Behavior Modification Tools for Obsessions, Cravings and Addictive or Compulsive Behavior #behaviormodification #NCMHCE #OCD

NOTE: ALL Podcasts are for educational purposes only and are NOT a replacement for medical advice or counseling from a licensed professional.

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) 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