Relationships are Fundamental
Part of my role as a behavior analyst is supervising behavior technicians who provide Applied Behavior Analysis (ABA) Therapy to children with Autism. When I introduce behavior technicians to new clients, I often tell them “find out what your client cares about and become one with that thing.” This is obviously an exaggeration, but many children with Autism struggle in establishing and maintaining relationships due to preoccupations with items and activities which hold more sway. One of the most important lessons I have learned in ABA is to first build rapport and then to teach and intervene.
It can seem pretty obvious to most folks that having a good relationship sets the tone for how successful you will be in the work that you do. One can see the importance of relationship in customer service, therapy, education, public policy, and anywhere else that benefits from (or even requires) a healthy bond between two or more individuals.
In an address to my sister community Women Youth Apostles, Dr. Azcarate of Youth Apostles shared the following in regards to relationships in ministry: “Ultimately, care is at the root — love is at the root — and you build on truth, and then you make the choices” (Azcarate, 2022). In the order of relationship, reason, and responsible action, it is relationship that comes first. Love leads us to the truth which sets us free (see Jn 8:31b-32). Relationship is fundamental in ministry and service — and the same is true when working with those whom we serve in ABA.
Care (Love) → Truth → Freedom
Why is relationship first in all of this? It is because relationship is the context and the motivation which precede all problem-solving, skills, self-advocacy, self-regulation, and overall growth. Why is it the end to which the right actions and truth are oriented? Ultimately, our freedom is meant for good. What’s good? Next time someone asks you that as a greeting, simply respond, “you.” You are good. We are meant for loving relationship with God, others, and even with ourselves. Living in truth and in responsible, selfless freedom for excellence will lead us to the healthiest possible relationships filled with loving responses to the incomparable value of others and to God Who is Love Himself.
A Model for Relationship
I recently attended a continuing education webinar with Allison B. Carris, BCBA, LPCP in which she discussed “Clinical Interviewing: Active Listening” (Carris, 2023). Her main point was that behavior analysts should look at the skills learned in counseling to have a healthy, supportive relationship with clients that communicates empathy and attentiveness. My favorite part of the presentation was when she showed the 5-Stage Interview (Ivey, Ivey, & Zalaquett, 2013) in a circular diagram: Empathetic Relationship, Story & Strengths, Goals, Restory, Action. Then it all goes back to Empathic Relationship. The crux of this model is relationship. Do we prize this in our work with clients?
Here is a simple, circular model based on ultimate Christian values of love, truth, and responsible freedom. If alliteration helps, think of these as “The Three Rs.”
Dr. Greg Bottaro of CatholicPsych Institute frequently says on his podcast that we come from, are wounded in, are healed in, and ultimately made for relationship. Relationship is not just some ingredient in the ABA cocktail. It is the glass within which everything is poured. On the journey, it is our starting point, our destination, and the company we keep along the way.
In psychology, the predominant school of thought on relationships is attachment theory, originally proposed by John Bowlby in 1969, which posits how our bonds early in life shape our bonds with other people and with ourselves in the future. I would add they also shape our relationship with God. Relationships, especially with our parents and ones made early in life, deeply affect us in how we perceive, feel, think, and act across our lives. This primary factor influences us whether the relationships were (are) secure, insecure, absent, or some kind of mix of these experiences.
A Word of Affirmation for Parents
Parents “are in a way the first representatives of God for man” (CCC #239). The relationship that a child has to his or her parent serves as the template by which all other relationships may be mapped. This is also not just a passive “well I guess my kid is going to get what they get from me.” It is rather an active, deliberate effort on the part of the parents to prepare their child for healthy relationships by demonstrating healthy relationships themselves.
From the perspective of ultimate flourishing and meaning, the family, as the most basic social unit, provides the foundation for emotional, intellectual, moral, and spiritual development … parents seek to form their children so that they will be able to respond to their vocations, which are ways of participating in human and spiritual flourishing and of growing in truth, goodness, and love (Vitz, Nordling, & Titus, 2020, pg. 321).
Some of us as parents might ask: “what if my kid does not want relationships? Or at least not want one with me?” Here is the affirmation: you are right to desire a healthy relationship with your child, and to desire healthy relationships in general for your child. I am not encouraging emotional dependency on your child in which your happiness depends on him or her, but I am encouraging you to work toward having your child having a sense that he or she is loved by you unconditionally and in truth.
I believe one of the greatest challenges of a parent is knowing when you are rightfully restricting choices and when you are wisely letting them make choices in freedom, knowing that they may not make the best choice. The major determining factors in making that distinction are age, development, the risk of harm, and the strength of the relationship.
