Montana Integrated Behavioral Health Webinar: Behavioral - - PowerPoint PPT Presentation
Montana Integrated Behavioral Health Webinar: Behavioral Activation Monday, September 11 th , 2017 2-3pm MST Housekeeping GoToWebinar INSTRUCTIONS: Join the webinar: How to join https://attendee.gotowebinar.com/register/490 the webinar?
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I nstitute fo r F a mily He a lth Gio rg io Cha te la in, L CSW-R
L ac k of ac tive e ngage me nt in e nvir
De pr e ssive Symptoms
Cha lle ng e s in life c a n le a d to de pre ssio n. Be ha vio r vs. Mo tiva tio n BA he lps pe o ple c ha ng e wha t the y do in o rde r to
de c re a se the ir de pre ssio n.
BA fo c use s o n c re a ting struc ture a nd sc he duling a c tivitie s
tha t fo llo w a pla n.
BA suppo rts ide a tha t c ha ng e is e a sy whe n yo u sta rt sma ll BA e mpha size s re -e ng a g ing the pa tie nt in a c tivitie s tha t
the y pre vio usly e njo ye d
T
he pra c titio ne r a c ts a s a c o a c h a nd
T
ro ub le sho o ts po ssib le b a rrie rs to a c tiva tio n
Ro b ust e ffe c ts ha ve b e e n fo und in re vie ws o f
b e ha vio ra l a c tiva tio n fo r de pre ssio n
L
a rg e -sc a le tre a tme nt studie s with yo ung e r pe rso ns fo und BA to b e mo re e ffe c tive tha n Co g nitive the ra py a nd e q uiva le nt to me dic a tio n fo r tre a ting de pre ssio n.
Re se a rc h with o lde r a dults fo und simila r
re sults, indic a tio n tha t o lde r individua ls re spo nd we ll to BA.
BA ta rg e ts pa tte rns o f avoidanc e,
withdr awal, a nd inac tivity
BA is struc ture d – a pla n is c re a te d BA is b rie f a nd e a sy to use BA he lps de pre sse d pe o ple impro ve the ir
mo o d b y e ng a g ing in ple a sura b le a c tivitie s.
Re -e sta b lish ro utine s tha t ha ve b e e n
dro ppe d due to de pre ssio n
I
nc re a se po sitive e xpe rie nc e s to b re a k de pre ssio n c yc le
Be a b le to a pply skills le a rne d in the future
to de c re a se re c urre nc e o f de pre ssio n
I nc re a se d he a lthy b e ha vio r Po sitive E xpe rie nc e s I mpro ve d T ho ug hts & Mo o d De c re a se de pre sse d b e ha vio r
Ac tivity Monitor
ing
Ho w is the pa tie nt spe nd ing the ir time no w?
Ac tivity Sc he duling
F
the y a re no t d o ing no w
Wha t po sitive a c tivitie s c o uld b e a d d e d into the ir d a y to b o o st mo o d ?
Cr
e a ting Ac tivity Pla ns
Be a s spe c ific a s po ssib le re : a c tivity, d a y, time e tc .
Re vie wing Pr
e ss
At e a c h visit re vie w lo g , c he c k mo o d a nd id e ntify ne w a c tivity
Ac tivity Monitor
ing
Ho w is the pa tie nt spe nding the ir time
no w?
Re vie w b o th po sitive a nd ne g a tive E
xplo re wa ys to minimize ne g a tive b e ha vio r b y de c re a sing it
E
xplo re wa ys to inc re a se po sitive b e ha vio rs
Se lf-re po rts a re no t a s a c c ura te a s a lo g
De pre sse d pe o ple te nd to unde r re po rt po sitive e xpe rie nc e s, e mpha size ne g a tive pe rc e ptio ns, a nd fo c us mo re o n fa ilure s tha n o n suc c e sse s
T
he Ac tivity L
ma ny se tting s
Ha ve the c lie nt fill in his/ he r a c tivitie s fo r e a c h
time b lo c k b e fo re the me e ting .
E
nc o ura g e the c lie nt to write in a c tivitie s tha t a c tua lly o c c urre d , no ma tte r ho w munda ne . E .g . b a thing , dre ssing , e a ting , tra ve ling , ta lking with o the rs, wa tc hing T V a nd sle e ping .
Ask the m to ra te (simple 1-10 sc a le ) the
de g re e o f e njo yme nt e xpe rie nc e d fo r e a c h,
tha t wa s a sso c ia te d with the a c tivity.
Simple ta sks mig ht re c e ive hig h ra ting s Clie nts sho uld try to g ive the mse lve s c re dit fo r
sma ll a c c o mplishme nts, b e c a use pro g re ss is g e ne ra lly ma de in sma ll, inc re me nta l ste ps.
L
two re a so ns
If the r
e is little involve me nt in ac tivitie s that most pe ople would c onside r highly ple asur able and
If the c apac ity for
e xpe r ie nc e joy or ple asur e is blunte d
Are the re pe rio ds o f time yo u e xpe rie nc e
e njo yme nt o r ple a sure ?
Wha t kinds o f a c tivitie s se e m to g ive yo u ple a sure Are the re c e rta in time s o f da y whe n yo u fe e l le ss
ple a sure ?
Wha t a c tivitie s did yo u do in the pa st tha t ha ve
b e e n sto ppe d o r re duc e d?
