FS06. Consequences & Reinforcers

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, your loved one and behavioral health professionals 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. Look at the “Reinforcement Matrix Handout”. Unwanted behavior is decreased by adding reinforcers 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). A basic technique to decrease our loved one’s unwanted behavior is to take a “time-out” from reinforcers. Taking a time-out doesn’t mean having your loved one sit in the corner facing the wall like they may have done as a child, it is removing a specific reinforcer that is tied to a specific unwanted behavior. The reinforcer you withdraw needs to be something your loved one will miss when it is gone and value when it is reintroduced. It should be easy to take away, can be removed close to the time of the unwanted behavior, and is comfortable for you to withdraw (Meyers and Wolfe, 2004).

REMOVE REINFORCERS ACTIVITY

Step 1: What positive reinforcers (object, activity, or behavior) are your loved one getting right now that would be appropriate to withdraw to get them to do less of the unwanted behavior you described?____________________________________________________________________________________________________________________________________________________________________________________________________________

Step 2: Are there any potential negative consequences or complications for you or your loved one that could come from removing these reinforcers?____________________________________________________________________________________________________________________________________________________________________________________________________________

2. One of the easiest most powerful reinforcers to remove could be you. Chances are your loved one wants to spend time with you. However, if they have been drinking, using, or misbehaving, you might want to help them see that you don’t want to spend time with them under those circumstances. Drs. Meyers and Wolfe refer to this as the “Big Chill.” That may mean you leave the room or the home. Depending on the situation, this might also be safer or more appropriate for you. For example, maybe you and your loved one had planned on going out for dinner, at a favorite restaurant. But they came home late after stopping and having a few drinks. You could respond by saying, “I am glad you are home safe. I really enjoy going to dinner with you when you haven’t been drinking. Since you chose to drink, I am going to the bedroom to read for the night. There is food in the fridge if you would like something to eat.” In this example, you removed the reward of going to dinner together. You also didn’t turn it into an argument or let your strong emotions get the best of you (Meyers and Wolfe, 2004).

Discuss: Has the Big Chill been effective for you? When do you think it might be a good idea to use the Big Chill?____________________________________________________________________________________________________________________________________________________________________________________________________________

3. Despite the best-laid plans, there is no guarantee that the anticipated change in your loved one’s behavior will occur when you withdraw a reinforcer. Use this ‘time-out’ procedure when you are prepared to handle the range of possible outcomes. If there is any potential for violence, self-harm or life-threatening behavior then choose a different reinforcer to remove. Keeping track of how you removed the reward and how your loved one responded at every point in that process will help you be better prepared for the next time.

4. The second basic technique for decreasing our loved one’s unwanted behaviors is to allow for natural consequences. “The hardest thing you can do to someone you love is to let them experience the consequences of their behavior. But if you really love the person, you must” (Meyers and Wolfe, 2004, p. 113). Chances are we have been covering for our loved one, not letting them face the full effect or natural consequences of their unwanted behaviors. For example, we feel the need to clean up our loved one when they come home drunk and end up throwing up on themselves, or maybe we think, “I can’t let them lose their job because they overslept again. I’ll call in sick for them”.

5. We might be working very hard to protect them from themselves, but it isn’t helping them or us. In fact, there are significant consequences to our fixing and protecting. First, we get burned out. We only have so much to give and fixing what our loved one messes up and protecting them from their own choices is exhausting. Second, our fixing and protecting may actually be making it easier for them to do the unwanted behavior. Third, by always being there to pick up the pieces or to fix whatever goes wrong we are actually sending a message that we accept their behavior (Meyers and Wolfe, 2004). Fourth, our loved one may feel that they are incompetent or fragile and need to be rescued. Of course, some consequences are too harmful to allow. Your job is to identify the natural consequences you can tolerate that are not life-threatening and let them “speak for themself” in your loved one’s life.

