Behavioral Treatment of Chronic Psychiatric Patients

Using Single-system Research Designs to Evaluate Practice

“…The use of any research tool such as SSRDs needs to be carefully evaluated in terms of its appropriateness for various cultures and clientele, in order to avoid any tendency towards cultural imperialism (Ngan, 1993). In the United States, some of the foremost advocates of SSRDs are human service professionals with Chinese and Japanese (Wong et al, 1987;Kahng et al, 1997) backgrounds. In the United Kingdom a similar role is being played by the social worker Mansoor A.F.…”

Operant Learning Theory

“…In an analogous fashion, staff members in institutions have been trained to use rein forcement contingencies to manage urinary incontinence in elderly residents (Pinkston, Howe, & Blackman, 1987) and to reduce delusional verbalizations and disruptive behavior (Wong, Woolsey, & Gallegos, 1987), to restore appropriate conversational speech (Wong & Woolsey, 1989), and to improve grooming skills and personal hygiene (Wong, Flanagan, et aI., 1988) in chronic mental patients. Behavioral procedures have also been utilized to teach technical skills to professional staff or interns such as facilitative and supportive ut terances during family therapy (Galant, Thyer, & Bailey, 1991), clinical interviewing skills (Iwata, Wong, Riordan, Dorsey, & Lau, 1982;Schinke, Gilchrist, Smith, & Wong, 1978), management of visits between parents and children in foster care (Kessler & Greene, 1999), behavior management skills to staff in group homes for persons with mental retardation (Schinke & Wong, 1977) and adult day care centers (DeRoos & Pinkston, 1997), and be havior analysis skills to graduate social work students (Dillenburger, Godina, & Burton, 1997).…”

“…Schizophrenic Disorders Operant learning principles have been applied with some of the most severe behavior disorders in adults involving the emergence of bizarre or grossly disorganized behavior and the associated deterioration in social functioning, vocational per fonnance, and self-care, Wong and his colleagues (Wong, 1996;Wong, Wilder, Schock, & Clay, 2004) have recommended that the treatment of these disorders be multipronged and address the specific behavioral excesses and deficits exhibited by the individual client In an early study, Patterson and Teigen (1973) used token reinforcement and verbal feedback to reestablish factual statements about personal background in a 60-year-old woman with a long history of delusional speech. Wong, Woolsey, et al (1987) later applied positive reinforcement to increase accurate verbalizations and response cost (removal of positive reinforcement for inappropriate behavior) to reduce delusional speech in a 24-year-old woman with the diagnosis of Paranoid Schizophrenia, In a series of studies that examined the relationship between psychotic behavior and appropriate alternative behavior, Wong and his colleagues (Corrigan, Liberman, & Wong, 1993;Wong, Terranova, et aL. 1987;Wong, Wright, TelTanOVa, Bowen, & Zarate, 1988) demonstrated that a broad array of bizarre and repetitive responses could be displaced by both sedentary and strenuous recreational activities in 14 persons with severe mental disorders bearing varied diagnoses, Beginning the lengthy process of restoring functional repertoires in clients with long histories of severe mental disturbances, Wong and Woolsey (1989) used a highly struc tured, discrete trials format to teach rudimentary conversational skills (e.g., saying "Hi" or "Hello") to four actively psychotic patients with Schizophrenia, Working with three higher functioning patients with Schizophrenia, Wong et al (1993) applied traditional social skills training procedures to teach more sophisticated conversational skills (e,g" conversational questions such as "How is the weather outside?…”

Evaluating the Effectiveness of Cognitive-Behavioral Treatment of Residual Symptoms and Impairment in Schizophrenia

“…The social work profession has a long and distinguished history of intervention development and research in treatment of persons with schizophrenia that have incorporated a variety of cognitive, behavioral, and psychoeducational interventions. Significant innovations in treatment have been developed by social workers in assertive community treatment (Stein & Test, 1980;Test & Stein, 2000), family psychoeducation (Anderson, 1977;Anderson, Hogarty, & Reiss, 1980;Anderson, Reiss, & Hogarty, 1986), behavioral treatment (Wong, 1996;Wong, Woolsey, & Gallegos, 1987), sociotherapy (Hogarty, Goldberg, Schooler, & Ulrich, 1974) and personal therapy (Hogarty et al, 1997).…”