Motivation and Motivation and

Goal SettingGoal SettingUnit 1

Review of Last Week

0 You reviewed your Addicted vs. Sober worksheet and circled each characteristic you want to change

0 Pick one characteristic and identify the 3 things you can do to change it.

0 Have group members who identified the same characteristic share their ideas on how to change it

Objectives

0 Define motivation0 Explain how motivation is related to goal setting and

change0 Learn how to identify goals0 Understand the process for setting (and achieving)

goals0 List the different levels or stages of motivation0 Discuss ways to increase motivation0 Define the FRAMES approach

What is Motivation

0 Motivation is a key to change.0 Motivation can be modified.

Aspects of Motivation

0 Commitment (Energy)0 Control (Ability)0 Challenge (Perception)

Motivation is Multidimensional0 Emotional expression of concern about the perceived

problem (e.g., "I'm really worried about what is happening to me.")

0 Cognitive (Thoughts and Beliefs: Recognition of the problem (e.g., "I guess this is more serious than I thought.")

0 Physical (Energy/Control) Optimism about one's ability to change (e.g., "I know that if I try, I can really do it.")

0 Social (Peer Pressure, Social Support)

Change Causes Crisis & Crisis Causes Change

0 Emotional0 How you feel about the current behaviors0 How excited/hopeful you are for change0 Fear of failure, rejection and the unknown

0 Mental0 Reasons for changing0 Reasons for staying the same0 Belief that you can change

0 Physical0 Amount of energy available for change0 Plan for dealing with discomfort

0 Social0 Peer pressure to change0 Peer pressure to remain the same0 Potential changes in peer group when you change0 Desire to keep current friends0 Influence of family

Activity

0 For the following goals, identify the motivationCommitment

Control

Challenge

Emotional Motivation (Feelings about the issue)

Mental Motivation (Thoughts/Rationales)

Social Motivation (Supporters, Peer pressure)

Physical Motivation

0 Weight loss or getting in shape0 Depression0 Addiction

Motivation is Dynamic & Fluctuating

0 Different issues can have different levels of motivation0 Reasons (Motivations ) for behaviors can change0 Motivation levels will wax and wane0 Stages/Levels of Motivation

0Precontemplation0Contemplation0Preparation0Action

Activity

0 Review the list of changes you identified from the Addicted vs. Sober self activity.

0 Pick 3 that you feel most motivated to work on0 Identify the following reasons for change

0 Emotional0 Mental0 Physical0 Social

FRAMES

0 Feedback0 Responsibility0 Advice0 Menu of options0 Empathy/Support0 Self-Efficacy (Can-Do Attitude)

Decisional Balance

Benefits of ChangingBenefits of Changing Benefits of Staying Benefits of Staying the Samethe Same

Drawbacks to Drawbacks to ChangingChanging

Drawbacks to Staying Drawbacks to Staying the Samethe Same

Activity0 Using the answers from the previous activity, create a

decisional balance chart

For Change Staying the Same

Benefits EmotionalMentalPhysicalSocial

EmotionalMentalPhysicalSocial

Drawbacks EmotionalMentalPhysicalSocial

EmotionalMentalPhysicalSocial

Behavior Basics0 Reinforcement

0 Increases the chance of a behavior by either providing a reward or eliminating something unpleasant

0 Punishment0 DEcreases the chance of a behavior by either adding

something unpleasant (i.e. Antabuse vomiting) or eliminating something pleasant (commitment to a residential facility)

0 Extinction Burst (Cravings)0 Attempts to get a reward will increase until it is not worth the

effort (Think temper tantrum or contraband)0 Shaping

0 Rewarding “Successive approximations”/Good Tries

Activity

0 For the three behaviors you want to change identify0 Rewards for doing the next right thing0 Punishments/consequences of doing the wrong thing0 How you are going to deal with cravings

Increasing Motivation

0Consciousness raising is increasing information about the problem.

0Self-reevaluation involves assessing how one feels and thinks about oneself with respect to problem behaviors.

0Hardiness means committing to act, believing that it is within your control and seeing it as a challenge.

0Competing Responses means developing alternative, healthy coping behaviors to deal with distress and discomfort.

0Creating Safety means avoiding or addressing things that trigger problem behaviors.

0Reinforcement means identifying and ensuring rewards for good choices.

0Helping relationships are created by being open and trusting with people who care.

Activity0 For each of the goals identify

0 What information/knowledge you need about the causes/consequences and alternatives to the problem (Consciousness raising)

0 How you feel and think about yourself with respect to problem behaviors. (Self-reevaluation) Review the decisional balance exercise to identify how change will affect you

0 What parts are within your control and worth the effort (Hardiness)0 Alternative, healthy coping behaviors to deal with distress and

discomfort. (Competing Responses)0 Triggers and ways to avoid, eliminate or cope with them (Creating

Safety)0 Rewards to keep you motivated (Reinforcement)0 Supportive people who can help you stay motivated (Helping

Relationships)

0 Assess bio-psycho-social needs0 Biological0 Emotional and Physical Safety0 Supportive Relationships0 Self-Esteem

0 Identify areas in which you are motivated to work0 Write the Goal Statement

0 Answers the question “How will I know when I have accomplished this?”

0 States what new behaviors, feelings will be present

Review: Process and Format

0 Knowledge0 Identify areas needing increased knowledge (i.e. causes

of depression, treatments, personal triggers etc.)

