pbsi 305 exam 3 vocab

Developing a Plan

Think of your plan as occurring in stages / phases

• Different goals at different stages Two stage process of shaping behaviors:

1. Avoiding high risk situations

2. Building new behaviors

• Especially useful for consumption behaviors

Stage 1: Avoiding High-Risk Situations

Identify problematic antecedents
- External antecedents (e.g., your environment, difficult situations)
- Internal antecedents (e.g., emotions, thoughts)

In this first stage, helps to gain distance from behavior
- Build confidence in ability to resist
- Trust in own ability to avoid all together if necessary
Make sure to reward self for successful avoidance

Goal might not be to avoid high-risk situations forever
May not be possible to avoid high-risk situations forever
This is where we move to Stage 2
- Move from avoidance toward building new behaviors

Stage 2: Building New Behaviors

Application of previously discussed interventions
- Goal of substituting new behaviors
- Brain storm several possible coping strategies (new behaviors)
- Practice! (imagined rehearsal, in vivo, etc.)
- Principles of reinforcement in rewarding self for any progress
- Self praise / use of mediators
- Principles of shaping behaviors / hierarchy of difficulty

Involves approaching the high-risk situation
- E.g., going to bar with friends with goal of reducing drinking
Experiment with several coping strategies
- Useful to have a “toolbox” of several possible coping strategies
- If one strategy isn’t working in the moment, try another one
- Coping strategies can be synergistic
- If nothing seems to work in the moment, leave the situation

Coming up with Ideas

Brainstorm as many ideas as solutions for your situation as you can
- Generate a large quantity of ideas
- Do not criticize / evaluate ideas just yet
- Think creatively
- Combine new ideas to create new ones
- Can get ideas from others who have been successful

Developing If...Then Coping Plans

Develop If...Then... coping plans to help give you an idea of what to do when tempting / problematic situations arise

• If this happens, then I will....

Ways to develop useful If...Then... plans:

1. Imagine all problem situations that may arise and write out plans to deal with them

2. When unexpected problems come up and you make a mistake, work out an If...Then... plan for the next time that happens so you don’t get caught off guard in the future

Behavioral Contract for Plan

Having a signed behavioral contract can help improve success at behavior change
Explicitly stated:
- Subgoals
- Rules
- If...Then... plans
- Rewards or punishments
- Reminders of helpful self-statements
- Timelines for behavior change (be generous with yourself)
- Keep it somewhere readily available to you to be viewed / remind yourself of ultimate goal and strategies

Six Features of a Good Plan

1. Develop precise, measurable goals and sub-goals

2. Develop clear rules for behavior

3. Practice the behavior

4. Provide immediate and consistent feedback based on your self-observations

5. Compare feedback to your goals / sub-goals to track progress

6. Adjust the plan if necessary

1. Develop Goals and Sub-Goals

Must be clear, explicit, and measurable
- Allows you to provide feedback for improvement
- E.g., Reduce smoking behavior (no more smoking)
- E.g., Reduce my anxiety when talking to strangers (below a “3”)
- E.g., Use meditation to cope with stressful emotions
- Can get even more specific than all of the above
- When exactly do you want to perform (or not perform) the behavior?
- In which exact situations do you want to change your behavior?
- What exactly do you want to do?

Goals and sub-goals should be logically related
- Completing sub-goals should lead to goals
- E.g., Studying 4 nights a week > Getting A on the exam
- E.g., Complimenting friends > Improving relationships
- E.g., Jogging throughout week > Competing in marathon

2. Set Rules for Behavior

Rules are meant to guide your actions
- How you plan to implement goals and sub-goals
- Typical plans often involve many rules at once
Examples:
- Each day in class, make at least one comment to stay engaged
- Exercise for 20 minutes on Monday, Wednesday, and Friday at 7 pm
- Drink no more than one drink per hour
- Alternate between alcoholic and non-alcoholic drinks
- Introduce myself to at least one stranger a day
- Allow myself no more than 2 servings of dessert per week

Don’t set impossible rules
Rules should be specific, not general
Set rules with specific problem situations in mind
(when you are tempted is when you need them the most)
Stick to your rules / avoid lapses
Start with easier to follow rules, and increase difficulty over time (e.g., 3 cigarettes per day > 2 > 1 > 0)

3. Practice the Behavior

The “art of practicing”
Practice the parts that are hardest for you, not what you
have already mastered
Practice in vivo if you can, imagination if not
Experiment with practicing in challenging situations (but
remember to try to set self up for success)
Balance of challenge vs. frustration

4. Feedback

Continue to monitor behavior throughout the process of
behavioral change
- Should already have a plan for how to record behavior
- Try to record as soon as possible (sooner the better)
- Record information about the A-B-C’s
- Record thoughts, emotions, behaviors
Cybernetics Theory and importance of feedback
- Without feedback, how do we know if making progress or not?

