行動分析学研究 35(1): (2020)

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1 Japanese Journal of Behavior Analysis 2020, Vol. 35, No. 1, 実践報告買い物行動に対する介入と効果の検討研究の目的研究計画場面参加者 72 介入行動の指標結果結論 Key Words 目的 obsessive-compulsive disorder OCD OCD Franklin & Foa, 2011 OCD exposure and response prevention ERP Foa et al., 2005; Öst, Havnen, Hansen,& Kvale, 2015 OCD Newsome, Newsome, Fuller, & Meyer, 2019; 2016 Beavers, Iwata, & Lerman, 2013; 2013 OCD 方法参加者 mg 生活歴 5 52

2 現病歴 A 1 71 B B C 72 D 家族症状問題のアセスメントと機能推定買い物の困難について資源ごみの廃棄の困難について 45 5 単独での外出の困難について 53

3 35 1 他者への過度な確認について 5 生態学的アセスメントクライエントが希望した治療目標標的行動主な標的行動 2 1 ERP 2 54

4 副次的な標的行動 1 従属変数介入アセスメントと心理教育 ( セッション 1~3) 3 ERP クリニック内での ERP と確認行動に対する家族への心理教育 ( セッション 4~7) 4 ERP ERP D ERP Törneke, 実際の店での ERP( セッション 8~13) ERP

5 35 1 ERP 新聞雑誌に対する ERP( セッション 14~17) 14 ERP 車に対する曝露法 ( セッション 18~21) 結果スーパー等に入店する行動と商品の購入行動について 1 1 ERP ERP 9 10 図 1 スーパー等に入店した累積頻度スーパー等で購入した商品数および新聞を読んだページ数 56

6 ERP 新聞を読む行動について ERP ERP 1 17 一人で自宅から店まで徒歩で行く行動について家族や親戚お客様相談センターに確認の電話をする行動について 6 3 図 2 一人で自宅から店まで徒歩で行った累積頻度図 3 確認の電話をかけた頻度 (2 週あたり ) 57

7 35 1 その他の行動について考察 OCD OCD Franklin & Foa, 2011 Kanter et al., , 2016 OCD Critchfield, Tucker, & Vuchinich 1998 Critchfield et al., 1998 ERP ERP ERP ERP ERP ERP 58

8 ERP ERP ERP ERP ERP ERP ERP ERP 謝辞引用文献 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, 46, Critchfield, T. C., Tucker, J. A., & Vuchinich, R Self-report methods. In K. A. Lattal & M. Perone Eds., Handbook of research methods in human operant behavior pp Boston, MA: Springer. Foa, E. B., Liebowits, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E.,... Tu, X Randomized, placebocontrolled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessivecompulsive disorder. American Journal of Psychiatry, 162, Franklin, M. E., & Foa, E. B Treatment of obsessive compulsive disorder. Annual Review of Clinical Psychology, 7, Kanter, J. W., Landes, S. J., Busch, A. M., Rusch, L. C., Brown, K. R., & Baruch, D. E The effect of contingent reinforcement on target variables in outpatient psychotherapy for depression: A successful and unsuccessful case using functional analytic psychotherapy. Journal of Applied Behavior Analysis, 39, Newsome, D., Newsome, K., Fuller, T. C. & Meyer, S How contextual behavioral scientists measure and report about behavior: A review of JCBS. Journal of Contextual Behavioral Science, 12, , , Öst, L. G., Havnen, A., Hansen, B., & Kvale, G Cognitive behavioral treatments of obsessive-compulsive disorder: A systematic review and meta-analysis of studies published Clinical Psychology Review, 40, Törneke, N Metaphor in practice: A professional s guide to using the science of language in psychotherapy. Oakland, CA: Context Press

9 35 1 PRACTICAL REPORT Intervention for Shopping Behavior of an Elderly Woman Who Was Afraid of Making Other People Sick: A Single Case Study of Exposure and Response Prevention ATSUSHI SEGUCHI Ritsumeikan University Abstract Study objective: To evaluate the effects of an intervention involving exposure and response prevention (ERP) that was used with an elderly woman who had a fear of harming others by passing germs on to them. Behavioral measures were used to manage the frequency of behavior that was related to her shopping. Design: Multiple baseline design across behaviors. Setting: A counseling room at a mental health clinic and nearby stores. Participant: A 72-year-old woman who was diagnosed with obsessive-compulsive disorder. Intervention: The client participated in 21 sixty-minute counseling sessions, 1 session every 2 weeks. The total duration of her participation was 309 days. During the sessions, the client went to a convenience store and a drug store with the author, and was encouraged to touch the products. After that, she was encouraged to walk by cars that were parked on the street. Measures: Frequency of going into stores such as supermarkets, number of goods purchased, number of newspaper pages read, frequency of going to stores by herself, and frequency of making confirmatory phone calls. Results: The frequency of going into stores, number of goods purchased, number of newspaper pages read, and frequency of going to stores by herself increased. The frequency of making confirmatory phone calls decreased. Conclusion: The intervention appeared to be effective for increasing the positive behavioral repertoire of the client. Key Words behavior measures, single case experimental design, ecological assessment, exposure and response prevention, elderly person diagnosed with obsessive-compulsive disorder 60

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

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