Foundations of Addiction Counseling
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transcript
7 Skills FOR ADDICTION-FREE LIVING
00:05I miss those relationships and you know a few of us have been through you know some heavy things together and… and they're not here anymore.
00:15AN ALLYN AND BACON PRESENTATION A PEARSON EDUCATION COMPANY PRODUCED BY GOVERNORS STATE UNIVERSITY
00:20It’s like I know I can do the work, but I doubt myself so much you know and I… I… I procrastinate.
00:25John And then I get sad and I feel I'm just not good enough. I don’t know how to even pick out a shirt to wear.
00:407 Skills FOR ADDICTION-FREE LIVING A Video Series WITH YOUR HOSTS Dr. Jon Carlson & Dr. Judy LewisGovernors State University Professors THIS VIDEOTAPE FEATURES Dr. Reid Hester BEHAVIORAL SELF-CONTROL
01:00Dr. Jon Carlson Hi, I'm Jon Carlson
Dr. Judy Lewis And I'm Judy Lewis . This program is on behavioral self-control.
01:05Dr. Jon Carlson You know Judy , when I think of behavioral self-control, I think of you know wanting to do something different this voice comes to me. You know from mymother . My mother always said to me the road to hell is paved with good intentions. You know there are so many things that we want do and we just never get around to doing it.
01:25Dr. Judy Lewis You know that’s really right. We all do have good intentions. Don’t we? They're always… always things that we wish that we could work on and we think we ought to work on, but then day by day goes by and it’s hard to find the right time to do it. Isn’t it?
01:45Dr. Jon Carlson Sure, you know Judy we're lucky here today because we've got a studio audience with us, a group of people in various stages of recovery. Why don't we find out from them, what are some of the things… what are some of the good intentions that they have? What are some of the things that they would like to work on?
02:00Dr. Judy Lewis What are some of the things that you've been thinking about waiting for just the right time to work on say some kind of new behavior and now the right time is here.
02:15Well I want to stop smoking and like I said getting into the exercise on a regular routine.
02:20Dr. Judy Lewis Stopping smoking and getting into exercise.
02:25Right.
Dr. Jon Carlson (inaudible ) good intentions, yeah. Who else?
02:30Mary Ann I want to start eating better and also exercising more.
Dr. Judy Lewis Good.
Dr. Jon Carlson Okay.
02:35John I'd like to ah… quit smoking, but I think maybe realistically I should think about cutting down from 30 cigarettes a day to ten or something like that maybe. This might be easier.
02:45Clayton Brown Because of my health problems being a diabetic, I'd like to stop drinking. I don’t drink a lot but I know I shouldn't drink at all, but I do.
03:00Dr. Jon Carlson Okay good.
Tim I'd like to remember to focus on time for myself where I'm aware of whatever problems I may have and… and be able to take care of them instead of working helping this person doing this.
03:20Dr. Jon Carlson Judy this is quite a list. There is a lot of different… different possibilities and I think lot of different behaviors to change.
03:25Dr. Judy Lewis Yeah and I think what's really interesting about the behavioral self-control as you go on you'll find that the same kinds of steps might be helpful for a whole variety of different kinds of issues. So when Reid has to works with you I think that you'll find that you can apply some of what he's gonna teach you to whatever behavior you want to work on.
03:50Dr. Jon Carlson Why don’t we move on now and go and talk to Reid and find out just what that behavioral self-control is.
03:55Dr. Judy Lewis Great.
04:00Behavioral Self-Control A Discussion with Reid Hester
04:15Dr. Judy Lewis Reid I know there is a set of skills under the rubric of behavioral self-control and you can actually teach people these skills. What do you mean by behavioral self-control?
04:25Dr. Reid Hester Well Judy , it’s really a matter of defining specific behaviors that you wanna change and then going through a set of procedures to make those changes happen.
04:35Dr. Judy Lewis So, if there's a behavior that I would like to have, there is something I would like to learn to do I can learn a set of procedures that will help me achieve that change in my behavior.
04:50Dr. Reid Hester Yes.
Dr. Jon Carlson What kind of behaviors can you work with? What are appropriate for this kind of training?