5. Comparison of Feedback to Goals

Specifically set aside time to review your progress
- Make a regular appointment to review
- E.g., End of week, ~30 minutes
- Spend time going over plan and what is working or not
- Don’t “just wing it”
- If progress is not being made, consider adjustments...

6. Adjusting Plans

Expect to adjust your plan from week to week
- This is a good thing! Adapting to the situation as new information arises
- Evolution of project over time
Progress not being made
- Change of strategies? Add more interventions?
- Possibly missed important information related to behavior?
Making mistakes / not reaching sub-goals / cheating or breaking contingency
- Decrease difficulty for a bit before resuming with harder goals
- Increase difficulty slowly to allow for success
- Continue with reinforcement

Improving Ongoing Plans

Consider “losses,” “slip-ups,” or “mistakes” as information
about skills that need work
- Actually a gift!
- Learning opportunity to be used to improve your plan
Can be frustrating when we experience set backs
- How can we manage this?

Control your attention:
- Distract yourself from the frustration or negative emotion
- Focus on what to do different to prevent mistakes in future
- Don’t critically compare yourself to others
- Focus on next immediate step, “What can I do TODAY?”
- Focus on how far you have come, NOT how far you have to go

Alter your emotions:
- Recognize that developing a skill takes time and effort
- Recognize that mistakes are part of the process
- Recognize that dealing with mistakes is also a skill to be learned

Ongoing Recording

Changes / adjustments come up commonly
What about changes in recording?
- If you select a new aspect of the behavior to change, establish a new baseline if the change is substantial and abrupt
- If you select new aspect of behavior that is merely an addition to the original behavior, continue monitoring both

Examples:
- Grades > Time spent studying > Anxiety / thinking errors
- Working out > Time spent at gym > Time spent on task, sleep
- More friends > Smiling > Making eye contact / asking people to hang out

Ongoing Recording During Intervention Phase

Plan to let intervention go on for at least a week or two
before making serious changes, unless it is obviously not
working at all
Balance of not giving up too early vs. Not banging head
against the wall with faulty strategies

Evaluating Plan

Important to keep recording for sake of being able to evaluate how effective plan is

• Change is often slow and easy to miss

• Person may get frustrated, lose motivation, believe they are failing > quit program before finding success

• Monitoring progress can help prevent this and shift interpretation

Evaluation strategies:

1. Calculate an average

2. Calculate percentages

3. Use a graph

4. Calculate an average Average for the entire week can often be more helpful to monitor change than just daily fluctuations

5. Calculate percentages How often did I successfully do new behavior in tempting situation?

6. Use a graph to discover trends Plot your actual data using a graph for a visual representation

Use any of these strategies to monitor how effective plan is and whether changes should be made or adjust goals Helps remind you to set clear goals

• E.g., Reduce average anxiety rating to 6

• E.g., Improve percentage success to 80% Helps monitor whether you are making change

1. Calculate an average

Add up and divide by total number of scores
Balance of frequency of feedback, and legitimacy of data
A week is a good sample size most of the time
Most useful for intensity ratings or frequency counts

Averages for...
- Time spent studying
- Time spent exercising
- Number of cigarettes
- Number of swear words
- Time spent chewing nails
- Number of negative and positive self-statements
- Etc.

2. Calculate percentages

“How often did I successfully do new behavior in tempting situation?”
Divide number of times event occurred by total number of times it could have occurred

Example:
- "Goal is to study for 30 minutes, Monday through Friday...”
- “Only studied 3 out of 5 nights...” 3/5 = .60 or 60%
- “How can I bump that percentage up?”

Other examples:
- When tempted to smoke, use relaxation strategy instead
- When tempted to bite nails, squeezed stress ball instead
- Percentage of days I brought my own lunch to work
- Percentage of days I’ve taken a walk around the neighborhood

3. Use a graph to discover trends

Mark time intervals along the lower, horizontal axis
Mark levels of the behavior / ratings along the vertical axis
Inspect the graph to determine the pattern of progress
Graph more than one behavior/rating if beneficial

Problem Solving and Prevention

Two “time frames” for when problems can emerge when
engaging in self-modification:
- While you are actively engaging in the change project
- Relapse after the project has concluded
Expect problems to arise – and respond to them!

