FS05. How to Increase Wanted Behavior
Welcome to the Family Support Group Program.
Here you can download the session PDF below by clicking on the button or continue scrolling to the online version. The videos password is craft.
Session Online Version
CHECK-IN SECTION – Maximum time 20 minutes
Mindful Minute -- take a break from what you have been doing, breathe deeply, relax and recharge.
Step 1: Find a comfortable seated position with both feet grounded on the floor. Put a hand on your stomach. Close your eyes.
Step 2: Take a deep breath in through your nose and out through your mouth. Notice your thoughts and feelings and any tensions in your body.
Step 3: As you inhale and exhale, breathe deeply so your belly fills and empties with air. The hand on your stomach helps you practice belly – not chest breathing.
Step 4: For the next minute make breathing in and out your only focus. Let your thoughts come and go without trying to control them. If you find an area of tension in your body, relax it and let the tension go.
Step 5: At the end the minute slowly open your eyes. Gently bring your presence back to your surroundings.
Our Purpose
CRAFT Connects’ Family Support groups are for parents, partners, families and other Concerned Significant Others (CSOs) who have a loved one that is struggling with a substance use or mental health disorder. We know from first-hand experience that loving someone with these challenges can be a difficult, lonely journey. To create a safe place for honest sharing of our lived experience we use appropriate language and behavior. We are empathetic, nonjudgmental, genuine, respectful, steer clear of confrontation and imposing our own solutions. We encourage hope and compassion for all. CRAFT Connect helps to reframe and energize connections between you and your loved one into a “therapeutic alliance” that leads to progress and healing. There is a lot we can learn from one another.
What experience did you have practicing CRAFT Connect principles and skills?
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What did you do to purposefully take care of yourself and show self-compassion?
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LEARN SECTION – Maximum time 30 minutes
1. CRAFT Connect principles and skills are motivated by love and concern. They are about helping our loved one make positive changes by changing the way we interact with them. In this session we are going to learn about simple powerful ways to encourage positive changes in our loved one’s behavior through the use of reinforcers, small steps that can lead to a larger change. (Meyers and Wolfe, 2008) People are naturally programmed to do and repeat behavior that gives them some type of a reward. These positive experiences may take the form of enjoyable physical sensations or emotions or in gratifying social situations that go hand-in-hand with the behavior. To help our loved one change we need to try and understand specifically in what circumstances our loved one is behaving, and why. Completing the mapping process using the “Analyze Behavior Worksheet” and “Sample Analyze Behavior Handout” accompanying this session is a good first step. By getting specific about what their behavior does for them, we can more easily spot what we might be able to help change to make positive wanted behavior even more rewarding.
2. Look at the Reinforcement Matrix Handout. “A positive reinforcer (a reward) is something that is experienced as pleasurable by an individual, thereby making the individual interested in repeating the behavior that got him or her the reward in the first place” (Meyers and Wolf, 2008, pg. 135). Think about all the areas in your loved one’s life that could become reinforcers for their behaviors. These reinforcers could include objects, behaviors (like stepping away from your relationship) or activities. Reinforcers that are pretty easy and comfortable for you to deliver to your loved one, are free or inexpensive and are immediately available. Rewards should not come from a single source or be of the same type. That way, a setback in one area can be counterbalanced by the availability of reinforcements from another area.
Watch: “The Big Bang Theory” video.
3. With CRAFT rewards are not the typical, “If you do this, you will earn a chocolate” type of thing as portrayed in “The Big Bang Theory” video. Rewards can simply be good things that can potentially compete with the unwanted behavior we want to change. You plan on rewarding your loved one with what he or she likes. For example, let’s say that your loved one abuses alcohol. You thought specifically about their typical drinking episode and it usually happens after a stressful day of work. They seem to drink to relax, starting with a drink shortly after they walk in the door. You realize that you may be able to come up with some rewards and positive alternatives to help your loved one relax that could outcompete with their drinking behavior. You start by turning off your internal editor and brainstorming potential rewards that could increase the motivation for your loved one to stay sober. List everything you can think of, even if it sounds crazy or impossible. If you get stuck, here are some ideas: Offer to do the dishes. Rub their feet. Encourage them to take a relaxing bath. Dance with them. Watch a movie together. Sing for them. Turn on some relaxing music. Take time to ask about their day, then really listen. (Meyers and Wolfe, 2004)
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Discuss: How does adding something positive as a consequence of positive behavior increase your loved one’s motivation to change? How could even small steps be reinforcing?
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4. Think of a wanted behavior of your loved one that may have diminished as a result of their behavioral health disorder, one that you would like to see more of. Be as specific and complete as possible. You will use this behavior as the bases for the next two activities. The behavior should be one that:
Your loved one enjoys or has enjoyed in the past.
Competes with unwanted behaviors in terms of time and function.
Occurs fairly often currently, or can occur often in the future.
