Coping and Behavior Modification

1. Journey to Recovery:
Behavior Modification Basics
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs
Host: Counselor Toolbox
AllCEUs.com Unlimited CEUs and Specialty Certifications $59

2. Objectives
 Define behavior modification
 Explore how behavior modification can be useful in
practice
 Learn basic behavior modification terms:
 Unconditioned stimulus and response
 Conditioned stimulus and response
 Discriminitive stimuli
 Learned helplessness
 Reinforcement
 Punishment
 Extinction Burst
 Premack Principle

3. Why Do I Care
 Behavior modification principles will help you
understand some of the reasons people act/react the
way they do
 By understanding what rewards(causes and motivates)
people’s behavior or discourages (punishes/Strains)
their behavior, we can better address their issues
 The focus on observable, measurable conditions to
the exclusion of cognitive interpretation underscores
the mind-body connection

4. How can this
be useful in
practice
 Traditional (strict) behavior
modification can be quite useful
in simplifying stimulus/reaction
 Integrating the cognitive
interpretations (labels) can help
people in identifying and
addressing what is causing their
“distress” (Behaviorists would
refer to excitatory response)
 Understanding what causes
feelings can also give people a
greater sense of empowerment.

5. Example
 Organisms learn behavior through direct and
observational reinforcement and correction
 Puppy 1 tackles puppy 2  threat
 Puppy 2 responds by tackling puppy 1  counter threat
 Both puppies get a surge of adrenaline
 The puppy that dominates receives a dopamine surge
that reinforces the prior behaviors --- do that again.
 If Puppy 1 plays too rough, then puppy 2 will either
become more aggressive or leave.
 Either way, puppy 1s behavior is punished.

6. Example 2
 In addition to direct and observational learning,
humans learn to label certain internal experiences
with feeling words (angry, scared, happy)
 Sally goes to a pet store.
A puppy comes out, sits in her lap and puts is head on her
leg. This contact (we know from studies) usually causes
the release of dopamine and oxytocin –both reward
chemicals. Sally calls this “happy”
If Sally had previously had a threatening experience with a
dog, when she saw it, her body would likely respond by
secreting adrenaline, kicking off the fight or flight
reaction. Sally would label this as “fear”

7. Points
 People with dysphoria or unhelpful behaviors may
need to:
 Recondition X is not actually a threat (anymore)
 Relabel the state
Stressed vs. hungry vs. bored vs. tired
 Explore the dialectics: Excitement/Fear
 Unhook– X is causing me to have the feeling that…

8. Basic Terms
 Unconditioned stimulus and
response
 Something that evokes an
unconditioned/automatic
response in an infant and adult
Loud noises
Pain
Excessive cold/heat
Contact

9. Basic Terms
 Conditioned Stimulus
 Something that in itself has no
meaning to the person (yellow light)
 Conditioned Response
 The person’s reaction to the stimulus
(slow down or floor it)
 Stimuli and responses can be
traced back to survival: Fight-Flee-
Forget-Repeat

10. Basic Terms
 Discriminitive stimulus
 The stimulus which triggers the
reaction. (Includes vulnerabilities)
Going to work
 Good day
 Bad day
 Learned Helplessness “Damned
if I do, damned if I don’t”
 A response which occurs when
people have tried and failed.
Giving up.

11. Fight or Flee
 Stimuli that present a threat of pain or death can
trigger the excitatory fight or flight response
 A useful intervention is to identify
 The threat
 If it is actually a threat
 Break down parts of the situation into controllable and
uncontrollable

12. Conditioning
 Mindfulness can help people identify
 Positive stimuli  dopamine  “happy”
 Negative stimuli  adrenaline  fight or flee
Little things build up and lead to a big reaction.
(Pressure cooker)
 Stimuli that trigger a negative reaction can be
reconditioned as neutral by
 Embracing the dialectics: Find the positive (snowy day)
 Being psychologically flexible: Not worth the energy
(rainy day)

13. Conditioning: Repeat
 Adding and noticing positive stimuli in the
environment is vital
 Happiness Triggers
Smells (pumpkin spice…lol)
Sights (wildlife, my kids)
Sounds (babbling brook)
Feel (crisp autumn breeze)

14. Putting it Together
 How can you use discriminative stimuli to:
 Increase a feeling of control and “self-efficacy”
(Remind them to have a can-do attitude)
 Increase “self-esteem” (Remind them they are lovable)
 Decrease angry responses (Remind them to use coping
or distress tolerance skills)

15. New Terms
 Positive Reinforcement
 Providing something positive in
order to increase the likelihood a
behavior will occur again
 Examples
Touch
Gifts (Food, Money (Paycheck))
Words of Affirmation
Acts of Service
Power (Choosing activities,
promotion)
Quality Time
 What can be added that is
rewarding AND helpful for the
person

16. New Terms
 Negative Reinforcement
 Removing something negative in order to
increase the likelihood a behavior will
occur again
 Examples
 Reducing nagging and fighting
 Dropping restitution or additional charges
upon completion of counseling
 Can leave the table once vegetables are
eaten
 What can be eliminated that would be
considered rewarding AND helpful for the
person

17. New Terms
 Positive Punishment
 Adding something negative to
decrease the likelihood that a
behavior will recur
 Examples
 Antabuse
 Additional Chores
 Additional sessions
 Rubber band snaps
 What can be added that would be
considered unpleasant for the
person

18. New Terms
 Negative Punishment
 Removing something positive to decrease
the likelihood that a behavior will recur
 Examples
 Freedom/privileges
 Money (Fines)
 Relationship/Setting boundaries to stop a
behavior
 Control/power
 What can be eliminated that would be
considered desirable?
 You cannot just eliminate a behavior.
You must put something in its place.

