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Chronic Idiopathic Constipation
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Despite a paucity of studies that compare different medical and behavioral treatment interventions, combined medical and behavioral treatments in larger subject samples have been reported. Levine and Bakow (28) reported a success rate of 78% utilizing parent counseling, initial bowel-cleansing with enemas and/or suppositories, extended use of mineral oil and oral laxatives to promote regular defecation, and habit training by having the child attempt to defecate on the toilet after breakfast or dinner each day. Lowery et al (21) reported a long-term success rate of 61 % using a similar protocol that also included contingent use of enemas if the child failed to defecate for 2 consecutive days, more structured praise and tangible reinforcers following bowel movements and for accident-free periods, and handling accidents in a nonpunitive manner. Similarly, Christophersen and Rainey (30) successfully utilized cleanliness and habit training together with daily enemas or suppositories to maintain rectal sensitivity and promote defecation. Unfortunately, there have been no component analyses to ascertain the most important aspects of these treatment regimens.
Behavior Modification
Published in Eli Ilana, Oral Psychophysiology, 2020
The use of desensitization to treat dental anxiety gained wide acceptance in the 1980s.34-45 A desensitization method for fearful patients that combines progressive relaxation, bio-feedback training, and the use of videotaped dental scenes has been described.37 In a series of controlled studies, the technique was shown to be effective in reducing dental fear and in enabling patients to undergo treatment.35,38-40 When the technique was compared to treating anxious dental patients with general anesthesia, it was shown to be significantly more effective. People who had long avoided treatment because of severe dental fear and were treated according to the described desensitization protocol, completed their treatment programs and showed a higher reduction in their dental anxiety level40 The advantage of the behavioral treatment over using general anesthesia was also shown in the long term. When patients were followed up 2 and 10 years later, it was found that among those who had received behavioral therapy, the frequency of attendance for regular dental care was consistently higher than among those treated under general anesthesia.38,39,46
Managing Problems In Dementia Patients: Depression And Agitation
Published in Zaven S. Khachaturian, Teresa S. Radebaugh, Alzheimer’s Disease, 2019
Similar to other caregiver education programs, behavioral treatment incorporates providing basic education about AD, information about community and family resources to assist with caregiving responsibilities, and developing short- and long-term care plans. More unique, behavioral treatment involves teaching methods of behavior observation and change, identifying and developing strategies to maximize patient function, and teaching effective problem-solving skills for day-to-day difficulties in patient care.
The current and future relationship of basic research and intervention research in social work practice in the addictions: a conversation with Michael Fendrich, PhD
Published in Journal of Social Work Practice in the Addictions, 2023
A topic of great interest in recent years, with the persistent opioid epidemic, has been expansion of medication-assisted treatment (MAT). There has been basic research on these medications – it is clearly an evidence-based practice for treating opioid addiction. It was rolled out, and then you had a lot of folks trying to figure out how to gain its acceptance in certain communities, in certain treatment contexts. Something that involves medication might be more acceptable in the clinical world for certain clinicians, especially when they’re in a medical rather than a behavioral treatment environment. On the other hand, there are particular challenges to implementing the use of some medications (particularly opioid agonists) in the criminal justice system – where a great deal of addictions treatment occurs. Our experience for example, in drug court research suggested that criminal justice officials often (wrongly) saw these medications as creating another type of dependency. This just further illustrates the challenges of implementing evidenced based practices in treatment settings.
Quantitative-Analysis of Behavioral Interventions to Treat Sleep Problems in Children with Autism
Published in Developmental Neurorehabilitation, 2020
Amarie Carnett, Sarah Hansen, Laurie McLay, Leslie Neely, Russell Lang
Behavioral intervention approaches are derived from operant learning theory and have been used to treat sleep problems for many decades.31–38 Behavioral treatments for sleep problems in children with ASD have typically focused on antecedent events (e.g., saliency of the discriminative stimulus) and contingent consequences that influence sleep. Specifically, the focus is on arranging environments and programming contingencies (e.g., reinforcement, extinction) such that behaviors likely to facilitate sleep (e.g., laying down still and quiet in bed) are supported via reinforcement and factors that impede sleep (e.g., bright lights and noise) are removed.35,39–41 Jin, Hanley, and Beaulieu42 highlighted the importance of utilizing a comprehensive approach that involves a functional assessment of the sleep problem to identify its operant function and inform the development of an individualized behavioral intervention. For example, behavioral assessment may reveal that a child frequently leaves their bedroom at night in order to escape the dark and therefore treatment might involve changes to environment (e.g., night light) and reinforcement for staying in a dimly light room. However, a child with the same topography of sleep problem might receive an entirely different intervention if the operant function was to obtain adult attention. In this way, behavioral treatment can be aligned with behavioral assessment results to tailor intervention components for specific children with respect to their individual needs and context.
Evidence-based treatment of Tourette’s disorder and chronic tic disorders
Published in Expert Review of Neurotherapeutics, 2019
Joey Ka-Yee Essoe, Marco A. Grados, Harvey S. Singer, Nicholas S. Myers, Joseph F. McGuire
Behavioral interventions for TD are based on the neurobehavioral model for tics [19,28]. This model acknowledges the genetic, biological, and neurological basis of tics, but suggests that internal and external factors influence the expression of tics. For instance, most patients experience an aversive somatosensory sensation called a premonitory urge that precede tics and cause distress (92% in adults [14]; 79% in children [16]). Patients with TD report that premonitory urges are reduced by the expression of tics [14], which has been confirmed in several experimental studies [29–31]. Consequently, tic expression becomes negatively reinforced due to the reduction in the aversive premonitory urge, which makes this pattern more likely to occur when a premonitory urge is experienced again. This same relationship holds true for external factors as well. Individuals with TD may have difficulty managing tics during certain undesirable activities (e.g. completing homework assignments) [23,32,33]. This can result in the disruption, early discontinuation, and/or avoidance of the activities. As these undesired activities are avoided or discontinued early, the expression of tics in these situations becomes negatively reinforced. Behavioral interventions such as habit reversal training (HRT), the comprehensive behavioral intervention for tics (CBIT), and exposure with response prevention (ERP) aim to interrupt this reinforcement pattern using different therapeutic approaches. Below, we provide a brief description of each behavioral treatment approach and describe the short- and long-term outcomes in clinical trials.