The Clinical Use of Operant Learning Approaches: Some Complex Issues
STANLEY I. GREENSPAN M.D.1
1 Senior Research Psychiatrist, Mental Health Study Center, National Institute of Mental Health, 2340 University Blvd., East, Adelphi, Md. 20783
The clinical use of operant learning approaches demands a full understanding of a patient's behavioral organization and the many experiences that constitute reinforcement. This involves considering the appropriate functional response classes, the "core" functional response classes, the integration of precursor and end goal behaviors (as seen in the natural development of complex behavior patterns in children), program flexibiity, and the variety of stimulus configurations a patient may experience as reinforcing. The author raises a basic question regarding the value of changing behaviors versus changing the patient's experience of reinforcement.