Problem Solving

Preparing for problems:
- Start with the best plan you can devise
- Know that some problems will emerge
- Observe difficulties / obstacles
- “Tinker with” and adjust the plan to make it more effective in dealing with the unexpected problems

Systematic problem solving

means thinking about the obstacles to your progress in a systematic way and figuring out how to overcome them

Four steps to problem solving:

1. List all the details of the problem as concretely as possible

2. Brainstorm as many solutions as you can without criticism

3. Choose one or more of the solutions

4. Think of ways to put the solutions into operation (and check to be sure you are using them)

If not making progress, consider going back to some of the earlier steps in the process

• I.e., Listing details, brainstorming, selecting a solution If making some progress, make note of that as well

• Why were things going well for a while? When did things go wrong?

• How can I alter my plan to account for the issue?

• Keep parts of the plan that worked

1. Listing details of the problem

Normally, we tend to think of our problems in an abstract way
- “I overeat” “I stress out too much” “I procrastinate”
Listing out all of the details helps us to view the problem in a more concrete, specific way
What specific situations or conditions elicit the problem
behavior?
Gives us ideas about areas where we can intervene

2. Brainstorm as many solutions as possible

Do not criticize your ideas during this part of the process
Helps encourage creative solutions to problems
Helps get out of “stuck” with no ideas
Can provide a potential list of several solutions to choose from in the heat of the moment (when problem arises)
Can have multiple tools in the “toolbox” in trying to change behavior
Unconventional strategies can sometimes be effective, even when they sound silly when first coming up with them
(hint: it’s not silly if it works!)

3. Choose one or more of the solutions

Select one that seems feasible for you to do / that you will
actually follow through with
Select ones that you think seem most likely to help
Be open to trying out solutions that might not seem logical on the surface (to you)

4. Try out new plan and monitor progress

Start trying out selected new solution
Monitor progress as you go (keep records!!)
Possible reasons for lack of progress:
- Inconsistent recording / monitoring of progress
- Not enough time for intervention to be successful
- Not properly using reinforcement and contingency principles
- Missed some key detail in step 1 that is driving the behavior
- Problem with the strategy itself (not an effective strategy)

Problem Solving

Ask yourself: What is making it difficult for me to perform the desired behavior?
- Antecedents
- Behaviors
- Consequences

Antecedents – What antecedents or triggers are getting in
the way?

Emotional states (depression, anxiety, fear, stress)
Old thinking habits
Tempting thoughts
Situational cues / stimulus control
Environmental barriers

Behaviors – Have the correct behaviors for change been
selected, and are you practicing them?

Include behavior to increase as important part of plan
Plan for specific behaviors
Setting attainable initial goals (shaping)
Practicing behaviors ahead of time

Consequences – What consequences are getting in the way of change?

Still being reinforced for old, problem behaviors?
Use reinforcement for new, desired behaviors
Rewards / punishment must be contingent on behavior
Relying too much on punishment / not enough on reinforcement?
Too much time between behavior and reward?

Common Problems in Self-Modification

Staying focused
Discouragement
Ambivalence
Stress
Alcohol / Mind-altering Substances
Self-Control Fatigue

Staying focused

Self-change requires consistent focus
Lack of adequate self-observation is a common reason why people fail at self-change
- “I’m tired of recording! Can’t I stop now?”
Keep recording the behavior until it becomes automatic
If you stop recording and behavior stops, may need to keep
recording

Sources of Discouragement

Lack of progress
Negative beliefs about change
Discouraging people in life

Lack of progress / progress slowing down

Can be frustrating / discouraging
Tempting to stop keeping records because records say what we don’t want to hear (i.e., things are not going well)
Can lead to avoidance / abandoning project completely
Important to stick with recording to find out where going wrong
Are my goals unrealistic? Any improvement is better than none at all / completely giving up
Progress often slows down after early, initial stages of change
Set mini-goals to encourage you along the way

Negative beliefs about change

Person does not truly believe they can change
Monitor your own thinking, track successes as well as failures, take credit for small successes
Person does not think the techniques can work
Try the techniques first, THEN evaluate them

Discouraging people in life

People in life may be discouraging or actively punishing your change efforts
Well-meaning temptations
Not-so-nice sabotage
Avoid these people or assertively confront them

Ambivalence

Person may not really want to change, or is not at a place in their life where they are ready to change
Stages of Change model
Are you truly giving it your best effort?
Use strategies to reward behavior, increase motivation, self-efficacy, etc.
Note: Difference between “lack of motivation” and lack of progress from other issues (lack of motivation vs lack of skill)

Stress

Stress takes your attention away from self-change
Often gets in the way of self-change
May be best to first learn to better cope with stress or reduce stress in your environment (refer to previous strategies for stress / relaxation)

Several ways stress interferes with change
- Unhealthy coping behaviors
- Exhaustion
- Frustration / hopelessness

Alcohol / Mind-altering Substances

Many substances reduce our self-control and self-awareness
Much more likely to give in to unwanted behaviors when under influence
Generally avoid these when in problem situations

Self-Control Fatigue

The more we have to rely on self-control, the more vulnerable we become to temptation
- I.e., I resisted the offer of cake, but now there are donuts at home
Self-control decisions also harder later in the day
Use distraction, avoidance of situation, or remind self of coping plans

Lapse

is a short-term slip or a mistake
- Have a few smokes, overeat for a weekend, skip out on studying for a week, make some negative self-statements, etc.