05:00Dr. Reid Hester Well, it’s interesting that you asked thatJon . The behavioral self-control originally came out of weight reduction.
05:05Dr. Jon Carlson Okay.
Dr. Reid Hester And when I came into the field about 17 years ago, it had been adapted for use with problem drinking.
05:15Dr. Jon Carlson Okay.
Dr. Reid Hester And since that time it has again been expanded out to helping people learn how to become and maintain abstinence, ah… as well as deal with other kinds of lifestyle behaviors such as smoking…
05:30Dr. Jon Carlson Okay.
Dr. Reid Hester …and ah… exercise and that sort of thing.
05:35Dr. Jon Carlson So exercise, drinking, smoking, weight reduction are four of the most prominent?
05:40Dr. Reid Hester Yes.
Dr. Jon Carlson Uh-uh.
Dr. Judy Lewis Now if I understand correctly I know you did mention abstinence from alcohol and other drugs or cutting down on smoking or drug use, but if I understand it correctly you really try to focus on developing new positive behaviors more so than just eliminating behaviors that you wanna get rid of. Is that right?
06:00Dr. Reid Hester Well, much of that if you know to implement new positive behaviors sometimes requires eliminating old negative behaviors ah… and that’s… that’s where it comes into… into use with drinking and with smoking for instance. So it’s been used to help people learn how to cutback on their… their drinking. It’s been used as a stepping stone to abstinence for people who wanna quit smoking ah… and then they can start to implement these other healthy behaviors that are in somewhat of they're in conflict with these addicted behaviors.
06:45Dr. Judy Lewis So there is both sides to it. You can use behavioral self-control to try to eliminate or cut down on negative behaviors and try to learn positive behaviors to take their place.
06:55Dr. Reid Hester Precisely.
Dr. Jon Carlson What about dealing specifically with substance abuse? Can you talk about how these skills would be used in recovery?
07:05Dr. Reid Hester Sure. Ah… You know there's a broaduniverse of people who drink excessively and who develop alcohol related problems.
07:15Dr. Jon Carlson Okay.
Dr. Reid Hester And if you actually look at the overallpopulation of such individuals you find that there is a very small percentage of them who become severely dependant and physically dependant and who develop very severe alcohol and drug related problems. There is a much larger universes by four to five times that size of individuals with less severe alcohol related problems who could benefit from changing or modifying their behaviors.
07:45Dr. Jon Carlson Okay so this is all continuum.
Dr. Reid Hester Right. It is a continuum of… of… of ah…
07:50Dr. Jon Carlson Use…
Dr. Reid Hester Of use and of alcohol related problems.
Dr. Jon Carlson Okay.
07:55Dr. Reid Hester And self-control training has been found to be very effective particularly with people at the less severe end of the spectrum in terms of helping them to modify and… and reduce their drinking so that they don’t progress on to more severe problems.
08:10Dr. Jon Carlson And so if I was say drinking four beers a day and I wanted to maybe cut that down to maybe drinking twice a week. How would you help me?
08:20Dr. Reid Hester Hmm… hmm… Well, that would be one way to define the goals that you have. If you're drinking four beers everyday and you wanted to go from seven days a week down to two days a week that would certainly you know significantly cut the overall amount that you drink. At the same time if you are drinking those four beers in an hour you're gonna be achieving very high blood alcohol levels. So I might suggest that you consideralso spacing those drinks out across of time. So you do not become intoxicated.
08:50Dr. Jon Carlson Okay so that might be one… one way that you would help me is to drink little less frequently, that’s often.
08:55Dr. Reid Hester Correct.
Dr. Jon Carlson And this would be really important so that somebody actually knows how to bring about their change. I mean a lot of people want things that happen differently and yet they just don’t know how and is that what your program does is helps people to make these dreams a reality?
09:10Dr. Reid Hester It really is a set of procedures for helping people learn how to change.
09:20Dr. Judy Lewis And the first of those procedures is making sure to develop goals that sounds like that are very realistic and specific and you help a person figure out what the goals should be.
09:30Dr. Reid Hester Correct. For instance ah… with smoking we know from the… from the research that very few people although there certainly are some, but very few people who've been moderate smokers can go… can go to cutting back to having one or two or three cigarettes a day. Most people find that very difficult and that’s a high risk situation for relapsing back to heavier smoking.