0 Skills0 Based on the on your SNAP (Strengths, Needs, Abilities

and Preferences), identify skills or behaviors that will help him achieve his goal

0 Abilities0 Abilities are merely skills that have been successfully

used in the natural environment

Review cont…

0 Characteristics0 Emotional 0 Cognitive0 Physical0 Social0 Environmental

0 Method0 Small goals success and reward

Maintaining Motivation

A Note About Motivation Changes

0 Loss of motivation indicates0 You missed something---a reason for your behavior0 You are trying to change for the wrong reasons---

Replace CV joint to try and fix engine knock; change people without changing self first

0 The reward of change is not worth the effort0 You chose the wrong rewards (expecting your spouse to

immediately see change and forgive and forget)

0 Functional0 Observable0 Measurable0 Time Limited0 Achievable

Characteristics of Good Goals

0 The old behavior served a purpose0 The new behavior must accomplish the same goal in a

healthier way0 Assess how the old behavior impacted the person

emotionally, mentally, physically, socially, spiritually and environmentally.

0 Add three new behaviors for every one you are trying to eliminate

Replace Chocolate with…

0 Sights, sounds, smells, times of day, activities associated with the old behavior

0 Will trigger cravings/urges0 Need to be

0 Eliminated0 Addressed0 Changed to elicit a different behavior

A note about Triggers

0 Develop and Enhance Coping Skills0 Objectives

0Knowledge: 0 Identify 5 to 10 ways you deal with stress0 Learn about 3 different coping methods including Radical Acceptance, REBT and

Reality Therapy/Choice Theory by reading handouts, participating in coping skills group and discussing with primary therapist

0 Evaluate the effectiveness of your existing coping skills and eliminate those that do not work

0Skills0 Add at least 1 new coping skill to your list0 Practice using those skills in group and session with scenarios and as you

discuss your current issues

0Abilities0 Keep a log each week of stressors, how you coped, how effective it was, anything

you might need to do differently and discuss in group

Fundamental Goals

0 Self-Esteem0 Knowledge

0 Learn what self esteem is and how self esteem is created in children and maintained in adults by attending educational group

0 List the traits you envision in your ideal self, and list the traits in your real self. Discuss in group the differences and your goals for change

0 Skills0 Use Cognitive Behavioral approaches to identify those “ideal traits”

that help you achieve your goals0 Use behavior modification and goal setting to develop 3 goals

0 Abilities0 Report back to the group/therapist each week your progress in

achieving your goals and the impact on your self esteem.

Fundamental Goals Cont…

0 Social Support0 Knowledge

0 Learn about the characteristics of healthy relationships0 Learn effective communication skills0 Identify the traits in a friend that you find important0 Identify places/ways you might meet such people

0 Skills0 Practice effective communication skills in group0 Create a plan to nurture current healthy relationships and create at

least one new relationship0 Abilities

0 Implement your plan and discuss its effectiveness0 Discuss how your relationships and communication skills have

improved0 Modify your plan as needed

Fundamental Goals Cont…

0 Basic Needs0 Knowledge

0 Learn about safety by doing a safety assessment0 Learn about wellness by attending the wellness group and completing

weekly worksheets0 Learn about the mind-body connection

0 Skills0 Develop a realistic plan for improving your health and wellness0 Improve any areas of your environment that are unsafe

0 Abilities0 Implement your plan and discuss the positive improvements0 Modify your plan as needed to maintain motivation and ensure

success

Fundamental Goals Cont…

0 Depression0 Knowledge

0 Learn about the mental and physical causes of depression0 List your triggers for depression0 Of those triggers, identify which ones you can control and which ones you

cannot.0 Identify those things that make you feel less depressed0 Identify exceptions. “What is different when you are not depressed

0 Skills0 Develop a plan for increasing the exceptions and things that make you feel less

depressed0 Use behavioral and cognitive behavioral strategies to address those things you

cannot control0 Abilities

0 Discuss how effective your plan is, things that need to be altered in your plan0 Discuss the different strategies you use to address those things you cannot

control and how effective they are.

Fundamental Goals Cont…

0 Anxiety0 Knowledge

0 Learn about the 6 basic fears0 Learn about the fight or flight reaction and how anxiety is not

necessarily bad0 Learn about eustress and distress0 Identify those things that make you anxious and why0 Identify things that make your anxiety better or worse

0 Skills0 Develop a list of positive self-statements to use when you are anxious0 Identify ways to eliminate unnecessary stressors0 Discuss ways to use the anxiety to your advantage

0 Abilities0 Practice, Discuss and Modify and needed

Fundamental Goals Cont…

0 Goal Setting serves to0 Help you learn to problem solve0 Develop a roadmap for treatment0 Communicate with supportive others/team members

0 Goal Setting needs to focus on KSAs—Learn, practice, rehearse/apply

0 Trying to change is most effective when 0 the you only focus on a couple goals at once0 You receive frequent rewards

Summary

Homework

0 Using the Addicted vs. Sober worksheet, pick one characteristic you want to change and 0 Do a decisional balance exercise0 Identify ways to keep your motivation up to do what

you need to do