About the Dependency, Contingency Distinction

Q: Should behavior analysts make a distinction between dependency and contingency or should they be treated as synonyms?

A: We have found the dependency, contingency distinction critical. Most of us find that if the light switch, flip it, light on dependency switches to a contingency, we call an electrician. 

Clinically we have often found it necessary to make the distinction. As a result of a particular unsatisfactory interaction a beneficial outcome occurs. That interaction may repeatedly occur without the outcome. The clients may maintain that the outcome can’t be a source of the issue since the behavior often occurs without it occurring. We point out that they are considering the relation a dependency. We ask, “but does the outcome occur without the interaction?” When contingencies are overlooked people tend to turn to an internal story where their feelings and thoughts are offered as causal explanations for the pattern often involving certain hypothetical dependencies. We find that the supposedly causal feelings and thoughts change when the contingencies are addressed (including the action of alternative sets of contingencies). Accordingly, the distinction is critical for both the client and the therapist. 

About Eating Disorders

Q: Can anorexia be treated with applied behavior analysis?

A: Over the years, I successfully worked with several anorexia cases. There is no single behavioral intervention. One must analyze the contingencies specific to each case. Recent work on other reactive patterns suggests it may be possible to use a key reinforcer, distancing, to shape other behaviors in what we call a nonlinear topical intervention. But, I have found that long-term success often requires a systemic intervention (see this link). The goals of such an approach often do not even specify the anorexic pattern. At times, the problem will resolve itself without direct intervention if the systemic variables are addressed.

About Jargon and the Term Behavior Analysis

Question: What are your thoughts on the use of the term behavior analysis to describe our field?

Answer:

Personally, I have never liked the term behavior analysis. I have never been much interested in the topic, though I once did an ethogram looking at Grebe behavior. I am interested in the relation of the organism to its environment as measured by an investigator. In my case, my interest is in consequential (operant) and precedential (respondent) contingencies. Accordingly, I have always described what I do as contingency analysis, of which behavior is a part. I find audiences, including those who have never heard of our field, respond well to this, as the emphasis is on an understanding of their relation to the environment. When I speak to new audiences, I typically begin with a somewhat formal description of contingency. Then we begin to apply it to a range of issues. I found this resonates well with people and results in almost no resistance to the concepts. The emphasis switches from changing behavior, to understanding it and arranging the world to get better outcomes for individuals.

When I worked in the education field, when talking to school districts, I would introduce myself as a basic and applied learning scientist. Then we would talk about contingencies, both within instruction and within the school and classroom. Academic problems were treated as problems of contingencies, not of teachers, parents, or children. We did not have behavior or learning problems, we had problems in the arrangement of the environment. I once was offered the position of chief academic officer for one of the largest school districts in the country talking this way. (I told them there were too many early-morning meetings.)

For the over 30 years I did this, I never met with hostility nor resistance. Part of the reason, I believe, was that we always took a constructional approach and never advocated for, or attempted to decelerate or eliminate any behavior, that included learners, teachers, or administrators. We wanted to understand the alternative sets of contingencies which made the disturbing pattern sensible and adaptive. We always took the position that the consequences that maintain behavior should never be removed and simply be made available through other patterns at less cost, while still being available for the disturbing pattern.

We found that when one takes this approach, there is little resistance by newcomers, and they make an active effort to participate. I recently spoke to an important European Union governmental group with absolutely no background in our field, even the basic concept of reinforcement was somewhat foreign. By the end of the day, they were generating proposals to include contingency analysis into their work. They became excited about the science. 

About Dr. Goldiamond

Question: Is there an active group of practitioners using the processes and techniques developed by Dr. Goldiamond?

Answer:

Yes! There is a Facebook group of over 400 members who apply the constructional approach and nonlinear contingency analysis in their work.  https://www.facebook.com/groups/700952357829957

It is also widespread in work with zoos and companion animals. See for example:

Barbara’s Force Free Animal Training | Transforming Animal Behavior (barbarasffat.com) and

Constructional Approach to Animal Welfare and Training (caawt.com)

About Prompting

Question: Why are prompts “evil?” Do your concerns with prompts extend to clinical work with typically-developing individuals?

