Step 2 – Select the client (may only be one). Do this by clicking the check box to the left of the client’s (child) name. Then click the button “Go to patient’s file”.
Step 3 – Check out the various options and screens to get familiar with the system. You will be directed to the “View Account Detail” screen.
If this is your first time logging in, there may not be any transactions found. At the top of the screen you will see a number of menu items – system, add, edit, delete. If you click on these items, a menu bar will appear below it as shown below.
For some menu items that drop down, there may be further submenus (ones with black triangles). Click on the various top menu selections to see the available options.
The BMS is similar to on-line banking with multiple accounts that are Points, Checking, Savings and Charity. These account are not tied to any real bank accounts, they simply help account for your child’s points and the financial balances with the parents/primary caregivers. Points are the tokens of this home economy that parents use to “sell” privileges to their child. Under this system, there should be no loans. If they don’t have the points, they can’t purchase the privilege. The client earns points for responsibilities, chores and positive behaviors and loses points when purchasing privileges and exhibiting negative behaviors. Dollars (optionally) are applied to the various accounts with an allowance or through money earned and saved. Dollars are deducted when the child requests money or to pay for expenses incurred through loss or accident (i.e. child loses cell phone). In order to create this token economy, the primary caregivers working with their clinician performed an initial assessment. This assessment automatically added the elements of the token economy. These elements are called “Allowed Transactions”.
These are predefined items in the client’s file that can be recorded as a transaction that may affect their point or dollar account balances. These items can be used to record behaviors, privileges or can serve various administrative uses. Allowed transactions can be added, copied from a built-in library, edited or deleted. Only Allowed transactions can be recorded (hence the name “Allowed”), although the content of the transaction can be edited prior to it being recorded.
Allowed Transactions appear like the pictures below (only 1 Allowed Transaction shown) when the Edit =>Allowed Transactions =>Responsibility is selected using the top menu bar:
The screen shown above is only the tip of the iceberg. Many more elements of the Allowed Transaction appear to the right if you move the scroll bar to the right. Notice in the picture above there are many fields or boxes that can be edited. These are the Description, Transaction Type, Priority, Reply Type, Value and the entries for School, Points, Checking, Savings and Charity. Clicking the number in the ID# field opens up a new window providing the ability to edit the selected Allowed Transaction in greater detail. For convenience you may edit and update multiple transactions with a single click of the “Submit Edited Transactions” button on the far right bottom of the editing window.
Allowed Transaction Field Definitions
The following section defines the fields of the Allowed Transaction.
Description: Short description of the Allowed Transaction.
Transaction Type: Select the appropriate type for classification and operating purposes.
Responsibility - Activities for which Patient is expected to perform unconditionally such as going to school, doing homework, etc.
Chore - Activity for which Patient has some choice or for which performing the task includes rewards
Positive Behavior - Behaviors for which caregivers desire to see increased or maintained
Negative Behavior - Behaviors for which caregivers desire to see reduced
Privilege - Anything provided by caregivers to Patient beyond required by law. Examples include allowance, toys, games, going out with friends, transportation, driving privileges, computer use, video games, upgraded or desired clothing, etc.
Email Notify - This transaction type,
when Scheduled will automatically notify by email caregivers or
patients at a preset time and/or date.
Financial (not available to all Caregivers): These transactions are used to report on or adjust the various fictitious accounts including Checking, Saving, Charity, School and Points.
Timed Event (not available to all Caregivers): This transaction allows the use of email or text messaging to serve as a time clock to record the elapsed time between subsequent messages. This can be used to easily record the amount of time is spent on an activity. When the transaction contains a value, the amount of time (ie. hours worked) will be multiplied by the value (pay rate) for a total value (i.e. money earned).
Priority: The relative priority of this allowed transaction to the primary caregivers ranging from Low to Critical.
Reply Type: This defines the response transactions entered by email or text messaging. If set to Off, no reply of the account balances (points, dollars) is returned when the transaction is received. Other settings including: Confirm, Dollars (reply with balances of Checking, Saving and Charity Accounts), Points (reply with Points balance), School (School points balance), Remind (do not record transaction, simply send a Reminder to the Email address specified in Email Notify 1).
Using the mouse to scroll the screen to the right, you will see the next fields of this Allowed Transaction.
These fields are used to define the schedule for the transaction.
Scheduled Day – The day of the week, days of week, day of month selected to define when this behavior or transaction is scheduled to occur. This information is used in the Weekly Schedule report and can be used to automate the recording of the transaction if the Scheduled Action is enabled. Select from many options using the drop down box.
