Behavioral

Assessment
GROUP 8
CHAPTER OUTLINE
The Behavioral Tradition
• Sample Versus Sign
• Functional Analysis
• Behavioral Assessment as an Ongoing
Process
Behavioral Interviews
• BOX 9-1: Clinical Psychologist
Perspective:
• Stephen N. Haynes, Ph.D.
Observation Methods
• Naturalistic Observation
• Examples of Naturalistic Observation
• Controlled Observation
• Controlled Performance Techniques
• Self-Monitoring
• Variables Affecting Reliability of
Observations
• Variables Affecting Validity of
Observations
• Suggestions for Improving Reliability and
• Validity of Observations
• Contemporary Trends in Data Acquisition
Role-Playing Methods
Inventories and Checklists
Cognitive-Behavioral Assessment
• BOX 9-2: Clinical Psychologist
Perspective:
Karen D. Rudolph, Ph.D.
Assessment
 Table of Contents
The Behavioral
1 Behavioral 2 Interviews
Tradition

Observation Role-Playing
3 Methods
4 Methods

Inventories Cognitive-
5 and 6 Behavioral
Checklists Assessment
 1
The Behavioral
Tradition
Personality is a system of constructs that greatly influences
behavior. However, behavior therapists and assessors see
personality more in terms of behavioral tendencies in
specific situations. Behavioral assessment is especially
relevant for work with children and adolescents. Most
personality theorists agree that the youth have not yet
developed a set of stable personality traits. Thus,
personality assessment is rarely conducted with youth, but
behavioral assessment is quite common.
Another central feature of behavioral assessment is
traceable to B.F. Skinner’s (1953) notion of functional
analysis. This means that exact analyses are made of the
stimuli that precede a behavior and the consequences that
follow it. Crucial to functional analysis is careful and precise
description.

For example: A child is aggressively disruptive in the

classroom. One assessment might be directed towards that
the child is trying to satisfy something.
A useful model for conceptualizing a clinical problem from a
behavioral perspective is the SORC Model:

S = stimulus that brings on the problematic behavior

O = organismic variables related to the problematic behavior

R = response or problematic behavior

C = consequences of the problematic behavior

Behavioral clinicians use this model to guide and inform
them regarding the information needed to fully describe
the problem and the interventions that maybe
prescribed.
 Differences Between Behavioral And Traditional
Approaches To Assessment
1. Assumptions
a) Conception of personality
Behavioral
Personality constructs mainly employed to
summarize specific behavioral patterns.
Psychodynamic
Personality as a reflection of enduring
underlying states or traits
b)Cause of behavior
Behavioral
Maintaining conditions sought in current environment
Psychodynamic
Intrapsychic(within the individual)

2. Implications
a) Role of behavior
Behavioral
Important as a sample of person’s repertoire in specific
situation.
 Psychodynamic
Behavior assumes importance only in so far as it indexes
underlying causes.
b) Role of history

Behavioral
Relatively unimportant, except, for example, to provide
a retrospective baseline.
Psychodynamic
Crucial in that present conditions seen as a product of
the past.
c)Consistency of behavior
Behavioral
Behavior thought to be specific to the situation.
Psychodynamic
Behavior expected to be consistent across time and setting.
3. Uses of data

Behavioral
To describe target behaviors and maintaining conditions,
to select the appropriate treatment and to evaluate and revise
treatment.
 Psychodynamic

To describe personality functioning and etiology, to classify

The table illustrates behavioral assessment at various
and to make prognosis.
stages of treatment. First, diagnostic formulations provide
descriptions of maladaptive behaviors or potential targets
for intervention. Second, the patient’s context and
environment is a must to be assessed. And lastly, an
evaluation of the clients resources such as skills, level of
motivation, beliefs, etc. is also important.
 Behavioral Interviews

To begin a functional analysis, one must know first what

the problem is. Yoman (2008) says that the important first
step in functional analysis is to define the ultimate
outcomes of desired behavior change. In other words, the
behavior therapist asks the client about the hoped-for
results.
This interview then results in a chain of behavior changes
and results of consequences that can inform the therapist
about how short-term consequences of behavioral
change that may be tied to the ultimate outcomes.
2 Behavioral
Interviews
Stephen N. Haynes
 Clinical Psychologist Perspective: Stephen N.
Haynes, Ph. D.
Dr. Haynes is a professor and former Department Chair and
Director of the Clinical Psychology Program at the
University of Hawaii at Manoa. He is an expert in
behavioral assessment, clinical case formulation,
psychological test development and evaluation and
psychopathology. He also published 150 articles and books
on these topics.
What originally got you interested in the field of
clinical psychology?

