In Reflections on Behaviorism and Society, Skinner challenged us to “accept the fact that the task is to change, not people, but rather the world in which they live”. That we should not “continue to neglect the conditions that must be changed if we are to solve our problems.” In this issue of Operants, we see a collection of articles, book reviews, and interviews that apply these same views to the important topic of medical and treatment adherence. Treatment adherence (what a person will do) is contrasted with treatment integrity (what a person can do) and is an important topic to consider when trying to understand why people might not adhere to medical and treatment plans. When a person inconsistently takes their prescription medication, do we call them forgetful and lacking attention to detail? When a caregiver fails to follow through on a behavior plan in the home, do we think they lack buy-in or are lazy? When a person with an intellectual or developmental disability refuses to comply with a medical procedure, do we label them with challenging behaviors? Do we continue to neglect the conditions that should be changed to solve these problems?
I hope our readers will enjoy the collection of articles including topics such as the role effort plays in reducing or promoting adherence and the programmed use of positive reinforcement for taking medications. We include a variety of articles on behavioral procedures to promote cooperation with health and hygiene routines and the role behavior analysts can play in promoting medical adherence in hospital settings and through training of medical providers. We also include a book review of Dardig and Heward’s Contracting with Kids contributed by Stacie Bancroft, highlighting the book’s unique educational method for promoting adherence to behavioral contracts in families. Lastly, we include a touching In Memoriam to Vicci Tucci.
Alice Shillingsburg, PhD, BCBA-D
Editor-in-Chief
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