10. Interaction Therapy

Interaction therapy is developed from the behavior therapy perspective and can be defined as a structured interviewing process in which behavior therapy techniques are used to effect the necessary changes in family interaction.  This approach is designed to be used in clinical intervention with families that exhibit inappropriate familial interaction which results in maladaptive behaviors.

Characteristics of Interaction Therapy

A main characteristic of interaction therapy is that it is an approach in which the family’s description of their own maladaptive behaviors is basically and prima facie accepted by the therapist as the beginning baseline of behavior incidence, that is, as an estimate on the nature and extent of the problem behaviors to be modified.  The only major exception to this is that the therapist aids the family in translating the maladaptive interaction into observable and countable behavioral terms, such as who, what, when, where, and how often.  Consequently, a formal gathering of baseline behavioral incidence by systematic observation is thus rendered unnecessary.  This assertion is based on the idea that the family members can be trained to use effective behavior modification techniques (e.g., positive reinforcement and mild aversive consequences), regardless of the nature and extent of the behavioral difficulties presented by the family members in question; it is also based on the idea that all behavior obeys the same principles of learning.

Another characteristic of interaction therapy is that it is a brief approach which focuses the attention of the family members on the resolution process from the time of the first session.  For example, during the first session the family members are asked and helped to: (a) give a verbal account of their difficulties; (b) draw a therapeutic contract with the therapist; (c) reformulate the family’s experienced difficulty into behavioral terms; and (d) draw an exchange contractual agreement designed to modify individual behaviors.  The family is then given the necessary instructions on observing their daily performance of behaviors in their exchange contract and on charting those same behaviors on the Interaction Assessment Form (see Appendix 5).

The Family Council Technique

Additionally in the first session, and in an effort to help the family learn and practice positive reinforcement behaviors, they are instructed in the use of a modification, by the present author, of the family council technique.  Weaver and Mayhew (1959) defined the family council technique as “a meeting, together, as a group, to attempt to solve democratically problems which affect one or more members, or which affect the group as a whole” (pp. 71-72).

The principal modification of the family council technique as used in this investigation is that the family members do not attempt to solve problems in their daily meetings, but rather they positively reinforce appropriate or prosocial behaviors in themselves or in other family members.  To this effect, the family members are instructed to spend together some 15 minutes on a daily basis, ideally at the same time every day.  During the first part of these meetings, the family members are asked to assess in an evaluative but nonjudgmental manner each family member’s compliance with the behaviors in the exchange contract.

This investigator defines evaluative but nonjudgmental assessment as a process in which the behavioral output of the individual is matched against an agreed-upon standard, with no other assumptions or expectations mediating in the process.  For example, if a child’s exchange contract stipulates that he or she is to be on time at school, then this behavior is to be rated according to the scoring system, without the child being told, for example, of the virtues of being at school on time.  The data thus collected in ascertaining compliance with the contract is to be entered in the Interaction Assessment Form. Additionally, and during the rest of the 15-minute meeting, the family members are instructed to list on the reverse of the Interaction Assessment Form any and all behaviors that are positive reinforcers of appropriate or prosocial behaviors, or, for that matter, to list anything that all the family members agree on was fun for the individual or the family that day.

To maximize the learning aspects involved in the process of the nonevaluative assessment of compliance with the contract, and of the listing of positive reinforcers or fun behaviors, the family members are given the following instructions.  First, any items on which the family members disagree are to be tabled and not listed on the Interaction Assessment Form, nor as part of the list of positive behaviors.  Secondly, the family members are instructed to rotate the role of “secretary” among themselves on a daily basis in order to insure active and equalized participation.

Ongoing Therapeutic Processes

A rationale for interaction therapy is that in carrying out the listed tasks immediately after the first therapy session, and before the second session occurs, the family members can be producing significant modification of, and/or gaining insight into the family’s deviant interactional behavior.  During the first part of the second therapy session, the family members are given as much verbal, positive reinforcement as practicable for any and all attempts each of them made to comply with the therapist’s instructions.

This positive reinforcement of compliance with the program leads to the application of any other behavior therapy techniques specific to the individual needs of the family.  Examples of the behavior therapy techniques that have been used by this investigator in interaction therapy include the following: positive reinforcement (Skinner, 1938, 1953, 1969; Ferster & Skinner, 1957; Premack, 1959), contractual agreements (Sulzer, 1962; Pratt & Tooley, 1966; Homme et al., 1966; Shapiro, 1968; Stuart, 1971; Stuart & Lott, 1972), and time-out from reinforcement (Ferster, 1957, 1958; Patterson & White, 1969; Verhave, 1962; Leitenberg, 1965).

Furthermore, the contractual agreement technique used in the first session does not usually entail the addition or deletion of contract items in subsequent weeks.  This is due to the brief nature of interaction therapy.  As a result, family members who wish to contract for other behaviors are encouraged to do so during the session time or on their own.  Thus, the original contractual agreement and the recording of behaviors are usually maintained until the family members have mastered the agreed-upon behaviors, or until the technique loses some of its therapeutic effectiveness.  In order to better understand the processes involved in interaction therapy, a hypothetical case study follows.


© 1976 Angel Enrique Pacheco, Ph.D., C.Psych.  All Rights Reserved.



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