09:55Dr. Judy Lewis Hmm… hmm…
Dr. Reid Hester Ah… So, if someone is looking at either quitting or cutting back we… I share that experience with them that… that the chances of them being successful at long-term maintenance(ph) of moderate smoking are small.
10:10Dr. Judy Lewis So you know what the research is about how likely it is that someone can be successful in making a particular change. You share that in an understandable way with the… with the person and then of course it’s the person's decision what his or her goal is right?
10:30Dr. Reid Hester Its always the persons decision.
Dr. Judy Lewis Yeah.
Dr. Reid Hester But you know the individual always decides what his or her goals are, regardless of what I as a therapist might you know tell or suggest or recommend. So ah… keeping that in mind I always share with my clients ah… what we know from scientific research aboutthe appropriateness of certain goals to change. Just as ah… as it is risky and ah… it’s a real health risk to lose too much weight too quickly.
11:05Dr. Reid Hester Ah… and if a person comes to me must lose 50 pounds in… in… in three weeks or four or two months…
11:15Dr. Judy Lewis Yeah.
Dr. Reid Hester …you know I advice them that they should really consult with their physician because that’s a health risk.
11:20Dr. Jon Carlson Hmm… hmm…
Dr. Reid Hester And they're more likely to eventually put that weight back on. A more realistic and appropriate goal for them might be lose one to one and half pounds a week.
11:30Dr. Judy Lewis Hmm… hmm…
Dr. Reid Hester And do that over a course of a year. Same thing with drinking. Ah… There are some folks who can successfully moderate their consumption and others who are not successful and who're not able to do that and that’s really a function of the level of problem severity in level with of dependence that the client has when they decide to change.
11:50Dr. Judy Lewis What are the differences between the people who would fall into the category of people who would be good candidates for looking at moderation as a goal versus the people who would be a lot better off working to what abstinence as there as their goal?
12:10Dr. Reid Hester Hmm… hmm… Good question.
Dr. Jon Carlson Yeah. If you'd answer it.
12:15Dr. Reid Hester Yeah. If you ah… if you think of problem drinking as on a spectrum on a continuum from less severe to more sever, very severely dependant, the chances of succeeding while in term we're talking two to eight years after training. The chances of succeeding with moderate drinking decline as the problems severity increases.
12:35Dr. Judy Lewis So the more severe your problem, the less likely it is that moderation is a good direction for you to go.
12:45Dr. Reid Hester Correct.
Dr. Judy Lewis With the less severe problem of maybe a shorter duration, maybe you've just been starting to develop some problems with alcohol, it’s kind of getting in your way, but you're not physically addicted at this point. If you're in that situation then moderation might be something that would be more realistic for you.
13:10Dr. Reid Hester Precisely and more acceptable to you. Now clearly stopping drinking just as in stopping smoking is the safest way to avoid any alcohol or nicotine related health hazards and any consumption has some risks that's involved with it.
13:25Dr. Judy Lewis Oh yeah.
Dr. Reid Hester But we have to take into account what people are willing to accept.
13:30Dr. Jon Carlson So one of the obstacles would be is thatwe may say we're supposed to do this, but we're not ready. Are there other obstacles to… to bringing about the changes that we want?
13:40Dr. Reid Hester Well, sometimes that’s not knowing how to do it, how to actually set some appropriate goals to keep track of what it is that you're doing to change the specific behaviors.
13:50Dr. Jon Carlson Hmm.
Dr. Reid Hester To set up rewards for making those changes and then to figure out alternative ways of achieving the… the good things that the… the old behavior used to provide.
14:05Dr. Jon Carlson Is that very common in the substance abuse area where people are in recovery and they just don’t know how to do these things?
14:15Dr. Reid Hester Yes it is.
Dr. Jon Carlson Uh-uh.
Dr. Reid Hester Its pretty common in change in general.
Dr. Jon Carlson And you've done a lot of research in this area and is that so much which the prevalence that you've really researched the effectiveness of this model, the model that you've developed in working with people in recovery?
