I'm Ben Ryman, and this is BehatherSpeak. [MUSIC] Dr. Asmaan Saleh Khalil is a professor, board certified behavior analyst, and founding member of the Association of Behavior Analysis in Lebanon. With over 12 years of experience in child psychology and behavioral therapy, she co-authored the children's book, The Day the World Went Boom, to help children process the 2020 explosion in Lebanon. In this conversation, Asmaan discusses the critical need for improved safeguarding strategies in education, particularly in the context of sexual health in the Arab world. Join me for this amazing conversation. Welcome, Asmaan. Thank you, Ben. Thank you for having me. So, before we start, I just want to acknowledge that I am producing this podcast in the lens of the galais commos, homo conan, plavan first nations, and grateful to be here. So, what do you tell me a little about yourself? A little about myself, professionally, personally. There's a lot about myself, so picking a little would be a challenge. Tell me a lot about yourself. Thank you. So, my name is Asmaan Saleh Khalil. I am a half Lebanese, half Syrian, BCBAAD now. I got my doctorate a year ago, actually, November of last year. From Queens University, I was working with Dr. Krolla Duneberger, who I owe my knowledge, her great help in getting me where I am today as a professional. So, I'm a behavioral therapist. I work with children and families and therapists in schools on behavioral therapy in general, but I've been particularly advocating for safeguarding strategies. And implementing safety procedures for all children and vulnerable adults. So, that has been the main focus of the past four or five years since I started my research in this field. Because the topic of my doctorate research and a few years before starting that, my work had been centered around sexual health education and the whole adolescent puberty stage of children in general with autism and intellectual disabilities. So, I went from wanting to learn more about sexual health education and autism and Arab world together into turning that into more into safeguarding strategies and more about how we can implement them and why have I not learned how to implement them earlier on. So, that has been basically my message and my song. Personally, I'm a mother of two, two little monkeys added and Sophia, and I live in the UAE. I moved to the UAE actually four years ago before that I was here in Lebanon. Yeah. That's it, I guess, in the nutshell. So, what made you get into into this field in the first place? I guess, I guess like a lot of us were kind of driven into the humanitarian field first. I don't know, I feel like with a lot of my colleagues, this is where we started off. I remember my father really pushing us very early on into getting jobs. You know, I have this thing where he tell us, I'll pay you whatever they'll pay you. So I'll double your salary, just get a job, whatever it is just so at around 15, 16 years of age, I was working at this summer camp camp at this daycare. It was a mainstream summer camp daycare arrangement and I was put in a class as an assistant teacher or something like that. And I was immediately driven to the one boy in the class who has cerebral cerebral palsy. Cerebral palsy. Yes. If you can. Yes, not coming out. So I was driven to him and I became basically his very professional, his childhood teacher. And, and I guess I stayed in and around children with difficulties and with disabilities from then on college came around. I joined the Special Olympics College Club and by the end and by my last year at the American University here in Pedro. I was president of Special Olympics College Club and we, it was April and we had to do an event and I had no idea what event I could do. I knew that I had to do something so I looked it up and friends out April is autism awareness month and I was studying special ed at the time. I still had very little knowledge about autism and I was a fourth year college student. So I got in touch with the autism center here in Lebanon told them to come to the university for a sports day. I met them. I met the children. I met a few parents of the children that came. One of the parents needed she had a BCBA and she needed someone to train that the BCBA could train up over the summer so that she can work with her child. I guess that was my first experience with ABA in particular so I got the training over the summer. And I just fell in love with the field, I guess, with the science behind it. I felt it was nice coming from an education background. It was nice to have the science to the behaviors that we're seeing and to feel confident. I felt that immediate confidence in what I'm doing when I was able to track the impact of my work and the changes in behavior or lack thereof. I guess that's what kept me in it and it took off from there and it took off from there. And so there was a was the BCBA in Beirut or. There was one I think at that time there was one BCBA but it was a area that was training me. They were getting someone in jail, which was still a wonderful friend and colleague. Now in Jia near Dush, they were getting her from Bahrain, I believe, at that time because there weren't any. By the time I became certified, I was the third one. And the and the second BCBA when I was the one that was my supervisor at the time who was signing my hours, but it was in jail that did my training. And we were very little. I mean, now there's a much bigger number here in Lebanon. But at the time in 2016, I was the third BCBA to get certified. And what sort of I had a little bit of a conversation about ABA and autism in Lebanon and she shared a little bit of the history. What just so might be recapping some of the stuff that she discussed. What was sort of when you kind of got first got I got into the field and you said there was was an autism center. What sort of the the state of kind of what was the state of kind of autism support and understanding of autism in Lebanon at that time and what's it like now. Since from the time that I got into the field until now and I think even worldwide, there has been an increase in awareness and acceptance and the services and how people really approach autism services in general. I have noticed throughout my humble experience in this field that it's really an upward trajectory. We still have our challenges. Obviously, Lebanon is a small country. We've had our ups and downs with our economic crisis and with our political crisis. But really we we've managed to set up early on a year after I got certified. I think we set up the association for behavior analysis. What we've done is that we've really gathered up all of the few professionals that we had. We were three four at the time and now we're 12. So we've managed to stay connected. We've managed to really help each other out. I feel like this is something that stands out in Lebanese people in general and it's fed into the ABA profession in Lebanon where we're really always a team. You know, you don't really find any kind of competitiveness or we're always sticking together. We're always trying to fight against any misuse or misrepresentation of ABA, which happens, which happens in Lebanon. And I'm sure it happens everywhere else happens in the UAE. You know, you have the those that, you know, pain to be doing ABA, but the services are not up to standards. You have those that have had bad experiences. So I think just us being working together as a team as the Association of Behavior Analysis in Lebanon, which is a chapter of ABA. I think this has really helped maintain the service standards in Lebanon. And we're just doing our best to keep that up and to keep that upward trajectory, hopefully, but the awareness has grown, the acceptance has grown. People here are generally very welcoming, very accepting, the community at large is always very helpful. I can easily take a child that I'm working with to my local coffee shop and ask them to give him a placement there or to give him a, you know, vocational training and they would welcome him with arms wide open. I've had that with several of the students that I've worked with. I was rarely, rarely if I can remember maybe once we were rejected, but otherwise really people have had open door policies when it comes to the children and other lessons that we work with. That's amazing. And so you got your BCBA. What kind of work were you doing sort of in your early years as a behavior analyst? Early intervention, correct me if I'm wrong, but again, I feel like this is where everyone starts, right? I was an early intervention. I remember I used to boast that I'll only ever be an early intervention and this is where we see the most progress and this is the most reinforcing for me and this is where I'll always be. That was the first couple of years until actually until I got certified to 16 I got certified 17 I was placed in a school and a colleague summer