Behavior Modification Tools for Obsessions, Cravings and Addictive or Compulsive Behavior
#behaviormodification #NCMHCE #OCD
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Objectives
Review basic behavior modification interventions and their utility with addictive and compulsive behaviors
Baseline
To understand a behavior you first need to understand the
Frequency
Intensity
Duration
Vulnerabilities
PACER proximal triggers (Discriminative stimuli)
Compliance is enhanced with checklists
Behaviors
Obsessions/cravings or compulsions/addictive behaviors that take more than 1 hour per day and/or cause clinically significant distress
OCD: thoughts about…; Counting, checking, washing…
Body Dysmorphic: thoughts about…; Fixing, covering up, checking
Addictions: thoughts about…; using
Recovery
Sleep, exercise, nutrition, pain management; biofeedback
Happiness promoting
Positive thinking
Working Toward Change
Natural consequences
Rewards / Reinforcement (Individualized)
Increase the likelihood of a behavior
Positive Reinforcement
Adding something positive
What positive consequences exist if you change your behavior? (PACER)
Negative Reinforcement
Taking away something unpleasant
What unpleasant thing will be removed if you change your behavior? (PACER)
DEcrease the likelihood of a behavior
Positive Punishment
Adding something negative
Functional Analysis
Explores the vulnerabilities and triggers for and functions of the behavior
Behavioral Alternatives
3:1 When you remove a behavior replace with a menu of 2 or three others
Competing Responses (Hint: Look for exceptions)
Chew gum while cooking
Crochet while watching television
Journaling instead of checking
Playing with your kids instead of smoking
Sing when going over a bridge
Call a friend/sponsor when triggered
Nicotine gum
Aversion
Drinking: Antabuse
Non-hunger eating: Only keep low preference foods available (celery, rice cakes)
Compulsive behaviors: Pushups, squats, hold ice cubes, rubber band snap, pictures to remove the desire
Response (Delay) Prevention
Journaling (book, online, checklist)
What, why, alternatives
Calling friend/sponsor
Time delay and distress tolerance activities
Distance
Website firewalls and internet lockouts
Don’t keep substance in the house
Successive Approximations
Goal is to stop the addictive or compulsive behavior
Reduce frequency, intensity or duration
Smoking
Non hunger eating
Ruminating / “obsessing”
Checking
Picking / Hair pulling
Scaffolding
Scaffolding is similar to successive approximations, but uses a support to help you get the rest of the way to your goal
Get as far as you can then call your sponsor/coach
Notice
Stop
Choose an alternative
Do the alternative (get into your wise mind)
Evaluate the triggers and vulnerabilities and identify ways to prevent the problem in the future
Summary
Behaviors are triggered by PACER discriminative stimuli
Vulnerabilities make people more likely to be triggered by discriminative stimuli
Behavior modification seeks to
Implement new rewarding behaviors that are desirable and either prevent vulnerabilities or aid the person in coping with distress
Make undesirable behaviors less rewarding
NOTE: ALL VIDEOS are for educational purposes only and are NOT a replacement for medical advice or counseling from a licensed professional.
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