Psychopathology of the Brain
Dr. Trevor Hurwitz
Program Director – UBC Neuropsychiatry program

This presentation will give a brief overview of major psychopathologies, their impact on the brain and how these relate to common behavioral disturbances.

Traumatic and non-traumatic brain injury may present primarily or exclusively with psychiatric symptoms. Psychopathology is often modified by the brain injury itself. This presentation will describe how brain injury filters and distorts phenomenology and clinical syndromes.

The various domains in the mental state will be reviewed. This includes general appearance, level of consciousness, behavior, speech, and language, affect, mood, cognition, perception and cognitive-intellectual functions. Participants will learn about the neuroanatomical structures that are believed to be responsible for mental state disturbances and how the emergent psychopathology is identified and assessed with  special emphasis on the link to brain injury.

Applied Behavior Analysis and Psychopathology
Dr. Douglas Lee, ABPP, BCBA

Applied Behavior Analysis (ABA) has been used successfully in combination and as an alternative to psychopharmacology interventions for individuals with neurological impairments who exhibit challenging behaviors.  What ABA actually is and how it can be coordinated with medical and pharmacological interventions will be outlined.

Concurrent Sessions (Afternoon)
Managing Anger and Aggression
Dr. Michael R. Johnston, BCBA

Anger and frustration can be a pervasive challenge for individuals with neurological disorders. Often, these difficulties stem from an inability to express oneself or to communicate effectively. This session will focus on some techniques for staff, family members, and patients to learn to manage aggressive behaviors when they do occur. Teaching family and staff some ways of preventing most aggressive behavior will also be discussed.

What You Need to Know About Positive Behavior Support
Cristin Johnston, M.A., BCBA

When supporting individuals with neuropsychiatric or developmental issues, we often face difficult issues ourselves in meeting the needs of the individual. We often struggle to make important decisions around the level of care and support required and fostering independence and community involvement. This process of balancing effective treatment and meaningful learning gains with quality of life issues can be time consuming, overwhelming and difficult to implement. Additionally, funding and staffing issues can often limit the individual’s access to meaningful experiences in the community, with family and friends.

Positive Behavior Supports (PBS) is a process of address all of these areas while specifically tailoring treatment goals with the individual dreams and goals of the person requiring supports. This presentation will cover all of the major steps involved in creating an individualized behavior support plan that is based in the desires of the person served and implemented using the evidence-based practice of Applied Behavior Analysis. Utilizing a Positive Behavior Support approach to case management requires team work, individualized goal setting and support strategies, building community involvement and social capital, data-based decision making and careful application of behavior analytic principles for teaching new skills and maintaining skills overtime. We will also address how decreasing problem behaviors through prevention strategies can reduce the intensity, frequency and duration of instances, which in turn increases the number of positive interactions between the individual and his or her family, support staff and other important people in the community. Quality of life for all persons involved can be directly impacted through this process.

Managing the Arousal Cycle
Larry Beierbach, RPN

Many challenging behaviors involve a fairly predictable arousal cycle.  Managing the arousal cycle in such cases is an essential component of effectively assisting the person to manage his/her behavior.

This five stage cycle is a reaction that happens to all of us when we experience strong emotions such as fear and anger. Knowing what happens to us at each stage of this cycle gives us the beginning tools that will help us to be more aware of how are emotions are tied to our ability to make effective judgment calls.

Learning how to effectively deal with our emotions in a crisis is a proactive step in managing ourselves in an effective and positive manner.

Simple Methods for Collecting Behavioral Data
Cynthia Clark, B.A.

Data collection forms the basis of the evaluation methods used to draw conclusions about behavior change and involves the objective measurement of behavior over time. Basically, data provide a measure of how often and/or how long an individual engages in a particular behavior. These measures are required in order to choose the most effective change procedure and to indicate if, when, and how much change is occurring.

Data collection techniques to be discussed will be: anecdotal, event recording, duration recording, time sampling, A-B-C, communication function, motivational assessment scale, scatter plot, mood chart, and sleep chart.

Language Capacity and Cognitive Behavior Therapy
Jim Bruzzese, M.A. / Michelle McAtee, M.A.

Often people with receptive language impairments can “hide” their deficits through reliance on subtle nonverbal cues from the person talking to them to help understand what is being said. In addition, their receptive abilities may also be overestimated if they appear to display competence in their speech. 

Some clients referred for counseling may talk and use a variety of sentence structures, may memorize or repeat vast amounts of verbal material and, at first glance, display verbal fluency. This verbal fluency however may mask some substantial communication and receptive language problems and their apparent competence in language may be superficial. There may be relatively little in the way of meaningful content conveyed in their discourse.

Language deficits can have a significant impact on the effectiveness of therapy. Clients referred for counseling services however, rarely come with any information on their language functioning. As a result we have been conducting language assessments prior to cognitive behavior therapy to ensure the therapist has current information regarding the client’s language capacities. This presentation will outline how this system works and will discuss some of the benefits it provides for therapy.

Living Better through Behavioral Definitions
Kristiina Thackray, CCC

Properly defining challenging behaviors is essential for developing effective strategies for solving such problems.  This session will demonstrate practical methods for defining the challenging behavior as well as defining effective alternative behaviors that may replace the challenging behavior.

The initial step in the process for all behaviour change strategies is to define the challenging behavior(s) in objective terms. Is it observable? Measurable? Discrete?

This is critical for baseline data collection and on going evaluation of the success of the strategy implemented. Objective behaviour definitions are also a critical component of implementing the second stage of behaviour change strategies which is to identify alternative behavior(s) to replace the challenging behaviour. In order to ensure the success of any reinforcement-based program, objective behaviour definitions must be established.

Safety Plan vs. Behavior Change Plan
John Holmes, B.Sc.

Historically, various support and intervention strategies have been utilized to address challenging and potentially injurious behavior.

These often include proactive strategies to facilitate behavior change (i.e. teaching new skills, changing the environment or the nature of the support), and reactive strategies, which typically address immediate safety concerns such as minimizing or preventing injury to the client and others.

Unfortunately, underlying causes or reasons for maladaptive behavior often go unaddressed and intervention plans with restrictive procedures tend to remain in place for long periods of time without a plan of how to decrease the need for them over time.