NATURAL CONSEQUENCES ACTIVITY

Step 1: Individually consider a typical situation during the last month when you could have allowed for the natural consequences of a loved ones’ unwanted behavior. Be as complete and specific as you can. ____________________________________________________________________________________________________________________________________________________________________________________________________________

Step 2: Brainstorm positive and negative outcomes that could have resulted from allowing the natural consequences.

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Step 3: Decided on outcomes you will permit next time this same situation occurs. ____________________________________________________________________________________________________________________________________________________________________________________________________________

Discuss: How might allowing for the natural consequences of a loved one’s behaviors help you and them?

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6. Research by B. F. Skinner and others psychologists have shown that although punishment may weaken or suppress unwanted behavior it does not eliminate it. People can learn new behaviors, but they can’t unlearn old behaviors. Punishment doesn’t teach new behavior. To help a loved one understand that they are not being “punished,” by allowing a natural consequence or removing a reinforcer, we need to always include an explanation. Informing your loved one in advance about these consequences will help them to not be surprised. What we say should help tie consequences directly to the unwanted behavior How we say it makes a big difference in helping our loved one hear what we are communicating, while minimizing their defensiveness and wanting to argue or fight. An essential part of learning to change is lost if our loved one doesn’t connect the consequences to their unwanted behavior (Meyers and Wolfe, 2004).

7. We want all of our communications with our loved one to be as effective as possible. PIUS statements help our communication to be that. Using the “PIUS Communication Worksheet” accompanying this session will help you prepare to more effectively talk with your loved one about the consequences of their behavior. For example, imagine that your loved one didn’t come home the night before. They walk in the door the next morning while you are having breakfast smelling of marijuana smoke or alcohol and still high. Read the ineffective and effective communication examples.

Ineffective: Where have you been? Looks like you have been out all-night smoking weed (or drinking) again. I am sick of it. You are grounded from the car.

More effective PIUS: I am glad you are home safe. I was worried something had happened. As we have talked about, I am uncomfortable with your driving our car when you are using. Please don't use the car for the next week. Right now, I need to go to work. I'd be interested in talking with you more about this when you are sober.

Discuss: What makes the “PIUS” example more effective? How can being prepared to talk about the consequences of their unwanted behavior help you and your loved one?____________________________________________________________________________________________________________________________________________________________________________________________________________

GROUP SHARING SECTION – Maximum time 30 minutes

8. 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

9. 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 the “PIUS Communication Worksheet” to plan how to talk with my loved one about the consequences of their behavior.

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?____________________________________________________________________________________________________________________________________________________________________________________________________________

What will I do differently because of what I learned?

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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.)

PIUS Communication Worksheet

There are seven principles to positive or PIUS communication:

1. Be brief. Resist the urge to bring up too much. Keep it simple.

2. Be specific and clear. Focus on one thing.

3. Be positive while communicating what you want. Avoid blaming, name calling and over generalization

4. Label your feelings. Describe the emotional impact on you in a calm, nonjudgmental, non-accusatory way.

5. Offer an understanding statement. Try seeing it from the other person’s point of view.

6. Accept partial responsibility. Share a small piece of the problem.

7. Offer to help.

Write down a verbal/text or email interaction between you and a loved one.

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Using the seven principles write what you might communicate with a loved one the next time the same situation occurs, in a way that limits defensiveness and does not lead to an argument. Be sure to refine and practice your PIUS statement before using it.

I… (HOW DO YOU FEEL?)

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when you…(DESCRIBE THE BEHAVIOR OR CONDITION) ________________________________________________________________________________________________________________

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because… (WHY DO YOU FEEL THIS WAY?)

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I would like… (WHAT DO YOU WANT TO HAPPEN?)

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I know… (YOU UNDERSTAND THE OTHER’S POSITION)

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Let’s try… (YOUR WILLINGNESS TO SHARE RESPONSIBILITY)

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(HOW CAN I HELP?)

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Session Online Version

Reinforcement Matrix Handout

PIUS Communication Worksheet

FS05. How to Increase Wanted Behavior

FS07. Plan to Change