Clinical behavior analysis is a subspecialty of ABA. Behavior analysts apply behavior analytic principles and methods to treat mental health challenges in this subset.
Clinical behavior analysis addresses various areas of mental wellness, including the following.
- Substance misuse
- Sleep disturbances
- Chronic pain
- Impulsivity and inattention
Clinical Behavior Analysis Models
Clinical behavior analysis includes a growing number of therapies. Acceptance and commitment therapy (ACT), behavioral activation (BA), community reinforcement and family training (CRAFT), functional analytic psychotherapy (FAP), and integrative behavioral couples therapy (IBCT) are a few of the research-supported models.
Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT) is one of the fastest-growing third-generation behavioral therapy models. ACT is an approach to modifying verbal behavior to increase psychological flexibility. When someone is experiencing behavioral rigidities that are harming their quality of life, ACT can be beneficial.
There are six key components to ACT, which make up what is known as the ACT Hexaflex.
- Acceptance: Becoming aware of internal and external events without placing judgment
- Values: Defining what is most important to one's self
- Committed action: Taking actionable steps toward one’s values
- Present moment awareness: Focusing on sensory experiences in the present moment
- Self-as-context: Observing one’s own thoughts, feelings, and actions
- Cognitive defusion: Understanding one’s thoughts as environmental stimuli, but not necessarily as fact
Behavioral activation is a treatment model most commonly used to treat depression and other mood disorders. This model is based on the theory that people experiencing depression are contacting positive reinforcement significantly less frequently. This is because people who are depressed tend to engage in increased avoidance and isolation, which can heighten their symptoms.
The goal of behavioral activation is to support individuals experiencing depression by gradually increasing their engagement with activities that will help them to contact positive reinforcement, thus improving their mood. Clinical behavior analysts use the person-centered planning (PCP) approach to care by first discovering what is most important to the individual before recommending individualized strategies.
Activities encouraged in behavioral activation therapy might include those the individual previously engaged in before experiencing depression. For example, exercising, spending time with friends and loved ones, and completing daily chores and household activities. Activities may also include novel ones like trying a new hobby or learning a new skill. Sleep and diet modifications are also commonly addressed through behavioral activation, as depression tends to alter an individual’s habits in those domains.
Behavioral activation is a systematic process. It is well established that treating depression is not as simple as telling someone just to get out and have fun. However, with slight changes and gradual steps, behavioral activation can be a beneficial treatment.
Community Reinforcement Approach and Family Training (CRAFT)
Community reinforcement approach and family training, also known as CRAFT, is a behavioral approach used to treat substance misuse and addiction. CRAFT is a method of teaching family members strategies for supporting their loved one who has challenges related to substance misuse. Addictions reduce motivational control, making it challenging for the individual experiencing the addiction to be self-motivated to seek treatment. As a result, only about 10% of people experiencing substance misuse or another addiction seek professional help. CRAFT, therefore, is a treatment modality focused on training family members, friends, and loved ones of the person experiencing the addiction.
CRAFT aims to improve loved ones' understanding of addiction and adjust their own behaviors to create a supportive environment. It also teaches ways of increasing the addicted person’s motivation to seek treatment. Several studies have found that this family approach significantly increases the likelihood of entering treatment compared to traditional methods.
Functional Analytic Psychotherapy
Functional analytic psychotherapy (FAP) is a relational and behavioral psychotherapy approach. In this approach, the therapist and client collaboratively work to identify unhelpful behavior patterns and systematically shape these behaviors within sessions. Therapists trained in FAP first focus on developing rapport with their clients, ensuring that trust and mutual respect are well established. Then, as the therapeutic relationship is created, the therapist carefully evokes the client’s identified problematic behaviors, providing direct, honest feedback and reinforcing improved behavior.
FAP helps people learn behaviors necessary for the development and maintenance of relationships. Therapists shape interpersonal behaviors, emotional awareness, and behaviors of self-expression that are beneficial for healthy relationships.
