Teaching individuals with developmental disabilities to learn and use self-control techniques is the long-term goal of both Relaxation therapy and the Imagery-based therapy called Picture Rehearsal. An individual demonstrates self-control when they use an adaptive behavior in a situation that formerly had been identified as a setting for problem behaviors.
From this perspective, self-control is defined as a set of responses that can be taught; learning and using those responses reduces the need to depend on external control by others. Both relaxation and picture rehearsal are procedures that teach a specific set of responses that an individual can use to achieve and maintain self-control.
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Stress produces both physiological and behavioral effects in an individual. Relaxation involves learning a set of responses that can be used to change a tense body state to a relaxed one, thereby reducing the stress being experienced. In relaxation, the individual first learns to discriminate between muscles that are tense and muscles that are relaxed. This is taught in a structured session, beginning with readiness skills if needed (sitting, eye contact and imitating), and moving to sequentially tightening and relaxing large muscle groups (arms, hands, legs). Physical prompts and modeling are often used during instruction, as well as immediate reinforcement for each successful trial. Breathing exercises are added next, and then a repeat sequence of just relaxing the muscle groups, without first tensing, is added. This routine is practiced daily. As the individual improves his or her ability to control muscle responses, other muscle groups are added to the routine, usually in a head to toe sequence. Relaxation prompts are provided by teachers or parents when signs of bodily tension are observed.
When the individual can respond reliably to relaxation prompts, instruction in when to use relaxation begins. The focus is on helping the individual to identify both bodily signs of stress and the situations that elicit them. One advantage of relaxation therapy is that is can be used in any setting, school, home or workplace, whenever a stressful situation occurs. It is a positive, preventive strategy in which the learner actively reduces stress by engaging in a familiar routine that, through practice, has become inherently reinforcing.
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Picture rehearsal is a pro-active instructional strategy, based on imagery techniques, using sequenced pictures and an accompanying script. The pictures and the script create a scene or story which describes when, where and how to use a particular behavioral sequence and ends with reinforcement for successful performance. The behavioral sequence depicted is typically a coping strategy, individually designed for use in a situation that has been identified as stressful for the learner.
Picture rehearsal scenes are written within the positive reinforcement framework and have three components: the antecedent (A); the behavior to increase (B); and the reinforcer or consequence (C). For each individual, this information is obtained from a number or sources, including a functional analysis of the target behavior, an ecological inventory, a stress survey, and reinforcement surveys. It is then put into the A-B-C format with pictures and a script for each component. Each scene is designed to match the individual’s attention abilities, language level, sequencing abilities, picture preferences and reinforcers. It depicts the desired sequence of adaptive behavior the individual can use in a specific stressful situation.
Daily practice of the picture rehearsal scene increases the likelihood that the individual will be able to use it when the actual situation occurs. Picture rehearsal programs, a unique adaptation of imagery-based therapy, combines a proven behavioral approach to learning with a visual support system that results in an effective, internally-mediated self-control strategy.
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