Beyond Compliance: Constructional Exposure Therapy, Psychosis, OCD, and Changing Healthcare

What if severe behaviour isn't something to eliminate—but evidence that important skills or opportunities are missing? Katie Gibson joins Behaviour Speak to explore the Constructional Approach, an increasingly influential framework developed from Israel Goldiamond's work and expanded through Nonlinear Contingency Analysis. Rather than asking how to stop behaviour, Katie explains how clinicians can identify the repertoires that are absent and build those instead. The result is often that severe behaviour decreases naturally, without ever directly targeting it. Throughout the conversation, Katie shares powerful real-world examples from her work in hospitals and complex behaviour programs. She explains how a teenager experiencing psychosis wasn't treated by challenging his delusions, but by helping him build friendships and social skills that ultimately made those behaviours unnecessary. She also describes Constructional Exposure Therapy, showing how children with severe needle phobia, OCD, and medical trauma can safely participate in healthcare without restraint while maintaining assent and dignity. The discussion extends into collaboration with psychiatry, nursing, families, and healthcare systems, demonstrating how behaviour analysis can improve patient care far beyond traditional autism services. This episode offers practical ideas alongside a broader philosophical shift that challenges many long-held assumptions within behaviour analysis. Watch on YouTube: https://youtu.be/UEwEJeOqtfo Continuing Education Credits (https://www.cbiconsultants.com/shop) BACB: 1.0 Learning IBAO:  1.0 ABA Topics QABA: 1.0 General CBA/CPD: 1.0 Learning   Follow us! Instagram: https://www.instagram.com/behaviourspeak/ LinkedIn:  https://www.linkedin.com/in/behaviourspeak/ TikTok:  https://www.tiktok.com/@behaviorspeak   Contact Katie Gibson LinkedIn https://www.linkedin.com/in/katiegibsonbcba/ Links Find articles and resources on The Constructional Approach Website! https://theconstructionalapproach.com/ Related Behaviour Speak Episodes Special Series On The Constructional Approach https://www.behaviourspeak.com/category/constructional-behaviour-analysis