Answer: 

The trouble with prompts

Prompting as a strategy to establish behavior is ubiquitous in much of ABA practice. Behavior under the control of one stimulus is used to try to establish control by another stimulus. This is often implemented by pairing an existing stimulus control relation with a different stimulus. Another method is to compel responding, via a guided correction if a learner does not respond as requested. These procedures often fail or take many repeated trials to achieve the targeted outcome. Fading prompts are often exercises in sharpening control by less and less of the prompted stimulus.

In the case of the pairing procedure basic research in stimulus control suggests that success may be preempted by a phenomenon known as blocking. A stimulus that controls behavior, when combined with another that does not, has been shown to prevent, or block the new stimulus from gaining control (see Olaff, et al., 2022 for implications for autism interventions). This has been shown to occur across species. But hasn’t there been laboratory examples of the transfer of stimulus control? Yes, but these are painstakingly defined relations that involve careful manipulation of both SD and S-Delta stimuli combined with stimulus change (that disrupts current control. Terrace, 1963; Touchett, 1971) that is mostly absent in applied applications. Moving a hand or other prompts, when kinesthetic feedback from movement is not the targeted stimulus control, may produce a particular behavior under context, but extension beyond that context is unlikely, and the learner may resist further instruction.

The failure of prompting became obvious as programed instruction evolved in the 1960s. First, formal prompts were discouraged, then recency and sequence prompts, eventually followed by thematic prompts (Markle, 1969). It was shown that instead of facilitating responding prompts inhibited the stimulus control the program was trying to establish. Judy Doran and Jim Holland (JABA, 1971) using eye movement measures demonstrated that learners skipped reading text in which critical information was presented if a prompt controlled responding. Prompting was training learners to ignore other important textual stimuli. By 1990 all prompting was discouraged (Markle, 1990).

Establishing targeted stimulus control is best served by procedures that make the control more likely from the outset. Some use the term stimulus prompting, but it is the controlling stimulus control relation that should be the focus. A stimulus control relation, (AKA stimulus control topography) must first occur before it can be reinforced (Ray & Sidman, 1970). Reinforcing a behavior in the presence of a stimulus does not insure such control. Accordingly, the job is to “prime” (as one primes a pump) the controlling relation from the outset. There are a range of procedures for doing so. One involves ensuring the learner observes the actual stimulus or stimulus feature targeted. Another is to make sure the response itself can be performed fluently. A programed instruction example is presented below.

In the presence of left and right handles on a faucet, the learner will turn the right hand knob to obtain warm water. Can they discriminate left from right, warm and cold? Can they reach, grasp, and turn fluently? Those are all components of the discrimination that need to be fluently in place before teaching the relation. So the question becomes. What are the stimulus elements that need to be established and what are their components, and what are the response elements that are required and that are their components? Teach those first prior to establishing the targeted relation. We can then set up discrimination exercises using juxtaposed stimuli, and we may highlight dimensions to be used, or make responding along the response vector more likely. Here is a link to the errorless establishing of conditional chain. Notice how elements are used to establish directional control. Also notice how past history is recruited, pushing a wheeled object, which primes directional movement. Look at how earlier conditional control is established. This is all achieved without prompting a response that is controlled by a stimulus that is orthogonal (differs greatly from) to the target repertoire.

Bibliography

Markle, S. M. (1969). Good frames and bad: A grammar of frame writing: 2nd Edition. NY: Wiley.

Markle, S. M. (1990). Designs for instructional designers, Seattle, WA: Morningside Press.

Olaff, H.S., Vandbakk, M. & Holth, P. Blocking of Stimulus Control in Children with Autism. Psychol Rec 72, 305–317 (2022). https://doi.org/10.1007/s40732-020-00454-7

Ray, B. A., & Sidman, M. (1970). Reinforcement schedules and stimulus control. The theory of reinforcement schedules, 187-214.

Terrace, H. (1963). Errorless transfer of a discrimination across two continua. Journal of the Experimental Analysis of Behavior, 6, 223-232.

Touchette P. E. (1971). Transfer of stimulus control: measuring the moment of transfer. J Exp Anal Behav.,15(3): 347-54. doi: 10.1901/jeab.1971.15-347.

