Journal of Contemporary Psychotherapy

, Volume 47, Issue 3, pp 173–180 | Cite as

Functional Analytic Psychotherapy for Nursing Home Residents: A Single-Subject Investigation of Session-by-Session Changes

Original Paper
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Abstract

Nursing home settings contain unique environmental factors that may promote the acquisition and maintenance of problematic interpersonal behaviors. Functional Analytic Psychotherapy (FAP) is a contextually-based behavior therapy that can be used to modify problematic interpersonal behaviors via carefully provided and contingent in-session responses of the therapist to client behaviors. Thus, FAP would appear to be a particularly well-suited intervention approach for nursing home residents. To date, the effects of FAP have not been reported for nursing home residents. The current single case study assessed the effects of FAP on three nursing home residents using a single-subject AB design. The AB design consisted of a 2-weeks baseline phase followed by a 4-week FAP treatment phase. The nursing home residents completed pre-treatment and post-treatment measures of interpersonal relating. Client interpersonal behaviors were also recorded during each session and coded into two categories: Maladaptive in-session behaviors and adaptive in-session behaviors. Using the reliable change index and Swanson’s dsw to evaluate questionnaire outcomes, results indicated that all three participants reported a significant change in interpersonal functioning. Analysis of in-session behavior indicated that there were significant decreases in maladaptive behaviors and an increase in adaptive behaviors for two clients. Finally, observed in-session behavior changes were congruent with self-reported changes in interpersonal behavior. These results indicate that FAP was an effective intervention for these nursing home residents.

