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Introduction

Positive behavior support (PBS) is an approach used to decrease problematic behaviors (What is positive behavior support, 2014). Problematic behaviors will have a negative impact on social interactions (Sailor, Dunlap, Sugai, and Horner, 2009) and quality of life such as in the case of a domestic abusive relationship. Using a positive behavior approach, occupational therapists can provide interventions that include preventing challenging behaviors, reinforcing appropriate behaviors, and teaching replacement behaviors in order to assist these individuals to alter their negative violent behaviors.

Theory

Behavioral theory was selected as the theory because it is believed that behavior is the result of the external environment and experiences lived. The theory suggests a person is capable of unlearning maladaptive behaviors in order to produce adaptive behaviors. Occupational therapists can use shaping, teaching, and reinforcing behaviors that are appropriate to use in their relationships with others.The ultimate goal is to change negative behaviors into effective behaviors that can assist the individual to have a better quality of life.

Evidence

The Domestic Abuse Education Program (DAEP) is a group which provides intervention for male batterers by incorporating pro-feminist and cognitive behavioral approach. When comparing the results from the pre-test and post-test, it is evident that the intervention had an effective change in behavior and attitudes of the male participants (Cranwell,Schmidt, Kolodinsky, Carsten,Schmidt,Larson, & MacLachlan, 2007). The men had taken responsibility for their actions by analyzing their belief system and possible causes for their abusive behavior. Once a man takes responsibility for his attitude it is reflective of a positive behavioral change (PBS) (Cranwell,Schmidt, Kolodinsky, Carsten,Schmidt,Larson, & MacLachlan, 2007). The goal of DAEP is for the male batterers to analyze their behaviors and find possible solutions for improving their relationship with their partners.

Case Study

As an occupational therapist, part of our profession is to provide inclusive services. This includes those who are survivors of domestic abuse, as well as those with a history of violent behaviors. For this session we are working in a group setting with individuals who have been the ones inflicting abuse in domestic relationships, and who are interested in changing this behavior. The goal of therapy is to reduce violent tendencies and to offer alternative and appropriate behavior strategies to improve romantic relationships.

Intervention Plan

Problem Statement: Inability to maintain healthy relationships due to maladaptive and violent behaviors.

Outcomes: The desired outcome of intervention is to reduce maladaptive and violent behaviors and introducing alternative positive behavioral strategies.

Long term goals

1. Clients will report a decrease in aggressive behaviors, as evidenced by 10 tokens, in order to improve domestic relationships by 20 weeks.
2. Clients will report implementation of at least 3 positive replacement behaviors in context to improve domestic relationships in 2 months.

Short term goals

1. Clients will participate in role play with other groups members and will apply at least 1 positive behavior strategy in 2 weeks.
2. Client will implement 1 positive behavior strategy in the community or at home in order to improve relationships by 1 month.
3. Clients will report a decrease in aggressive behaviors, as evidenced by 5 tokens in order to improve domestic relationships by 10 weeks.

Intervention format: Group

Description of the setting (time and place): YMCA conference room, twice a week

Supplies (if any): None

Agenda & description

Clients will be educated on positive behavior support and skill deficits (15 min.)

Group members will share stories and will discuss the consequences of their negative behaviors (30 min.)

Set up token economy to reduce the aggressive behaviors (10 min.)

• Use different colors coins to specify the amount of time spent without exhibiting aggressive behaviors

Summary and debriefing (5 min.)

Documentation

SOAP Note describing the intervention session

S:  Group members agree and acknowledge that they need to change their behaviors.

O: During the session, each group member was educated on the theory behind positive behavior support. They discussed the importance of communication, and the positive and negative effect it may have on relationships. Each member shared at least 1 negative consequence of their violent behaviors. The clients were introduced to the token economy, and how they would be given a coin for the amount of time they report the reduction of negative behaviors.

A: Clients showed their willingness to change by expressing remorse for their actions. Some individuals were ashamed to share their experiences. After learning more about the importance of positive behavior support and the way it can improve their relationships, clients showed increased insight based on their ability to identify one of their negative behaviors. They were open to the idea of the token economy and were eager to participate.

P: The next group session will discuss positive replacement behaviors to improve their relationships and role play said positive replacement behaviors.

References

What is positive behavior support. (2014). Retrieved from http://www.apbs.org/new_apbs/genintro.aspx#definition

Sailor, W., Dunlap, G., Sugai, G., and Horner, R. (2009). Handbook of positive behavior

support. New York: Springer.

Schmidt, M., Kolodinsky, J., Carsten, G., Schmidt, F., Larson, M., & MacLachlan, C. (2007). Short Term Change in Attitude and Motivating Factors to Change Abusive Behavior of Male Batterers after Participating in a Group Intervention Program Based on the Pro-Feminist and Cognitive-Behavioral Approach. Journal Of Family Violence, 22(2), 91-100. doi:10.1007/s10896-007-9064-4