she she took me on. I don't know why God bless her. She took me on. I was six months pregnant. I was newly certified. I had no idea what I was doing, but she believed in me and she really held my hand through that and I took on two houses of adolescents with autism. And I figured that's fine. I was doing early intervention, I just accommodate the objectives to older ages. That should be, you know, a walk in the park. I had a supervisor that I was working with at the time to make sure I stayed up to standards and followed the procedures, but I had no idea what I was up against at the time. These are the lessons, these two classes, I think they were total up to between 12 to 15 adolescents with autism intellectual disabilities. And yeah, so I kind of took a dive. And since then I have been focusing more about age group, because I realized how much as a, as a, you know, fresh graduates at that time with all of the knowledge still fresh in my head. I learned nothing about adapting our objectives and our assessments and our, our just, you know, our views and everything that we do, I had no training and adapting those to the older ages. And there was a huge gap in services and huge gap in research even a huge gap in cultural translation. So, so I, I, a lot of the students were going through the phase of puberty and they were dealing with sexual behavior and we had no idea what to do. And, you know, the Arab culture is relatively conservative and modest. So I was, I was kind of struggling with that. I was, I am conservative and I am a modest person in general. And we put these two things together. And so I sought out supervision from someone who was specialized in Dr. Torres time. He was wonderful. She really helped me out very much. She also helped my hand. With a lot of hand holding for someone who was newly certified at the time. But I remember that with Dr. Stein, every time we would meet, I would spend the first, you know, we would spend together the first half of that meeting, culturally translating everything, trying to explain to her the difference because she was based in the U.S. I was based in Lebanon. So we really had to make sure that whatever suggestions or objectives were put were, you know, were applied. So that's when I decided that if I ever, you know, do my PhD continue in my research, it would be on sexual health for autism in the Arab world. And yeah, around four years after that, I did start my doctorate program with Dr. Tylenberger, who was also the supervisor, Dr. Stein at the time. This is how I reached out. And, and yeah. And I've been advocating for that since then, because I don't know, then maybe you can also tell me, but I mean, we never really learned. There was never a focus. I mean, I learned about the importance of mending and I learned about the importance of, you know, independence. But I never got that message straight up handed to me that listen, before you do anything, we need to make sure that these children are safe, right? Some of their first demands need to be about safety before anything else. These children need to be physically safe and emotionally safe and socially safe. So, so I've been on to eating for that ever since I got into this research. I really stood out to me how how much my, my education and my training was lacking and everything that has to do with safeguarding strategies. And I'm actually happy to see that a lot of the research now is focusing on that. And I based a lot of my research. So what I did is that I studied behavioral activation, just a form of TPT, originally intended for dealing with depression and anxiety. Sorry. For typically developing individuals and then they modified it for autism. So it was, it was meant for that. And I took it and I adapted it as an intervention for kind of inappropriate sexual behaviors. And I tried to focus as much as I can through that on any preventative approaches that we can take with regard to safety and safeguarding. And I'm happy to see that a lot of the research. So I did find a lot of recently published articles that supported this. For example, Elias, Dr. Elias, Elias had published about the big four, which I, which I think is, is to be celebrated. This article is to be celebrated because it talks about the big four in terms of flip the functions around on their head. And she's like, if these are the functions of problem behaviors, then why don't we turn them into preventative approaches that we can teach before any problem behavior arises. And I kind of took that and turns it also into how we can translate that for safety and safeguarding as well. Colu Camille Colu also spoke a lot about buffers against adverse childhood experiences and what we can do to make sure that the children are safe in case they should ever encounter any kind of adverse childhood experiences. So there has been a lot of research on that. And I'm just trying to do my part in terms of bringing it into the Arab world, making sure it's culturally modified and appropriate for the population that I search. Okay, I have a lot of questions. Okay, I'll come back to kind of how you culturally modify things. And I'm also curious about just buying for what you're doing because of some of the whole conservative identity over there. But before we do that, I want to ask you a couple questions about some of the, some of these kind of behavioral pieces you're talking about. Tell me a little bit more about about the big four. I don't know much about that. It's an article. Maybe we can link it. Dr. Earl, I was honest, and a couple of colleagues. I'm sorry. I don't have them memorized. I could pull it up now. And just to make sure everyone gets credit for credit, he'll do about what they discussed is that they discussed these four important for nursing skills that need to be taught as early as we meet the child in order to ensure a holistic approach to any kind of intervention that we do in order to prevent or minimize we can't prevent obviously, but we can minimize any kind of risk for developing problem behaviors. And the big four were the child having a master easy generalizable way to amount for attention, having leisure skills of some sort, having a consistent way of requesting the wants and the needs, the likes and the dislikes. And I love how they included the likes and the dislikes, because when it comes to sexual health or when it comes to safeguarding, we really make sure we want to teach saying yes and no. And I want and I don't want sure, which is often overlooked, right? So, attention, leisure, wants and needs and tolerating so distrust tolerance and coping. So these are the big four that they focus on teaching and the importance of teaching these four, you know, as the first lead that you meet a child in order to make sure that the chances of problem behaviors, developing is minimized. Do you have a credential with the international behavior analysis organization, the qualified applied behavior analysis credentialing board, the behavior analyst certification board, or would like a certificate of attendance for another organization. And then you can earn one and a half continuing education units by going to www.behaviorspeak.com, click on CDs and enter the three secret words. The first secret word is Arab. The buffers, I understand a little bit about Dr. Colu's work around, you know, a lot of our workers around trauma and trauma informed work and so the buffers are kind of essentially these things that we can do to sort of prevent trauma in the first place. Tell me a little bit about, and forget me, I know when we talk before recording, we're going to focus primarily on sexual health, but you brought up some concepts that I just have always been curious about, but know nothing about that. Just tell me a little bit more about behavioral activation and kind of what that is. Sure. So behavioral activation, as I said, it was based on controversial therapy. Okay, it was it started coming about around the early 70s. And it was first meant for an intervention for depression, and then later on, like a lot of the evidence-based procedures, it ends up, you know, taking different shapes and forms. So then they ended up using it for a lot of PTSD, anxiety, even dealing with different types of addiction. They even used it with those that had troubles sleeping, and then it was taken and used for anxiety for high functioning individuals with autism. And so what it is, it's basically a way to help the individual put together a schedule. Okay, so it's kind of putting together a schedule. The reason why I chose it is because it's highly modifiable. According to whatever culture you belong to, whatever abilities you have, whatever difficulties you have, if you are verbal, vocal, or if you're reading, if you're not reading, if you are. So all the spectrum basically covers it. It's easy, modifiable, and the participants that I worked with were evidence to that because they each