His reason was it started to occur in Kalamazoo, Michigan

where he was always drawn to questions about his
environment. They had intriguing and hilarious
conversations about different topics which he ultimately
enjoyed. Psychology for him is a fascinating application of
science and was super interesting. It was on April of his
sophomore year that he decided that he could make a
career of clinical psychology.
 Describe what activities you are involved in as
a clinical psychologist
He was involved mostly on researches and clinical
assessment. He also taught behavioral assessment and
adult psychopathology courses to graduate students. They
studied scientific principles of psychological assessment and
applied the principles to different families.
He also enjoyed editing and writing. He reviewed thousands
of manuscripts submitted for publication and continued to
interview many manuscripts every year.
 What are the future trends you see for
clinical psychology?
1. An increasing emphasis on empirically validated
treatments and the use of empirically validated
assessment instruments.
2. An increasing emphasis on clinical case formulation
to select the best treatments, as empirically
supported treatment options expand and we are
more familiar with the individual differences
among clients with the same behavior problems.
3. An emphasis on ongoing evaluation of treatment process
and outcome (time-series measurements), using valid
measures, so that changes in programs can be
implemented quickly.
4. In assessment, increasing use of alternative assessment
strategies, such as handheld computers, computerized
interviews, analogue clinical observations, brief screening
instruments, and specifically focused questionnaires.
5. Concepts and methods of psychology that combine
information about our physiology, thinking, emotions, and
actions.
 The focus of the discipline is also likely to
change:
1. An emphasis on the Ph.D. as a clinical supervisor and
administrator.
2. A reduction in the number of expensive Psy.D. programs
because of decreased payoff for the Psy.D. in private
practice.
3. An increased focus on the science of clinical psychology.
4. An increased focus on program evaluation by Ph.D.'s
(evaluating how well treatment programs are working at
different agencies).
 What future trends do you see in behavioral
assessment?
1. Continued integration with mainstream psychology.
2. Increasing use of computer technology.
3. Increasing use of analogue clinic assessment.
4. More cost-efficient assessment:
5. Increased understanding of sources of error in
measurement and ways to control for measurement errors;
6. Increasing sophistication in the functional analysis of
clients and matching treatments to the functional analysis.
 3
Observation
Methods
 Naturalistic Observation
Is a method that involves observing subjects in their
natural environment. The goal is to look at behavior
in a natural setting without intervention.

Naturalistic Observation is hardly a new idea.

McReynolds (1975) traced the roots of naturalistic
observation to the ancient civilizations of Greece and
China.
 Examples of Naturalistic Observation