14:30Dr. Reid Hester Well I must say I didn’t actually developed this model, this was ah… you know…
14:35Dr. Jon Carlson Uh-uh
Dr. Reid Hester This was done before I… you know really got into the field almost 30 years ago now.
14:40Dr. Jon Carlson So this is been around a long-long time.
Dr. Reid Hester It’s been around a long-long time.
14:45Dr. Judy Lewis You know what I think is really interesting about it was really appealing about this model to me is that they're sort of like technology of behavior change. There is things that… that are known about how behavior actually changes and a lot of times we think that there are some experts who know that, who know how to do that, who know how to change behaviors, but I think what you're really saying is that we can all become experts. We can learn the technology that we need to know in order to change our own behaviors, whatever the behaviors are that we wanna work on.
15:15Dr. Reid Hester That’s right. Now that doesn’t speak towhat you read up a little bit ago The History of Motivation, do I wanna change those behaviors.
15:20Dr. Judy Lewis Hmm… hmm…
15:25Dr. Reid Hester That isn’t… That isn’t… That’s a… That’s a preceding question you know. Do I really wanna eat less chocolate cake?
15:30Dr. Judy Lewis Yeah.
Dr. Reid Hester I really like chocolate cake, but I don’t like what it does to me.
15:35Dr. Jon Carlson Hmm… hmm…
Dr. Judy Lewis So what are the things that you do when you're doing training is first to help people decide exactly what their goals are, how real those goals are to them and then it wouldn't really be time to get into that next step about how you're going to do it until you're pretty sure that that’s what you want.
15:50Dr. Reid Hester Well actually making sure that that pretty sure you wanna do something about your smoking or your drinking, really kind of precedes the goals.
16:00Dr. Judy Lewis Yeah.
Dr. Reid Hester Because the first question is do you wanna change anything? Do you wanna change at all? You wanna get rid of these alcohol related problems.
16:10Dr. Jon Carlson Uh-uh.
Dr. Reid Hester Ah and once the person’s made that decision then how you go about doing it is the next logicalquestion to ask.
16:20Dr. Judy Lewis Want to get back for just a minute to thequestion about ah… alcohol and… and moderation of drinking as a… as something that somebody's trying to achieve. I know sometimes people get so upset when they hear about that, but I think that must be because they're thinking of people whose problems are so severe that they're in treatment for alcohol addiction and those people would fall into the group that wouldn't be the best group for looking toward moderation as an outcome, but thenwhen you think about treatment, treatment doesn’t have that much to offer to people who don’t have such severe problems, but wanna make some changes and for them if they can learn the techniques to change their drinking habits before things get out of hand this would be ideal for them right?
17:10Dr. Reid Hester That’s correct. Ah… The people… The people who have developed problems that are severe enough to went to want specialized treatment ah… are the poorest candidates for any sort of moderation training and… and in my clinical experience I found that most individuals who've had severe problems related to their drinking when you discuss goals of change and what moderate drinking is and what is not and what…
17:40Dr. Judy Lewis Oh yeah.
Dr. Reid Hester …and what… ah… you know what the alternative is there ah… there is no question about it. The heavy drinkers, the alcoholics will say that’s not… that’s not drinking.
17:50Dr. Judy Lewis Also when you say that about only… only two drinks a couple of days a week.
Dr. Reid Hester It’s not true thing.
17:55Dr. Judy Lewis Not worth it right.
Dr. Reid Hester Why even bother, you know.
Dr. Judy Lewis Yeah.
Dr. Reid Hester That’s like you are not anything. It would be easier in the first place not to start not to resume drinking in the first place and I say yes that’s right.
18:05Dr. Judy Lewis Yeah.
Dr. Reid Hester Hmm… hmm… Now you know we're all interested and our clients are interested in getting rid out of their… out of their alcohol related problems or with their drug related problems.
18:15Dr. Jon Carlson Hmm… hmm…
Dr. Reid Hester And that’s where the bottom line in our business. How they go about doing that is you know involves multiple pathways. There is no single approach, there is no single goal of change that’s gonna work best for everybody. We do know that people who are more severely dependant are less likely to be successful with moderating their drinking.
18:35Dr. Judy Lewis Yeah.
