personal behavioral change|My course tutor

Posted: March 7th, 2023

Counseling Tool Presentation – 25 points

You will also complete one presentation this semester about a behavior change tool that you feel would be helpful for clinical practice. As mental health providers, many of us ask our clients to complete activities outside of therapy to aid in their progress. But how do we find ideas for relevant activities? And how are they grounded in what we know about how people learn and change?

For this assignment, you will be locating or creating a homework activity for a client that is based in concepts of learning and behavior change. (This can be a real client you are working with or you can create a fictional client.) You will have 15 minutes to present the tool to your “base group,” discuss how it relates to course material, illustrate how you would use it with a real or fictional client, and lead a group discussion about it. Like with the other presentations, you will create a 1-2 page handout, upload it to Canvas (along with a copy of the behavior change tool), and distribute it to your “base group.” Your grade will come from the quality and clarity of the material on your handout.

My goal for this assignment is to help you familiarize yourself with resources that you can add to your “toolbox” and use in your clinical work. There are amazing books and websites for this, but you may be too busy at practicum or in your clinical practice to search for them later! This will also help you see how the theories and interventions you are learning about in class can apply to clinical practice, and allow you time to self-reflect about which particular interventions fit for you as a mental health provider.

Opportunities to locate homework activities include:

· Collecting resources at your practicum site (books, handouts, etc.)

· Searching for books of tools that you can access free from the UST library site (e.g. ‘Treatments That Work’ series; ACT Made Simple; books with “homework,” “treatment planning,” or “toolkit” in the title)

· Locating books about interventions for specific groups (e.g. children), theoretical perspectives (e.g. DBT, motivational interviewing) or diagnoses (e.g. anxiety, depression)

· Searching websites like actmindfully.com.au or therapistaid.com (free, but not as comprehensive as the above resources)

· I will also share many more resources with you in class!

· If you prefer, you can also create your own homework activity. This can be helpful if you are working with a real client at practicum and want to create or modify something that you feel is the right fit for that client.

Want ideas? Here are some topics from previous students to help get you thinking:

· Client with Major Depressive Disorder: A handout of information about behavioral activation ideas and a sheet to rate and track their progress for the week.

· Client with Social Anxiety Disorder: A handout of tips for how to be assertive, along with a list of exposure activities they want to do that will require assertiveness. They will fill out a worksheet where they write down their thoughts and SUDS levels before and after behaving assertively.

· Child client with anger outbursts: An “anger thermometer” worksheet they will fill out with you during your therapy session to help them recognize the signs that they are starting to get upset. Their parent and their teacher at school will track their expressions of anger each day and give them a small reward each day they use the thermometer and don’t have an outburst of anger.

· A couple who want to improve their communication: A worksheet of how to phrase criticisms in a healthy way, which you will use to role play healthy and unhealthy communication in the session. Then they will use this on their own for a week and report back.

· Client with high levels of stress: Information about relaxation strategies and a worksheet for them to monitor their physical sensations of anxiety and anxiety-related thoughts before and after using the strategies.

Please use the following headings for your handout. A copy of the grading rubric is provided on Canvas.

· Citation (2 points)

· Include an APA-style citation of the book, website, etc. where you found the tool or citations for any resources you used to help you create your own tool.

· Client Description (3 points)

· Include a brief description of your client, including demographic information, presenting problem, and diagnoses (if you are using a real client, make sure the information is deidentified)

· Ethical and Diversity considerations (5 points)

· What are 1-2 ethical considerations AND 1-2 cultural diversity considerations that you feel are important regarding the use of this tool in clinical practice? Although of course there is an overlap between diversity and ethics, make sure you are addressing each area separately (for example, mentioning considerations for using it with individuals experiencing poverty and also mentioning concerns regarding confidentiality, nonmaleficence, boundaries of competence, etc.).

· Link to Course Material (5 points)

· How specifically is this tool grounded in theories of learning and/or principles of behavior change? Make 2-3 clear connections, such as how a course term, theory, or concept might apply. (In some cases, your article might explicitly discuss this but in other cases you will need to make those connections yourselves.)

· Discussion Questions (5 points)

· Write at least 3 discussion questions that you feel will get your group members thinking about the tool on a deeper level.

· Make sure you also include a copy of the resource in PDF form. This is typically allowable under the “Fair Use” copyright guidelines for educational purposes. (5 points)

Behavior Change Paper – 45 points

This assignment will provide you with the opportunity to engage in personal behavioral change and to reflect on your own change process. My goals of this assignment are for you to: A) experience what it is like to attempt to change a behavior, B) apply concepts of learning and behavior change, C) refine your skills at using APA style, and D) hopefully benefit personally by making healthy behavioral changes!

At the beginning of the semester, I will ask you to choose a behavior that you would like to work on changing over the course of the semester. Since you will be sharing the behavior with the instructor and a small group of your classmates, please choose a behavior that you are comfortable sharing in some detail. Please select a behavior that you have some reasonable motivation to change so that this activity is meaningful to you! You might choose to:

· Start a behavior, such as beginning an exercise or weight-loss program; or starting to cook a new meal each week;

· Increase/improve a behavior, such as reading course material before class more often, improving sleep hygiene, meditating more frequently, being more assertive, or eating mindfully more often;

· Or decrease a behavior, such as reducing caffeine use, stopping biting your nails, decreasing phone usage, viewing less television, etc.

