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Book Reviews   |    
Principles and Practices of Behavioral Assessment
Reviewed by Nirbhay N. Singh, Ph.D.
Psychiatric Services 2002; doi: 10.1176/appi.ps.53.8.1038-a
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by Stephen N. Haynes and William Hayes O'Brien; New York, Kluwer Academic/Plenum Publishers, 2000, 348 pages, $59.95

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At the core of this volume are the concepts and strategies of behavioral assessment, which is a subset of psychological assessment. The book goes beyond the simplistic behavioral assessment strategies that are widely employed in behavioral research and clinical practice today. For example, in much contemporary research and practice, behavioral assessment is almost synonymous with functional assessment, a method used to assess the generic conditions that purportedly maintain problem behaviors. As this book clearly shows, however, functional assessment is simply one method of assessment that, by itself, provides an incomplete picture of the behavior of interest.

In Principles and Practice of Behavioral Assessment, Haynes and O'Brien eschew the current myopic view of behavioral assessment and suggest a much broader array of methods that researchers and clinicians can use to develop a more informed view of why a person may be behaving in a certain way. The authors also emphasize that the beliefs and values of the person who is doing the assessment greatly influence which assessment paradigm is used, which in turn affects the selection of an assessment, of the variables for assessment, of the assessment strategies for examining the behavior, and of the measures to be obtained. These choices in turn affect the case formulation and the treatment decisions. The authors rightly note that behavioral assessment, like psychological assessment itself, involves the use of quantitative as well as qualitative methods to obtain a coherent picture of the multiple motivations that underlie the repeated occurrence of a problem behavior.

Haynes and O'Brien discuss the characteristics and applications of behavioral assessment and how these variables are related to the critical issue of clinical judgment. They note that practitioners have few empirically derived guidelines for making clinical judgments, and virtually no guidelines for designing effective intervention programs. The authors discuss how to avoid the oversimplification strategies that clinicians use to make sense of the large data sets that behavioral assessments produce.

Many behavioral researchers and clinicians hold the view that behavioral assessment and therapy are part of a science that is based on reliable and observed behavior. However, they forget that even in behavioral therapy, case formulation is an art that is ultimately based on the therapist's hypotheses and judgments about the problem behaviors, causal variables, and functional relations among multiple behaviors, environments, and so on. Moreover, as Haynes and O'Brien point out, case formulation affects clinical intervention, and many uncontrolled factors moderate treatment effects. These moderator variables include the person's goals and strengths, presence of medical and psychiatric problems, characteristics of the treatment environment, use of recreational and prescribed drugs, social support, and others. To their credit, the authors present a clinically astute model that relates behavioral assessment to good case formulation, which leads to appropriate clinical intervention that will result in enhanced treatment outcomes.

I enjoyed reading this book. It presents a wealth of information in a very readable format. The authors amply demonstrate the merits of taking a broad approach to behavioral assessment, as it is a powerful method for assessing and making sense of complex human behavior. They also emphasize the need for good case formulation—a topic rarely taught in university courses and usually ignored in textbooks on behavioral assessment. If I could have only one book on behavioral assessment, this would be it.

Dr. Singh is professor of psychiatry, pediatrics, and psychology at the Medical College of Virginia of Virginia Commonwealth University in Richmond.

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