Not All Treatment Challenges are Created Equal: Effects of Reduced Integrity on Treatment Outcomes

Not All Treatment Challenges are Created Equal: Effects of Reduced Integrity on Treatment Outcomes

with Claire St Peter, PhD, BCBA-D

Treatment integrity refers to the extent to which a behavioral program is implemented as designed or described. Ensuring adequate treatment integrity is important for several reasons. Higher integrity is typically associated with better treatment outcomes. Additionally, high treatment integrity is necessary to ascribe changes in behavior to the intervention. Behavior analysts often train individuals to implement procedures with a certain level of integrity. For example, a clinician might train staff members until the staff member implements the procedure with 80% or 90% integrity. However, we are still unsure how much integrity is necessary to produce desired behavior changes. This matter is further complicated because the amount of integrity necessary may vary depending on the type of procedure and the type of integrity failure. In this presentation, I’ll describe recent studies that have evaluated ways to measure integrity and outcomes associated with reduced integrity, particularly in the assessment and intervention for behavioral excesses (such as the treatment of aggression) and deficits (such as the development of manding). Our recent work suggests that the measurement strategy used, type of intervention, and type of integrity failure interact to affect treatment outcome.

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