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Behavioural analyses thus concentrate on the here and now of what
actually happens. The meaning to the parents of the behaviour (‘he’s
becoming a criminal like his uncle’), and their explanations for it (‘it’s
the crisps, doctor’) may usefully be explored, but are not part of a strict
behaviourist approach.
Negotiation of goals with parents and young person
1 Specify the target behaviours as precisely as possible. Many parents find
this difficult, having diffuse concerns: ‘he’s disobedient’, ‘he’s a Jekyll
and Hyde’, ‘she’s sad’, etc. The work is to help the parent work out
specifically what is worrying.
2 Assess the impact of the behaviours on the child’s or adolescent’s
life, and on that of the siblings and parents, considering the following
domains:
(a)emotional/personal impact
(b) social
(c) developmental
(d)learning/competence
(e)self-esteem.
Going through this list often helps the parents review the overall impact
from their child’s point of view, rather than just their own. For example,
they may have arrived concerned by the smell and inconvenience to
themselves of a boy who soils. Assessing the impact may make them
aware of the social impact on friendships and emotions. This is often
helpful in reducing negativity, and in engaging sympathy and motiva-
tion to implement the treatment programme. Parents also become fully
aware of the long-term disadvantages of the current situation, rather
than just the immediate inconvenience, which may further add to the
gains they can visualise from engaging in therapy.
3 Agree the desired outcome in behavioural terms. Again, this will not be
a generality (‘he should become nice to me’) but specific (‘he will dress
himself after being asked only once in the morning, without shouting
at me; he will be in bed by 8.30 at night’). If a child has frequent major
tantrums lasting over five minutes involving kicking and throwing, an
appropriate target may be to reduce this to once a week. Total abolition
is unrealistic and unnecessary.
4 Formulate the positive behaviours desired. This may not come easily to
parents, who are more inclined to think in terms of stopping negative
behaviours such as fighting, running, shouting, wetting the bed, etc. The
desired behaviours in each case might be: play nicely with your brother,
walk calmly, speak quietly and use the toilet properly. The major part of
behavioural work is not the elimination of unwanted behaviour (a child
who is only aware of what not to do has no help in finding his or her
direction, and if totally obedient would stay rooted to the spot), but the
promotion of desired behaviour in its place, so the unwanted behaviour
simply fades away. Once the desired behaviours have been formulated,
it is possible to start planning an intervention plan, with emphasis on