each had a different completely different learning profile and learning history. So basically what it does is again, it helps the individual and his team, his family, identify objectives that they bring him or her pleasure, something that he or she enjoys doing. Eliance with their values, so also acts came into that a bit. Eliance with their values, putting these into a schedule that is gradually sickened as we go. Breaking it down into small pieces and reinforcing every step of the way in order to make sure that the child without the lesson can access more of the things that bring him or her joy and access to things that need them to align, like behaviors that align with his or her values, and less of the things that are harder for him or her to enjoy and align with him. It's when it came to sexual health, that looked like a child who had trouble, for example. So when we talk about inappropriate sexual behavior, we are merely talking about sexual behavior that is happening either in the wrong place or at the wrong time in the sense of it's in the way of the child. There's nothing else that's inappropriate about sexual behavior except the location and maybe the timing that it's happening because you would need to wait until you get to the appropriate location, right? So that would just help the child in that time in order to be able to accept that or tolerate that distress in waiting to get an appropriate time or location, being able to access a schedule that makes it very clear what it is he or she would like to engage in. What are the behaviors that he or she can engage in that align with her preferences with his preferences or with his or her values until we reach that designated time or location. So we saw how having that set activation schedule helped these students, participants, generate that delayed accessing there, you know, yeah. Yeah, yeah, that sounds perfect. Definitely something I need to learn more about. So let's talk about your dissertation and kind of everything kind of around that sexual health in the Arab world seems like something that would be difficult to even get into in the first place. How are you able to sort of kind of, I guess, I guess like you said, make it culture responsive, make it culturally appropriate so that you can even, you know, sort of start having these conversations. Yeah. So I guess my biggest motivation to even start with this is the lack of support that I felt as a profession. I would have had no idea again when I was an early intervention. I thought, you know, those that were working without the lessons knew what to do. They'll deal with the child when he's that age I have has nothing to do with early intervention and that's probably a problem that's already solved. But once I was working in that then I saw the lack of support and I saw that there was absolutely no professional in the Arab world that I can go through for this. That motivated me that you know, no matter what it would take, you know, especially when you're thinking of doing a doctorate, you really need to be married to your topic and going all in and making sure that this is something that, you know, keeps you up at night and wakes you up in the morning. I found out with this topic because I found that parents really lack support, therapist lack support, full center, everyone that dealt with adolescents, or a growing child lack support, you know, along came me who wanted or wanted to, you know, to make a change and to have whatever positive impact I could have, especially that I am Arab myself, I identify very proudly with the culture, and I felt that that gave me a good window into what would be needed. So, you know, one thing I was musing about with a colleague the other day is, you know, I get asked a lot about, you know, and you asked me now about buying and how I got parents to, and honestly, that was the easiest part. That was the easiest part of the whole thing, getting parents to sign up for the trainings or to sign up for the researcher. That was the easiest thing. Because I, every single parent of a growing child knows that this is a topic that's about to come up. Yes. No one can deny that, you know, we all went through puberty, we all went through that phase and we all found their answers somehow. When I was joking about joking me, again, this is all anecdotal with my colleague, who was also Arab, who was also trying to get me to speak at one of the centers that she that she worked in. What we were talking about is that the only times where I had resistance about either presenting or reaching out to research participants, was when I was dealing with a non Arab in an Arab world, because I think people that I don't really understand the culture very well. Again, coming from a very well-meaning place, but if you don't understand the culture very well, you would have that bias that it's not very Arab to talk about this, but the Arabs themselves are ready to talk about it, you know. So we're confident between each other to say, hey, you know, let's talk about this and let's do a workshop on this. And the first, I remember the first person that really welcomed me with Arms Wide Open was a person in Jordan. And he was like, of course, you're welcome to our platform, anything you want to do, anything you want to talk about, because he was Arab, working in an Arab country with Arab people, and he knew that this was much needed. But then the rejections that I got was when there was a non Arab that was working in an Arab center and Arab school, and they were concerned about how the Arab population or the Arab parents or professionals would handle this. That was the only time I dealt with any trouble. Otherwise, really, I think it was a connective yes to everything. Other time, another, sorry, just to be fully transparent here, another struggle that I often have is when I'm trying to advocate for change or for, you know, Reformation, let's say, in the objectives that we set in early intervention. Because I'm saying, Hey, early intervention, help me out here, you know, try to hand me the lessons who are ready for whatever I'm about to teach. I don't want to start teaching the child to, you know, brush their teeth, or, you know, I'm ready to teach him how to shave. Please handle the tooth brushing at earlier ages to make sure that he's fully independent. So when I try to talk to early intervention, and I try to advocate for change in early intervention programs, I also face some trouble because they are not yet aware like I was, again, very humbly saying I had no idea that this was important when I wasn't early intervention. So they kind of say, no, we're working on other things right now. So it's that or again, working with non Arab professionals in the Arab world. Otherwise, it has been really pretty easy. Yeah, you know, and it definitely will give me some pause to reflect because I'm coming in with that bias just with the sort of assumption that I think this is sort of this assumption around conservatism in and of itself. And even you can have conservatism presents, I mean, the sort of conservative mindset into Western society is, I think, a much different type of conservative as well. I think in some ways, you know, I am social health conversations would probably have have less bias here. Yeah, if I am. Yeah, it's, it's, it's, it's a dimension to look at this conservatism and modesty is something to look at within every country. It's not particular to the Arab world. And I came across an article early, early on in my research by found and to not come. And I don't want to butcher this, but it said something along the lines of every, every society has a culture in every family has a subculture. Something along the lines of that it's in one of their articles that really that I think I believe I'm not mistaken in that article, they coined the term, or maybe it was before that actually, but that was my first experience with the term culture and humanity, which was also was also a cornerstone of the work that I'm doing culture and humidity coming into even as an Arab myself. I still approach every single Arab family with complete humidity as if I am alien to their culture. And I asked the same questions and I make sure that I don't jump into any conclusions because I've seen what that quotes from Fong and Tanaka said that really every family has a subculture and you cannot assume even within the Arab world that you know what it's like and you know their preferences and you know their background and you know they're family values and parenting philosophies and so on. So, I make sure in one of the one of the steps of my intervention was this kind of a testament that I took myself through with a parent of asking them, you know, how comfortable are you discussing sexual. Are there specific words that you make you uncomfortable. You're not happy to use and what words could be used as replacements. How comfortable are you using