Scheduled Action - The automated schedule can be turned off or can be assigned to automatically apply (Apply Transaction in the Scheduled Action field) on the Scheduled Day after the Start Date (if defined) and that Scheduled Time (if not defined, it will be recorded at within 2-3 hours of midnight). This example demonstrates that an “Attend School Weekly” Responsibility transaction will be automatically recorded each Friday. Since the transaction had a point value of 10, 10 points will be automatically added to the client’s account balance and a transaction will appear in the clients account at that time. The Scheduled Action can also be set to serve as a reminder that the transaction has not been recorded within a certain number of days. In this case instead of being recorded, a reminder Email is sent. The content of the “Notes” field of the Allowed Transaction will be included in the body of this Email.
Start Date – If a date is entered in this field, this is the earliest date the automated schedule can occur. If the Scheduled Day is set to “Once” the transaction is recorded only once on this date. When updating transactions to occur, for example after school starts again after summer, simply set the value to the appropriate date after the fist week of school.
Scheduled Time – This the time of day the transaction is to be scheduled. This is important when organizing a child’s schedule. If a time is specified, it will appear in its appropriate spot in the child’s “Schedule Chart”. The Schedule Chart, a weekly calendar, lists the activities scheduled as chores, responsibilities and privileges. If the Scheduled Action is set to “Apply Transaction”, the transaction will be automatically recorded and/or emails (text messages) sent at that time (within a few minutes).
Scroll the screen further to the right to see additional fields of the Allowed Transaction.
You will see two different sets of fields. One set allows the setting of which caregivers are authorized to record the transaction. Parents have access to almost all allowed transactions but other caregivers may be limited to seeing transactions for which they are authorized to record. The Email Notify fields 1-4 define who will be notified (Caregivers or client) automatically when the transaction is recorded. Note that it is not necessary to set a caregiver to notify. Only caregivers authorized can be notified regarding these transactions.
Caregiver 1-4 – These are the caregivers (drop down box) authorized to record and edit this transaction. Caregiver 1 is the caregiver that created the transaction and this field cannot be edited. However the transaction can be deleted by a Primary Caregiver (parent) or by the Referring Caregiver (clinician). If the caregiver is not authorized to record the transaction, it will not appear to be edited or recorded.
Email Notify 1-4 – The Email Notify fields define who will be notified (Caregivers or client) automatically when the transaction is recorded. For most transactions NO caregiver will set to notify. Although the drop down boxes only select the primary email address (-1) and secondary email address/text message (-2) of authorized caregivers, detailed editing will allow an alternative manually entered Email Notify 4 address.
In order to give your child credit for completing responsibilities or to charge them for privileges or negative behaviors, these behaviors or privileges must be applied or “recorded” to the system. Consistently recording transactions is critical to behavior management. Negative and positive behavior transactions should be recorded as soon as reasonably possible to the behavior to discourage or encourage future behavior.
Recording a transaction (behavior, privilege, etc.) can be accomplished in several different ways. You can log into the BMS and select the transaction(s) to record via the web, you can use emails to record transaction(s) via your Blackberry™ or you can call the Interactive Voice Response System (IVRS) using your telephone.
Record by Phone (IVRS)
The voice activated phone-based system is perhaps the easiest and quickest way to record a single transaction.
Tip: Program the local number in your cell phone’s
speed dial or contacts list with a name that places it at the start of your
contacts list by inserting a “space”, or “@” symbol at the start. Make sure you
disable call blocking by inserting the necessary codes (i.e. *82) at the start
of the number if you have this enabled on your phone.
Recording by phone is ideal for recording behaviors in front of your child. It demonstrates that there will be immediate consequence of their action. It is hoped that eventually you may only need to pull out your cell phone to gain your child’s compliance with your commands.
The phone-based system allows you to quickly get point and account balances. Simply say either “Get Account Balance” (Checking, Saving and Charity) or “Get Point Balance” (Points) to the “Say Transaction” prompt. You will not be prompted for a quantity.
If you are recording many transactions at one time, it may be more convenient to do it on-line. Further, if the transaction needs to be edited in any way such as value, description or notes added, it must be recorded via the web.
To record a transaction via the web, the caregiver logs in and selects the child. Then, using the top menu bar, selects Record, and then selects which type of transaction to record – Chore, Responsibility, Privilege, Positive Behavior, Negative Behavior, Financial Transaction, Memos/Notes, Email Assessment and Contest Entry. See the following picture.