19. Types of Rewards and Punishments
 Rewards and Punishments can be:
 Emotional (Happiness)
 Mental (Improved decision making, cognitive clarity)
 Physical (Appearance, health, pain, energy, sleep,
relaxation)
 Social (Acceptance, admiration, support)
 Spiritual/Karmic
 Financial
 Environmental (freedom, pleasant conditions)

20. Apply It
 The more rewards that can be gained the stronger
the motivation to repeat the behavior

21. Apply It
 Behavior 1: Social Withdrawal
 Social withdrawal is rewarding mainly due to negative
reinforcement (elimination of the unpleasant)
Old Behavior: Social
Withdrawal
New Behavior: Social Support
Benefits Avoid extra stress
Won’t disappoint anyone
May increase depression
More time with my cats
Won’t burden anyone else
Buffer against stress
Can increase positive
neurotransmitters
(serotonin/oxytocin)
Drawbacks Does not help Some friends will disappoint
Not everyone will understand
I will feel needy

22. Apply It
 Behavior 2: Emotional Eating
Emotional Eating Coping Behaviors
Benefits Love food
Comforting—releases dopamine
and serotonin
Easily available
Help me eat when I am hungry
Can enjoy food when I am eating
Assist in addressing the problem
Drawbacks Gain weight
Feel bloated
Feel weak
The problem is still there
Can disrupt sleep
Embarrassed to eat in front of
others
Compulsions are hard to overcome
Coping behaviors are not as
satisfying

23. New Term
 Behavior Strain
 The point at which the
reinforcement or punishment is
no longer effective
 Effected by:
Age
Cognitive development
Strength of the reinforcement or
punishment
 Smaller, more frequent rewards
for completion of smaller goals:
Provide rapid benefits
Maintain momentum

24. New Term
 Extinction Burst
 A temporary increase in a behavior when
rewards are absent or insufficient
 Child in the store
 Pigeon wanting food
 “Acting Out”
 The behavior ceases when the
demands/costs of the behavior exceed
the potential reward
 What the person is doing for a promotion
 What the person is doing to feel
better/get his way

25. New Term
 Premack Principle
 Concurrently pairing something
undesirable with something
desirable
 Examples
Laundry folding with watching
television
Exercise with
socialization/puppy time/nature
Studying with peer support
Cleaning with
music/tv/aromatherapy
Work with coffee

26. New Term
 Shaping
 Rewarding the successive approximations of
the target behavior
 Punishing or ignoring non-target behaviors
 Ignore if negative attention is better than
no attention
 Solidify gains
 Withhold reward for a higher level of target
behavior
 Goal: Brewster meet me at the door
quietly and sitting
 Target behavior 1: Not jumping
 Target behavior 2: Sitting on command
 Target behavior 3: Sitting when I walk in
without command

27. Apply It
 Shaping
 Cutting Behavior
Target Behavior #1: Ice cube or ink pen
Target Behavior #2: Alternate self-soothing behavior
 Stress Eating
Target behavior #1 Fruit on a plate + mindfulness
exercise (premack)
Target behavior #2 Drink + mindfulness exercise
Target behavior #3 Mindfulness exercise

28. New Term
 Chaining
 A cascade effect leading to a
behavior
 Behaviors, stimuli,
reinforcements and punishments
that lead up to a positive or
negative result

29. Apply It
 Example 1: Car problems
 Slept well
 Get up on time (Monday
morning)
 Get ready for work
 Eat breakfast
 Start driving to work and
the car breaks down
 “Get Irritated”
 Call for assistance
 Example 1a: Car
problems (dysregulation)
 Didn’t sleep well
 Get up late(Monday
morning)
 Get ready for work
 Eat breakfast and spill
coffee on your shirt
 Start driving to work and
the car breaks down
 “Get Angry”
 Cannot think straight

30. Apply It
 Example 2: Stress Eating
 Bad day at work
 Come home
 Start eating
 Feel better
 Example 3: Panic Attack
 Didn’t sleep well
 Get up
 Drink 2 cups of coffee
 Get stuck in traffic driving to work
 Panic attack

31. Summary
 If you eliminate a behavior, you must replace it
with at least one, preferably 3 new ones
 People are “motivated” for rewards and to avoid
punishment.
 Decisional balance exercises can help people
make new behaviors rewarding and old
behaviors…less rewarding
 Reinforcers must be reinforcing to the person

32. Summary/In Practice
 When a client is trying to change a behavior
 Analyze exceptions (chaining---what was different
when you did not …)
 Behavior chains can help identify antecedents/triggers
and vulnerabilities
 Remember that every behavior is maintained by
rewards (getting up, going to work, eating)
 Eliminating a behavior means
 Making that behavior LESS rewarding than the
alternative
 Making the new behavior MORE rewarding than the
alternative