images, would you like to use real images or do you prefer drawings. Do you prefer drawings with faces or without faces because this is also this also varies from family to the next. How do you feel about gender and discussion of sexual health. Do you prefer that I talk only to the mother and not to the father. Do you prefer a male talk to the father instead if we're talking about a male adolescents. For example, I made sure I had my questions and I went through them at the beginning of every meeting to make sure that I'm using the right language. I'm approaching this with cultural humility versus cultural competence, which is what I learned earlier on I learned about cultural competence and the importance of that and took a few see you felt I was culturally competent and ready to go but then this also this term turned me upside down like no it's not about competence about humility and approaching every family without understanding. That was really also a turning point in my research. Yeah, it's really cool. Okay, tell me about this study. Tell me, tell me give me a Coles notes of kind of what the process was and what were your research questions and what the work looked like. So there were many dimensions to this. I studied. I looked at the art culture in general so that was one of my background chapters sexual health, sexual abuse worldwide and in the art world in particular. I looked at behavioral activation and, you know, got familiar with all of the evidence for that. And then I got into I study I looked at five participants and how my main research question was how behavioral activation, how effective was behavioral activation in reducing inappropriate sexual behavior. I was also using a fully tell the health based models for that. So I was based in the UAE but I wanted to make sure that because I was covering the Arab world I had participants from different countries. So I had Egypt, Jordan, and Lebanon, and the UAE, I believe one family was from the UAE. So I had these four nationalities. And yeah, so I looked at how behavioral activation would affect inappropriate sexual behavior and what came on. So the findings were positive. There were two significant findings. One, that behavior activation was effective reducing inappropriate sexual behavior down to zero actually. But in two, one particular finding in two of the participants was that a delay in applying an intervention led to a significant increase a peak and inappropriate sexual behavior. And following that after we started with the behavioral activation, the decrease followed. So what happened was, I'm sorry, this was a bit confusing. I'm going to make it a bit clear with two of the participants. I started off with the procedure with the intake with all of the questions with the training, but then for one reason or the other, the parents decided to discontinue with the services with the intervention with one family because they were uncomfortable. They wanted to follow an abstinence based intervention to teach the child to not engage in any sexual behavior at all, which is one of my only red lines is the one thing that I cannot do. I can with the turn my interventions to suit whatever it is you need. I can stand on my head while applying the intervention. I don't mind. But one thing I cannot do is teach the child to not engage in solo sexual page. Right. So, so one of the parents, that's what they wanted. So after we did the intake procedure, they felt too uncomfortable. They said, no, I don't want to teach them to do this property. I want to teach them to not do this at all. So I'm like, I hope you change your mind. If you ever do, I'm right here for you. And they went off another family for unknown reasons. They also decided to discontinue. And both these families came back a couple of weeks later and a couple of months later with a significant increase in sexual and inappropriate sexual behavior with both of them. The child was actually perpetrating inappropriate sexual behavior that was getting a sibling and relatives in significant danger, right, in situations that they should not be in. So they were masturbating in the presence of the sibling while the sibling was asleep. And they're in their room. And the other one was kind of asking the younger relatives to undress or making them undressed in order to look at their private parts. And that increased significantly between the time that they left and the time that they came back and what the message that I was trying to give and then after that a decrease to zero and we were good to go after the intervention was applied and after they came back and they said, okay, we're ready. And the reason why I focus on that in my research is because I try to use these stories, these participants and the data I have, and it's very clear on the graphs when I, the graphs sit in there, is that there is no way out except through. No matter how uncomfortable this could be for families, there is no way out of this inappropriate sexual behavior except through. And no matter how uncomfortable this is, it's not more uncomfortable than what it could lead to potentially need to if we did not target it early on. So we could avoid talking about sexual health, we could avoid teaching the child how to masturbate appropriately in a private location and appropriate time. We can avoid that all you want because you are uncomfortable, but you're still going to be uncomfortable when the child is trying to access this behavior at the wrong time at the wrong place, you're going to be uncomfortable both ways. One of them is going to need to discomfort for yourself and potentially family members or others around him or, you know, so one of the children was even that out of the school, he was not able to access his school anymore because of his behavior. Or you're going to be uncomfortable, but on the way to more socially appropriate behavior and a healthier and generally healthier presence within society and within the family. And this is what I've been trying to advocate, right, starting as early as possible to avoid getting to more uncomfortable situations. I hope I wasn't too confusing without if there's anything I can clarify, please let me know. The second secret word is Lebanon. No, no, I don't think so. I think it's great that these two families came back to you after the fact and that they felt safe to kind of return was that difficult for them. Listen, so what's with one of the families, they had really tried to go to so many other professionals. They were Arab, but they did not live in an Arab country. So they felt like all of the professionals, professionals that they went to were not giving them the answers they wanted. They figured that if they came to someone Arab, they would help them with the abstinence approach. But I think once they saw that even with all of the cultural modifications that I was willing and able to do, this was still not something that I was willing to do. I felt that that was the last straw for them. They figured that if someone that really understands the culture and understands their religion and understands everything is still insisting on this, then it must be the only way out. And, you know, thankfully by the end of the intervention, everything was good and it was a positive experience for them, but it's just always that first step. Accepting that this is what needs to be taught is always difficult for everybody. I completely understand. And with the second family, it wasn't difficult to come back at all because, I mean, I try as much as I can to stay in touch. I'm very responsive as a therapist in general. Anytime anyone has a question, I'm fully accessible any time, any day. So we kept that communication going. And I kept saying, "Here's your need me, here's your need me." And then when they realized that it really did peak to a point that the family members were being abused to say things as they were. They realized that something needs to be done. I actually got a phone call. The father called me saying, because I was not answering at the time, and then I remember he sent me a message saying, "You either answer me now or I'm taking my son to the police station because I have no idea what else to do." He's putting all these people in danger. He needs to stop. And then I obviously answered, and I'm like, "Okay, I'm here. Let's start. Let me just try this intervention first, and then we'll see what we'll do." So, yeah, so I hope from their side, I mean, I ended up doing a social validity assessment. And that was also very close. That was also part of my research. And the social validity was relatively high compared to what I was expecting. It was easy to apply. It was relevant. And it did result in long-term benefits for the child, and for the participants in the family. You touched a bit on what behavioral activation is, which was great. Can you kind of walk me through what the intervention looked like