the consequences of their behavior, and the behav-
ior itself.
Of course, there are potential problems with
self-monitoring. Some clients may be inaccurate
or may purposely distort their observations or
recordings for various reasons. Others may simply
resist the whole procedure. Despite these obvious
difficulties, self-monitoring has become a useful and
efficient technique. It can provide a great deal of
information at very low cost. However, self-
monitoring is usually effective as a change agent
only in conjunction with a larger program of thera-
peutic intervention.
A variety of monitoring aids has been developed.
Some clients are provided with small counters or stop-
watches, depending on what is to be monitored. Small
file-sized or wallet-sized cards have been developed
upon which clients can quickly and unobtrusively
record their data. At a more informal level, some cli-
ents are simply encouraged to make entries in a diary.
These days, electronic dairies can be used for self-
monitoring. Electronic diaries can take the form of
personal digital assistants (PDAs), palmtop computers,
or even mobile phones. Electronic diaries provide
higher-quality data than paper-and-pencil diaries
because time stamps indicate exactly when the expe-
rience was logged, and it is possible to portray the
sequence of moods, behaviors, and cognitions across
time (Piasecki, Hufford, Solhan, & Trull, 2007).
Self-monitoring diaries are especially useful
when assessing or treating problems such as mood
dysregulation, obesity, substance use problems, anx-
iety, and even psychotic experiences (Trull &
Ebner-Priemer, 2009). These aids can help rein-
force the notion that one’s problems can be
reduced to specific behaviors. Thus, a client who
started with global complaints of an ephemeral
nature can begin to see that “not feeling good
about myself”really involves an inability to stand
up for one’s rights in specific circumstances, speak-
ing without thinking, or whatever. An example of a
self-monitoring log—in this case, a dysfunctional
thought record—is shown in Figure 9-2.
Thedysfunctional thought record(DTR) is com-
pleted by the client and provides the client and ther-
apist with a record of the client’s automatic thoughts
that are related to dysphoria or depression (J. S.
Beck, 1995). This DTR can help the therapist and
client target certain thoughts and reactions for
change in a cognitive-behavioral treatment for
depression. The client is instructed to complete the
DTR when she or he notices a change in mood.
The situation, automatic thought(s), and associated
emotions are specified. The final two columns of
the DTR can be filled out in the therapy session
and serve as a therapeutic intervention. In this way,
clients are taught to recognize, evaluate, and modify
these automatic dysfunctional thoughts.Variables Affecting Reliability of Observations
Whether their data come from interviewing, testing,
or observation, clinicians must be assured that the data
are reliable. In the case of observation, clinicians must
have confidence that different observers will produce
basically the same ratings and scores. For example,
when an observer of interactions in the home returns
with ratings of a spouse’s behavior as“low in empa-
thy,” what assurance does the clinician have that
someone else rating the same behavior in the same
circumstances would have made the same report?
Many factors can affect the reliability of observations.
The following is a good sample of these factors.Complexity of Target Behavior. Obviously, the
more complex the behavior to be observed, the
greater the opportunity for unreliability. Behavioral
assessment typically focuses on less complex, lower-
level behaviors (Haynes, 1998). Observations about
what a person eats for breakfast (lower-level behav-
ior) are likely to be more reliable than those cen-
tering on interpersonal behavior (higher-level,
more complex behavior). This applies to self-
monitoring as well. Unless specific agreed-upon
behaviors are designated, the observer has an enor-
mous range of behavior upon which to concen-
trate. Thus, to identify an instance of interpersonal
aggression, one observer might react to sarcasm
while another would fail to include it and focus
instead on clear, physical acts.268 CHAPTER 9