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PROGRESS IN BEHAV!ORJAL SOCIAL WORK
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Behavioral Treatment
of Chronic Psychiatric Patients
Stephen E. Wong
James E. Woolsey
Estrella Gallegos
SUMMARY. Behavioral treatments for hallucinations and delu-
sions, aggressive and destructive responses, inappropriate social
behavior, poor self-care and grooming, and deficient recreational
and vocational skills in chronic psychiatric patients are reviewed.
Consideration is given to the short-term, long-term, and general-
ized effects of these interventions. Three case studies illustrate
behavioral procedures of reinforcement, response
cost, graphic feedback, differenrial reinforcement of other behav-
ior (DRO), and overcorrection. The potential contribution of clin-
ical social workers in applying such programs on a psychiatric
unit is discussed.
This article reviews learning-based treatments for functional
disorders manifested by chronic psychiatric patients. The popula-
tion presents a formidable challenge for clinical social workers
with a bewildering array of problem behaviors that are unaffected
by conventional therapies. The efficacy of behavioral inteivcn-
tions for ameliorating these disorders has been well documented
Dr. Wong is Program Director and Mr. Woolsey is Unit Director of the Behavioral
Treatment Unit, Northeast Florida State Hospital, Macclenny, Florida 32063. Ms.
Gallegos is a clinical social worker at the Behavioral Rehabilitation Unit, Las Vegas
Medical Center, P.O. Box 1388, Las Vegas, New Mexico 87701. The authors thank
Miguel Larranaga, MA, who served.as primary therapist on Case Study 1. Appreciation
also goes to J. Pete Martinez, RN, Cecilia Archuleta, LPN, Jessie Archuleta, LPN,
Maria Clayton, LPN, and the other staff of the Behavioral Rehabilitation Unit for their
assistance in Case Study 2, and to the staff of the Clinical Research Unit, Camarillo
State Hospital, for their help in Case Study 3. Reprint requests should be addressed to
Dr. Wong.
© 1987 by The Haworth Press, Inc. All rights reserved. 7