You also enjoy (if applicable)
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WANTED BEHAVIOR ACTIVITY
Step 1: Take a few minutes to brainstorm possible reinforcement (objects, behaviors or activities) that might encourage the wanted behavior described above. Since you probably know your loved one better than anyone else you are in a unique position to do this. Write down as many possible rewards as you can think of. If you are unsure of possible rewards, a key to successfully establishing a pattern of positive reinforcement for wanted behaviors may be to get your loved one’s help in generating ideas of what they think is rewarding.
Reinforcement Rate | Reinforcement Rate
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Step 2: Look at your list, think about each reinforcement or reward the way you think your loved one would. Using the scale below, rate each item on your lists the way you think your loved one would rate it for pleasure” (Meyers and Wolfe, 2008). Write their rating by each reward.
1--------------------------2------------------------------3------------------------------------4--------------------------5
Very little pleasure Moderate pleasure Tremendous pleasure
Step 3: Decide what would you tell your loved one about why you are giving them a reward?
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5. You can also use simple meaningful validating verbal and non-verbal reinforcers anytime you see your loved one doing a wanted behavior. Things like a smile, showing affection, and simply telling them how much you appreciate them. Let them know how happy it makes you feel when they are clear headed. Whenever possible we want to reinforce wanted behaviors immediately after they occur and clearly tie the ‘reward’ to the behavior. You could say something like, “I really enjoy spending time with you when you are taking your medication. Thank you.” This is nice. This is simple positive reinforcement (Meyers and Wolfe, 2004). More examples of validating statements can be found in the “Validation, Don’t Try to Fix” session.
VERBAL AND NONVERBAL REINFORCERS ACTIVITY
Step 1: Brainstorm some simple, verbal and nonverbal reinforcers your loved one might appreciate that you can do to reward the above wanted behavior. These reinforcers can be delivered in person or using technology.
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Step 2: Take a look at your list. Circle the rewards that seem to be the ones that your loved one would really like.
Step 3: Share a few of your ideas with the group.
6. You have probably been told at one time or another that you are “enabling” your loved one’s behavior. Let’s get clear about what is enabling and what it is not. Negative enabling is when you do something that reinforces unwanted behavior. Maybe it is giving your child money, so they won’t “go hungry,” even though you know they will use the money to buy pot. Or maybe it is calling in sick to work for your partner when they are not sick because you are afraid that they will lose their job.
7. Rewards are not enabling. Rewards are positive things for positive behaviors. The wonderful thing about rewards is they are 100% motivated by the fact that you love and care about your loved one. They are genuine. When your loved one comes home after work instead of stopping at the bar, you hug them, welcome them home warmly, and thank them. When your daughter, who struggles with a mental health disorder, gets up on a morning when you are not feeling well and gets her younger siblings dressed, fed and off to school on time -- instead of just lying-in bed as she usually does-- you thank her, hug her and maybe go get pedicures together. This is good. This is natural. This is positive.
8. There is a good chance you have heard people describe themselves as “codependent”. Maybe you have thought about yourself and your loved one that way. Codependency is usually described as a dysfunctional relationship where one person relies on the other for most or all of their needs. The concept of codependency is actually not supported as a mental health disorder (APA, 2013). Do not become concerned with developing a “codependent” relationship with your loved one by using rewards. Remember, you are simply rewarding the positive with something positive. There is nothing enabling or codependent about that.
Discuss: What is the difference between enabling and rewards? Can you share some examples of both? Have you ever been told you are codependent?
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GROUP SHARING SECTION – Maximum time 30 minutes
9. We will now begin the sharing portion of the meeting. You are invited to share from 3 to 5 minutes about your experience as it relates to your loved one’s recovery, this week’s session or what you are currently working on. Please focus your sharing on potential solutions rather than the problems. We will conclude the sharing five minutes before the end of the meeting. Who would like to begin?
MY COMMITMENTS SECTION – Maximum time 10 minutes
10. Please remember that what has been shared here is confidential and that the opinions expressed are of the individuals who shared them. These are our group commitments, we will start the next CRAFT Connect session by reporting on them. This week I will:
A. Do the in-between session assignments.
· Use rewards to encourage a wanted behavior from a loved one.
B. Share what I am learning with my family, friends and community.
C. Show kindness for myself by self-care.
As you listen to a song about connection take a few minutes to quietly think about what you learned in this session. Write your thoughts and personal commitments below.
What are the most important things I learned in this session? ____________________________________________________________________________________________________________________________________________________________________________________________________________
What will I do differently because of what I learned? ______________________________________________________________________________________________________ ______________________________________________________________________________________________________
Reinforcement Matrix Handout
Wanted behavior is increased by consequences that our loved one wants, likes or will work to get (a reward) or that stops or reduces an unpleasant painful condition. Unwanted behavior is decreased by consequences that our loved one dislikes or will work to avoid or when something our loved one wants is withheld until the unwanted behavior is corrected (Meyers and Wolfe, 2004). All reinforcers, pleasant and unpleasant, increase the likelihood of your loved one’s wanted or unwanted behaviors continuing. (LO is shorthand for your loved one.)
Analyze Behavior Worksheet
The following question should help you begin to establish a framework for understanding factors that can influence the occurrence of any particular behavior – wanted or unwanted.
