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The Expanding Vision of The Expanding Vision of Positive Behavior Support: Positive Behavior Support: Happiness, Helpfulness, Happiness, Helpfulness,

Hopefulness Hopefulness Edward G. Carr, PhD, BCBA, FAAMR Edward G. Carr, PhD, BCBA, FAAMR

State University of New York at Stony Brook State University of New York at Stony Brook

Dr. Ted Carr Dr. Ted Carr Leading Professor Leading Professor Dept. of Psychology Dept. of Psychology S.U.N.Y S.U.N.Y Stony Brook, NY 11794 Stony Brook, NY 11794­ ­2500 2500 [email protected] [email protected] www.sunysb.edu www.sunysb.edu/autism /autism

Accomplishments: Accomplishments: What We Have Done What We Have Done

Journal of Positive Behavior Interventions Journal of Positive Behavior Interventions Association for Positive Behavior Support Association for Positive Behavior Support Annual International Conference on PBS Annual International Conference on PBS Website ( Website (www.apbs.org www.apbs.org) ) Linkage to cognate organizations Linkage to cognate organizations

(e.g., the PBS SIG in ABA) (e.g., the PBS SIG in ABA) Impact on government funding priorities Impact on government funding priorities (e.g., multiple grants for PBS research) (e.g., multiple grants for PBS research) Codification of PBS in Federal law: IDEA Codification of PBS in Federal law: IDEA

Unfinished Business: Unfinished Business: What We Need To Do What We Need To Do

Develop a conceptual framework, Develop a conceptual framework, grounded in relevant theory and data from grounded in relevant theory and data from multiple sciences, to guide our efforts in a multiple sciences, to guide our efforts in a systematic, prescriptive fashion systematic, prescriptive fashion

Build infrastructure to ensure the future Build infrastructure to ensure the future viability of the PBS approach: viability of the PBS approach: preservice preservice, , inservice inservice, organizational , organizational change/reallocation of resources change/reallocation of resources

Unfinished Business: Unfinished Business: What We Need To Do What We Need To Do

Disseminate the PBS approach to new Disseminate the PBS approach to new venues and to new populations by venues and to new populations by developing relevant strategies developing relevant strategies

Articulate and promulgate a set of Articulate and promulgate a set of standards that accurately and concretely standards that accurately and concretely define the nature of PBS to ensure define the nature of PBS to ensure procedural integrity and quality control procedural integrity and quality control

Three Themes Three Themes

Happiness: QOL as the central dependent Happiness: QOL as the central dependent variable in PBS variable in PBS Helpfulness: Systems change as the Helpfulness: Systems change as the central independent variable in PBS central independent variable in PBS Hopefulness: Facilitating the development Hopefulness: Facilitating the development of QOL and systems change by of QOL and systems change by incorporating knowledge from other incorporating knowledge from other sciences sciences

Happiness Happiness

Centrality of QOL Centrality of QOL

What can go right in a person’s life? What can go right in a person’s life?

vs vs

What are the forms of psychopathology that What are the forms of psychopathology that ruin a person’s life? ruin a person’s life?

Dimensions of Quality of Life Dimensions of Quality of Life

Material well Material well­ ­being being Health and safety Health and safety Social well Social well­ ­being being Emotional well Emotional well­ ­being being Leisure and recreation Leisure and recreation Autonomy Autonomy

Material Well Material Well­ ­Being Being

Adequate housing Adequate housing Basic necessities (food, clothing) Basic necessities (food, clothing) Sufficient income Sufficient income Availability of transportation Availability of transportation Amenities (toys, computers, valued Amenities (toys, computers, valued personal possessions) personal possessions)

Health and Safety Health and Safety

Adaptation to chronic illness and/or Adaptation to chronic illness and/or physical impairment physical impairment Appropriate medication Appropriate medication Access to medical services Access to medical services Personal safety Personal safety – – home and community home and community Health and wellness Health and wellness

