In January, our discussion focused on the concept of happy, relaxed and engaged (HRE) and how to apply this to our current clients.  We discussed topics such as filling the environment with reinforcers and items for engagement, pairing and the building of therapeutic rapport, the concept of trust between therapist and client, and the goal of cooperation in shared experiences rather than getting compliance at all costs.  The moral of the story is to co-regulate first and teach second!!

In February, our discussion focused on how to assess and reduce problem behaviour maintained by escape from instruction in a child with Autism.  The previous research has shown that escape-maintained behaviour can depend on several things – task difficulty, rate of instruction, types of requests and the characteristic of the instructor.  This emphasizes that antecedent variables can be critical elements when you are designing effective interventions.

In March, we looked at another type of escape-maintained behaviour.  The problem behaviours in this article were resulting in the reduction or removal of an aversive stimuli (negative reinforcement).  The researchers paired non-contingent reinforcement (NCR) with time out from the aversive stimuli.  They started to deliver small food reinforcers while the aversive sound was occurring, for longer and longer periods of time and at different decibel levels.  This article led to an indepth conversation of the ethical considerations around the use of food as a reinforcer and the fact that the aggression in this case was severe enough that it was a consideration.  The point was made that food in this case was a very closed-ended reinforcer so that other open-ended reinforcers that would have required removal, might have triggered other aggressions.

Participating in a journal club also supports our commitment to professional and ethical practice. The Behavior Analyst Certification Board Ethics Code and the standards set by the College of Psychologists and Behaviour Analysts of Ontario emphasize the importance of practicing within our areas of competence, maintaining evidence-based practice, providing effective treatment, and collaborating with colleagues. Engaging with research as a team allows us to uphold these standards while continuously strengthening our clinical knowledge.

By discussing research and exploring how it can be applied in real-world settings, journal clubs help to:

• Promote evidence-based practice
• Strengthen clinical skills and critical thinking
• Encourage ongoing professional development
• Foster a collaborative learning culture within the clinic

Each month, a different team member takes on the role of discussion leader. Everyone reads the selected article ahead of time and comes prepared to share their thoughts. The discussion leader prepares a brief summary of the article along with several critical thinking questions designed to spark conversation and explore how the techniques described in the research might be implemented in our clinical practice.

Our journal club has quickly become a valuable opportunity for our team to learn from both the research and from each other.

We should continue to ask ourselves, how can we continue to bridge the gap between research and real-world practice to better support the clients we serve?  

Written By: 

Kim Deoisa, MSc., BCBA, RBA. Reg. (Ont.)

Clinical Supervisor