Fillable Printable Behavior Contract Template - University of Washington
Fillable Printable Behavior Contract Template - University of Washington
Behavior Contract Template - University of Washington
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
1
Example Behavioral Contracts
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Recommended Resource: Scott P. Sells, Ph.D. (2001). Parenting Your Out-of-Control Teenager: 7 Ways to
Reestablish Authority and Reclaim Love. St. Martin’s Press: New Yo rk.
1. State House Rules
HOUSE RULES
Rule #1: Treat family members respectfully. No fighting.This means no
kicking, pushing, shoving, hitting, throwing things, or spitting at someone.
No verbal (e.g., threatening to hit, kill, hurt) or physical threats or gestures
of harm (e.g., holding up a fist, m oving to push, shove) toward family
members. No swearing at or about family members.
Rule #2: Be where you are supposed to be (Be accountable for your
actions). This means at all times you need to be where you are supposed to
be (school, home, park, approved friend’s house, grandparents’ house). Do
not leave to go to another place without getting permission from your dad or
mom. It is your responsibility to reach us. If you cannot reach us, you are to
stay where you are or come home.
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
2
2. Individualize Behavioral Contracts
Preadolescent Female’s Contract
Parents will determine if a rule has been broken.
Curfew is 9:00pm on weekends
Rule #1: Treat family members respectfully. No fighting.This means no kicking,
pushing, shoving, hitting, throwing things, spitting at someone. No verbal (e.g.,
threatening to hit, kill, hurt) or physical threats or gestures of harm (e.g., holding up a fist,
moving to push, shove) toward family members. No swearing at or about family
members.
Rule #2 Be where you are supposed to be (Be accountable for your actions). This
means at all times be where you are supposed to be (school, home, park, friend’s house,
grandparents’ house). Do not leave to go to another place without getting permission
from your dad or mom. It is your responsibility to reach us. If you cannot reach us, you
are to stay where you are or come home.
For Either Rule:
On the first violation, you lose your radio for 24 hours
On the second violation, you lose your phone for 24 hours
On the third violation, you lose two hours from your curfew from one weekend night (8
p.m. curfew)
On the fourth violation, instead of coming in two hours early, you will not go out that
weekend night.
On the fifth violation, you will lose t.v. for 24 hours
If you have used up all of the weekend nights, it rolls over to the next weekend
Rewards
If you are respectful (rule #1) for three days in a row
(no violations), OR if you are where
you are supposed to be (rule # 2) for three days in a row (no violations), you can choose
one of the following rewards approved by S & J
1. Drive with mom or dad on an outing (approved by S & J)
2. Have a friend spend the night on the weekend (friend approved by mom and dad)
3. Go to mall or movie on weekend with an approved friend
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
3
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
4
2
nd
Female ADOLESCENT Contract
Parents will determine if a rule has been broken.
Curfew is 11:00pm on Friday or Saturday for auction
Rule #1:Treat family members respectfully. No fighting.This means no kicking,
pushing, shoving, hitting, throwing things, spitting at someone. No verbal (e.g.,
threatening to hit, kill, hurt) or physical threats or gestures of harm (e.g., holding up a fist,
moving to push, shove) toward family members. No swearing at or about family
members.
Rule #2: Be where you are supposed to be (Be accountable for your actions). This
means at all times be where you are supposed to be (school, home, park, friend’s house,
grandparents’ house). Do not leave to go to another place without getting permission
from your dad or mom. It is your responsibility to reach us. If you cannot reach us, you
are to stay where you are or come home.
Consequences for either rule:
On the first violation, you also lose your radio for 24 hours
On the second violation, you will lose your phone for 24 hours
On the third violation, you will not be able to go to the auction on the weekend
On the fourth violation, you lose your T.V. for 24 hours.
On the fifth violation, you lose your cd-player for 24 hours.
If you have used up all of the weekend nights, it rolls over to the next weekend
Rewards
If you are respectful (rule #1) for three days in a row (no violations), OR if you are where
you are supposed to be (rule # 2) for three days in a row (no violations), you can choose
one of the following rewards approved by S & J:
1.Have an approved friend spend the night on the weekend
2.Go to mall on weekend with an approved friend
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
5
YOUNGER BOY’s Contract
Parents will determine if a rule has been broken.
Curfew is 9:00 pm on weekends
Rule #1: Treat family members respectfully. No fighting.This means no kicking,
pushing, shoving, hitting, throwing things, spitting at someone. No verbal (e.g.,
threatening to hit, kill, hurt) or physical threats or gestures of harm (e.g., holding up a fist,
moving to push, shove) toward family members. No swearing at or about family
members.
Rule #2 Be where you are supposed to be (Be accountable for your actions). This
means at all times be where you are supposed to be (school, home, park, friend’s house,
grandparents’ house). Do not leave to go to another place without getting permission
from your dad or mom. It is your responsibility to reach us. If you cannot reach us, you
are to stay where you are or come home.
Consequences For Either Rule:
On the first violation, you also lose your Nintendo for 24 hours
On the second violation, you come straight home after school the next day (no friend’s
house)
On the third violation, you lose your pool table privileges for 24 hours
On the fourth violation, you cannot ride dirt bike for 24 hours
On the fifth violation, you lose your t.v. privileges for 24 hours
Rewards
If you are respectful (rule #1) for three days in a row (no violations), OR if you are where
you are supposed to be (rule # 2) for three days in a row (no violations), you can choose
one of the following rewards approved by S & J
1.Have an approved friend spend the night on the weekend or you can spend the
night with an approved friend
2.Go fishing with a parent or approved friend on the weekend
3.Extend your curfew by 1 hour on the weekend
Monica Fitzgerald, Ph.D.
Medical Univ. of South Carolina
TF-CBT Training
6
YOUNGEST BOYS Contract
Parents will determine if a rule has been broken.
Curfew is 9:00 pm on weekends
Rule #1: Treat family members respectfully. No fighting.This means no kicking,
pushing, shoving, hitting, throwing things, spitting at someone. No verbal (e.g.,
threatening to hit, kill, hurt) or physical threats or gestures of harm (e.g., holding up a fist,
moving to push, shove) toward family members. No swearing at or about family
members.
Rule #2 Be where you are supposed to be (Be accountable for your actions). This
means at all times be where you are supposed to be (school, home, park, friend’s house,
grandparents’ house). Do not leave to go to another place without getting permission
from your dad or mom. It is your responsibility to reach us. If you cannot reach us, you
are to stay where you are or come home.
Consequences for Either Rule
On the first violation, you lose your Nintendo/Sega for 24 hours
On the second violation, you lose your phone privileges for 24 hours
On the third violation, you come straight home after school the next day (no friend’s
house)
On the fourth violation, you lose your pool table privileges for 24 hours
On the fifth violation, you lose your t.v. privileges for 24 hours
Rewards
If you are respectful (rule #1) for three days in a row (no violations), OR if you are where
you are supposed to be (rule # 2) for three days in a row (no violations), you can choose
one of the following rewards approved by S & J
1.Have an approved friend spend the night on the weekend or you can spend the
night with an approved friend
2.Go fishing with a parent or approved friend on the weekend
3.Extend your curfew by 1 hour on the weekend