About Contingency Analysis and Values

Question: How does a contingency analysis approach the topic of values?

Answer: The issue is a complicated one. I value silver over steel, but value gold over silver along a monetary continuum, but value silver over gold aesthetically, or steel over either sentimentally (a gift from a loved one). In essence, value is determined by the contingencies and potentiating variables and changes given changes in contingencies. Accordingly, any definition of value is in essence a contingency analysis. Similarly, being valued says one’s behavior is arrayed along a continuum of outcomes, and is preferred over other possibilities on the continuum. One’s work is “valued” is an example. Thus, acting in accord with one’s values and being valued are different. The former is a description of one’s own value, versus the latter, which is what others might prefer. The preferred versus valued distinction is an interesting one, and likely necessary for a concept analysis.

The delay discounting literature helps make a distinction between preferred and valued. I of course value $200 more than $20, but may prefer $20 if I have to wait a year for the $200. So any concept analysis must make the distinction between value and prefer, though that is not easy. Utility theory has the most to experimentally say about quantifying value and uses preference to do so (see optional reading for NCA course). They treat value as indicated by the activity specific consequences versus other consequences. How much would one have to be paid to switch from college professor to garbage collector as a measure of how much one values a profession. It is a measure of competing value. Here preference switching is not used to indicate a change in value, but as an indicator of value. The activity specific consequences of being a professor is valued at $500,000 in income. One still values being a professor, but not as much as earning $500,000 per year.

The difference between activity specific consequences and superimposed consequences is typically the values conflict most describe. I value kindness, but my job requires me to be a bit nasty. Translated: The effects of acts of kindness are positive reinforcers and would maintain that behavior if the consequences of on the job nastiness didn’t prevent it. Searching for one’s values is often disentangling the activity specific reinforcers from the other reinforcers/aversives imposed by organizational or social requirements.

Given a range of activities, and their activity specific consequences, the ones selected by the contingency (including the behavior that meets the contingency requirement) define value. That value will change if the contingencies and potentiating variables change. Why certain activity specific consequences are prepotent over others is the study of programing. Whether one prefers what one values, is a function of other contingencies. From this one can derive the critical and varying features, but I will leave that to you.

About Rule-governed Behavior

Question: What is the role of rule governed behavior?

Answer: Briefly, a better term is rule-established behavior. Technically it is “supplementary verbal stimulation that makes one pattern of optimizing consequences more likely than another.” The resulting behavior enters into a contingency and is maintained by it. There are a range of variables that account for whether or not one will see a change when contingencies change. Often one has to ask, what has been the history of not doing what has been instructed? In essence not complying is often punished, or has a history of punishment. That makes it appear that the pattern has no consequence. An experimenter demonstrates a pattern, the participant imitates it, and it is maintained even though another pattern would be more profitable. Any such demonstration is a mand. Most mand compliance is maintained by what happens if one does not comply. Mom ask you to pass the salt. You do not, what is likely to happen? Is it really the thank you that maintains passing the salt? 

Another factor is response effort. If the patten takes little to perform, the fact that another patten might have a better payoff may make less of a difference. Another is how much variability occurs in the pattern such that it contacts other consequences. Oftentimes recent experiments use pressing a space bar as the manipulandum. In a 1958 experiment Azrin had subjects press a button under a range of conditions on an FI reinforcement schedule. The subjects did not show the FI scallops obtained with rats. Instead of concluding that human verbal behavior interfered with the schedule, that is a self-rule, Azrin tightened the button, making it harder to depress. Sure enough, beautiful FI patterns emerged. The tightening brought the participants into contact with the schedule.

Yet another consideration, what precisely is the actual Ocn-behavior relation. Skinner used an example of an apprentice blacksmith learning to use a bellows to make sure lighted coals are hot enough to do the job. The apprentice is given a little poem, “Up fast, down slow. That’s the way to make the coals glow.” Now change the type of coals used, which requires a different pattern and we may see the apprentice persist with the old pattern. That is because the coals are not the SD, the poem is, the coals are the potentiating variable for reciting the poem. If on the other hand the apprentice had been told to carefully observe the coals and to adjust the up and down pattern of the bellows until the coals are white hot, changes in coals would lead to changes in bellows pattern. In the first case the rule makes the apprentice insensitive to the coal changes, in the second case the rule makes the apprentice more sensitive to coal changes. 