with the spare loops? Yeah, so there's several steps. The first step is kind of what in ABA we would call the preference assessment, but in CBT, it's kind of like a day tracker and mood tracker, you know, trying to look back at what are your preferred activities, what are some of the things that you enjoy doing, how each activity relates to your mood. So again, depending on the child that's with one participant, sorry, it was a preference assessment. And with others, it was more of a question. What are some things that you enjoy doing? What brings you joy? Remember the time that you were happy? What were you doing? So just a preference assessment was step one, step two, looking at their values and what are some of the things that they want to do, but haven't been doing so much. So we look at their values and value aligned behaviors with some participants. It was, again, directly asking them with others. It was asking their families. What are some things that you'd like to work on with your son. So that could be anything from physical fitness to math to reading. So, you know, spending time with the family preference assessment values. And then we look at the different schedules that we could introduce again for each participant. It looked different for some. It was a, you know, it was a full weekly schedule, a Monday through Sunday with, and then for others, it was a first-hand schedule and it could vary for everything in between. And then we kind of look at contingency management, which again looks very different. It could be a token. It could be media treatment for following a stand schedule. So we look at the preferred activities. We put it in a schedule. We decide on the contingencies that are going to manage this schedule and, you know, follow it along. And then we look at any skills that we need to teach. Right. So for some, it was, with some of the students, we had to teach breathing techniques, you know, when an adolescent already has an erection and he's already aroused. We really need to either get physical or teach, or teach breathing techniques to kind of ease up on all of the differences, your logical changes and feelings that are happening. So there's sometimes some skills that you want to directly teach the child to engage in. With one of the participants, it was interesting that without participant that was trying to kind of undress people around him and he was not very aware of the boundaries of different people. While he was aware, he just had trouble following through what we had to teach. So what we figured out with that particular participant is that he was told earlier on that males and females are the same. He asked the question, what's the difference between boys and girls and he was told they're the same because parents did not have any better answer. They wanted to avoid. They were a bit avoidant of that question in general. How do I explain the difference between male and female? So there is nothing different. One has long hair, one has short hair or something along the lines of a very dismissive answer. But as an adolescent, he knew that something was off, obviously. And he was off to figure it out by himself. And that's why he kept trying to undress. So the skill that we had to teach there was that I have a private question. Or at that time, we talked to circles, if you're familiar with the circles, relational circles that they teach. So we talked, we talked him about the circles and the circle in the middle was him and his dad. And we taught him to ask his dad that I have the question inside the circle. And we promised him that any question inside the circle would be answered on his tea and with all the facts that you would want. And we prepared a social story of the difference between males and females and we tried to make that this culturally appropriate and comfortable for the parents to go through with him. But it was a simple as teaching him a prompt to tell his father that I have a question and please answer me, honest, that was that was like a quick prompt for him to get access to that reinforcement. But again, so, right. Reference assessment, values, scheduling, contingency management, any kind of skill that needs to be taught at that time, putting all of these together and applying them when it's needed the most, which is basically when the child is under any kind of stressful situation, which is when there is arousal or when there is, in that case, curiosity, you know, I need to wait until I have access to my father until I can ask him any question that I that I need. Was that clear that I think that well. Yeah, no, super clear, super clear. And so kind of going back to one of your points about how there's no inappropriate sexual behavior, it's just more, it's inappropriate where you do it or when you do it. And so it sounds like a lot of this behavioral activation piece is just around getting them to sort of understand that this isn't the time. But right now you can do these sorts of things until you get to a time where this isn't the place and right now you can do these sorts of things to get to the place. Yeah, so with one up with two of the students, actually, two of the participants, the skill that we had to teach was private versus public or open door closed door. It depends on the child in the history that he has either I don't want to introduce new words. Sure. So that was the skill that we had to teach where am I allowed to engage in this behavior that was the skill and then I need to tolerate the delay until I get access to a private location or a closed door location. Then this is often the only skill that they need to learn and if they have that if they have the ability to discriminate between what is private or is public or what needs to happen behind a closed door and what needs to what can happen behind an open door. Then the child, well, in most cases, not to all cases, obviously the child would learn what to do with himself for herself, you know, just having access to privacy, which a lot of adolescents, I think, don't have access to privacy. They don't have access to private location. They're often assisted 24/7, but just giving access to that, allowing them to discover themselves and to discover their preferences and to discover what they want to do with their own body when they have a certain feeling or when they're aroused at different stages of their day. You know, sometimes they just want privacy because they want privacy, not because they want to engage in any kind of sexual behavior. So I find a lot of value in teaching privacy or teaching just a month for a long time. This is something I love to teach earlier. I can teach a four-year-old how to man for a long time. And I think that would be helpful at any stage and any age. And in this study, did you have to teach any sort of, you know, you mentioned already that, you know, a lot of the time, you know, once they understood where and when they kind of figured the rest out themselves, but they don't always figure out, figure the rest out themselves. So did you have to teach any of those skills? No, no, they don't. Some children don't know what to do with some children. So you really meet a lot. It really depends on each other. I still call them children. I'm sorry. It's something I'm working on. Some other lessons or adults even that I work with. Again, they struggle with a specific learning history. So we have those underless and short adults that were told that what they're doing is wrong or that they need to get their hands out of their pants. So even when they are in a private location, they don't know that they need to undress, for example. So they end up hurting themselves or hurting their skin or just not being able to do anything, just being in that private location and not knowing that they need to undress and follow specific steps. You have some other lessons or adults. So there was a couple of cases actually that I worked with that I've seen this. I don't know if any other professionals have come across this, but I've seen this more than once where because they were repeatedly told no, probably their sexual behavior as soon as it started brought a lot of anger and angry reactions from their caretakers. They have learned that this is very wrong. So what they started doing is whenever they would have an erection, they would hit the erection, right? They would hit it to make it go away because they want the erection to go because if there's an erection and if they're engaging in that sexual behavior, then their caretaker or their work, whoever it is would get upset. But they would fear. So we had a lot of fear and anxiety. On top of the arousal, we would have fear and anxiety about the arousal. So that was the cocktail of emotions that we have to work with and behaviors that we have to work with. So yeah, it's not always a linear path. Hence the advocacy for early intervention in reciting as early as we can in