Home Observation
Observation that is carried out in the patient’s home by
trained observers using an appropriate observational
rating system.
One of the most well-regarded systems for home
observation is the Mealtime Family Interaction Coding
System (MICS; Dickstein, Hayden, Schiller, Seifer, & San
Antonio, 1994), which is based on the McMaster Model of
Family Functioning (Epstein, Bishop, & Levin, 1978).
School Observation
Behavioral observation that is conducted in the school
setting. As with home observation, trained observers rate the
patient using an appropriate observational system.
An example of a behavioral observation system used in school
settings is Achenbach’s revised Direct Observation Form
(DOF; McConaughy & Achenbach, 2009) of the Child Behavior
checklist. The DOF is used to assess problem behaviors that
may be observed in school classrooms or other settings
(McConaughy & Achenbach, 2009).
Hospital Observation
Observation that is carried out in psychiatric hospitals or
institutions using an observational device designed for that
purpose.
An example of a hospital observation measure is the Time
Sample Behavior Checklist (TSBC) developed by Gordon
Paul and his associates (Mariotto & Paul, 1974). It is a time-
sample behavioral checklist that can be used with chronic
psychiatric patients.
Controlled Observation
An observational method in which the clinician exerts a
certain amount of purposeful control over the events being
observed; also known as analogue behavioral observation.
Controlled observation may be preferred in situations
where a behavior does not occur very often on its own or
where normal events are likely to draw the patient outside
the observer’s range.
 Parent–Adolescent Conflict
To more accurately assess the nature and degree of parent–
adolescent conflict, Prinz and Kent (1978) developed the
Interaction Behavior Code (IBC) system. Using the IBC,
several raters review and rate audiotaped discussions of
families attempting to resolve a problem about which they
disagree. Items are rated separately for each family member
according to the behavior’s presence or absence during the
discussion (or for some items, the degree to which they are
present). Summary scores are calculated by averaging scores
(across raters) for negative behaviors and positive behaviors.
 Controlled Performance Technique
An assessment procedure in which the clinician places
individuals in carefully controlled performance situations and
collects data on their performance/behaviour, their emotional
reactions (subjectively rated), and/or various
psychophysiological indices.

Contrived situations allow one to observe behavior under

conditions that offer potential for control and standardization.
A, perhaps, exotic example is the case in which A. A. Lazarus
(1961) assessed claustrophobic behavior by placing a patient in
a closed room that was made progressively smaller by moving a
screen. Similarly, Bandura (1969) has used films to expose
people to a graduated series of anxiety-provoking stimuli.

A series of assessment procedures using controlled

performance techniques to study chronic snake phobias
illustrates several approaches to this kind of measurement
(Bandura, Adams, & Beyer, 1977):
  Behavioral Avoidance
- is a behavioral act that enables an individual to avoid
anticipated unpleasant or painful situations, stimuli, or
events, including conditioned aversive stimuli.

More recently, Armstrong, Sarawgi, and Olatunji (2011)

used a controlled performance technique called a
behavioral avoidance task to assess the level of behavioral
avoidance and distress in a group of individuals with
contamination fears, a symptom characteristic of obsessive-
compulsive disorder.
Specifically, the researchers had participants enter a public
restroom and progressively perform the following tasks:

1. Touch inside the restroom sink.

2. Touch inside the restroom trashcan.
3. Touch the toilet seat.
4. Touch the rim below the toilet seat.
5. Touch the inside of the toilet itself.
 
Therefore, in this controlled situation, the clinical
researchers were able to get perhaps a more realistic
idea of how severe the avoidance behavior and distress
was for each individual because each person was
actually faced with situations that invoked
contamination fears.
 Psychophysiological Measures
Psychophysiological Measures are used to assess unobtrusively
central nervous system, autonomic nervous system, or
skeletomotor activity .
These measures have been used in the assessment of a host of
clinical conditions, including anxiety, stress, and schizophrenia.

Examples of Psychophysiological Measures:

Event-Related Potentials (ERPs)
Electromyographic (EMG) activity,
Electroencephalographic (EEG) activity, Electrodermal activity
(EDA)
 Self-Monitoring
- Is an observational technique in which individuals observe
and record their own behaviors, thoughts, or emotions
(including information on timing, frequency, intensity, and
duration).

Clinicians have been relying increasingly on self-monitoring, in

which individuals observe and record their own behaviors,
thoughts, and emotions.
 
 Electronic Diaries

- A technique used in behavior assessment in which

individuals carry handheld computers that are
programmed to prompt the individuals to complete
assessments at that moment in time.
- Electronic diaries can take the form of personal digital
assistants (PDAs), palmtop computers, or even mobile
phones.
 
Dysfunctional
Thought
Record (DTR)
Completed by the
client, it provides
the client and
therapist with a
record of the
client’s automatic
thoughts that are
related to
dysphoria or
depression.
 Variables Affecting Reliability of Observations
 
In the case of observation, clinicians must have
confidence that different observers will produce basically
the same ratings and scores.
 
