Why Clinical Psychologists Use Applied Behavior Analysis
“Clinical psychologists meet with clients to identify problems—emotional, mental, and behavioral—in their lives. Through observation, interviews, and tests, the psychologist will diagnose any existing or potential disorders. Then, together with the client, they formulate a program of treatment according to the client’s needs. Psychologists monitor the client’s progress on a regular basis to ensure that their needs are met by the course of action, and to adjust it if necessary.”
A clinical psychologist’s chosen treatment plan for a client can very well be ABA-driven, as ABA is an incredibly effective method for treating various behavioral difficulties. There are many reasons why a clinical psychologist may choose applied behavior analysis over other forms of treatment; they may also choose to use ABA techniques in conjunction with another type of therapy such as dialectical behavior therapy (DBT) or cognitive behavior therapy (CBT).
Out of all the available management techniques for behavioral disorders, applied behavior analysis (ABA) has earned its place as one of the most prominent and effective tools in a clinical psychologist’s arsenal. There are several key reasons behind the success of ABA, including its emphasis on scientific methodology and overall flexible approach to treatment. Understanding the full value of this kind of therapy helps patients, caretakers, and practitioners appreciate the opportunities it provides to people who are struggling with cognitive, emotional, or social disorders.
The top reasons why clinical psychologists choose applied behavior analysis:
- Integration with Family System
- Supported by Scientific Evidence
- Scales with Patient Development
- Quantifiable Progress
- Personalized Therapy
1. Integration with Family Support
Being able to generalize therapy strategies into a natural environment is important, not only for the client but for those around them. Clients who are learning ABA strategies can learn to integrate what they have learned in a clinical setting with their home, school, and community setting; however, it is not solely up to the client to achieve successful generalization. Children, teens, and adults need support from their family and friends to be successful outside of a therapeutic setting, and learned applied behavior analysis strategies can easily be moved from one setting to another.
It is possible for someone who is not an expert at ABA principles to apply them at home or in the community. Parents, for instance, can learn the skills that their child is learning in therapy, and encourage those same skills at home.
For example, a parent might want a child to clean up their toys after playing. The parent can take simple ABA strategies and apply them for their child to successfully clean up. By using simple steps, modeling, using visuals, and providing positive reinforcement this task can easily be learned by the child and continued without parental assistance.
A clinical psychologist can easily train parents on strategies they are using in therapy sessions that can generalize to the home, as well as give resources to the parent so that they may continue learning about ABA.
Integration with family support is crucial. ABA skills need to eventually leave the clinical setting with the client and be generalized into other natural settings.
2. Supported by Scientific Evidence
Another reason why many psychologists use applied behavior analysis is the relatively large body of evidence that supports its results. Treatments have been shown to offer benefits for people suffering from a wide range of conditions. However, research related to its applications for intellectual disabilities and autism spectrum disorders (ASDs) is the most prevalent, according to the Behavior Analyst Certification Board.
Over the past 100 years, there has been an extensive body of literature and hundreds of peer-reviewed, scientific studies published—including several meta-analyses—on applied behavior analysis.
Applied Behavior Analysis is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.
“Evidence-based means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. ABA therapy includes many different techniques. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior)” (Autism Speaks).
Many studies that include ABA procedures are called single-case designs.
[These are] “studies using single-case designs are controlled studies where treatment is applied in a manner that allows one to demonstrate that the treatment was responsible for the change in behavior. These studies are methodologically rigorous because they involve direct observation of behavior and objective data collection where behaviors are defined and counted (often using a computerized data collection system). A second observer also collects data independently to ensure reliable and accurate data collection” (Kennedy Krieger Institute).
The following strategies have been clinically proven to be effective with individuals with autism and within an educational setting; however, they can also be used in other settings and with other groups of people. This list does not exhaust all ABA strategies.
- Functional Behavior Assessment
- Picture Exchange Communication System
- Task Analysis
- Differential Reinforcement
- Social Narratives
- Visual Supports
- Functional Communication Training
In the realm of ABA, various other behavioral strategies are evidence-based and proven to work with multiple populations.
3. Scales with Patient Development
Applied behavior analysts apply their expertise to help their patients build social skills and coping mechanisms through an incremental process. They can start small with a single action or interaction, then combine these separate actions to create a larger pattern that results in more acceptable behavior. The ability to scale from small steps to large leaps as clients develop is another reason why ABA is considered an effective treatment.
Two examples of how clinical psychologists can utilize ABA therapy in this manner are to use task analysis and incorporate chaining into tasks.
Task analysis is the process of taking a skill with multiple steps, such as washing hands and breaking it down into smaller tasks for the client. Instead of directly telling the client to wash their hands, by using task analysis the clinician would tell the client to first get their hands wet, then put a dollop of soap on their hands, then rub hands together for x-amount of seconds, and so on. With certain populations, it is beneficial to use a visual when completing a multi-step task.
The steps in a task analysis include:
- Identifying the target skill
- Identifying the prerequisite skills of the learner and the materials needed to teach the task
- Breaking the skill into components
- Confirming that the task is completely analyzed
- Determining how the skill will be taught
- Implementing intervention and monitoring progress
Chaining is part of task analysis and is the process of physically teaching each small step for the task to be successfully complete.
Both task analysis and chaining are ABA strategies that clinicians, educators, and parents can easily use with the individual who is receiving the strategy.
4. Quantifiable Progress
The benefit of ABA therapy is that any technique worked on and each behavioral change that is made can be observed and recorded. Going back to the task analysis of a child washing their hands, each small step within the task can be recorded as done correctly or incorrectly, and therefore the person working with the child on the task will know which small steps need to be worked on more to complete the task.
All behavior is observable and measurable; it is as simple as that. Clinical psychologists should be able to directly or indirectly measure client progress on behavior goals.
5. Personalized Therapy
Even though the basic elements of applied behavior analysis are common among all patients and practitioners, each person’s therapy can be tailored specifically to their needs. The ability to personalize and customize treatment programs is one of the most valuable features of ABA. Since patients are direct participants in therapy, they are also partially responsible for the outcome. Psychologists can build treatment programs that cater to and accommodate a patient’s specific needs, strengths and weaknesses.
As stated earlier, ABA therapy can be combined with DBT, CBT, or another type. Those needing a behavioral intervention may also require therapy that helps with trauma or depression, for example.
Depending on a client’s needs, a clinical psychologist can pick and choose which ABA interventions and strategies best suit him or her.
Conclusion to Why Clinical Psychologists Use Applied Behavior Analysis
Behavioral disorders may not be as urgent as medical emergencies, but they can still have a crippling effect on the client’s life. These disorders can greatly hinder performance at school, limit career potential, and detract from interactions with friends or family members. Applied behavior analysis isn’t a perfect therapy, but there are plenty of reasons why it continues to be an effective technique for people facing various behavioral and social obstacles.
Master of Education (M.Ed.) | Northeastern State University
Behavior and Learning Disorders | Georgia State University
Updated April 2021