As you can see, a range of variables must be considered when talking about so called rule governed behavior. Sadly, this seldom is the case.

About Programing

Question about the definition of “program.”

Answer: The simplest definition of a “program” is: a sequence of contingencies with changing criteria that lead to a specified outcome. History is a sequence of contingencies with changing criteria that lead to an observed outcome.

A program is not simply a collection of activities or protocols to be followed. 

A program is a sequence of contingencies with changing criteria that lead to a replicable outcome. The key element of the program are the changes in contingency requirements over time. Different programs can produce different outcomes given the same entry repertoire even where the terminal perfomance looks identical. A discrimination may be abolished by a drug if established with a trial and error program but not if established with an errorless program. The terminal discrimination performance is identical for each, the IV that accounts for the difference in response to the drug is the program.

Critical is the step-by-step elements of the program. Notice, in Sean’s description he said of the dog failed to meet criteria, reinforcement was delivered, and the “program,” the contingency requirement, was changed. The dog’s success was a function of the criterial steps of the program, not of reinforcement.

About Extinction

Joe, I have a question about extinction.

I love what Izzy says – behavioral patterns during extinction differ if it comes after past reinforcement or past punishment. Extinction burst occurs when the response is meeting reinforcement contingency and it is followed by extinction (reinforcement no longer occur after the behavior). But does extinction burst order when the response were previously punished? 

I feel like all the graphs the I saw of extinction burst is after the reinforcement, not punishment. 

Izzy says that the response will recover during extinction, it the response was punished before. 

Answer: It is a bit more complicated than that. A behavior that is punished is being maintained by something, typically a reinforcer. A punishment contingency is then superimposed upon that contingency. Extinction of punishment, often allows the underlying contingency to have its affect, and the punished response returns. If both are placed under extinction at the same time, one may not get quite the same effect. If the underlying contingency is broken, extinction is introduced, prior to punishment, the punished response may not return at anywhere near the same rate

• How would you think about this worry activity in terms of eliminative and constructional goals? What would a good constructional outcome look like?

• What are your thoughts on the private events aspect of this? Forget about it and just focus on how they behave in the context of repetitive negative thinking? Or is there a means by which we might target the private worry behavior? We would anticipate that if we impacted non-linear contingencies that the worry would drop off, correct? 

Answer: Our approach is as described in our book. It may include both topical and systemic interventions. First, we ascertained what it would look like if the problem were solved.  In essence, the constructional interview. Next, we would have the client keep daily event logs. From that we would develop the therapeutic outcomes to be achieved. We considered GAD to be much like cigarette smoking. That is a consistent behavioral topography that occurs under a variety of situation, each of which may serve different functions. 
For some functions, we used the anxiety as an opportunity to examine the behavioral requirements one faces and ascertain whether they can lower the requirement or increase their competency, for others we may find it recruits various forms of support from significant others, for yet others it may serve to allow the person a rationale for not doing things they really don’t want to do, and so on. It is often all of the above. 

Under some conditions the pattern may be vestigial. That is, the consequences that established it are no longer potent (or as potent given the change in consequences for alternatives). Here Constructional Aggression Training (CAT) type (nonlinear topical) procedures might be used as described for the lizard phobia in the book. This replaces exposure procedures. What is often overlooked is what we addressed in our hallucinations paper. For generalized anxiety to be effective (consequentially) in some situations, it must occur in other situations for which there is no payoff. As we wrote, “For a behavior to be reinforced on certain occasions(SD), it must also occur under circumstances which will not lead to reinforcement (S-delta), and may even produce an aversive consequence. Its occurrence under what is traditionally termed S-delta, as well as under SD, serves as a conditional discriminative stimulus for the reinforcing verbal community.” Accordingly, once there is a solution for the SD situations, the S-delta conditions will often change without intervention or with minor topical interventions (here is where relaxation procedures might be used).

We may employ the CAT type procedure as we look at the functions and social contingencies and program for them. The Constructional Interview and weekly Logs will guide us in that respect.

