#6 Skill Based Treatment: Branch Planning

Our Guides are designed to get you started with the many resources we have to offer! Have more specific questions? You can always make a post in our FaceBook Community!

Skill-Based Treatment (SBT) is all about gradually teaching individuals to be able to engage in important skills that improve their quality of life without engaging in challenging behavior. We focus on communication, toleration, and contextually appropriate behaviors (CABs). These CABs include things like sharing favorite items, smoothly transitioning between activities, getting academic work done, playing independently, following the rules of a game, completing chores, and taking care of oneself.

Ultimately, our goal in SBT is to build trusting relationships between individuals and their caregivers, while also teaching individuals how to navigate the uncertainties, surprises, and everyday ups and downs of life with confidence and effectiveness.

So how do I plan a branch?

First things first – you can use these workbooks to plan out your CAB branches. This includes determining your terminal goal, and then mapping out the shaping steps to reach that goal. You can find FTF workbooks in multiple translations, as well as the Centria workbook. (Also available in Italian and Russian!)

PFA & SBT Workbook from FTF

PFA & SBT Design Workbook from Centria

What visuals and examples are there for CAB branch planning?

Here you can find presentations and documents related to branch planning. There are so many different ways to program your CAB branches – the sky is the limit! These resources are a great starting point for writing meaningful and individualized goals.

Get started with “CABS are here!”

CAB Design Examples

How can I get more training on writing branches?

In addition to the great documents, here you can find presentations related to branch design.

Videos

Below you can find some free hangouts on our YouTube page on a variety of SBT related topics!

CABs are here!

From the 10 Hour CEU Course to HRE & CAB Creation

CMO-R during the SBT process

Hangout with Denise Smith: Lessons Learned

Deeper Dive with Ed Sidley & Hillary Laney

10K Q&A with Greg Hanley

C’mon Man(d)!

Learn While Teaching

Art of Shaping

SBT branch discussions to check out

Read on for some FaceBook threads related to branch design.

Can someone give some examples for different CAB branches you have implemented for k-2 students?

I have several kiddos in that age group that I am doing “after school routines” with using modified SBT. For example, one boy gets home from school and it’s his way for a bit then we start his routine. We interrupt his way then present an option like “do you want to clean up your room or practice putting on your socks?” Basically just transition him from his way to the adults and then pick something to work on (setting him up for success of course by helping more at first or shorter durations at first)

I also have several kids who attend our social skills program after school at the clinic. One buddy can’t yet tolerate actually spending the entire group time with peers. So he gets to the clinic, chooses which room he wants to be in that day (with the option of joining his peers), and we let him get HRE. Then we use the SBT phases to transition him to the area peers are in to work on whatever the current expectation is. Started with standing near the area peers were in; then going into the same area for short durations; then doing similar activity as peers in the same area but not cooperative/joint. Now he is joining them (within SBT and spontaneously) for extended durations and playing with them this guy also struggles with peers playing games or music on their devices, so we worked outside of his SBT on him using an FCR to ask us to turn off our phones when we played music (“cassie, will you turn it off?”) He now tolerates a several minute delay after us saying “not right now, I’m sorry” and I think it’s helped a ton with group stuff!

Also have a client who realllyyyy struggles being around peers. I’ve been using his SBT to transition him to a peer and have that peer ask him an already mastered personal wh question to work on convo skills. Or having him give a peer a high five. Or going to same area as peers but not playing directly with them for short durations (for exposure to the noise level, etc.)
-Cassie Workman

Amazing examples above! I would ask yourself:
1. What areas does child struggle with? (Recess, lunch convos, sitting on the rug for circle, etc)
2. What environments are available during SBT and how to build in varied transitions and expectations away from the table?
3. What does the student enjoy doing that he could do more of at school?
I’d love to see more leisure branches surrounding building repertoires for play/recess time as well as school-based self-help skills such as zipping a backpack, tying shoes, putting on a jacket & zipping!
-Nicky Schneider

Has anyone done a branch for dealing with losing games? The SR+ would be not losing the game, so a do-over…?

I’ve spun this depending on the needs of the learner. I will know well beforehand, which games are “too hot” to start out with and will introduce a game that’s neutral or one they don’t care about at first, and get progressively more high stakes as they demonstrate toleration and flexibility.

With some learners, I’ve found they don’t care a lick about actually losing the game. They care if there’s an additional contingency in place, so “winners get to pick X for the class,” (and the like). So I’ve also run this where we started with losing well with no additional yoked contingencies and then started with neutral yoked contingencies until we got up to what was previously challenging for them.
-Emily Beal Wilkinson

I have done this in the past but I approached it differently than Emily. I’m sharing mine so that you can choose what would be the best fit for your particular learner. I start out with losing on purpose. Depending on the learner this may be CAB3 but I’ve found it to be a helpful way to take the heat of losing. With losing on purpose, I use races. Hey, we are going to run a race and this time I want you to lose on purpose. Races are great because it is easy to lose on purpose and a quick turn around after to win the next race. CAB 4-5 are tolerating “losing” or hard to accept moves for varying amounts of time. For example,
me: I rolled a six, it looks like I am going to win.

learner: My way?
me: not this time buddy.
learner: “Okay”.

Then I start to move my dice and after like 1 move (intial step is tolerating not winning for 1 second), I say thanks for letting me move my piece, I am happy to just move 1 square this time.
-Taylor Johnson

What are some branches you have targeted in SBT?

Which teenage games do you all use in which you have control winning/losing?

What about treatment integrity?

Collecting treatment integrity data for the implementers can help ensure that treatment is being conducted with fidelity.

How do I handle R1s and R2s (escalating behavior) during treatment?

The following documents are designed to help clinicians and staff decide what to do when R1s and R2s occur doing treatment. Do we reinforce? Do we push through? The answer is it depends, but these decision trees and visuals should help.

Here are some relevant facebook threads that include good tips on this topic.

FB thread: Unpredictable EOs, increase in R1s

FB thread: Research Articles supporting reinforcing problem behaviors

FB thread: Regression to an earlier CAB

FB thread: Encouraging persistence through an R2

FB thread: Whether or not to prompt the FCR again

Do you need more resources on FCR and TR selection?

Here’s a handy guide! Also available in Dutch!

You’ve made it to the end of this guide, but this is only the beginning! These tools and resources are a great starting point, but you can also utilize our other guides, resources, mentors, and partners to help you along your PFA & SBT journey. Didn’t see your question answered? Want to connect with others? Come join us on our FaceBook community by clicking here. (And don’t forget to answer the membership questions when you join! 😉)