Relapse

is a return to previous, full-blown pattern of unwanted
behavior
- Quit trying to lose weight, stop smoking, etc.
- Not just about addictions, but any unwanted behavior

Trick is to expect lapses, to keep them from becoming relapses!

Abstinence Violation Effect

Person sets standard / rule for self of total abstinence (zero tolerance for any unwanted behavior).
- Any lapse is considered a violation of this rule
- Guilt, self-blame, decrease in self-efficacy > increase probability of full relapse
- Now have even MORE negative emotions to serve as triggers for unwanted behavior!

High-Risk Situation

A situation that presents a greater than usual temptation for unwanted behavior

1. Being emotionally upset

2. Social settings in which you are tempted

3. Consuming alcohol / mind-altering substances

4. Unanticipated tempting situations

1. Being emotionally upset / high emotionality

Extreme moods often trigger many of our unwanted behaviors
Many of us use unwanted behaviors to regulate our mood
If you use the unwanted behavior to regulate mood, specifically look for other ways to manage your mood instead

2. Social settings in which you are tempted

People in our lives can encourage our unwanted behavior
Social settings can be inherently tempting
Avoid problem situations, ask for support, assertively confront discouraging others, or develop coping strategies for tempting situations

3. Consuming alcohol / mind-altering substances

Reduces our self-awareness and self-control
Increases risk of lapsing into old behaviors

4. Unanticipated tempting situations

Try to plan ahead with coping strategies as much as possible
Have a general coping plan for unanticipated scenarios
Use unanticipated situations to plan for next time

Identifying High-Risk Situations

Important to identify our own high risk situations
Emotions, thoughts, tempting situations
Be more aware of our own seemingly “unrelated” decisions that lead to unwanted behavior
Ambivalence and denial can lead us to put ourselves into high-risk situations without realizing it
- E.g., “It just happened!”
Ask self: “Am I tempting myself here? Do I want to do that?”

Coping with High-Risk Situations

1. Avoid temptation when possible

2. Replace “hot” thoughts with “cold” ones

3. Remind self of long-term goal and why important

4. Remind self that cravings often pass quickly

5. Encourage yourself in your resistance of temptation (self-efficacy)

6. Remind yourself of past successes in a resisting (self-efficacy)

7. Acknowledge tempting thoughts in a calm, detached manner

8. Distract self

9. Plan ahead of time for your own attempts at rationalization: “I’m going to tell myself that ‘it’s just one drink’ later, do not listen to that statement”

Acquiescence

Pattern of consenting to unwanted behavior after a small lapse
- “Oh what the heck, I may as well drink as much as I want now”
- “I already screwed up, may as well just enjoy it”
- Another reason why lapses > full relapses
- Challenge these thoughts! Never too late

Coping with Lapses (Relapse Prevention)

Coping with lapses and guilt
- Excessive guilt / shame can increase risk of relapse
- Cycle of negative emotions and unhealthy coping strategies

Change requires acknowledging our own shortcomings /
mistakes... but excessive guilt increases our risk of relapse
- Difficult to find balance

Responsibility and Guilt

What is the point of guilt?
- Helps us to acknowledge when we made a mistake
- To learn from our mistakes / prevent behavior from happening again in the future
- Some guilt is normal and probably helpful

Excessive guilt / shame is problematic
- Increases negative emotions > risk of relapse
- Can lower self-efficacy
- Lower overall quality of life

May use some of the strategies discussed in class to deal
with excessive guilt / shame
- Thought substitution
- Challenging cognitive distortions
- Acknowledging influencers of behavior

Thought substitution
- “I did the best I could at the time”
- “I deserve to love and have value. Making a mistake doesn’t erase that”
- “I’ve beat myself up enough – it will just make things worse”
- “Instead of beating myself up for the past, I want to focus on doing better in the future”

Challenging cognitive distortions
- “Just because I made a mistake doesn’t make me a bad person”
- “Even though I’ve made mistakes, I can still try to do better in the future”

Our behavior is influenced by:
- My own thoughts, emotions, choices, past learning, etc.
- The effects of the environment
Can acknowledge, feel remorse over my actions
Can also acknowledge the role the environment played

Moving Past the Guilt

If possible, apologize and make amends for those you
have wronged
Focus on learning from past mistakes for the future
How can I do better moving forward?