The CAT procedure when done correctly, where the removal of the stimulus is under the control of the patient, not only reinforces “calmness,” but provides a sense of accomplishment and control that did not previously exist. It increases the likelihood of patient follow through and perseverance while working to establish other systemic elements typically related to component social repertoires. Some real successes are being obtained using CAT to deal with highly fearful situations. What is surprising to those implanting them is how quickly ti appears to work.

About Mindfulness

Asked to respond to this definition of mindfulness:  a type of self-awareness that helps the client to remain in the presence of aversive Sds (such as negative thoughts, feelings and events) that typically evoke avoidance repertoires. In turn, this provides an opportunity for new, more adaptive behavior to emerge and be reinforced. (R.J. Kohlenberg)

Reply: There are many problems with Kohlenberg’s definition. And, I would argue a less than optimal therapeutic approach. I doubt many of the Buddhist monks practicing mindfulness have a history of trying to avoid aversive stimuli. It may be useful when confronting pain and other aversive events, but I doubt that is the reason they would give you for its practice. Those activities that constitute “mindfulness” likely each have their own establishment history and consequences that maintain them, none of which are private. A key question is what are the observable independent variables, and what are the observable dependent variables? The instructions, the breathing exercises, and the trained diaphragmatic control are all observable.
Clinically, once established, in the face of coalescing contingencies reflecting a behavioral requirement that are difficult to meet that gets described as particular recurring thoughts in order to bring others into contact with the contingency requirements; it matters little what they are for, how anyone can know that the thoughts they they think they are thinking are the thoughts they are actually thinking, since discrimination training for thoughts is impossible. Actually, Verplanck demonstrated that the self-generated rules people claimed they were following were not in fact followed), one can follow instructions to engage in the learned diaphragmatic control, which has two effects. One is that by so doing, control by those other contingencies is momentarily lessened, and there is accomplishment of meeting the requirements of the diaphragmatic control. The problem of course is that the contingencies that gave rise to the issue in the first place are unchanged. One is simply superimposing one contingency on another and hoping the resulting behavioral variation has positive outcome.

But is that really mindfulness? What are the social contingencies that help maintain the practices? More on that on Friday. Hope this helps a bit.

More from the dialog:

Reply: Early in the discussion you make the point that a variety of different procedures occasion the use of the term mindfulness. You clearly point out that one use of the term may not reflect the use of the term by others. Accordingly, there is no application of any one set of procedures one can confidently assert represents mindfulness training. 

Accordingly, mindfulness is a match to an experimenter’s scoresheet by certain prescribed indicator responses. These are all observable and include, posture, breathing rate, perhaps specified changes of behavior in described contexts, and verbal reports. When participant behavior results in meeting criteria defined by a certain number of scoresheet matches, that particular use of mindfulness is defined. Thus, the differences in the usage of mindfulness is a function of the difference in scoresheets. These constitute the dependent variable in mindfulness studies.

The independent variables are the potentiating variables, instructions, and consequences arranged that result in the scoresheet matches. 

This may be made more clear by making some changes in your descriptions, for example:

Quote: “Though few studies rigorously demonstrated experimental control, the single subject design was a useful design. It permitted authors to document training outcomes. They evaluated if mindfulness practices as described and used in the experiment, performed under specific condition, impacted other behaviors of interest. And participants benefitted, finding the experience useful and helpful as indicated by… For example, a breathing activity impacted academic engagement. Mindfulness-informed activities Activities such as… improved on-task behavior and performance. These activities characterized by the authors as MBPs resulted in decreased aggression, noncompliance, off-task behavior, and smoking.” 

Mindfulness discussions often veer away from the observed world into what is referred to as private events or experiences. Observed instructions are hypothesized to alter one’s private responses to this experiences. To the extent one assumes that the indicator responses recorded reflect private responses of some sort, one is engaged in the operationism of methodological behaviorism criticized by Skinner (1945). Further, no matter what the instruction, or the participant verbal reports, one cannot assume that reported private experience of the participant is actually occurring, or matches what another participant is experiencing who reports the same exact thing. Arguing over what private experience is or is not occurring is likely fruitless.

