1996
... The following pages contain brief treatment plans covering the following problem or skill are... more ... The following pages contain brief treatment plans covering the following problem or skill areas:Delusional verbalizations Oppositional behavior Bizarre stereotypic behavior Social (conversational) skills Grooming and hygiene Prevocational skills Community/independent ...
Journal of Social Service Research, Dec 16, 1987
Behavioral treatments for hallucinations and delusions, aggressive and destructive responses, ina... more Behavioral treatments for hallucinations and delusions, aggressive and destructive responses, inappropriate social behavior, poor self-care and grooming, and deficient recreational and vocational skills in chronic psychratric patients are reviewed. Considcration is given to the short-term, long-term, and generalized effects of these interventions. Three case studies illustrate behavioral procedures of consumable reinforcement. response cost. eraohic feedback. drfferential reinforcement of other bchavior (D~o) , and overco;rection. The otential contribution of clinical social workers in applying suc programs on a psychiatric unit is discussed. R This article reviews learning-based treatments for functional disorders manifested by chronic psychiatric patients. Thc population presents a formidable challenge for clinical social workers with a bewildering array of problem behaviors that are unaffected by conventional therapies. The efficacy of behavioral interventions for ameliorating these disorders has been well documented
Journal of Applied Behavior Analysis, Jun 1, 2000
This study evaluated effects of a checklist on the accuracy of self-assessment of blood glucose l... more This study evaluated effects of a checklist on the accuracy of self-assessment of blood glucose level by a diabetic woman with memory impairments caused by viral encephalitis. The checklist consisted of 54 steps for operating an electronic glucometer, which the subject performed in sequence and checked off when completed. Following introduction of the checklist, the percentage of steps completed correctly increased in simulated and actual blood glucose tests and yielded clinically useful information. DESCRIPTORS: antecedent control, textual prompts, memory aids, brain injury, diabetes management Impaired memory and delayed reacquisition of verbal and motor skills are among the significant sequelae to brain injury. These disabilities can have adverse effects on clients' social relationships, employment, and performance of tasks necessary for independent living. The rehabilitation literature often recommends using visual and textual stimuli, such as calendars, appointment books, and lists of things to do, as prosthetic memory aids for brain-injured clients. Empirical research supporting these recommendations, however, is far from extensive. Written prompts have been validated as effective prosthetic aids for persons with brain injury to increase completion rate of vocational rehabilitation assignments and self-care tasks We thank Terry Keel and Gary Seale for their administrative support.
Psychiatric Services, Aug 1, 1988
Schizophrenic patients typically have poor grooming and self-care skills, which binder their soci... more Schizophrenic patients typically have poor grooming and self-care skills, which binder their social relationships and their chances of successful adaptation in the community. A practical and inexpensive program for teaching grooming skills to hospitalized chronic mental patients has been developed in a California state hospital. Patients are also taught to evaluate their grooming behavior and to car?:)' out grooming activities independently. Grooming deficits and improvements are rated on an 1 1-category performance checklist. Two small-scale pilot studies showed that the program
Research on Social Work Practice, Jun 19, 2012
Objective: The authors examined outcomes of a graduate course on evaluating social work practice ... more Objective: The authors examined outcomes of a graduate course on evaluating social work practice that required students to use published research, quantitative measures, and single-system designs in a simulated practice evaluation project. Method: Practice evaluation projects from a typical class were analyzed for the number of research references cited, type of client, goals or problems, measures, interventions, single-system designs, and outcomes. Results: More than half of the students conducted self-improvement projects monitored with self-report measures, and goals or problems selected and interventions applied varied widely. More than 80% of the projects were evaluated with simple AB designs, over 45% of which were associated with statistically significant improvements and an additional 43% showed gains that did not reach statistical significance. Conclusions: Results suggest that students can be taught techniques and skills needed to formulate interventions derived from published research and to evaluate effects of these interventions using single-system designs.
Behavior Modification, Oct 1, 1989
Behavior and Social Issues, Oct 1, 2006
Behavior analysis, once a promising approach to understanding and treating severe mental disorder... more Behavior analysis, once a promising approach to understanding and treating severe mental disorders, has been obscured by the biomedical model of mental illness and its ubiquitous psychotropic drugs. The present paper gives a brief overview of behavioral research on psychotic disorders followed by a critical review of the prevailing biomedical model including psychiatric diagnoses, anti-psychotic medications, clinical outcomes, and adverse effects of drug treatment. This paper also examines ideological, political, and economic mechanisms of control that have blocked the application of behavior analysis with severe mental disorders.
Ethical Human Psychology and Psychiatry, 2015
This study assisted clients in a locked facility for persons with mental disorders and substance ... more This study assisted clients in a locked facility for persons with mental disorders and substance abuse problems to explore the communities into which they were to be discharged using the Internet. Four patients with either the diagnosis of bipolar disorder or schizophrenia were provided Internet access with instructions to search for any of 6 categories of resources (i.e., potential housing, employment, public services, shops and restaurants, recreational facilities, and social or religious organizations) in their prospective communities. For 3 out of 4 patients, initial instructions to search for any of 6 categories of resources lead to very few relevant websites being visited. When patients were instructed to choose one of these 6 categories to explore and to give their reasons for selecting that category, the number of relevant websites visited increased severalfold. Narrowing search instructions and reviewing personal goals can be helpful in overcoming the numerous distractions on the Internet and allowing clients to obtain needed information from this vast communication network.
Behavior and Social Issues, Oct 1, 2007
Scientific discoveries and technological advances are achieved through the expenditure of human a... more Scientific discoveries and technological advances are achieved through the expenditure of human and material resources. Clinical research and program development in mental health services are no exceptions. In the present rejoinder to Dr. Wakefield's second critique, this point is briefly discussed as well as fallacies in his claim that across-setting generalization was the main reason why behavioral programs have not been more widely utilized in the treatment of psychosis.
American Psychological Association eBooks, 1996
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Papers by Stephen E . Wong