A preliminary evaluation of mitigating relapse of countertherapeutic caregiver behavior

Abstract

Caregiver treatment adherence is necessary for the long‐term success of behavioral interventions such as functional communication training. Standard behavioral skills training (BST) can effectively teach caregivers to implement treatment with procedural fidelity, but previous research has shown it is insufficient at preventing relapse to countertherapeutic caregiver behavior present before training (e.g., reinforcing challenging behavior). We compared the effects of standard BST with an enhanced BST procedure for improving treatment adherence and mitigating relapse within a laboratory arrangement developed by Mitteer et al. (2018). During enhanced BST, caregivers were exposed to role‐play trials involving higher rates of challenging behavior. When exposed to a treatment‐adherence challenge involving higher rates of challenging behavior and variable communication responses, all three participants assigned to the standard BST group displayed relapse to countertherapeutic caregiver behavior, whereas relapse was eliminated for all three participants in the enhanced‐BST group. Implications and future directions of the laboratory findings are discussed.