Maintaining Behavioral Gains

Even after we have developed new, positive behaviors, we are at risk for them dropping off

• New behaviors are not yet entirely habitual

• Can be thrown off course by unexpected problems that can break the positive habit

• Behavior falls off again

Problems in behavioral change:

1. Relapse: Return to previously high levels of problem behavior

2. Maintenance problem: Return to previously low levels of positive behavior

3. Transfer problem: Positive behavior not generalizing to other areas

Relapse problem:

• Resume high levels of drinking / smoking behavior Maintenance problem:

• Spent time throughout the semester increasing time studying

• Grades improving

• Time goes by, study behavior drops off Transfer problem:

• Study skills increased in English courses

• Still not studying for science or math courses

Set up natural reinforcements / punishments

It’s difficult to maintain positive behaviors most of the time (especially for an entire lifetime)
Plan natural situations (experiences) that will reinforce your new competence without punishing you for skills you still lack
Try to set up your environment to be rewarding for your positive behavior
Experiment with your new behavior in environments where you are likely to find success

Examples of setting up natural reinforcements:
- Social anxiety > Putting self in situations where you are likely to be social and successful, make new friends
- Better study skills > A fresh course (instead of one you have historically struggled / found dreadful)
- Improving assertiveness > Use it with less aggressive / intimidating, more reasonable people first

Strategies to Maintaining Behavioral Gains

When you plan for self-change, use continuous reinforcement schedules (reinforce behavior every time it occurs)

• Remember: continuous reinforcement results in faster learning However, in the “real world,” every instance of our behavior is not normally reinforced

• When applying new behavior to the real world and positive reinforcement no longer occurs, may find that behavior quickly extinguishes (remember: extinction principles)

To guard against extinction, switch reinforcement schedules from continuous (every time) to intermittent (some of the time)

• Process called “thinning” the reinforcement schedule Principles of reinforcement schedules:

• Continuous reinforcement > Faster learning

• This is better for early stages, when still learning behavior

• Intermittent reinforcement > More resistant to extinction

• This is better for maintenance, or continuing the behavior over time

Thinning process (switching to intermittent reinforcement):

1. Continue to record behavior

2. Provide less frequent reinforcement (e.g., less often, or require more of the behavior to get reward)

3. Keep practicing behavior

4. If behavior reverts too much back to unwanted levels, go back to continuous reinforcement or a more frequent intermittent schedule temporarily

Ask for reinforcement from others

It’s okay to ask for feedback! It is not bragging
Getting reinforcement from others can help maintain our gains
Again, set self up for success here
Ask for reinforcement from people who you believe are more likely to be reinforcing
Don’t be shy – ask for feedback

Examples:
- “How do you think I performed on the field today?”
- “How do you think I handled that social event?”
- “How did I do lifting today?”
- “What do you think about the way I handled our disagreement?”
- “How does this new outfit look on me?”
- “Have you noticed my nails?”

Strategies to Maintaining Behavioral Gains 2

Person believing “it was all the course / therapist”
“I’ll just revert back to my old ways”
Lack of self-efficacy, perceived personal “lack of self-
control” or failing as a person
Person will therefore make less effort to try to control it,
and which reduces chances of success

Building confidence / sense of self-efficacy

Recognize that the problem behavior is coming more under your control over time
Before you stop your formal self-change project, use the following rating scale:
my estimation of my ability to control my behaviors without my self modification plan is ...
1 no chance at all --> 5 total certainty

Rating scale

If score below 4, then not yet time to stop formal project
Ask yourself, “Why isn’t my confidence higher?”
Answer will guide you to what you should do to improve your confidence:
- “I still binge eat frequently” > Keep working
- “I keep telling myself I can’t do it” > Focus on more positive statements, recording instances of success, etc.

Strategies to Maintaining Behavioral Gains 3

You may decide to continue part of your plan for a long time, especially the self-observation and recording (which is probably most important part) Recognize that your ability to control your behavior will vary based on different situations

1. List the challenging situations in which you will be tempted

2. Rate your confidence in each situation to resist

3. Continue self-change procedures for situations where you still lack confidence

Strategies to Maintaining Behavioral Gains

Some stress in our lives is good –
- Motivates us to work / put in effort
- Many of life’s goals require effort to achieve (which can be stressful)

Stress can also be a source of relapse / maintenance issues

How to protect ourselves from negative effects of stress?

