I met BF Skinner when I was in grad school studying Applied Behavior Analysis. For me, meeting Dr. Skinner was the equivalent of a nursing student meeting Florence Nightingale, a medical student meeting Hippocrates, and a psychology student meeting William James – combined. BF Skinner’s research into human behavior1 shaped the careers for all behavior analysts – including me.
I was attending my first conference of the International Association For Behavior Analysis, riding in an elevator on my way to my very first poster presentation. I remember being majorly perturbed that the elevator stopped at each and every floor. At the 13th or 14th stop, I was juggling my poster, my handouts and my nerves, when a fellow passenger kindly offered help.
I accepted by offloading my handouts. From behind my poster, I managed to mumble, “thanks.” After a few minutes of paper shuffling, BF Skinner said, “Your research is intriguing, what is your booth number? I’d like to discuss this further”.
Oh, sure, BF Skinner is going to stop at my booth.
True to his word, he did stop by my booth. In the 1980s, almost every student enrolled in Behavior Analysis programs was being prepared for careers in special education. I chose a different route. My thesis employed Behavioral Approaches to solve very large problems — specifically, rewriting product installation directions to allow proper installation and use of energy conservation products3.
Dr. Skinner termed my research “socially relevant” and “important.” He asked me to keep in touch and handed me a slip of paper, torn from his conference schedule, upon which he had written his office telephone number.
Oh, sure, BF Skinner is going to take my calls.
Fred and I wound up talking several times a year well into his later years. He attended a few of my lectures, and asked a question or two. He challenged me to think through all of the possible consequences that could happen as a result of making one single decision. This is really important, and exceptionally difficult. Accepting this challenge is a part of everything I do.
I have no doubt that any success I have as a therapist working with patients who sustained brain injuries, or who were impacted by dementia and/or gerospych diagnoses; or any success that I have in my work as a business strategy consultant, product/application designer or operator is a very direct result of accepting help from a very kind stranger. Thank you, Fred.
Sr+ is BF Skinner’s notation for positive reinforcement where a reward is given contingent upon a desired behavior to increase the chances that the behavior will occur again. Sr+ is the guiding principle for this column. I hope to provide useful and actionable information that will increase the chances that you’ll continue to come back and read the next edition.
We’ll start with a few terms and definitions. The Behavioral ABCs2 provide the foundation for behavioral analysis at the patient and the enterprise level:
- A is for Antecedents. These are events that are present before a behavior occurs.
- B is for Behaviors. Behaviors are observable and measurable.
- C is for Consequences. These are events that occur after a behavior and can either strengthen or weaken the chances that the behavior occurs in the future.
Over the next few months, I plan to build on these foundational concepts to look at issues impacting senior care, including how to:
- Define behaviors — especially for patients diagnosed with dementia, mental illness intellectual disabilities and neuro issues
- Develop simple data management and analysis plans
- Design specialty programs:
- Use data to choose locations
- Address workforce issues especially hiring, fitting, training and turnover
- Develop admission and discharge criteria
- What happens to your entire business when you make the one decision to admit dementia/geropsych patients? We’ll discuss the impact on:
- Payer Mix
- Financial Performance
- Community Reputation
I’m looking forward to continuing the conversation.
2 A Charles Catania. B. F. Skinner’s Science and Human Behavior: Its Antecedents and It’s Consequences, Journal of the Experimental Analysis of Behavior, 80-3, (313-320), (November 2003). https://doi.org/10.1901/jeab.2003.80-313
3 Pavlovich, M. & Greene, B.F. (1984). A self instructional manual for installing low cost/no cost weatherization materials: Experimental validation with scouts. Journal of Applied Behavior Analysis, 17, 105-109.
Mark Pavlovich is the president of Yardstik Behavioral Analytics and a veteran senior care professional.