Example:
When an observer of interactions in the home returns
with ratings of a spouse’s behavior as “low in empathy,”
 
Factors Can Affect The Reliability Of Observations:

Complexity of Target Behavior

- The more complex the behavior to be observed, the greater the

opportunity for unreliability 
 Training Observers
- Is the one who’s responsible for monitoring, correcting
and assisting behavior.

Example:
Observers who are sent into psychiatric hospitals to study
patient behaviors and then make diagnostic ratings must be
carefully prepared in advance.
 Observer Drift

- Which observers who work closely together subtly,

without awareness, begin to drift away from other
observers in their ratings.
 
 Variables Affecting Validity of Observations

Content Validity
- Refers to the extent to which a measure represents all
facets of a given construct.
 
Concurrent Validity
- Refers to the extent to which the results of a measure
correlate with the results of an established measure of the
same or a related underlying construct assessed within a
similar time frame
 
 Construct Validity
- Is the accumulation of evidence to support the
interpretation of what a measure reflects. Observational
systems are usually derived from some implicit or explicit
theoretical framework.
 Variables Affecting Validity of Observations

Mechanics of Rating
• It is important that a unit of analysis be specified (Tryon,
1998). A unit of analysis is the length of time observations
will be made, along with the type and number of
responses to be considered. These movements would
then be coded or rated for the variable under study (e.g.,
aggression, problem solving, or dependence).
• In addition to the units of analysis chosen, the specific
form that the ratings will take must also be decided.
• Beyond this, a scoring procedure must be developed. Such
procedures can range from making checkmarks on a sheet
of paper attached to a clip- board to the use of counters,
stopwatches, timers, and even laptop computers.
 Observer Error

• No one is perfect. Observers must be monitored from

time to time to ensure the accuracy of their reports.
Sometimes they simply miss things or else believe they
have observed things that never really happened. The
result is a kind of halo effect so that later the observer
is more likely to assign favorable ratings to that person.
Whatever the nature of the potential bias or error, it is
important to hold careful training sessions for observers
in advance, along with periodic review sessions, to help
keep these sources of trouble in check.
 Reactivity
• Another factor affecting the validity of observations is
reactivity, Patients or study participants sometimes react
to the fact that they are being observed by changing the
way they behave.
• In any case, reactivity can severely hamper the validity of
observations because it makes the observed behavior
unrepresentative of what normally occurs.
• The real danger of reactivity is that the observer may not
recognize its presence. If observed behavior is not a true
sample, this affects the extent to which one can
generalize from this instance of behavior.
Ecological Validity
• One of the biggest problems in psychology (and one
that has never been fully resolved) is what Brunswik
(1947) referred to many years ago as ecological validity.
The basic question is whether or not clinicians do
obtain really representative samples of behavior.
 Suggestions for Improving Reliability and
Validity of Observations
The following suggestions are offered as ways to improve
the reliability and validity of observational. procedures. Like
similar suggestions made for inter- views (see Chapter 6),
they often cannot be fully implemented in clinical
situations. Nevertheless, an awareness of these points may
help focus the clinician's attention in directions that will
improve the validity of observations.
1. Decide on target behaviors that are both relevant and
comprehensive. Specify direct and observable behaviors
that can be defined objectively.
2. In specifying these behaviors, work as much as possible
from an explicit theoretical framework that will help define
the behaviors of interest.
3. Employ trained observers whose reliability has been
established and who are familiar with the objective,
standardized observational format to be used.
4. Make sure that the observational format is strictly
specified, including the units of analysis, the form in
which observers' ratings will be made, the exact
observational procedures, the scoring system, and the
observational schedule to be followed.
5. Be aware of such potential sources of error in the
observations as bias and fluctuations in concentration.
6. Consider the possibility of reactivity on the part of those
being observed and the general influence of awareness
that they are being observed.
7. Give careful consideration to issues of how
representative the observations really are and how
much one can generalize from them to behavior in
other settings.
Contemporary Trends in Data Acquisition
There are many ways in which technological advances
have begun to change the face of behavioral assessment
methods that involve observation.
• First, the availability of laptop and handheld
computers/tablets/smartphones facilitates the coding of
observational data by assessors.
• Second, handheld computers etc. can be assigned to
clients so that clients can provide real-time self-
monitoring data. One advantage of using handheld
computers is that they can be programmed to prompt
clients to respond to queries at specified times of the day
or night.
• Third, data from handheld computers can be loaded onto
other computers that have greater processing and
memory capacity so that observations can be aggregated,
scored, and analyzed.
• Finally, a variety of other technologies are being used
to gather data on patients while they are in their
natural environment. These include biosensors
(Haynes & Yoshioka, 2007), audio recordings (Mehl,
Pennebaker, Crow, Dabbs, & Price, 2001), and both GPS
devices and activity monitors (Intille, 2007). It is clear
that behavioral assessors will continue to capitalize on
future technological advances.
 Role-
4 Playing
Methods
 Role-playing