Stress Proofing Yourself

1. When anxious, welcome it as an opportunity to practice and improve your skills of self-control

2. Practice taking time to relax every day

3. Don’t let stress build up – notice it and do something

4. Look forward, not back

5. Avoid getting overtired

6. Build pleasurable activities into your life (as long as not problematic or goes against long-term goals) - non-contingent positive events

7. Recognize your achievements and praise yourself

8. Don’t avoid what you fear

Behavioral Gains

Maintenance problem:
- New behavior is successfully developed
- Over time, positive new behavior drops off

Transfer problem:
- New behavior learned in one specific scenario
- New behavior is not performed in different scenarios when desired

Principles of Transfer

Transfer effects can be very specific to the situation
Your new behavior may not transfer to new situations if
you don’t make a conscious effort to make it transfer
To transfer your new skills, you need to practice

Tips for Transfer

Practice the new behavior in a variety of situations
Skills are more likely to generalize / transfer from one
situation to another, the more similar those situations are
Bring along a friend to different situations!
Look for opportunities to practice
Use self-instructions to guide your behavior
Make use of overlearning (next slide)

Overlearning

is concept of continuing to practice even after you can do the behavior perfectly
- Batting cages and practice
- Practice the ‘perfect behavior’
- Leads to better consistency
Don’t practice “just” until you can do the behavior perfectly one time
- Keep practicing until performance is consistently perfect

Perfectionism

Don’t give up if you have not reached your ‘perfect’ goal
- E.g., Skill at an instrument, grades / studying
May have to settle for less than perfect sometimes (and that’s okay!)
Perfectionism and society’s standards

Balance of acceptance and commitment to change
Can desire things to be better and work towards that goal,
while still being accepting of yourself
If after many attempts at change and still struggling, might wish to ask, “Can I accept the situation where it is at right now and still be happy?”

After the Course

What’s next for you after this course?
Living a self-directed life
- Having goals to work toward and strategies to achieve them
Start planning for next goal
- What might be issues coming up for you in the future?
- What other behaviors might you wish to work on?
- What do you need to work on now to obtain your goals over the next year? 5 years? 10 years?
- Think of self-change as a skill
- Keep practicing and applying the skills in this course for variety of behaviors

Seeking Professional Help

Sometimes, need aid of a professional to obtain desired change in our lives

1. Trouble setting clear, personal goals (which allows us to select new behaviors to change)

2. Trouble applying the information learned through the class / textbook and coming up with own plan

3. Person’s environment is too chaotic or unyielding for plan to succeed

4. Person’s emotions may be so powerful that they interfere with the person’s ability to effectively plan and implement project on their own

Mental health professionals help you help yourself

• They don’t solve the problems; they help you develop the skills to solve them yourself

• They create an environment that fosters efforts to change

• They help establish situations that encourage developing new behaviors, thoughts, emotions

Search for a professional that meets your current needs on:

• Interpersonal style

• Expertise / appropriate training / credentials

• Flexibility

• Price Shop around if necessary – most therapists are aware of this and that not every therapist is a good match for every client

What is Happiness?

Can mean many things to many different people
Generally, happiness comes from:
- Attaining pleasure
- Minimizing / avoiding pain
- Feeling that life has meaning
- Satisfaction with life ** (used in research)

What is Happiness? (Genetics and set points for mood)

What influences a person’s happiness?
- Genetics and set points for mood

Set point

General baseline level of a characteristic, around which we tend to fluctuate
- E.g., Weight, mood

What is Happiness? (Life circumstances (positive or negative)

What influences a person’s happiness?
- Genetics and set points for mood
- Life circumstances (positive or negative)

What is Happiness? (Our behavior)

What influences a person’s happiness?
- Genetics and set points for mood
- Life circumstances (positive or negative)
- Our behavior

What is Happiness? 2

What influences a person’s happiness?
- Genetics and set points for mood
- Life circumstances (positive or negative)
 Our behavior
 Notice only one of these is truly under our control
 Genetics / life circumstances account for about 60% of variation
 Behavior accounts for about 40%
 The most effective thing we can do is engage in the behaviors that most often lead to happiness

Activities to Increase Life Satisfaction

Target behaviors to increase happiness or life satisfaction:
- Reduce negative emotions / increase positive emotions
- Acknowledge the positives in your life (“count your blessings”)
- Improve your lifestyle
- Spend time socializing
- Prosocial behavior / being kind to others
 Striving for important personal goals

Reduce negative emotions / increase positive emotions

- Build positive experiences into life
- Work on identifying rumination, negative thought patterns, and practicing thought substitution or other useful techniques
- Make use of relaxation techniques
- Make list of positive things about self, important people in life
- Review all things accomplished at end of day, even seemingly small things

Acknowledge the positives in your life

- Even minor, everyday occurrences
- Try to vary it up and come up with new things on list every other day

Improve your lifestyle

- Increase exercise
- Decrease substance use
- Improve diet
- Reduce stress / increase relaxation activities
- Quality of sleep

