“A Balanced Day allows a facility (and treatment team) to focus on the solution instead of the problem.”
Dr. Midkiff, Licensed Psychologist
Why Choose A Balanced Day
Expand Clinical Skills
An intuitive pathway for staff to expand their clinical skills when working with complex patient behaviors.
High-Value Reward System
The program focuses on reinforcing a patient’s desirable behaviors through a scheduled high-value reward system.
Reinforce Positive Behavior
Integrates a dual process system that can shape staff behavior to reinforce and shape patient behaviors.
Motivation for Change
Creates a culture of awareness between staff and patient of the tiny, incremental steps that lead to demonstrating optimal pro-social behavior.
Built for Youth
Gives your child a clear, fair map of what success looks like. Instead of rules that feel like punishment, they earn recognition for real effort. Over time, those small moments of being noticed add up to something bigger: a child who believes they’re capable.
Encourage and reward positive behaviors
Start building your patient’s reinforcement history today for the behaviors you want to see more of.
Behavior that gets reinforced gets repeated.
A Balanced Day uses a token — a coin — to mark and reinforce the everyday behaviors that build a stable, safer milieu. The coin is not the goal. It is the visible, immediate signal that a desired behavior just occurred and was noticed. That signal is what changes behavior over time
Each behavior carries its own history.
Every behavior carries a reinforcement history. Picture it as a jar — each successful reinforcement deposits a coin. The deeper the history (the more coins added to the jar), the higher the probability the behavior recurs. ABD is, at its core, a system for building those histories deliberately, behavior by behavior.
Lower-probability behaviors are reinforced by higher-probability ones.
Premack’s principle: a less-preferred behavior can be reinforced by access to a more-preferred one. On the unit, that means everyday tasks — lining up, attending group — earn access to preferred items in The Store. The structure is not bribery. It is sequencing, and the behavior becomes well-established.
Lower probability – Target the Behavior
Then
Higher Probability - Access to the Store
Ten target behaviors. Fixed times. Every day.
Reinforcement is delivered using a fixed schedule: ten identified behaviors at predictable points throughout the day, every day, for every participant. Predictability is a feature, not an accident. It removes ambiguity about what earns reinforcement and lets behavior change accelerate.
Today
- 7a
- 9p
- 12p
Ten reinforcement opportunities per day, repeated.
Tomorrow
The Next Day
Reinforcement happens at the moment of performance.
The coin is delivered at the moment the behavior occurs — not at the end of the shift, not retroactively. Delay weakens the connection between the behavior and its consequence. Same-moment reinforcement is what makes a token system function as a learning tool rather than a reward chart.
Behavior and reinforcement, paired in time.
An eleventh coin reinforces what we want to see emerge.
Beyond the ten scheduled behaviors, an eleventh shaping coin can be awarded once per day, by any staff member, at any time — for kindness, helpfulness, or attempting something new. This is intermittent reinforcement of approximations: the mechanism by which behaviors we want to see emerge actually do.
the shaping coin
- Kindness
- Helpfulness
- Trying Something New
Observation reinforces the whole room.
Vicarious learning is real and measurable. Participants observe peers earning coins and staff delivering reinforcement. Staff, in turn, observe one another’s language and modeling. The system is training everyone in the room — not only the participant in front of you.
Observation is itself a form of practice.
You can extend the system.
For example, during visits and after discharge (or other situations), your verbal reinforcement does the same work the coins do on the unit. To be effective, the reinforcement should be specific, immediate, and explicitly tied to the behavior. Continuity between unit and home is one of the strongest predictors of behavior maintenance.
say something like
“I noticed you said good morning to the nurse — that was kind.”
- Specific
- Immediate
- Named
Testimonials & Success Stories