Over the course of the term, I am asking you to make a serious attempt to change the behavior using theories and interventions from the course. I recommend that you keep a journal to help you do this. During class, we will have regular discussions, activities, and reflection opportunities that you can include in this journal which will help you identify behavior change techniques you will use. You can continue to use the journal outside of class to track your progress and prepare to write this paper.

Optional: If your goal is related to any topics included in the ‘Learn to Live’ programs, you can use this resource as part of your behavior change plan. It is available free of charge by going to www.learntolive.com/partnersLinks to an external site. and entering the code ‘STTHOMAS.’ You will first complete a self-assessment to see which area(s) you may benefit from the most, and will have the opportunity to choose any program you would like to complete. Programs include: sleep, stress/anxiety/worry, social anxiety, substance use, or depression. All programs are completely confidential and I will not have access to your results.

Once you have spent several weeks implementing your behavior change plan, please write a 5-6 page paper, double-spaced, in APA format (7th ed.). Make sure you cite the readings and other course material throughout. Your paper should address each of the questions below, and each one is worth 5 points. The paper will be graded based on evidence of critical thinking, depth of analysis, and evidence of personal reflection.

Please answer the questions in the order listed, and include first-level headings for Baseline, Implementation, and Post-Intervention, with second-level headings for the eight sub-topics. A copy of the grading rubric is provided on Canvas.

Baseline

1) Behavior, Beginnings, and Goals

· Provide an operational definition of the behavior you want to change and your goal (ex: “I want to sleep at least 7 hours per night at least 5 days per week. I will measure the hours slept based on time in bed with my eyes closed, regardless of whether I am truly asleep.”)

· Provide a detailed measure of where you began (ex: “I tracked my sleep for one week before beginning this project. I averaged 5.5 hours of sleep per night, and the hours ranged from 4.5-7 hours per night. I tended to sleep more hours on the weekend and fewer hours during the week. I drink coffee daily to try to be more alert and rely on naps on the weekends to catch up with sleep. On a scale of 1-10, with 10 being very alert, I would estimate that I feel a 3 most days.”)

· Make sure you include quantitative measurements when possible (but qualitative ones are encouraged too!).

2) Functional Analysis

· Complete a functional analysis/ functional behavior assessment to understand some of the factors that may be influencing your initial behavior at baseline. For example, your goal might be to exercise more, but your initial behavior might be not exercising at all.

· Include this functional analysis, including antecedents, your current behavior, and consequences in your paper and share what you learned from doing so. It may be helpful to include a chart in your paper to visualize this!

· Remember that your “A’s” are the things occurring in the environment that encourage your initial behavior and make it more likely. So if your initial behavior is ‘eating a lot of junk food’ then increased stress or lack of time might be “A’s” that lead to that behavior. If your initial behavior is ‘not exercising’ the same things could apply.

· Remember that your “C’s” are things occurring in the environment after your initial behavior. So if your initial behavior is ‘eating a lot of junk food’ then what happens after you do that? Do you feel relaxed? Do you have more free time than if you had prepared a healthy meal? If your initial behavior is ‘not exercising’ how do you feel after you choose not to exercise? What happens in your environment?

Implementation

3) Stages of Change

· What stage of change applied to your behavior initially? Did it change as you proceeded with the process? How did it influence the interventions you used along the way?

4) Interventions Used

· Please choose at least three interventions to try during the semester. Then, in your paper, tell us which interventions you utilized to change your behavior. Be specific about which ones you used and how they were utilized.

· Examples from the course might include: reinforcement/punishment, systematic desensitization/exposure, behavioral activation, Premack principle, stimulus control, modeling, increasing self-efficacy or self-regulation, changing schemas, scaffolding, incorporating the mesosystem, relaxation/meditation, urge surfing, values clarification, examining your motivation, etc.

· You are encouraged to employ cognitive principles in addition to strictly behavioral ones.

5) Problems and Challenges

· What problems and challenges did you encounter along the way and how did you respond to them?

Post-Intervention

6) Outcome

· Operationally define the outcome. (Ex: my goal was to increase my sleep to 7 hours per night at least 5 nights per week; I have been mostly successful because I now average 6 hours per night and sleep at least 7 hours 1-2 days per week)

· Do you feel you were successful?

· If you were successful, what benefits have accompanied the change? Are there any losses or negative consequences associated with the change?

· If you were unsuccessful, were there still some benefits or positive results

7) Future Considerations

· What do you see in the future for this behavior? What would help you maintain your progress or, if unsuccessful, what would help you be likely to make a change attempt again? What would you do differently if you had to initiate the attempt next semester?

8) Implications for Counseling

What have you learned from this process that you can take with you into your counseling work? I really want to hear your insights here! Please avoid the temptation to make this part very brief if you’re running out of room. Instead, make small edits to other areas to ensure you leave room for this part.

There will also be 5 points for APA style, so be sure to review how to format title pages, headings, references, etc. on Canvas.