Spend time socializing

- Close relationships commonly listed as one of the main sources of happiness for people
- Interacting with others is a common, important source of positive reinforcement and pleasant experiences in our environment
- Lack of socializing / isolation tied to depression, vicious cycle

Prosocial behavior / being kind to others

- Volunteering, complimenting others, donating blood, etc. - Expressing sincere gratitude - Practicing forgiveness

Forgiveness

What is forgiveness?
- Letting go of resentment, forgoing revenge, and not holding on to negative emotions (angry rumination)

What does forgiveness not mean?
- It does not mean you condone their behavior, that their
behavior was justified, or that the person did not wrong you in some way
- Also does not mean you must allow the person to remain in your life

Forgiveness 2

Ultimately, forgiveness is for your benefit, not theirs

• Continuing to hold on to anger / resentment harms us more than them

• Allows you to move on with your life without resentment weighing you down

• Easier if you are able to come to some understanding as to why person might have acted as they did

Striving for important personal goals

Humans like for life to have meaning
Freud: “Work and love” fundamental to good psychological health
Anything that takes the form of putting productive energy toward something of personal value
Commonly involve career, related education
Can include volunteering, artistic pursuits, etc.
Areas in which we give meaning to life

Giving Life Meaning

Four broad dimensions of behavior in which we can strive that produce a meaningful life:

1. Life work dimension: Feeling committed to our work and feel that it gives our life meaning

2. Spiritual dimension: Spiritual connectedness to the world around us; may involve conventional religion, general connectedness, joining a community of like-minded others

3. Relationship dimension: Intimacy and close relationships with others

4. Social dimension: Benefiting society in some way; leaving something good behind in the world

Relationship between Money and Happiness

People who are wealthy tend to be happier than people who are poor
- Difference largely due to the struggles and stress of being poor, rather than the excesses of being wealthy
- E.g., Not having adequate housing, inability to clothe or feed self or family, working multiple low-paying jobs, cannot afford medicine, unable to afford life’s necessities

What does research say, then?
- Increasing wealth seems tied to happiness... up to a point
- Once person is above poverty level, diminishing returns in middle-class and above
- $5k a year vs. $25k a year (compared to) $100k a year and $125k a year

What does research say, then?
- Able to afford basic necessities without worrying about finances, able to afford some additional leisure activities
- Social relationships / connectedness overall better predictor of happiness / life satisfaction

The Pursuit of Happiness?

The pursuit of happiness can sometimes be counterintuitive
- People can set unrealistic goals of obtaining ‘happiness’
- Unrealistic expectation of being happy all of the time
- Disappointed or frustrated with reality
- “Why aren’t I happier!? There must be something wrong with me!”
- Put so much pressure on ourselves to “be happy” that we forget to appreciate what we have and live in the present moment
- Miss out on the good things right in front of us
- Always chasing that next ‘thing’ that will finally ‘make me happy’

- Much better tactic is to take small steps to improve your life over time (more regular sleep, exercise, setting small achievable goals, making / maintaining social relationships, etc.)
- Happiness / life satisfaction will follow
- Even still, no one feels ‘happy’ all of the time
- That’s okay! The broad spectrum of emotions is a natural part of the human experience

Psychotherapy Interventions Modalities

Huge number of different types of psychotherapy:
- Psychodynamic therapy
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Cognitive Processing Therapy (CPT)
- Acceptance and Commitment Therapy (ACT)
- Humanistic Therapy
- Interpersonal Therapy (IPT)
- Group-Based Therapies
- Family Systems Therapy
- Parent Child Interaction Therapy (PCIT)
- Etc....

Intervention Styles of Psychotherapists

Therapists generally don’t restrict themselves to only one type of therapy
- They do, however, tend to have a select few types of therapy that they most specialize in, have the most experience with, or are most comfortable with
- Different types of therapy generally call upon different skillsets that require some level of training to use properly
- Cannot “master” every set of techniques
- E.g., Someone who specializes in CBT and DBT, but is not trained in Psychodynamic Therapy

Differences between therapeutic interventions
- Interventions may look different when being used with different populations, or be more effective with some populations than others
- E.g., CBT with young children versus with adolescents versus with older adults
- Interventions may also be more effective for some disorders than others
- E.g., DBT for Borderline PD, CBT / IPT for Major Depression

So, generally...
- A therapist cannot master every set of techniques
- Different techniques work better for different disorders
- Different techniques work better for different populations

Fit between Therapist Style and Patient

Remember previous conversation about choosing a therapist:
- Is the chosen technique appropriate for treating the type of problem the patient is facing?
- Does the therapist have training in using said technique?
- How does the patient respond to that particular technique?