empowering parents and making them confident in dealing with the phases of puberty and adolescence in January. And so we're all interventions. Do you ever implement this? No, not all of them. Some of them. I try to. So I try to work on when it comes to anything that has to do with sexual health. I always prioritize working with the same sex parent. It's a girl. I work with a mom. If it's a boy, I work with a dad. I felt like culturally, this is the most appropriate thing to do and for comfort purposes. And also, I like to get the father and their mother to relate with their child. I also need once a month. It's only you and you're not going to die. It's normal to happen to everybody. And I also get an erection. And this is Norman, you know, trying to normalize the processes that we all go through. Especially when it comes to adolescence with autism, where their social learning is limited and they're not seeking their peers to tell them that this happened to me too, right? So we need that connection. We need that validation from the parents. I do need best case scenario. I would work with the same sex parent. If that's not accessible, then I would work with opposites. So I would work with the mother with her son. If the father is not available or vice versa. If not, then I would work with the same sex therapist. If not, then I just work with whoever is there because something needs to be done. But I always have these steps that I try to go through before I get to, but with my participants, it really varied with some of them. The parents had absolutely no idea how to go about any of this, and they had a strong and solid team with some of them. It was the primary interventionist was the parents and with some of them interventionist was not necessarily a certified professional and RBT was just someone that came to spend time with a child like a social worker. I'm sorry, so yeah, it just depends on who had access to the child and who fits the criteria best. Really deep. This was sexual health in the Arab world, pretty broad category. How many countries are we talking about here? I know you only have like three or four in each time you put it. The Arab world is something like 22 countries. 22, not mistaken, in the 20s. Yeah, yeah, and are there a lot of, sorry, go ahead. No, I'm listening. Okay, are there, I mean, obviously there's a lot of differences, as you say, from family and family, individual and individual or the poor, it's a couple of humility. Trisha right to her to call us, send them all now and see it should be required reading to everybody on that topic. But there has to, there must be sort of some kind of major differences across countries and I would guess a big part would be legal because I think that a big barrier sort of here in North America and we've had a, I'm in Canada, but in the US they have a recent change in administration sort of there's a lot of concerns around sexual health and sexual health education and that a lot of laws are going to be changed or restrictions are going to be put in place, you know, sort of across all aspects of sexual health, whether it be the rights for those in the LGBTQIA to a two plus sort of category or group demographic or whether it be laws against perception and abortion and sort of all these different things and there's a lot of, you know, and a lot of barriers to just basic sexual education for young children. What's that like for you? What's that like for you? First, I guess, in Lebanon, but then sort of, you know, sort of across the Arab League. So yeah, so the Arab world really varies as you were saying from one country to the next. It's hard to put it all under one umbrella except the Arabic language is the primary language of all Arab countries, but it's not the only language of all Arab countries so even with language we can't unify it, but there are some similarities in culture and there are similarities and policies, but it's not really, really, it's more different system similarities when it comes to the Arab world. So I live and I work in the UAE, which is even more conservative in terms of the laws that they have than Lebanon. And what I always, I always make sure I explain to parents or anyone that I come across, because obviously the ultimate, sorry, the ultimate dream is to get into policy making and policy changing, right, particularly with this topic. And when it comes to safeguarding, but we really always have to be very respectful of the country that we live in, the laws of that country, the preferences of people of that country, right, we can never go above the law. And what I found is that personally from my experience, because I haven't worked with expats that live, you know, the UAE is majority of expats. I haven't worked with expats that live in the UAE. I've only worked with Arabs that live in the UAE. So there was a consensus on how we're going to stick the objectives that we're teaching and the way that we're teaching it really sticks to what the law of the country dictates. So if I were to take, for example, sexual health education programs from the US, from Australia or from the UK, and I were to bring it into the UAE, I would be breaking a lot of laws, right. Particularly when we're talking about the LGBTQ+ community, when we're talking about any kind of intimate relationship outside marriage, which are all a big part of sexual health education in the West. And they're a big part of the curriculum of sexual health education in the West. But in the Arab world, this is not something that is allowed by law or preferred by culture. So again, we have to be mindful of that, and we have to make sure that whenever we're teaching the child, one thing that I start whenever I'm presenting to more of a Western audience, I always start off with a definition of the UN of quality of life. I don't have it now in front of me. So again, I'm sorry to butcher it, but what's significant about it is that it says that the quality of life of a person depends on his functioning within his or her society within the society that he or she lives in. And I always highlight that that I cannot assume that the quality of life is the name of an individual is inferior to another, right, because of the specific objectives that he or she were not taught the opposite is true. If I were to come and teach an Arab adolescent, whatever country adolescent about premarital relationships, right, that would negatively impact his or her quality of life because of the society that he or she lives in, and the culture that he or she belongs to. Because I want to always make sure that I stick by the ethics and I stick by the ethics code of all the bodies that I belong to. So as a professional, I cannot be teaching any objectives that do not align with the individual's culture or laws of his or her country. So that was generally the framework that I was working with. So what I do is either, what I've done is that I've had a lot of access to different sexual health curricula. I've kind of taken bits and pieces here and there, and I've put together my own I have it thrown down on this excel sheet, where it's all the objectives that I want to teach according to, you know, hopefully maybe one day it's in the plans for me to publish this and to turn it into a modest sexual health curriculum or something that is appropriate for the countries that we live and work in. But yeah, so far there hasn't been anything comprehensive that I can take as is an apply. And now I love this answer, and it makes me think of lines of questioning. First being, I think, again, and I'm coming in from that kind of Western bias of what sexual education looks like and what sexual health curriculum looks like and what, you know, myself who, you know, is clearly left leaning when it comes to sort of political values, what would agree is sort of an appropriate, you know, sort of set of lessons in my culture may not be in yours and may not be for many Arab families over here as well. And I think a really important sort of direction, but I think probably safe to say that sexual safety, you know, certainly in terms of, certainly in terms of your own body parts and, and, and, you know, what you choose to do or not do with those. We can all agree on. There's probably the language. And for that, and I think in this close back to your piece around this kind of safeguarding strategy sort of these basic kind of skills that really kind of need to be in place in order for one to, you know, avoid further harm, not only to sort of themselves through unskilled activities or things like, you know, like, as you mentioned, folks that would, you know, hit their, you know, hit or punch their own erection because of sort of learning history to those that would potentially engage in, you know, what seemingly safe behavior in the environment of your bedroom becomes incredibly dangerous behavior in someone else's bedroom. This whole idea around