Date of Award

4-1988

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. Richard Malott

Second Advisor

Dr. R. Wayne Fuqua

Third Advisor

Dr. Malcolm Robertson

Fourth Advisor

Dr. Larry ten Harmsel

Abstract

The current study had two major objectives: (1) to evaluate the impact of a staff management package consisting of training, prompts, task assignments, and oral and graphic feedback, and (2) to assess the effects of prescribed staff interventions on the inappropriate behaviors of three psychiatric inpatients. Accomplishing these two objectives produced an objective data base for the detailed evaluation of patient behaviors. Study I was designed to get staff members to record patient behaviors, to use contingent and consistent interventions, and to record those interventions. Results yielded high staff performance without tangible incentives. Staff members were able to consistently, reliably (98%), and accurately record patient behaviors in a timely manner. Data collection forms were turned in 99% of the time during treatment phases as compared to 48% during pre-treatment phases. Prescribed staff interventions increased 33% during treatment. Weeks 13 through 29 of Study I ran concurrently with Weeks 1 through 17 of Study II. Study II was designed to provide a detailed analysis of the impact of prescribed staff interventions on four categories of patient behaviors: (1) aggressive behaviors, (2) noncompliance behaviors, (3) annoying behaviors, and (4) physically assaultive behaviors. Increased staff interventions had a negative impact on the inappropriate behaviors of one patient and no impact on the inappropriate behaviors of the other two patients; furthermore, increased interventions resulted in an increase in the use of restrictive procedures with all three patients over baseline measures. One interesting result of the program was that all three patients received increased privileges, and participated in more therapeutic activities than prior to treatment although there were no measurable decreases in inappropriate behavior for any patient. In conclusion, the use of a staff management package can effectively increase and maintain prescribed staff performance without the use of tangible incentives. Second, an increase in prescribed staff interventions may have no effect on patient performance and result in an increase in the use of restrictive procedures.

Comments

Fifth Advisor: Dr. Steve Hathaway

Access Setting

Dissertation-Open Access

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