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1 A Functional Analysis and Improvement of Resistance in Behavioral Psychotherapy: A Case Study. Takashi Muto & Yukari Umezawa Abstract Study objective: To improve resistance in behavioral psychotherapy based on on-going functional assessment and analysis based on several empirical data. Design: AB design, including a descriptive analysis, b correlational-regression analysis with scatter plot and functional formula, and c functional analysis used by behavioral-contingency diagrams, of client and therapist s clinically relevant behaviors. Setting: Behavioral psychotherapy was implemented by the therapist who is a professional clinical-behavior-analyst in a therapy room in a center of clinical psychology and psychotherapy. Participant: A male of forty with chronic panic disorder, who couldn t take any express-train and couldn t be in any crowded place. Measures: a The percentage of occurrence of client s resistance, or challenging behaviors such as refusal of advice given by therapist, b occurrence of advice given by therapist, and c occurrence of client s adaptive commitment in daily life. Independent variables Intervention : a Reducing any advice to client, b prizing verbally all behaviors of client which had some parts of adaptive commitment, and c prompting and fading them to completed commitment in daily life. Results: Intervention based on empirically functional analysis reduced the percentage of occurrence of resistance, and increased occurrence of client s adaptive commitment in daily life. Conclusion: These findings suggest that resistance in psychotherapy could be treated and improved with the behavior-analytic framework, or empirically functional assessment and analysis of client-therapist relationships. Key Words: resistance, challenging behaviors, functional analysis, behavioral psychotherapy, adult with chronic panic disorder resistance Freud, - / 69

2 p., a, b, identified resistance p. Iwata, Dorsey, Slifer, Bauman, & Richman, / challenging behavior Matson, function or functional challenging behavior Sturmey, Sturmey, 70

3 challenging behavior challenging behavior challenging behavior Panic and Agoraphobia Scale GHQ STAI WHO QOL.. H. W. m D... m 71

4 Clinical Behavior Analysis; Dougher, challenging behavior # # 72

5 # # # # # # # # Th Cl A Th 1 Cl Th Cl Th 73

6 Cl Th Cl Th A B A Cl Th Cl Th Cl Th Cl Th Cl 4 Th Cl Th 1 Cl b challenging behavior Figure challenging behavior Figure # # challenging behavior Figure # # 74

7 Percentage of Occurrence of Challenging Behaviors Baseline Session Therapist s Clinically Relevant Behaviors Baseline Session 75

8 challenging behavior challenging behavior challenging behavior Figure Percentage of Occurrence of Challenging Behaviors y = x (R² = ) Occurrence of Advice Given by Therapist Microsoft Excel for Mac ver... Excel Figure R². y =. x. challenging behavior challenging behavior... challenging behavior 76

9 negative reinforcement positive reinforcement consequence extinction challenging behavior # Figure challenging behavior. challenging behavior. Figure # Cl A A Th Cl 1 1 Th 3 77

10 Cl Th Cl A Th 3 Cl 1 3 A 2 Th Cl 2 1 A Th Cl Th Cl Cl 1 Th Cl 78

11 Th Cl Th 1 Cl Th 1 Cl 4 1 C Th Cl Th Cl C D CD 15 km E CE 20km 15 Th Cl Th Cl Y X Cl E F FR G Th Cl E a # challenging behavior 79

12 b challenging behavior, b challenging behavior challenging behavior # challenging behavior challenging behavior # # Excel y =. x. # challenging behavior y = f x Beavers, 80

13 Iwata, & Lerman, ; Hanley, Iwata, & McCord, Word challenging behavior Excel # # - b challenging behavior a challenging behavior # # abolishing operation; Laraway, Snycerski, Michael, & Poling, Beavers, Iwata, & Lerman,, Beavers, G. A., Iwata, B. A., & Lerman, D. C.. Thirty years of research on the functional analysis of problem behavior. Journal of Applied Behavior Analysis,, -. Dougher, M. J. Ed.. Clinical Behavior Analysis. Reno, NV: Context Press. Freud, S. - /. The question of lay analysis: The standard edition. Scranton: W. W. Norton & Company. Hanley, G. P., Iwata, B. A., & McCord, B. E.. Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis,, -.. Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S.. Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis,,. Reprinted from Analysis and Intervention in Developmental Disabilities,,,.. 81

14 p.. Laraway, S., Snycerski, S., Michael. J., & Poling, A.. Motivating operations and terms to describe them: Some further refinements. Journal of Applied Behavior Analysis,, -. Lowe, K., & Felce, D.. The definition of challenging behavior in practice. British Journal of Learning Disabilities,, -. Matson, J. Ed.. Functional assessment for challenging behaviors. New York, NY: Springer. a. "Identified Resistance".,, -. b. "Identified Resistance".,, -.. "Identified Resistance" :. Interactional Mind,, -.. ACT,, -. Sturmey, P.. Functional analysis in clinical psychology. Chichester: Wiley. Sturmey, P. Ed.. Functional Analysis in Clinical Treatment. New York, NY: Academic Press. 82

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