safeguarding is huge. And I think, you know, really, really opens the mind to sort of, you know, think about how, you know, even in my neck of the woods about how I might approach sexual health was with some of my clients, if I could sort of compartmentalize, you know, the right to do a lot of things that, you know, North Americans do. And I think it was, you know, like a lot of the work of Nicholas Mauether and others in the States who are focused on some land of flocks and stuff, having the podcast a couple times, she's like her and others who, you know, talk about sort of areas of sexual health that make me uncomfortable. I don't have to go there with my client. I can focus on, you know, do this in your bedroom and it's going to go a long, long way. It's going to go a long, long way. This is unsafe, safe behavior is unsafe behavior is, you know, teaching just that I feel like this is like really a missed opportunity from their years that that relational frame, you know, that stimulus equivalence that we teach it with same and different, right? Why not teach it with safe and unsafe? Because so many things can go under that umbrella, right? Safe and unsafe could be, you know, safety and what I'm eating and safety and what I'm wearing when it's called outside and safe. And safety and who is allowed to touch my body and whose party am I allowed to touch versus unsafe in the words that I'm using. So I feel like these are just big umbrellas that we can teach anybody at any age. The concept of private. So we often have the idea that private is something that needs to be stopped or something that needs to end is something that, you know, to the big no private is essentially saying this is allowed under specific circumstances or in a specific location. That's it. And there's so many things that are private beyond sexual behavior. There's privacy and when I'm showering, when I'm going to the toilet, when I'm undressing, there's privacy and some of the things that I might say, I might give a piece of information and say, Oh, this is private. This is between me and you. There's so many things that are private beyond, like, I don't know, for example, burping, you know, it's not wrong. It's just private, right. So teaching that to a four year old that's burping, right. Oops, I was private introducing that word introducing that frame, right of private and then that would make it so much easier to add into one as he grows, you know, we went from a bird being private to you changing your clothes being private. So you're going to the restroom, you need to close the door because it's private and then eventually to you engaging in sexual behavior that that's private. Just again, just setting it up for any culture at any age, any stage, any ability or any difficulty, you know, we can we can teach these basic things. And that would just save us a lot of trouble and introducing it the future. Yeah, I mean, there seems to be that barrier in sort of, you know, the broad early intervention world to avoid teaching skills that only become a problem later in life, you know, it's actually already being one, but, you know, it's a lot of being a big one. And I, I faced that, I faced that with parents and I faced that with professionals. Again, when we're working with younger ages because the older ages, they're already aware that this is going to be a problem or not a problem, but this is going to be something that we're going to have to target. But with the younger ages, it's hard to get them to really prioritize this, but once they do, it just makes everything, everything easier. And I realized one of the things that I did, one of my presentations, I looked at a lot of the studies that are on safety in general, because I talk about safety also beyond sexual health. I talk about safety and navigating your environment and crossing the road and not approaching dangerous sharp object and poisonous liquids. So I talk about safety in general, right. And so I looked, one thing that I did is that I kind of looked all of the, not all, but the most recent research on behavioral skills training, because that is the one that ties the evidence and efficacy in teaching safety skills. Safety procedures, Milton Burger has done wonderful work on this training. So what I've done is that I've kind of taken some, all of these different studies that I've come across, very like totally, I haven't published this or even written it up, but I have brought it up in some of the presentations. The total, the average of sessions that it took to teach all of this does not exceed five or six on average. Right. So it's not going to take a year of your time to teach the safety skills. You take five average, let's say 10 sessions, you know, to be on the safe side. And then you're good to go and it's just a maintenance thing. And I try to make that here for parents and professionals, and I'm not telling you to hold off on teaching all the academics. I'm just telling you, just just inserts in between these five or six sessions, these 10 sessions of safety skills. And then keep them in the maintenance box for maintenance later on and yours. You're good to go. You know, let's work on elopement. Let's target it. Let's teach the kid to swim. You know, let's teach the kid to ask for help or say, I'm lost. Here's my phone number. Can you call this number? So all of these different safety skills can come into play and could be also to work on as early as possible. Well, and I think, you know, this, this is sort of the, you know, in my mind, it's always been the biggest problem with their intervention is that early intervention has always been about academic readiness instead of adulthood readiness. You know, I mean, because it becomes much more difficult, at least, you know, in sort of our education system to teach those skills once the children enter the school, because now you have a whole other group of educators that are now untrained in all these areas and are aware of how to deliver these skills, which was all other, you know, separate podcasts. And so, you know, the opportunities and early intervention to get some of these basic basic things down there. I think it's, it's also easy to sort of assume because it could be really difficult to teach a, you know, a 37 year old man, you know, it's not the loping into traffic, but it's pretty simple to teach a tutorial. There's that there's, but there's, there's also, you know, this sort of idea. Well, a two year old's not going to be in traffic. So why don't we have to teach that. It's easy. Yeah. Yeah. We tend to freak out. It's Norman. It's normal. We forget that this is a growing child as this to parents all the time. Where do you see your child in five years, right during 10 years and I tried to program for five years. One thing that I've learned to do that I've brought in from a wonderful meditation experience that I've had. I had a meditation session with a professional. I don't know what they are, but a professional person that came and did the whole relaxing thing and close your eyes and she takes you into your inner child and all of that. And as soon as I opened my eyes, my first thought was, I need to do this with the parents and I did. And it worked like magic. I did. I channeled my inner meditation expert and I said, close your eyes. And I do that regularly now because I realize that we're close your eyes, relax, relax your shoulders, relax your tongue. You know, I go through all the process, feel your body sink into the chair. I add all of that sugar and spice. And I tell them, imagine your daughter's sorrow. Imagine sorrow. Right. Think of her. What does she look? Imagine her at 15. Imagine her at 25. What does she look like? What does her hair look like? What does she smell like? What is she wearing? Now take me through Sarah's day at 25. She wakes up in the morning. Where is she? Right. And I make them close their eyes and go through this process exactly like that meditation person did with me because I felt like I was actually there. And then this is what I've always been wanting parents to do. I've been wanting them to imagine their child as a 25, 35, 45 year old. And I take them through a day. You know, she wakes up in the morning where she is brushing her teeth is someone helping her. Right. She's getting dressed. Who's there? Is she getting dressed independently? And if they say yes to all of these things, I'm writing them down. I'm like, you told me she's dressing independently at 25. I need to make sure that at five, I'm gradually working towards that. Right. So I started doing that because it's hard for parents. It's hard for everybody. I can't imagine my second year old. I can't imagine him as a 10 year old. I know what it's like because you're still taken in by the day today. But sometimes at times, especially when we do these follow up sessions to sit and meditate about the future. I think it has been helpful for my practice. I