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## Breadcrumb

            -  Evidence for Program Improvement 
            -           Externalizing Behavior  Management      

# Externalizing Behavior  Management

## Outcome

### Externalizing Behavior

## Intervention Family

### Behavior Management Interventions

Behavior Management Interventions      

## Externalizing Behavior  Management 

## Evidence

The 27 behavior management interventions produced meaningful reductions in externalizing behavior, but the analysis did not identify additional effective core components. That is, there were no specific content, format, or setting components that distinguished more effective behavior management interventions from less effective ones.

Behavior management interventions aim to reduce problem behavior or increase desirable behavior by manipulating rewards and punishments. These interventions address externalizing behaviors by reinforcing desirable behaviors and discouraging undesirable behaviors.

The specific mechanisms vary, but examples include incentives, disincentives, and behavioral contracting. Some programs incorporate “contracts” between youth and adults, specifying behavioral and other goals, as well as rewards and sanctions associated with those goals. Others use “token systems,” which provide rewards for specific behaviors or for completing tasks. These tokens can be exchanged for rewards, such as toys or snacks. Many programs use a combination of these and other elements, based upon the assessed needs of the youth they serve. These techniques can be used either alone or in conjunction with other interventions

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## Characteristics of behavior management interventions (27 studies contributed evidence):

                          - Interventions lasted 23 weeks, on average.
                          - Sessions typically took place once or twice a week.
                          - Most interventions took place in the classroom (70%). Others took place in a separate space within the school (resource room or school counselor’s office; 15%) or a community setting (15%).
                          - About half of the interventions were delivered in a one-on-one format (52%).    Intervention examples- Behavioral contracting:  A behavioral consultant assisted the classroom teacher with four phases of behavior management and modification. In the first phase, the consultant observed the child in the classroom and identified the problem behavior. Next, the consultant shared the observation with the teacher and they created a plan for behavioral change using reinforcement and monitoring. The teacher and student worked together to create a behavioral contract that included a description of the desired change, the monitoring strategy, and the methods for reward delivery. Then, in the implementation phase, which typically lasted for three weeks or more, the teacher and student both monitored student behavior and the teacher provided feedback and reinforcement as goals were met. Once goals were met, the consultant returned for the final evaluation phase and conducted another observation of the student’s behavior. The teacher and consultant compared data to determine next steps (fade, continuation, or change of intervention).
- Token economy:  An 8-week preventative mental health program applied behavioral reinforcement techniques with children of military personnel. During the first two weeks, providers determined a baseline for child behavior and did not offer reinforcement. Starting in the third week, providers introduced a token system where children could earn tokens for good behavior and then use those tokens to ‘buy’ toys, candy, and school supplies. Through the seventh week of the program, children were able to earn tokens and verbal praise when they performed target behaviors. During the eighth week, the token system ended, but children continued to receive verbal reinforcement for desired behavior.
      Assess Feasibility- Needs assessment. Assess whether your program has a need for a greater level of behavior management. Do behavioral disruptions cause program interruptions or alter program outcomes for some participants?
- Program design. Identify potential benefits and drawbacks of adding behavior management structures into your program. Would doing so change critical elements of your program?
- Program structure. Examine whether there are opportunities to add a behavioral management intervention. Could it be folded into an existing program?
- Resources. Consider what resources are necessary to implement a behavior management intervention. What types of specialized training or professional development would be required for staff?
- Specific needs. Are there specific types of behavioral disruptions that could be addressed? Are there approaches that might work best with the youth you serve?
Take Action
Consider the following courses of action depending on the results of your feasibility assessment:
- Incorporate behavioral management interventions into your program.  Identify an approach to try, whether a token economy system, a behavioral contract, or some other form. Evaluate its fit and adjust as needed.
- Evaluate the effectiveness of specific forms of reward or punishment for the youth in your program.  Try different approaches to determine which is best suited for your context.
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