Issues for the Consulting Behavior Analyst: Don't Just Implement a Treatment Plan, Use the Ecology to Practice a Treatment Plan

Article excerpt

Currently distance consulting takes place in mental health rehabilitation centers, mental retardation rehabilitation centers, educational, preschool and even home locations. In each of these locations, but especially in home programs, the distance consultant can encounter very different education, training and experience backgrounds within Applied Behavior Analysis this articles talks about the importance of taking into account this part of the ecology in designing a treatment plan.

**********

Gillat & Sulzer-Azaroff (1994), Page, Iwata, & Reid (1982), speak of the importance of teaching those involved in a program how to provide effective training, consultation, and supervision to those who will implement a program. In this example they are speaking of training the trainers which differs slightly from the relationship that we are speaking of currently. In distance relationships involving the education and rehabilitation system, there is no guarantee, but generally individuals are available with an acceptable working knowledge about behavioral technology and its application. In addition there are usually senior staff members available, psychologists, social workers, or other specialists who can assist with training and supervision and add considerable assurance to the treatment effort. In an in home program the relationship that we are speaking of is much more direct, the distance consultant is the trainer, consultant and supervisor to those who will implement the program. This relationship is spread across a number of visits each year and may vary in length, but is generally a short six to eight hours every six to eight weeks and in some cases even longer. The amount of supervision that the distance consultant may provide in between visits varies but is generally limited to videotapes, telephones and advice via data analysis and email. In this type of environment the importance of face-to-face time and instruction of the trainers is at a premium.

Additionally, in an in home program, where implementers are often implementing the treatment plan while there are considerable competing events, the distance consultant must take into account the ecology of treatment when training the implementer to deal with the complexities of the treatment plan. As Malouf & Schiller (1995) have pointed out there are events in the ecology that are not conducive or may impeded or compete with standards of the treatment plan, like the other children in the family, the phone, preparation of dinner and other events in the ecology that are rarely considered in a behavioral change plan. While it remains clear that practicing the application of treatment is perhaps the most important use of the distance consultant's time, it becomes more a question of how to practice the application of the treatment plan. As Willems (1974) points out there are interdependencies among ecology, organism and behavior that leave the door open to widespread unintended effects. The possibility exists that the most highly advanced and technically perfect treatment plan may have contradictory effects without the consideration of the ecology. In fact it seems rare that a treatment plan developed for a school setting will be successful "as is" in the home or other settings. The plan simply must be developed considering the ecology, which includes the implementers themselves, their willingness to be implement the treatment plan, their knowledge and experience and the likelihood of "resistance" (see Cautilli & Santilli Connor, 2000 for more information) to follow the treatment plan.

The distance consultant working with an in home program must maximize the amount of time that is spent with a team working in the child's milieu and instructing those who will implement the treatment plan while they are implementing the treatment plan. A simple day of explanation and training about the treatment plan may have little effect once the instructors are left to implement treatment "in the real world" alone. …