What is Practical Functional Assessment and Skill-based Treatment (PFA-SBT)?

The Practical Functional Assessment and Skill-based Treatment (PFA-SBT) process is a highly effective approach for severe problem behavior. The process involves preventing escalation of problem behavior while teaching replacement behaviors that allow the individual to meet their needs. Teaching occurs in contexts that are highly reinforcing and gradually introduce challenges that often trigger severe problem behavior while shaping new responses. Key values of this process are safety, acceptability, and valuing the relationship.

Brief summary of the PFA-SBT process steps:

• Conduct interviews to discover synthesized reinforcement contingencies that are influencing problem behavior
• Design and implement a safe, efficient, and useful analysis from the interviews
• Design a skill-based treatment derived from the analysis that results in many new skills including social and leisure behaviors while minimizing escalated problem behavior 

Guiding beliefs:

• Severe problem behavior often occurs because it produces outcomes (reinforcers) relevant to the person
• It is possible to live a life free from severe problem behavior if individuals are explicitly taught skills for coping with challenging situations, and those skills are generalized across a variety of contexts

What is involved in the process?

A Practical Functional Assessment (PFA) is used to inform a Skill-based Treatment (SBT). 

Practical Functional Assessment (PFA)

1. Conduct an interview to gather information about the situations that lead to problem behavior.
2. Conduct an analysis, called a PFA, based on information from the interview:
   • First, set up the individual’s "perfect day"—or as close as reasonably possible. The individual’s personal reinforcers are freely available and there are no “triggers” for problem behavior. This is meant to establish trust, build rapport, and ensure that we understand what makes the individual happy, relaxed, and engaged (HRE).
   • Second, gradually introduce some challenges. If the individual shows any sign that problem behavior is imminent, immediately stop and return to the individual's perfect day situation. We do this to confirm that we understand factors that trigger problem behavior, as well as how to safely stop problem behavior. 
   • Repeat a few times to confirm that we have a strong understanding of the individual’s reinforcers and triggers.

Skill-Based Treatment

• Skill-based treatment follows directly from the PFA by understanding what is reinforcing and what are triggers so set up a context for teaching skills in a way that is safe, effective, and protects the relationship. 
• Skill-based treatment consists of progressively teaching communication, tolerance for frustration, and a range of contextually appropriate behaviors (CABs). Common CABs may include relinquishing favorite items, transitioning to a workspace, completing academic work, playing or engaging in leisure skills independently, following the rules of a game, completing chores, or completing self-care tasks.
• Repeated practice is essential to building these skills, along with reinforcement on an unpredictable and intermittent schedule.
• The overall goal is to "teach individuals how to behave safely and productively in spite of the normal ambiguities, unpredictability, and disappointments of everyday life" (Hanley). 

PFA-SBT Implementation Site Login

This section of the PFA-SBT website is available to sites participating as an implementation site working directly with START and FTF Consulting. To access the site, contact your lead ISD/district consultant.