• is another technique that has been used in behavioral

assessment. Role-playing or behavioral rehearsal
(Goldfried & Davison, 1994) can be used as a means of
training new response patterns. Although role-playing is
an old clinical technique, behavioral assessors have
carried out few systematic studies on the methodological
problems inherent in the technique as a means of
assessment-among them, demand characteristics,
standardization of procedures, rater halo effects, and
sampling problems involved in role selections.
 5
Inventories and
Checklists
Behavioral clinicians have used a variety of self
report techniques to identify behaviors,
emotional responses, and perceptions of the
environment. For example, the Fear Survey
Schedule (Geer, 1965; Lang & Lazovik, 1963) and
the Fear Questionnaire (Marks & Matthews,
1979) have been widely used to assess behaviors
associated with anxiety disorders.
 Cognitive-
6 Behavioral
Assessment
Behavioral approaches have become increasingly
cognitively oriented (Goldfried & Davison, 1994;
Meichenbaum, 1977). Cognitions along with behaviors are
becoming the subject of intense study as they relate to the
development of a pathological situation, its maintenance,
and changes in it. Central to this type of cognitive-
behavioral assessment is the notion that the client's
cognitions and thoughts (from self-images to self-
statements) play an important role in behavior (Brewin,
1988).
Indeed, Meichenbaum (1977) advocates a cognitive-
functional approach. In essence. this means that a
functional analysis of the client's thinking processes must
be made to plan an intervention strategy. A careful
inventory of cognitive strategies must be undertaken to
determine which cognitions (or lack of them) are aiding or
interfering with adequate performance and under what
circumstances.
Karen
KarenD.D.Rudolph
Rudolph
 Professor at the University of Illinois, Urbana-
Champaign. She received her Ph.D. in Clinical
Psychology at the University of California, Los Angeles,
and completed a clinical internship at the
Neuropsychiatric Institute and Hospital at UCLA. 

 She is an associate editor for the Journal of Clinical

Child and Adolescent Psychology and serves on the
editorial boards of Development and Psychopathology
and Journal of Abnormal Child Psychology.
• Her research focuses on person-by-environment
interactions that predict the emergence and
continuity of depressive disorders in youth, with a
focus on developmental transitions (e.g., puberty,
school transitions) that create a context of risk for the
onset or exacerbation of psychopathology.
 
• Dr. Rudolph shared her perspectives on the field of
clinical psychology and developmental
psychopathology.
Strengths And Weaknesses Of Behavioral Assessment
 The use of more systematic and precise methods of
evaluation in the field of behavioral assessment is
laudable. Behavioral assessors operationalize the clinical
problem by specifying the behaviors targeted for
intervention.
 This is in contrast to “traditional” assessment in which,
too often, assessment occurs only once, either before or
in the beginning stages of treatment.
 Diagnoses must be supplemented with data from more
traditional behavioral methods.
 Why the change of heart for most behaviorists?

• First, the criteria for the various mental disorders have

become increasingly objective and behavioral.
• Second, behavioral clinicians have discovered some
degree of utility in using diagnostic labels.
In behavioral assessment, not only are behaviors,
antecedent/stimulus conditions, and consequences sampled
but so are “organismic” variables (Goldfried & Davison, 1994).
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