Integrative Behavioral Couples Therapy
Integrative behavioral couples therapy (IBCT) aims to support couples in developing a stronger understanding of each other’s emotions. This therapy is based on the theory that relationship challenges stem not only from poor actions and inactions of partners but also from the partner’s emotional reactivity toward behaviors.
IBCT first starts with thoroughly evaluating the relationship from both partners' perspectives. The therapist then analyzes the information and develops behavioral strategies for the couple to build on their strengths in the relationship and techniques to address challenges. A key aspect is discussing the strategies the couple may have already tried and analyzing why those efforts failed.
What is Clinical Direction?
Clinical direction refers to the case supervision or oversight of a board certified behavior analyst (BCBA). In the majority of cases, registered behavior technicians (RBTs) provide direct care. The supervising BCBA gives case-specific guidance for 10-20% of direct treatment hours. Clinical direction may involve many activities, including implementing and modifying goals, data analysis and interpretation, direct observation of the RBTs implementing skill acquisition and behavior reduction goals, and training and feedback.
What is ABA clinical behavior analysis software?
ABA clinical behavior analysis software is an electronic data collection system that allows clinicians to closely monitor client progress and make evidence-based decisions. Using behavior analysis software, clinicians, technicians, and stakeholders can stay aligned with client progress, communicate important updates, and make necessary changes quicker, resulting in more rapid client progress.
Frequently asked questions
Clinical behavior analysts work with clients and loved ones to develop strategies for supporting healthy behaviors and reducing interfering ones, thus improving one’s mental well-being. Clinical behavior analysts implement behavioral principles to improve cognitions, emotions, and behaviors. The primary goal of a clinical behavior analyst is to increase their client’s quality of life.
ABA therapy can benefit people at any age, from early childhood into adulthood. Therefore, there is no set age that ABA therapy should start. However, a major focus in the ABA field is on caring for children with autism. As such, many children begin ABA therapy between 2 and 8 years old. With increased awareness and better diagnostic techniques, diagnoses are often made at a younger age. This allows children to begin medically necessary care sooner when neural pathways are forming rapidly.
The seven dimensions of ABA are a set of guidelines for behavior analysts.
The seven dimensions of ABA include:
- Generality: The degree to which a behavior carries over into other settings, with other people, and with different stimuli.
- Effective: Behavior change procedures result in a significant level of improvement.
- Technological: Procedures must be written with enough clarity and conciseness that another individual can replicate them.
- Analytic: Interventions are derived based on functional relationships between behaviors and the environment. All decisions are data-driven.
- Conceptually systematic: Interventions are consistent with behavioral principles supported via research.
- Applied: Behaviors targeted must be socially significant.
- Behavioral: Behaviors targets are observable and measurable.
Clinical ABA therapy is the application of behavior analytic principles and concepts to the treatment of mental health challenges. Interventions focus on understanding one’s covert behaviors, such as thoughts and feelings, as well as overt actions and developing strategies to modify thoughts, feelings, and behavioral patterns.
- American Psychological Association. (n.d.). Community reinforcement and family training (craft). American Psychological Association. Retrieved January 19, 2023, from https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement
- Archer, M., Harwood, H., Stevelink, S., Rafferty, L., & Greenberg, N. (2020). Community reinforcement and family training and rates of treatment entry: A systematic review. Addiction, 115(6), 1024–1037. https://doi.org/10.1111/add.14901
- Clinical behavior analysis - BACB. (n.d.). Retrieved January 19, 2023, from https://www.bacb.com/wp-content/uploads/2020/05/Clinical-Behavior-Analysis-Fact-Sheet_190520.pdf
- Functional analytic psychotherapy (FAP). Society for the Advancement of Psychotherapy. (n.d.). Retrieved January 20, 2023, from https://societyforpsychotherapy.org/functional-analytic-psychotherapy-fap-using-awareness-courage-love-treatment/