There are countless studies that demonstrate that what participants report as being subjectively experienced could not, in fact, be the case (Azrin Flanagan and Goldiamond 1958; Goldiamond, 1958a, 1958b, 1964; Goldiamond and Thompson, 1968; Layng, 1995; Layng, R. 2015). In all such instance the locus of control was determined to be in the instructions provided, not in the subjective event reported (see Layng, 1995). Reports of subjective events have also been shown to change in order to attain agreement with the therapist or experimenter (see Layng, et al 2022). For example, indices of (reported) experiential avoidance change simply by asking a participant to “respond to the AAQ-II survey as you think your therapist would want you to” (Layng, R. 2015; also see Layng et al 2022, chapter 9). This has been demonstrated for ambiguous public events as well (Robbins, Layng, and Karp, 1995). Where participants are unaware of the experimenter arranged contingencies responsible for their behavior they may resort to reporting private events, such as anxiety, as the basis for, or cause of their responding (Flanagan, Goldiamond, and Azrin, 1959). So doe that mean one should give up helping people achieve some of the benefits mindfulness practices are trying to achieve, or to understand intent, or curiosity, or compassion?

To the extent such qualities as intent, curiosity, compassion, etc. are to be encouraged or studied one can readily do so not by treating them as private things or events, certain behavioral qualia, or as specified sets of behavior, but instead as language games that reflect certain consequential contingencies (see Sumner, 2021 for a similar approach to “creativity”). That is, the words are used to bring others into contact with the contingencies (often undescribed) they are experiencing. For example, intent often describes the effect potentiating variables, and the occasions on which certain actions are likely to be reinforced. One can analyze intent much the same way as it is done in a court of law by assessing opportunity, means, and motive (payoff). If I say I did not intend to do X I describe the absence of one or more of these elements. If I intended to do it I describe the presence of these elements, and if intended to do it, but did not, I can be describing the effects other contingencies even though the behavior referenced (intended) did not occur. Goldiamond (1976) provides a much more detailed contingency analysis of intent that incorporates certain nonlinear (decision theory) relations as well.  

Feelings of conflict between what is intended and what actually occurs may describe the action of conflicting contingencies. The daily event logs used in the Constructional Approach makes these relations explicit moment-to-moment when clients are asked to describe hourly circumstances, activity intended or what you wanted, actual activity or what you got, comments and feelings. Intent is used as contingency indicators and bring the person into contact with them and teaches them that their private experience reflects contingencies and how to intervene to change them, and as a result the private experience itself. It does so without trying to superimpose one contingency on another as when is instructed to engage in certain breathing or other exercises when faced with a challenging circumstance (though this may occasionally be temporarily helpful), but by understanding and changing contingency requirements. One could argue, this is a form of mindfulness that brings one into the closest contact possible with the now all without putting the locus inside the individual, all without ignoring private experience. It may be worth considering how a consequential contingency analysis might serve to inform the practices and provide the benefits which are the goals of the various forms of mindfulness training. 

And later… A different approach to private experience may be more productive which (according to my philosophy major son) is more closely aligned with the Buddhist tradition. That is, there are no covert responses or stimuli, no words privately spoken, or images to see. What is experienced, during meditation, for example, is a change in a relation to the environment and the effects of changes in the variables that affect that relation. Since the verbal community has no access to that experience, we have no words for it. The words we use are those accepted by the verbal community when referring to that experience, a particular language game. They are not descriptions of that private experience. The Buddhist tradition is try to understand this and breakaway from description itself, of any kind. In essence, it is to be one with the moment-to-moment flow of contingencies and not put words to it. What we can observe are the contingencies responsible for the experience. So, instead of observing my experience of anxiety, what I am really observing is my experience of trying to meet a behavioral requirement for which I may not be prepared to meet. Saying, “I feel anxious,” is my attempt to bring others into contact with the contingency requirement I am facing. There is no private “something” called anxiety. The is how radical behaviorism can help us directly investigate private experience without resorting to methodological behaviorism’s operationism, or by trying to move stimuli or responses into the head.