Step 1: Describe the Behavior, something your loved one does on a fairly regular basis that has a discernable pattern. Be as complete and specific as possible regarding what you know about this kind of episode. Remember to provide information on What, How often, and How long. (See Note below.) ______________________________________________________________________________________________________________
Step 2: What are the External Triggers? Describe the environmental triggers that lead up to the behavior.
Who is loved one usually with when their behavior starts? ______________________________________________________________________________________________________________
Where does the behavior usually start? ______________________________________________________________________________________________________________
When does the behavior usually begin? ______________________________________________________________________________________________________________
Step 3: What are the Internal Triggers? Make your best guess about what you believe could be the internal triggers – thoughts and feelings -- that lead up to the behavior. Remember that thoughts are ways of dealing with feelings.
What do you think your loved one is feeling right before the behavior? ______________________________________________________________________________________________________________
What do you think your loved one is typically thinking about right before the behavior? ______________________________________________________________________________________________________________
Step 4: What are the “Red Flags” or warning signs? Assuming that in some way you have witnessed your loved one’s behavior think about the physical, emotional, behavioral indicators that signaled its start. Include words, voice tone, context, and non-verbal cues.
What are some physical signs that tipped you off that your loved one’s behavior started? ______________________________________________________________________________________________________________
What changes in your loved one’s emotions did you witness? ______________________________________________________________________________________________________________
What is the last thing your loved one says or does before the behavior? ______________________________________________________________________________________________________________
Step 5: What are the Positive Consequences? What do you think your loved one likes about the behavior? Remember to provide information on Who, Where, and When. ______________________________________________________________________________________________________________
What pleasant thoughts do you think your loved one has while doing this behavior? ______________________________________________________________________________________________________________
What pleasant feelings do you think your loved one has while doing this behavior? ______________________________________________________________________________________________________________
Step 6: What are the Negative Consequences? What do you think or feel are the negative results of your loved one’s behavior? Try to include the interpersonal, physical, emotional, legal, job, financial areas of their life. Note with a * any negative results that your loved one would agree with. ______________________________________________________________________________________________________________
Note: If you or a loved one is taking prescription drugs you need to separate the side effects of those drugs from the behavior. If you are not sure of the side effects one of these government websites will help https://dailymed.nlm.nih.gov/dailymed/, https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm.
SAMPLE ANALYZE BEHAVIOR HANDOUT
Unwanted behavior. Describe something your loved one’s does on a fairly regular basis or has a discernable pattern. Be as complete and specific as possible regarding what you know about this kind of episode. Remember to provide information on What, How often and How long.
Drinking a shot of tequila or whiskey. 6-7 12 oz beers. Cocaine use? Alcohol consumed over 5 hours, cocaine over 2 hours. 3-4 times a month.
External Triggers. Describe the environmental triggers that lead up to the behavior.
Who is your loved one usually with when their behavior starts?
Friends (not coworkers) Phil, Doc, Steve.
Where does the behavior usually start?
Starts drinking a Red’s Filling Station bar then moves to Doc’s place.
When does the behavior usually begin?
Friday nights. Drinking starts at 6:00 pm. Cocaine after 11:00 pm.
Internal Triggers. Guess what you believe could be the internal triggers that lead up to the behavior.
What do you think your loved one is typically feeling right before the behavior?
Pressured. Embarrassed. Happy in anticipation of using. Happy he’s part of that special group. In control, powerful.
What do you think your loved one is thinking about right before the behavior?
I earned this celebration. If I go it will shut Phil up. Natasha will be mad, but I’ll make it up to her tomorrow. I’ll save face if I go.
Warning Signs. Assuming that in some way you have witnessed your loved one’s unwanted behavior think about the physical, emotional, behavioral indicators that signaled its start.
What are some physical signs that tipped you off that your loved one’s behavior started?
End of the work week, ‘my night out with the boys’. Doesn’t respond to my calls or texts.
What changes in your loved one’s emotions did you witness?
Feels angry being asked to choose between coming home and a night out.
Positive Consequences. What does your loved one likes about the behavior? Remember to provide information on Who, Where and When.
They’re “crazy” different from coworkers. Feels safe there. Nobody will bother them. Likes to celebrate the weekend. Pleasant routine (feels cheated if he doesn’t go). Makes him feel special.
What pleasant feelings do you think your loved one has while doing this behavior?
Feeling like he “belongs”. Getting high. Feels special, the guys really like him. Excitement. Not stressed.
What pleasant thoughts do you think your loved one has while doing this behavior?
This is fun. It’s great to be part of this group.
Negative Consequences. What do you think or feel are the negative results of your loved one’s behavior? Try to include the interpersonal, physical, emotional, legal, job, financial areas of their life and yours. Note with a * any negative results your loved one would agree with.
Strained marriage* (from my worrying and his moods). I’m unhappy. He’s tired, hungry.* He’s irritable. Criticizes himself for not getting stuff done. He’s down (depressed). He’s afraid he’ll get caught and end up in jail.* He’s afraid people will find out and he’ll lose his job.* Money spent on coke. Sperm damage.*