Association for Behavior Analysis International

Functional analysis is at the heart of case conceptualizations in applied behavior analytic work and in behavior therapy (e.g., depression, anxiety). The breadth of variables that can be incorporated into functional analyses extends far beyond the five analogue conditions that have become synonymous with the term “experimental functional analysis” within the last two decades. Indeed, a wide range of circumstances - from physiological to sociocultural - give rise to, contribute to, or maintain clinically significant behavior patterns. Functional analyses are person-centered when they capture diversity. This symposium teaches attendees how to think about functional analysis broadly and illustrates functional analytic clinical case formulations with examples of interpersonal functioning and taking an individual’s physiological context into consideration. The benefits of using structured methods for presenting these case formulations are discussed.

Graduate students in practical training and post-degree professionals in clinical practice.

A functional analysis of interpersonal interactions requires a nuanced understanding of the cultural context for the interactions and how the lived experiences of the participants in the interaction contribute to the quality of their communication. In interpersonally focused behavior therapies, therapists need to have a clear case formulation for clinically relevant social behaivors so that they can a) identify whether the current situation reflects an appropriate antecedent context for the behavior of interest, b) determine whether the client’s social behavior is consistent with (or an approximation to) the functional classes of behavior targeted, c) provide a socially normative therapeutic consequence for the client’s behavior, and d) monitor the impact of such therapeutic consequences on behavior over time. This process requires the therapist to be able to view both the client’s behavior and their own behavior through a sophisticated functional analytic lens. The most meaningful social reinforcers obtain their function due to their intersection with a person’s unique history, the shared history of the dyad, and the broader social-cultural conext for the interaction. This presentation will focus on the skills needed to apply functional analysis to therapeutic interpersonal interactions.

People with compromised verbal repertoires are at risk of undetected physical problems, including acute infections, chronic conditions, or medication adverse effects. Undetected conditions may delay skill acquisition, cause or exacerbate problem behavior, and hasten repertorial decline. The BACB Ethics Code (Section 2.12) advises behavior analysts to refer to medical providers upon suspecting a “reasonable likelihood” of physiological involvement, yet standard functional analyses do not examine physical variables. When referral occurs, physicians’ effectiveness as diagnosticians at the intersection of physiology and behavior is unclear at best. Diagnostic algorithms typically rely on self-reports followed by physical examination, laboratory tests, and additional techniques for classification and quantification. Evaluations of diagnostic algorithms in everyday practice are rare, and there is a lack of standards for diagnostic expertise. Uncertainty is compounded when patients’ verbal skills are insufficient, and providers must rely on proxy reports. Studies suggest that behavioral concerns tend to overshadow physiological considerations and result in decreased healthcare access. To mitigate effects of diagnostic overshadowing and research gaps, this paper will propose formal behavior analytic strategies to detect and advocate for the proper management of physiological conditions. Systematic continuous assessment of potential physiological conditions and advocacy must be part of behavior-analytic training.