Keywords

Functional analytic psychotherapy Single-subject design Nursing home residents 

References

  1. Alonso, M., Lopez, A., Losada, A., & Gonzalez, J. (2013). Acceptance and commitment therapy and selective optimization with compensation for older people with chronic pain: A pilot study. Behavioral Psychology-Psicologia Conductual, 21(1), 59–79.Google Scholar
  2. Asaro-Saddler, K., & Bak, N. (2012). Teaching children with high-functioning autism spectrum disorders to write persuasive essays. Topics in Language Disorders, 32(4), 361.CrossRefGoogle Scholar
  3. Burgio, L. D., Engel, B. T., Hawkins, A. M., McCormick, K., & Scheve, A. S. (1990). A descriptive analysis of nursing staff behaviors in a teaching nursing home: Differences among CNAs, LPNs, and RNs. The Gerontologist, 30, 107–112.CrossRefPubMedGoogle Scholar
  4. Callaghan, G. M., & Follette, W. C. (2008). FAPRS manual: Manual for the functional analytic psychotherapy rating scale. The Behavior Analyst Today, 9(1), 57.CrossRefGoogle Scholar
  5. Callaghan, G. M., Summers, C. J., & Weidman, M. (2003). The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of clinical improvement using functional analytic psychotherapy. Journal of Contemporary Psychotherapy, 33(4), 321–339.CrossRefGoogle Scholar
  6. Carstensen, L. L., Fisher, J. E., & Malloy, P. M. (1995). Cognitive and affective characteristics of socially withdrawn nursing home residents. Journal of Clinical Neuropsychology, 1(3), 207–218.Google Scholar
  7. Castle, N. G. (2012). Resident-to-resident abuse in nursing homes as reported by nurse aides. Journal of Elder Abuse & Neglect, 24(4), 340.CrossRefGoogle Scholar
  8. Darrow, S. M., Callaghan, G. M., Bonow, J. T., & Follette, W. C. (2014). The Functional Idiographic Assessment Template-Questionnaire (FIAT-Q): Initial psychometric properties. Journal of Contextual Behavioral Science, 3(2), 124–135.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Drageset, J., Eide, G. E., Nygaard, H. A., Bondevik, M., Nortvedt, M. W., & Natvig, G. K. (2009). The impact of social support and sense of coherence on health-related quality of life among nursing home residents—A questionnaire survey in Bergen, Norway. International Journal of Nursing Studies, 46(1), 66–76. doi:10.1016/j.ijnurstu.2008.07.005.CrossRefGoogle Scholar
  10. Drageset, J., Eide, G. E., & Ranhoff, A. H. (2013). Anxiety and depression among nursing home residents without cognitive impairment. Scandinavian Journal of Caring Sciences, 27(4), 872–881.CrossRefPubMedGoogle Scholar
  11. Haaland, V. Ø., Haaland, A. T., Vogel, P. A., Launes, G., Hansen, B., Solem, S., & Himle, J. A. (2011). The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive–compulsive disorder. Behaviour Research and Therapy, 49(11), 781–788.CrossRefPubMedGoogle Scholar
  12. Hager, K. K., & Brockopp, D. (2007). Pilot project: The chronic pain diary–assessing chronic pain in the nursing home population. Journal of Gerontological Nursing, 33(9), 14.PubMedGoogle Scholar
  13. Heineken, J. (1998). Patient silence is not necessarily client satisfaction: Communication problems in home care nursing. Home healthcare nurse, 16(2), 115–120.CrossRefPubMedGoogle Scholar
  14. Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.CrossRefPubMedGoogle Scholar
  15. Jones, S. M. (2011). Supportive listening. International Journal of Listening, 25(1), 85–103. doi:10.1080/10904018.2011.536475.CrossRefGoogle Scholar
  16. Kaiser Family Foundation. (2010). Medicare and non-elderly people with disabilities.Google Scholar
  17. Kohlenberg, R. J., & Tsai, M. (1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. New York: Plenum.CrossRefGoogle Scholar
  18. Lachs, M. S., Rosen, T., Teresi, J. A., Eimicke, J. P., Ramirez, M., Silver, S., & Pillemer, K. (2013). Verbal and physical aggression directed at nursing home staff by residents. Journal of General Internal Medicine, 28(5), 660–667.CrossRefPubMedGoogle Scholar
  19. Landes, S. J. (2008). Functional analytic psychotherapy for comorbid depression and personality disorders (unpublished doctoral dissertation).Google Scholar
  20. Pillemer, K., Chen, E. K., Van Haitsma, K. S., Teresi, J., Ramirez, M., Silver, S., … Lachs, M. S. (2012). Resident-to-resident aggression in nursing homes: Results from a qualitative event reconstruction study. The Gerontologist, 52(1), 24–33.CrossRefPubMedGoogle Scholar
  21. Scruggs, T. E., & Mastropieri, M. A. (1998). Summarizing single-subject research: Issues and applications. Behavior Modification, 22, 221–242.CrossRefPubMedGoogle Scholar
  22. Scruggs, T. E., Mastropieri, M. A., & Casto, G. (1987). The quantitative synthesis of single-subject research: Methodology and validation. Remedial and Special Education, 8, 24–33.CrossRefGoogle Scholar
  23. Singh, R. S., & O’Brien, W. H. (2016). A meta-analytic review of functional analytic psychotherapy single subject research (OhioLINK Electronic Theses and Dissertations Center, & Bowling Green State University).Google Scholar
  24. Swanson, H. L., Hoskyn, M., & Lee, C. (1999). Interventions for students with learning disabilities: A meta-analysis of treatment outcomes. New York: Guilford.Google Scholar
  25. Swanson, H. L., & Sachse-Lee, C. (2000). A meta-analysis of single-subject-design intervention research for students with LD. Journal of Learning Disabilities, 33, 114–136. doi:10.1177/002221940003300201.CrossRefPubMedGoogle Scholar
  26. Swanson, H. L., Zheng, X., & Jerman, O. (2009). Working memory, short-term memory, and reading disabilities: A selective meta-analysis of the literature. Journal of Learning Disabilities, 42, 260–287. doi:10.1177/0022219409331958.CrossRefPubMedGoogle Scholar
  27. Tsai, M., Kohlenberg, R. J., Kanter, J. W., Kohlenberg, B., Follette, W. C., & Callaghan, G. M. (2009). A guide to functional analytic psychotherapy: Awareness, courage, love, and behaviorism. New York: Springer Science + Business Media.CrossRefGoogle Scholar
  28. Viera, A. J., & Garrett, J. M. (2005). Understanding interobserver agreement: The kappa statistic. Family Medicine, 37(5), 360.PubMedGoogle Scholar
  29. Weeks, C. E., Kanter, J. W., Bonow, J. T., Landes, S. J., & Busch, A. M. (2012). Translating the theoretical into the practical: A logical framework of functional analytic psychotherapy interactions for research, training, and clinical purposes. Behavior Modification, 36, 87–119.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.126 PsychologyBowling Green State UniversityBowling GreenUSA

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