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| Behaviorally Based Approaches to Changing Behaviors of Addictions and Recovery: A Symposium to Honor Sherman Yen, Ph.D. |
| Monday, May 27, 2019 |
| 5:00 PM–5:50 PM |
| Swissôtel, Event Center Second Floor, Vevey 1/2 |
| Area: CBM/BPN; Domain: Theory |
| Chair: Kathryn M. Potoczak (Shippensburg University) |
| CE Instructor: Kathryn M. Potoczak, Ph.D. |
| Abstract: Sherman Yen, PhD , founder of the Asian American Anti Smoking Association, student of Fred Keller, and one of the pioneer generation of Applied Behavior Analysts, among many other kudos, dedicated much of his career to applying Applied Behavior Analysis to addressing problems from addictions. We present work applying ABA to smoking cessation and recovery from opioid addiction. To honor that legacy, we present a symposium highlighting work applying ABA to change behaviors of addiction, and recovery, areas about which he cared passionately. Now more than ever opportunities to apply ABA to "mainstream" health behavior change |
| Instruction Level: Basic |
| Keyword(s): addiction, smoking cessation |
| Target Audience: attendees who would like to apply ABA principles and methodologies to effect behavior change for patients with addictions, recovering from addictions, preventing relapse, as well as targeting behavior changes for family members. this symposium will be useful for those wishing to effect these changes in both professional as well as personal life situations |
| Learning Objectives: Attendees will be able to apply ABA principles to - behaviors and habits to promote smoking cessation - behaviors and habits of family members of recovering addicts - behaviors and habits of recovering addicts, using behavioral activation to "reanimate" recovering addict |
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A Comparison of Contingency-Management Versus Feedback Alone for Smoking Cessation |
| JOSEPHINE DRESS (Columbia University; Shippensburg University), Kathryn M. Potoczak (Shippensburg University) |
| Abstract: The number of cigarettes smoked over five weeks was measured for four participants to determine if feedback only (FO), in the form of saliva cotinine levels, would be as effective a treatment for smoking cessation as contingency management (CM). After a one-week baseline, all participants were introduced to smoking reduction via a changing-criterion design, in which the allowed daily amount of cigarettes was 25% lower than their baseline level. Throughout the study, participants texted the daily amount of cigarettes smoked to a research associate. They also met with a research associate twice per week to have their saliva cotinine levels evaluated (values ranging from 0 to 6, 6 indicating high levels of nicotine in the saliva). Starting in Week Two, Participant A received one cash lottery draw for attending a meeting and received another draw if saliva cotinine levels were reduced from the previous meeting level (CM). Participants B-D simply received feedback regarding saliva cotinine levels (FO). Treatment continued for the next three weeks, with a 25% reduction targeted for each subsequent week, with a goal of complete cessation during the final week of treatment. While complete smoking cessation did not occur for any of the participants, all participants did reduce the daily number of cigarettes smoked from baseline levels, and results indicate that FO was as effective in producing this result as CM without the associated cost of the cash lottery. |
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| A Program Focused on Modification of Behaviors of the Family Members of the Post-Rehab Recovering Addict to Decrease the Likelihood of Relapse |
| RICHARD COOK (Penn State University; Applied Behavioral Medicine Associates, Hershey, PA; Ruth Pauline Cook Foundation) |
| Abstract: While the immediate family of the recovering addict is often the primary support system post discharge from a rehabilitation program, programs rarely are found to dedicate time to directly focus on making that home environment more reinforcing (and less likely to irritate the returning recovering addict to the point of leaving the home and relapsing) by deliberately focusing on identifying problematic behaviors of the family members, and modifying them to decrease the likelihood of problem interactions with the recovering addict, and increase the likelihood of continued building of stronger family relationships and patterns of behavior, thus decreasing the likelihood of being irritated by the family environment, and leaving to seek reinforcement elsewhere, possibly involving relapse. This presentation outlines a program in which in a systematic fashion deliberate attention is made to identifying past behavior and interaction problems within the family, and focus directly on changing those family member habits, and similarly, build upon prior family habits previously reinforcing. The applied behavior analyst is uniquely well positioned to apply the principles of behavior change in a robust fashion to the many habits that don’t simply go away by talking about them, thru the systematic application of techniques in the behavioral modification armamentarium including, but not limited to functional assessment, changing factors in the antecedent and consequent states, and directly modifying the topography of family member behaviors, as well as the differential reinforcement/punishment of competing, alternative, or incompatible behaviors. |
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| Behavioral Activation for Reanimation of the Recovering Addict |
| MATTHEW GROSS (Shippensburg University), Richard Cook (Penn State University; Applied Behavioral Medicine Associates; Ruth Pauline Cook Foundation) |
| Abstract: Patients undergoing recovery from addiction, especially following an acute inpatient rehabilitation experience, often experience a period of time during which they are "spared" from typical daily activities, responsibilities, and reinforcers. During this time, particularly if living "back at home," demands on them are initially reduced, or non existent, but ideally should gradually increase, commensurate with ongoing successfulnhabit development, but too often, they don't do so. Unfortunately, for some patients, their families, their rehabilitation clinicians, their healthcare payers/insurers, the legal system, their friends, and other key stakeholders in their recovery, either in being well intentioned..or simply by not paying attention.., set up an environment sheltering them not only from responsibilities "too much for them to handle" at this time, but unfortunately also from the many natural consequences that would bring life back to them, shaping their behaviors, overt and private, to assist to return them to (ideally, improved versions of) their "normal" lives. While they might participate in some sort of outpatient "program," sadly the absence of a systematically implemented, reevaluated, revised, and increased set of responsibilities and actions expected of them within their family or other living situation, outside of their formal outpatient drug rehab program activities, can allow them, or arguably, cause them, to become "permanent teenagers," returning from their outpatient program activities to their home, where they can isolate themselves into their rooms, pajamas, snack foods, phone, computer, and up all night schedules of internet or video or game controller or tv reruns, often absent even much interaction with other family members in the house. Instead of focusing on "esteem building," behavioral activation robustly employed, with a goal of developing patterns of behavior useful to returning to a (more desirable) day to day life going forward, can get them showered dressed, out of their rooms, out of their houses, and into volunteer or part time job activities which will, if guided well, expose them to natural reinforces that will train them, rehabilitate them, reanimate them, redefine them, and reintegrate them into the (hopefully well chosen) worlds around them, and increase the likelihood they will be fortified against the stimuli, internal and external, that might lead them to emit behaviors of relapse. |
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