Social Well Social Well­ ­Being Being

Social competence (interests and skills) Social competence (interests and skills) Social networks (friends Social networks (friends vs vs isolation) isolation) Community acceptance (social and ethnic Community acceptance (social and ethnic clubs, religious groups, hobby groups) clubs, religious groups, hobby groups) Accessibility of desirable social contexts Accessibility of desirable social contexts

Emotional Well Emotional Well­ ­Being Being

Close relationships (love, attachment, Close relationships (love, attachment, intimacy) intimacy) Positive mood Positive mood Emotional stability Emotional stability

Leisure and Recreation Leisure and Recreation

Social and solitary activities that generate Social and solitary activities that generate personal pleasure (hobbies, sports, personal pleasure (hobbies, sports, vacations, arts and entertainment, outdoor vacations, arts and entertainment, outdoor activities) activities)

Autonomy Autonomy Being able to choose basic items: clothing, Being able to choose basic items: clothing, food, personal belongings food, personal belongings Being able to make major life choices: living Being able to make major life choices: living arrangements, social relationships, arrangements, social relationships, recreation and leisure, vocation, academic recreation and leisure, vocation, academic interests, religion and spiritual preferences interests, religion and spiritual preferences Self Self­ ­sufficiency: achieving a level of sufficiency: achieving a level of competence that reduces the level of competence that reduces the level of support required from others (e.g., self support required from others (e.g., self­ ­care, care, food preparation, safety in the community, food preparation, safety in the community, money management) money management)

Impediments to QOL Impediments to QOL

Problem behavior Problem behavior Skill deficits Skill deficits Dysfunctional systems Dysfunctional systems

The Problem With Problem The Problem With Problem Behavior Behavior

Prevents full community integration Prevents full community integration (home/school/employment) (home/school/employment) Demoralizes family members Demoralizes family members (parents/siblings) and teachers (parents/siblings) and teachers Increases likelihood of institutionalization Increases likelihood of institutionalization (loss of choice/dignity) (loss of choice/dignity) Rejection by others (social isolation/no Rejection by others (social isolation/no friends) friends) Damages self Damages self­ ­esteem (shame/regret) esteem (shame/regret)

Summary Summary: Destroys quality of life : Destroys quality of life

Helpfulness Helpfulness

Support Support vs vs

Cause and Cure Cause and Cure

Laboratory (Analog) Research Laboratory (Analog) Research as a Prelude to Effective as a Prelude to Effective

Support Support

Support: Maintenance and Support: Maintenance and Sustainability Sustainability

Linking Sustainability to Linking Sustainability to Systems Change: A Model Systems Change: A Model

Elements of a Model for Systems Elements of a Model for Systems Change to Promote Sustainability Change to Promote Sustainability

of Effective Practices of Effective Practices

Vision Vision Skills Skills Incentives Incentives Resources Resources Action plan Action plan

Application of the Systems Change Application of the Systems Change Model Model

Vision Vision e.g., goodness e.g., goodness­ ­of of­ ­fit; person fit; person­ ­ centered planning centered planning Skills Skills e.g., collaborative teaming and e.g., collaborative teaming and team training team training Incentives e.g., Incentives e.g., responsivity responsivity to social and to social and emotional needs emotional needs Resources Resources e.g., life arrangement and life e.g., life arrangement and life coaching coaching Action plan Action plan e.g., group action planning e.g., group action planning

Hopefulness Hopefulness

Extending PBS: Multiple Extending PBS: Multiple Populations and Venues Populations and Venues

Populations Populations

Emotional and Emotional and behavior disorders behavior disorders Mental health / mental Mental health / mental illness illness Traumatic brain injury Traumatic brain injury Juvenile delinquency Juvenile delinquency Deaf / hard of hearing Deaf / hard of hearing Conduct disorder Conduct disorder

Bullies Bullies Literacy issues Literacy issues Typical families Typical families Fetal alcohol syndrome Fetal alcohol syndrome Alzheimer’s or dementia Alzheimer’s or dementia Sex offenders Sex offenders