Children with Autism can present additional challenges to parents in meeting their unique needs. Children having a diagnosis or condition does not mean that your child no longer requires healthy relationships. On the contrary, they need close relationships more than ever. You as the parents are integral to this effort. One of my colleagues shared the following examples:
The silver lining is that parents can directly impact building healthy relationships with their child in their day-to-day natural environment. One of the greatest positive impacts in building a positive relationship with your child could simply include spending uninterrupted quality time with them. What does that mean exactly? The truth is that this might look different to each family and child. One family might find a child’s interests are focused on building train tracks and repetitively pushing trains up and down the grooves. In this case, quality time can mean a parent sitting next to their child, making “choo choo” sounds, and commenting on how fast the trains are going. For this family, that play might be the only activity in which the child is interested, and spending time like this for upwards of 16 days straight might seem repetitive…one thought might even pop up such as “what is my child actually gaining from me being with them here and watching them push trains, repeating the same phrases?” The key take-away is that your child is learning, through repetition, that you are a positive person in their world. That parent is not placing difficult instructions or trying to incorporate more urgent learning. The parent is showing the child: “your interests are important to me because you are important to me.”
– Sherry Csutoros, M.Ed., BCBA, LBA
Every child is different and will be reached differently; yet there is always a universal need for relationship. Even physical touch is universal, though it varies widely. Some want the hugs, some want the pats on the back, some want the high-fives, and some want less than that. I do not encourage settling for zero touching indefinitely for parents with young children. Even if it is simply accepting your hand or tolerating a gentle pat on their arm for a second, it is important for children to learn what healthy, safe, parental touch looks like. It may even start with your nearness, your smile, and your kind voice. Nonetheless, Jesus has made physical affection sacred through His own example and gives a unique role to parents to do the same:
“And people were bringing children to Jesus that he might touch them, but the disciples rebuked them. When Jesus saw this he became indignant and said to them, Let the children come to me; do not prevent them, for the kingdom of God belongs to such as these. Amen I say to you, whoever does not accept the kingdom of God like a child will not enter it. Then he embraced them and blessed them, placing his hands on them” (Mk 10:13-16).
I have seen firsthand how phobias, anxiety, behavioral inflexibility, obsessions, compulsions, etc. are overcome in large part due to healthy relationships preceding any beautifully-crafted interventions and strategies. In fact, I have seen those interventions only be effective after repairing broken relationships, or creating new relationships where there was none. Parents, you have a God-given role to raise your children in love (e.g., CCC #2221-2231). To say that your role is really important is an understatement. Your role is critical.
Into the Weeds for Behavior Analysts
In terms of different “stimuli” of the overall constellation of stimuli (“environment”), the bond between two or more persons is the fundamental variable. The emotional or affective bond is the (jargon alert) “setting event,” “motivating operation,” “audience control,” and the overall context of behavior. The presence of and relation to another person, including the self, is usually the most salient “stimulus” in a person’s environment. In other words, how I am present to others and to myself precedes all covert verbal behavior (thinking) and selecting behaviors (deciding).
What is the implication for functional analyses, functional assessments, and intervention when working with human beings?
You are a human being with a relationship to God, your client(s) and yourself
Your client(s) have a relationship with God, you, others, and themselves, and this multiplies by how many significant persons are in their life (i.e., parents, siblings, caregivers, number of therapists or technicians, etc.)
Sometimes these relationships are mostly absent, but that does not make them unimportant. As a starting point, could we simply ask during intake with parents, “who has the strongest relationship with your child?” When appropriate, ask the child, “who are you closest to?” At the very least, always observe the client, and take note of whom he or she seems to approach most frequently.
Let us remember that we are forming minds (cognition and reason), strengthening wills (behaviors and volition), and shaping hearts (emotionally and relationally).
May God bless you for reading (or even skimming) this far.
Sincerely,
The Catholic Behavior Analyst
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Bio & Disclaimer:
Joseph (Joey) Clem is a Catholic licensed behavior analyst in Virginia. He is a husband, father, and lifetime full member in Youth Apostles. He works primarily with children diagnosed with Autism and volunteers in youth ministry. This article does not constitute professional advice or services. All opinions and commentary of the author are his own and are not endorsed by any governing bodies, licensing or certifying boards, companies, or any third-party.
REFERENCES
Azcárate, E. M. (2022). Truth, Freedom, and Care [Presentation to Women Youth Apostles]. Blacksburg Community of Women Youth Apostles: Blacksburg, VA (Presented on October 20, 2022)
Bottaro, G. (2023). Being Human Podcast. Catholic Psych Institute. https://www.catholicpsych.com/podcast
Carris, A. B. (2023). Clinical interviewing: Active listening [Webinar]. Behavioral Health Center of Excellence (BHCOE) Learning Hub. Accessed synchronously September 28, 2023.
CCC = Catechism of the Catholic Church (2012). Vatican City, Vatican: Libreria Editrice Vaticana. Retrieved from https://www.usccb.org/sites/default/files/flipbooks/catechism/
Ivey, A. E., Ivey, M. B., & Zalaquett, C. (2010). Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society [8th edition]. Cengage Learning: Belmont, CA
McLeod, S. (2023). John Bowlby’s Attachment Theory [Edited by Guy-Evans, O.; last reviewed Jul. 5, 2023]. Simply Psychology. Accessed via https://www.simplypsychology.org/bowlby.html on Sep. 26, 2023.
Vitz, P., Nordling, W. J., & Titus, C. S. (2020). A Catholic Christian Meta-Model of the Person: Integration with Psychology & Mental Health Practice. Divine Mercy University Press: Sterling, VA