Answer to precedential contingency (classical conditioning) question. The ordering of the sets X Y Z is not relevant to the definition of contingency (see chapter 3 in NCA book). Consequential: (x1 and y1) z1 or z0, Precedential: x1 (z1 and y1). In the precedential contingency z1 and the y1 that accompanies it (meat powder, z1, which elicits salivation y1) is made contingent on x1 (the sound of a bell, x1). Notice in both that  x1 and y1 must occur. What one also notices is that precedential relations always begin as dependencies, it is only after exposure that the relation shifts to x1 and (z1 or z0 ) y1. When we test we omit z1, leaving z0, we observe x1 y1, just as we do in consequential relations when we have z0. Cool right?

Clinical Question Here’s what is typically done:

Progressive Muscle Relaxation – this certainly helps with the physiological arousal that often accompanies chronic worry, but it doesn’t really impact the worry

Very cognitive approaches like: 1) attention control training (the theory here is that repetitive negative thinking occurs because they can’t control their attention sufficiently), 2) teaching clients to evalute the risk of the feared outcome and to focus more on all the ways they could cope if the undesriable event happened rather than focusing on how catastrophic it would be. 

Exposure to the feared outcomes to either achieve habituation or an increased tolearnce of the distress brought on by the worry activive.

This is basically what’s done. All eliminative of course. The distress tolerance item is the closest intervention to being non-eliminative.

I can certainly see how to construct a repertoire for these individuals. Most tend to withdraw (e.g., sit in a chair and stare at a wall while they ruminate)…so we’d work toward active behavior in these contexts. I would imagine that doing this will compete with the worry activity much of the time (e.g., if they are engaged in something it’ll be more challenging for them to focus on their worries) and we could also say that we’ll be satisfied if they are behaving in important ways even if their worries continue. But, I think to gain acceptance we’d need to find a pattern that could be built such that the client would say their repetitive negative thinking is no longer a problem. I realize I’m straddling the eliminative fence with this because that basically says we have to get rid of these thinking patterns. I guess my questions are:

• How would you think about this worry activity in terms of eliminative and constructional goals? What would a good constructional outcome look like?

• What are your thoughts on the private events aspect of this? Forget about it and just focus on how they behave in the context of repetitive negative thinking? Or is there a means by which we might target the private worry behavior? We would anticipate that if we impacted non-linear contingencies that the worry would drop off, correct? 

Answer: Our approach is as described in our book. It may include both topical and systemic interventions. First, we ascertained what it would look like if the problem were solved.  In essence, the constructional interview. Next, we would have the client keep daily event logs. From that we would develop the therapeutic outcomes to be achieved. We considered GAD to be much like cigarette smoking. That is a consistent behavioral topography that occurs under a variety of situation, each of which may serve different functions. 
For some functions, we used the anxiety as an opportunity to examine the behavioral requirements one faces and ascertain whether they can lower the requirement or increase their competency, for others we may find it recruits various forms of support from significant others, for yet others it may serve to allow the person a rationale for not doing things they really don’t want to do, and so on. It is often all of the above. 

Under some conditions the pattern may be vestigial. That is, the consequences that established it are no longer potent (or as potent given the change in consequences for alternatives). Here Constructional Aggression Training (CAT) type (nonlinear topical) procedures might be used as described for the lizard phobia in the book. This replaces exposure procedures. What is often overlooked is what we addressed in our hallucinations paper. For generalized anxiety to be effective (consequentially) in some situations, it must occur in other situations for which there is no payoff. As we wrote, “For a behavior to be reinforced on certain occasions(SD), it must also occur under circumstances which will not lead to reinforcement (S-delta), and may even produce an aversive consequence. Its occurrence under what is traditionally termed S-delta, as well as under SD, serves as a conditional discriminative stimulus for the reinforcing verbal community.” Accordingly, once there is a solution for the SD situations, the S-delta conditions will often change without intervention or with minor topical interventions (here is where relaxation procedures might be used).

We may employ the CAT type procedure as we look at the functions and social contingencies and program for them. The Constructional Interview and weekly Logs will guide us in that respect.

The CAT procedure when done correctly, where the removal of the stimulus is under the control of the patient, not only reinforces “calmness,” but provides a sense of accomplishment and control that did not previously exist. It increases the likelihood of patient follow through and perseverance while working to establish other systemic elements typically related to component social repertoires. Some real successes are being obtained using CAT to deal with highly fearful situations. What is surprising to those implanting them is how quickly it appears to work.