When Chore is selected (for example), the screen will then change to something like this:
To record a transaction, click on the select checkbox at the left of the transaction, change the quantity if not 1. Optionally you may enter a date (mm/dd/yy) if you want to record the date of the transaction other than today. You can edit the description or enter notes or comments about the transaction. This is helpful when relating the circumstance with a therapist in order to do a behavioral analysis.
You may also record a transaction while updating many of the preset values. Select “Record with full editing” and then select the type of transaction to record.
This allows the caregiver to record a transaction with significant editing to the Allowed Transaction. The screen will look more like Edit Allowed Transaction as more fields including the value of the transaction can be edited prior to recording the transaction.
In addition to the fields of the standard transaction recording, the “Record with full editing” allows the user to change whether the value is on/off, change the values of the transaction and select a single caregiver to send notification to (other than those selected for Email 1-3) via a selection in the Email 4 column.
When you have selected and edited the transactions, click on the “Record Transaction(s) CLICK ONLY ONCE!!” button. You will be asked to confirm. Do so and do not attempt to click the “Record Transaction” button again or it may result in duplicate recordings. Once the transaction has been recorded, the screen will return with an error report in red at the top of the screen. Take a quick check to confirm that the desired transactions were recorded.
If there is a message - “Edited transaction not generated”, this suggests that values for a transaction were changed but the check box was not selected to the left of the transaction.
When the transaction has been recorded (via web, email or phone), it is placed in a cue to be applied. It will not appear or have an affect on point or dollar balances until this occurs. This usually takes between 30 and 60 seconds.
If you make a mistake and want to cancel a transaction that has been recorded, simply reverse out the transaction by recording the same transaction (any method) with a quantity of –1 (minus 1). If you edited values, you will need to edit the values of the reversed-out transaction so the net effect on points and/or dollars is zero.
Fine Tuning the Values – Weekly Forecasting
In order to properly shape behavior, it is important to know the frequency of current behaviors and the goal (parent’s expectation of behavior) frequencies. These were setup during the initial assessment when the current estimated and goal quantity of behaviors were entered for each issue listed (allowed transaction). These estimates combined with the point value settings for each transaction will help to quantify the predicted net weekly effect on the point values. This estimated weekly change in points helps parents and caregivers know how to set appropriate values for the various allowed transactions. In general, we are expecting that current behavior would result in a large negative weekly change and our goal amount would result in a modest positive change in the balance. This ensures that the child is motivated to change in order to meet their needs for privileges.
A forecasting module is provided to easily edit the point values for each allowed transaction and conveniently view the predicted weekly change. This tool is used at the start of treatment and periodically thereafter as the current estimates are updated (using actual data) and goals are changed based on the changing needs of the parents and child.
There are two versions of the tool. The first, Weekly Forecast (all enabled), estimates based on all transactions and assumes that they are all enabled. This is useful to predict the effects of enabling the values for transactions in the future. The second, Weekly Forecast (as enabled), predicts the effects based on only the transactions that have their values enabled. Remember that when the value is off, the transaction can be recorded but there will be no effect on the clients account balances. This is useful when staging the privileges and negative behaviors allowing only positive effects on the point and dollar balances in order to build up a starting balance. Some behavior specialists recommend this approach although for simplicity we suggest simply starting the child off with 50-100 points and leaving all transaction’s value setting enabled from the beginning. This is the default setting during initial assessment. To access the Weekly forecast page, simply click on the menu item as shown in the figure below.
The Weekly forecast page will appear as in the following picture. There are 3 columns that can be edited. The first, yellow column is the Transaction Value. This value, times the quantity of the transaction recorded, will result in the total value of the transaction when recorded. The second editable column, “Current Estimated Quantity”, is the estimate of the number of times each week the behavior occurs. The column to the right, “Current Estimated Points” is the net effect on the points for that transaction each week. The “Goal Estimated Quantity” is the desired quantity of the behavior. This number should be realistic as no child will ever be perfect – completing all responsibilities, chores and never exhibiting negative behavior.
… not all transactions shown in this picture
Depending on the number of allowed transactions, there may be more than one page of transactions. Note that this illustration shows a negative point balance for Current Estimated Points and a smaller positive total for Goal Estimate Points. Ideally the current total should be between –100 and –300 and the goal value should be between +50 and +150. Values are also changed to increase the relative importance of a behavior or privilege to increase the motivation for change. Values are changed and then the “Submit Changes” button is clicked. The new values will appear in about 30 seconds.
Parents should be cautioned that past a certain point, increasing the value (positive or negative) will have no effect and may, in fact, cause discouragement. It can be expected that behavioral change will occur when the child experiences the cost of the behavior (for some children multiple times) and not when it is threatened (i.e. –1000 points cost for positive drug test).