love that because I do find it's that it is hard for parents to sort of, I mean, I think a lot of times we don't even ask questions to parents about sort of what's your vision for your child for five years, 10 years, 40 years from now. But to take them through a mindfulness process and actually be present with those thoughts and really think it through, especially after you've calmed them down with a breathing exercise or some quiet music or some muscle relaxation to sort of get them focused. Yeah, that's brilliant. Yeah, that's something that I'm still not an expert. I just try to remember what she took me through. Maybe I should get a license and meditation or something. Well, you know, I don't know. I don't think so. I mean, maybe, maybe I just have a child with a roller. I mean, she's brilliant at the mindfulness practice. Yeah, but I would be the person to come to you. I don't think meditation has always been described to me as, you know, just another muscle. And, you know, it's just something used to practice. There's nothing overly complicated about the skills required for me. It was such an eye-opening experience for me personally. I think because I did it. I mean, I did it last year. And it was like, it wasn't something. Something's like, why did I not know? And I loved being led into it, right? And she took me through it and I ended up in tears and I ended up, I loved being walked through the meditation. I don't know. Maybe it's just me, but it was a very unique experience for me. And I felt like I need to be taking parents to a similar journey. And her voice and the way that she did everything, it was really exceptional at that time. So I tried to channel that whenever I see that I need to. Well, I could see you being good at it. You've got a very calming voice. And so I could see you doing well to keep parents through that. So, not even your doctorate. I've seen that you've been doing some speaking and sort of talking about sexual health and that sort of thing. What's next for you? The third secret word is sexuality. Well, I'm starting off on my assistant professorship journey in January. So in a couple of weeks, it's going to be my first experience teaching at that level. But I'm excited for it. I'm excited for it. I'm excited to be working on some research projects with students. And I would love to show the reason why I applied to a university setting is because in the UAE, it's the only setting where you can do research. And I would love to see in research. I'm currently working on publishing these excerpts from my thesis. So that's one project. Another project I'm starting as an assistant professor with SIA universities at the university in the UAE. And I'm continuing to do, I'm offering courses for professionals on sexual health. I offer workshops and trainings for parents. A big part of my work, actually, we haven't discussed this year, but a big part of my work is with typically developing children. And their families, right? On the same topic, same concerns. We're all in the same boat, but a big part of my work is there. So I'm trying to do also a lot of advocacy for safeguarding procedures in general parenting. And what is the program at the university where you'll work? It's in a psychology department, so it's under that umbrella. And they have a wonderful team. I have yet to meet the students and get all of that done. I've just gotten the chance to chat with a couple of team members and I'm joining the department of psychology. They say, you know, congratulations. And so just doing this work in sexual health. Are there other, are there other sexual health providers doing any of this kind of work that you've seen in their countries? Or do you think you're the first? And there are lots of individuals that are trying, right? So I was offering, I offered, I did two rounds of 10 hour course on sexual health. And now for, for our culture. And the sign ups have been really overwhelming. Everyone is interested. All the professionals are really looking forward to learning more about this. And there's a joy. Yes. A lot of professionals are willing and able to learn. I would love to see more research. I feel like this. I've seen research feeds into practice so beautifully. And it's so important to not miss out on that, especially when we're talking about evidence based practices. And really trying to build up an evidence base for something. So I would love to see more research on the topic, but so far I'm happy and I'm grateful for the interest of professionals and learning more about this. And hopefully with some of my publications coming out, it would really entice more research on that. We'll see. And what's happening these days at projects and sort of goals for ABA Lebanon. Yeah, so we've been doing a lot of work. We've been trying to grow the platform. We've resamped our website. We worked closely with a company wider reach. I want to say, I'm sorry, I'm very bad with names to my apologies. So they're helping us call the wider each year was so I do something else anyway. So they're helping us really put together our website and articles and make sure we have a good online presence. So that's one of the projects with the recent happenings in the region, obviously with everything going on in Palestine and then in Lebanon and Syria. We've been trying to focus on community outreach. So we are getting wonderful training from Dr. Benjamin and Dr. Sasha who have been helping us learn more about therapy in drama response, which none of us were specialized in or are specialized in. But we live in a country where unfortunately in countries where unfortunately we there it has been on several occasions they need for drama informed intervention. So we are getting this wonderful training currently we're in the middle of it with Dr. Benjamin and Dr Sasha as a BA L and hopefully we would use that to reach out to the wider community in terms of interventions. And with everything going on has been hard for a be able to focus on anything but the community to do anything beyond reach out to those that have been affected by what's going on. So it's been the focus of the ABLs for the past year I'm going to see. There's a really cool picture coming on the podcast this was awesome. Thank you so much for having me. Thank you and excuse my voice barely coming out but I'm really happy that we got the chance to do this I really appreciate any chance to have you know enriching conversations to spread this message and to reach out to as many people as possible. So thank you for this wonderful opportunity. I really appreciate it. If you enjoyed this episode I encourage you to check out these episodes as well. Episode 149, Behavior Analysis in Saudi Arabia with Dr. Shahad al-Sarif. Episode 139, Threads of Hope, addressing trauma in a mid-war and civil discord with Shahzan Razuk and Episode 94, Behavior Analysis in Lebanon and Qatar with Rola Elanan. If you enjoyed this episode please consider leaving a review on Apple Podcasts Spotify or wherever you get your podcasts. And please follow us on Instagram @behavorspeak. [Music] [Music] [Music] [Music] [Music]
In this conversation, Asmahan discusses the critical need for improved safeguarding strategies in education, particularly in the context of sexual health and behavior management. She emphasizes the importance of cultural responsiveness in her work within the Arab world, highlighting the skills necessary for effective intervention. Asmahan explains the concept of behavioral activation, detailing how it can be adapted to address inappropriate sexual behaviors while respecting cultural values. The conversation also touches on her research findings, which demonstrate the effectiveness of behavioral activation in reducing such behaviors, and the practical steps involved in implementing this approach with families. She emphasizes the role of caregivers in sexual health education, the cultural and legal barriers faced in the Arab world, and the necessity of tailoring sexual health curricula to fit cultural contexts.
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Research Articles Referenced:
Ala’i-Rosales, S., Cihon, J. H., Currier, T. D., Ferguson, J. L., Leaf, J. B., Leaf, R., ... & Weinkauf, S. M. (2019). The big four: Functional assessment research informs preventative behavior analysis. Behavior analysis in practice, 12, 222-234.
Kolu, T. C. (2023). Providing buffers, solving barriers: Value-driven policies and actions that protect clients today and increase the chances of thriving tomorrow. Behavior Analysis in Practice, 1-20.
Related Behaviour Speak Podcast Episodes
Episode 149: Behavior Analysis in Saudi Arabia with Dr. Shahad Alsharif
https://www.behaviourspeak.com/e/episode-149-behaviouranalysis-in-saudi-arabia-with-dr-shahad-alsharif/
Episode 139 Threads of Hope: Addressing Trauma Amid War and Civil Discord with Sawsan Razzouk
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