Extending PBS: Multiple Extending PBS: Multiple Populations and Venues Populations and Venues

Venues Venues

Cross Cross­ ­cultural cultural settings settings Underserved Underserved communities communities Head start classes Head start classes High schools High schools

Interagency coordination Interagency coordination Rural settings Rural settings Normative work / living Normative work / living settings settings Medical / clinical settings Medical / clinical settings

Note: Source of entries is from the first and Note: Source of entries is from the first and second conference agendas of the second conference agendas of the Association for Positive Behavior Support, Association for Positive Behavior Support, Orlando, FL (2003) and Tampa, FL (2005) Orlando, FL (2003) and Tampa, FL (2005)

Extending PBS: Linkage to Multiple Extending PBS: Linkage to Multiple Sciences and Disciplines Sciences and Disciplines

Organizational management Organizational management Community / ecological psychology Community / ecological psychology Cultural psychology Cultural psychology Biomedical sciences Biomedical sciences Positive psychology Positive psychology

Organizational Management: Organizational Management: Systems Change Themes Systems Change Themes

Models for effective service delivery Models for effective service delivery Models for effective training Models for effective training Models for effective team building Models for effective team building Models for building motivation Models for building motivation Models for ensuring accountability Models for ensuring accountability Models for data management Models for data management

Community / Ecological Community / Ecological Psychology: Illustrative Examples Psychology: Illustrative Examples

A Focus on Prevention A Focus on Prevention Identification and analysis of environmental Identification and analysis of environmental risk factors risk factors Proactively addressing the issue of scarce Proactively addressing the issue of scarce resources (not enough time, money, resources (not enough time, money, personnel) personnel) Preventive support plans that appeal to the Preventive support plans that appeal to the broader needs of settings and communities broader needs of settings and communities

Community / Ecological Community / Ecological Psychology: Illustrative Examples Psychology: Illustrative Examples Building Sources of Social Support Building Sources of Social Support

Support networks in the lifecycle Support networks in the lifecycle Self Self­ ­help groups help groups

Empowerment Empowerment Networking Networking Influencing policy formation Influencing policy formation Effectively competing for resources Effectively competing for resources Building organizational coalitions Building organizational coalitions

Cultural Psychology Cultural Psychology

Cultural relativism: conceptualizing Cultural relativism: conceptualizing problems problems Cultural values: identifying acceptable Cultural values: identifying acceptable goals goals Cross Cross­ ­cultural competence: customs, cultural competence: customs, rapport, cooperation rapport, cooperation

Biomedical Science: Some Biomedical Science: Some Possibilities Possibilities

Knowledge of brain function influences Knowledge of brain function influences how to build competencies how to build competencies Biological factors as setting events for Biological factors as setting events for problem behavior problem behavior QOL and health psychology / behavioral QOL and health psychology / behavioral medicine medicine

Positive Psychology: Our Greatest Positive Psychology: Our Greatest Scientific Ally? Scientific Ally?

“ “Positive psychology is an umbrella term for Positive psychology is an umbrella term for the study of positive emotions, positive the study of positive emotions, positive character traits, and enabling institutions character traits, and enabling institutions (Seligman et al., 2005)” (Seligman et al., 2005)”

Positive Psychology: Our Greatest Positive Psychology: Our Greatest Scientific Ally? Scientific Ally?

A strengths A strengths­ ­based approach based approach Address behavior challenges by increasing Address behavior challenges by increasing competence competence Competence involves character building reflecting Competence involves character building reflecting six virtues: wisdom, courage, humanity, justice, six virtues: wisdom, courage, humanity, justice, temperance, and transcendence temperance, and transcendence Improve QOL by focusing on social and emotional Improve QOL by focusing on social and emotional well well­ ­being being Create institutions that enable positive affect Create institutions that enable positive affect Widespread application across populations and Widespread application across populations and venues venues

We Are Not a Lonely Voice in We Are Not a Lonely Voice in the Wilderness the Wilderness

We Are One of Many Voices in We Are One of Many Voices in a Chorus a Chorus