Are the re a c tivitie s yo u ha ve tho ug ht a b o ut do ing
b ut b e lie ve tha t yo u c a nt?
T
a ke the pa tie nt do wn me mo ry la ne b y a sking the m to re c a ll me mo rie s o f pa st ple a sa nt a c tivitie s
Ac tivity Sc he duling
Ge t po sitive a c tivitie s sc he dule d in T
ra c k pro g re ss (T ra c king F
So c ia l / physic a l a c tivitie s te nd to b e mo st
po te nt mo o d b o o ste rs
T
re a tme nt will a lso fo c us o n inc re a sing da ily ple a sa nt e ve nts
Onc e the pa tie nt se e s re la tio nships b e twe e n a c tivity a nd mo o d , the g o a l is to inc re a se tho se a c tivitie s like ly to ha ve the mo st po sitive impa c t o n the ir mo o d .
Ho w d o we d o this?
Ge ne ra te a list o f ple a sura b le a c tivitie s. Inc lude o ne s fro m the mo nito ring e xe rc ise (Ac tivity L
ple a sure
Bra insto rm with the pa tie nt to list so me ne w id e a s tha t ma y b e wo rth trying (T
r a c king F
m).
T he Pa tie nt de te r mine s whic h a c tivitie s to a d d to the ir d a ily ro utine .
Se le c t spe c ific time s a nd write the m o n the sc he d ule a s a pla n (Ac tivity Sc he dule L
Write in e a c h b o x: 1:Ac tivity 2: Mo o d Ra ting (1-10)
T ime M T We d T h F Sat Sun
6-7a m 7-8a m 8-9a m 9-10a m 10- 11a m
Ple asa nt E ve nts 1 2 3 4 5 6 7
1 2 3 4 5 T
Mo o d Sc o re
Ve r y sad 1 2 3 4 5 6 7 8 9 ve r y happy
State me nt
I do n’ t ha ve a ny mo ne y!
I a m in a whe e l c ha ir, so the re is no thing I c a n do !
I do n’ t like to do a nything !
I’ ll ne ve r b e a b le to do it!
It is just to o ha rd!
Re sponse s
Are the re thing s yo u e njo y tha t do n’ t c o st mo ne y?
Is it true tha t pe o ple in whe e l c ha irs do n’ t pa rtic ipa te in a c tivitie s?
Wha t wo uld yo ur fa mily/ frie nds sa y yo u like to do ?
Is the re a no the r wa y o f lo o king a t this situa tio n?
Wha t is the b e st thing tha t c o uld ha ppe n?
Ho w do e s this wa y o f thinking a ffe c t yo u?
T he mo r e de taile d the plan the mo r e like ly it is to be fo llo we d
I n the pla n c o nside r:
Da te o r da ys o f the we e k Wha t time o f da y Ho w lo ng With who m Othe r a spe c ts tha t ne e d to b e pla nne d Ba c k up pla n
Re vie w Pr
e ss
Id e ntify suc c e sse s
Mo dify the list o f a c tivitie s b a se d o n fe e db a c k
Sc he dule ne w a c tivitie s. (Ac tivity Sc he dule L
Mo dify sc he duling b a se d o n fe e db a c k,
b a rrie rs, c ultura l c o nside ra tio ns, a nd wha t wa s suc c e ssful fo r the pe rso n
Wha t a c tivitie s a c tua lly impro ve d the ir
mo o d is the ke y q ue stio n – to a sk a nd
Ho w did the c lie nt fe e l whe n e ng a g ing in in
ide ntifie d a c tivity. (Use ra ting sc a le )
Ha s the re b e e n a disruptio n in the c lie nt’ s ro utine
(re vie w mo nito ring she e ts, yo u ma y ha ve to b re a k do wn the ple a sura b le e ve nt.
Wha t is g e tting in the wa y o f the c lie nt’ s c o mple ting
the ple a sura b le e ve nt.
A – a sse ss wha t is ma king me de pre sse d C – c ho o se to se lf-a c tiva te T
– try the ne w b e ha vio r
I – inte g ra te ne w b e ha vio r into ro utine O – o b se rve the re sults N – Ne ve r g ive up
1. Ac tivity Monitoring –(Ste p 1) Ho w is c lie nt spe nding the ir time no w? (Ac tivity L
Wha t po sitive a c tivitie s c o uld b e ADDE
D I N to the ir da ys, to b o o st mo o d?
2. Ac tivity Sc he duling –(Ste p 2) Ge t po sitive a c tivitie s sc he dule d in. T
ra c k pro g re ss. (T
rac king F
3. Modify–(Ste p 3) Mo dify the list b a se d o n fe e db a c k, b a rrie rs, a nd
c ulture . (Ac tivity Sc he dule F
F
Ple a sa nt Ac tivitie s a Da y Ke e ps the Blue s Awa y
T he y do n’ t ha ve to b e hug e - Just Consc iously Chose n, a nd
De libe r a te ly Done to e xpe rie nc e c o ntro l.
ve nts/ a c tivitie s Co ntro l Mo o d.
he re fo re , to so me e xte nt, yo u c a n c o ntro l (influe nc e ) yo ur mo o d.
e ffic a c y o r ma ste ry fo r re duc ing de pre ssio n a nd impro ving yo ur q ua lity o f life .