Common Factors in Psychotherapy

History of debate about the effectiveness of various forms of therapy
Around the 1960s, discussion began about whether there were common factors that account for the effectiveness of psychological treatment
- Different psychotherapies may use different specific tools, conceptualize psychopathology in a different way, and use different terms...
- But many have similar underlying principles
This led to Common Factors Theory
- Specific forms of therapy are a medium through which common factors operate and have their influence

Common Factors

Therapeutic Alliance
- Most researched common factor
- Bond / relationship between therapist and patient
- Agreement on treatment goals and methods to get there
Empathy
- Ability to understand and share the feelings of another
- Effort toward understanding their emotional experiences
- Lack of judgment
Expectations for benefits of therapy
- Placebo effects and the belief that things will change actually result in change
- Think back on self-efficacy

So why even bother with having specific treatments and training?
- Common Factors is not a “treatment style”
- Characteristics of the interaction as a whole
Patients benefit from having their case conceptualized, giving them an understanding of how their symptoms came to be, and what can be done about them
- Different models address this differently
- Not addressed by common factors
Intervention modalities are the vehicle (or structure) through which common factors have their influence
- E.g., Exploring patient’s history and showing empathy

Psychodynamic Therapy

Probably most common therapeutic technique displayed in media
- E.g., Person lying down on a couch, facing away from the therapist, talking about their childhood

Based on principles of psychoanalysis
- Within a person, we have both a conscious mind that we are aware of and an unconscious mind of which we are not aware
- Idea that unconscious thoughts and emotions that are being repressed are negatively influencing our behaviors
- These thoughts and emotions can be accessed through psychoanalysis
- “Make the unconscious > conscious”

Sometimes we have strong conflicting feelings that are too difficult for us to acknowledge
- E.g., “I hate my mother” but also “It’s wrong to hate your own mother” results in conflict, true feelings are buried deep down
- Underlying, unconscious conflict drives negative emotions

If we can identify, acknowledge, and learn to cope with these unconscious / repressed thoughts, we can begin to improve / heal
- E.g., Become more aware of our own “baggage”
- Promote insight into our own behavior and relationships
- Helps us to acknowledge previously repressed emotions / thoughts from childhood (which we could not handle at the time)
- Now, as adult, have the tools to better cope with what was too much for us at the time

How does it work?
- Therapist encourages patient to speak freely about anything that comes to mind (fears, desires, dreams, fantasies)
- Promote an environment free of judgment where person reflects on and analyses their own thoughts and emotions (insight)
- Therapist helps point out themes and promote insight
More long-term treatment style (can take months to years of work to see improvement)
- May be less useful for young children

Repression and Unconscious Thoughts

As young children, we sometimes have difficult or traumatic experiences that bring about strong, negative emotions
As a child, we do not have the cognitive / emotional resources to cope
These difficult emotions are repressed into our unconscious mind
These unconscious experiences / emotions / thoughts stick with us
Continue to influence our behavior, despite not having awareness of them
E.g., Relationship with a parent who was neglectful and person developing a deep sense of insecurity in their relationships

Cognitive Behavioral Therapy (CBT)

Emphasis:
- Our thoughts, emotions, and behaviors are all interconnected and influence one another
- By intervening to change one, we influence the others

Basic (behavioral) principles:
- Psychopathology can be understood as a behavioral pattern
- May have developed over a long time
- Important to understand what factors are influencing their behavior
- Intervention needs to be done around one of the three pillars (thoughts / emotions / behavior)

Changing Thoughts:
- Analyzing thoughts / challenging thinking errors
- Thought substitution
Changing Behaviors:
- Behavioral activation
- Operant conditioning to shape behavior (using reinforcement)
Changing Emotions:
- Relaxation techniques
- Mindfulness meditation

CBT and Distorted Thinking

Aaron Beck (CBT; Cognitive Behavioral Therapy) calls self-statements “automatic thoughts” and maladaptive assumptions “distorted thinking” Automatic thoughts are:

1. Almost always believed

2. Experienced as spontaneous

3. Make use of “should,” “ought,” or “must” statements

4. Tend to “awfulize” or catastrophize

5. Unique interpretations to each person

6. Persistent and self-perpetuating

7. Learned patterns of thinking

Common Thinking Errors

1. All-or-Nothing thinking – “If I fail this test, I’m worthless as a person”

2. Overgeneralizing – “I’m having trouble making friends this semester, no one likes me”

3. Filtering out the positive – Not recognizing the good things about themselves

4. Mind-reading – Making assumptions about what other people are thinking

5. Catastrophizing – “If they dump me, my life is over!”

6. Labeling – “I’m a bad parent”, “I’m a loser”

7. Fortune-telling – Predicting the future