Dr. Reid Hester People who are less severely dependant are more likely to be successful with moderating their drinking, but if they wanna… if they choose to stop drinking entirely that’s also a perfectly appropriate path for them.
18:45Dr. Judy Lewis And if somebody has pretty successfully been able to cut out drinking, you know if that was an issue for them then they might still have some other health related behaviors to work on that would help them maintain the changes that they've made.
19:00Dr. Reid Hester Well yes that's true. Most people that are able to get into recovery from one addiction don’t automatically turn… turn into saints.
19:10Dr. Judy Lewis Yeah.
Dr. Reid Hester You know and (inaudible ). Umm… And… And there is a high… high rate of smoking for instance…
19:20Dr. Judy Lewis Yeah.
Dr. Reid Hester …in people who are in recovery from alcohol and drugs and we know from our research that people who continue to smoke are at a increased risk for relapsing back to alcohol abuse.
19:30Dr. Judy Lewis Hmm…
Dr. Reid Hester So quitting smoking after you quit drinking ah… increases your chances of long-term sobriety.
19:40Dr. Judy Lewis Now that’s really… I think that’s really something that’s… that’s interesting for people who might have succeeded in bringing about a change in one behavior and not making that connection to some other behaviors.
19:50Dr. Reid Hester Hmm… hmm…
Dr. Jon Carlson It sort of sounds like the sky is the limitwith this model you know that if you follow this you can change so many things about your life and in this program you're going to teach us about things like goal setting and how to monitor our own behavior and then actually to how to modify it.
20:10Dr. Reid Hester Hmm… hmm…
Dr. Jon Carlson And then we're going to move on to maybe some of alternatives that we can have in our future.
20:15Dr. Reid Hester Hmm… hmm… Well yes and no Jon . You can modify some of those things which are under your control. There are other aspects of real life which are not under your control.
20:25Dr. Jon Carlson Hmm…
Dr. Reid Hester Your genetic predisposition for instance to say cancer or heart disease. Those things are going toyou know come up and bite you ah… and sooner or later.
20:35Dr. Jon Carlson Hmm… hmm…
20:40Dr. Reid Hester But by making lifestyle changes about smoking, drinking, eating, exercise, you can certainly reduce the impact that those have and perhaps push them off for 10 or 20 years.
20:50Dr. Judy Lewis And you can feel a lot better while you're doing it too.
20:55Dr. Reid Hester That’s right. You have a lot more fun.
Dr. Judy Lewis Yeah.
Dr. Jon Carlson Hmm… hmm… But before we go on to having the fun of hearing you teach us these skills, we have an audience of people who are at various stages of recovery and they've been listening patiently at our interview and they have some questions or comments. Let’s move right to them now.
21:20Behavioral Self-Control Group Discussion
21:35John I smoke about 30 cigarettes a day, gets some day more someday less. Is it realistic to think about cutting back to ten a day?
21:45Dr. Reid Hester For some people it is for some people it isn’t. For some people going cold turkey is… is the best approach and for other people this warm turkey approach of cutting down with an eventual goal of… of stopping entirely. Some people find it… I can't predict for youindividually. You know it might be one way for you to stop.
22:10John Is it possible to go to 10 permanently is what I'm asking.
Dr. Reid Hester That is difficult for most heavy smokers and 30 a day I would consider you a heavy smoker.
22:15John I used to smoke 60.
22:20Dr. Reid Hester Hmm… hmm… and cutting back to 30 that's an improvement.
John Progress.
Dr. Reid Hester That's progress.
22:25Tim Ah… I have a question about you mentioned reward, the reward system based upon whatever behavior we may be trying to alter. Ah… You know I tried to lose weight in the past, I've tried to quit smoking in the past, tried to quitdrinking in the past. The drinking I've found that the only way for me to… to moderate is to actually quit completely.
22:45Dr. Reid Hester Hmm… hmm…
Tim Ah… Problems with for example a diet. If I lose 5 pounds over a period of two weeks for some reason my mental reward is a piece of cheese cake or something to that effect.
23:00Dr. Reid Hester And you're not alone in that.
Tim Right. I can’t seem to find the correct balance for a reward ah… for whatever it is; smoking, weight loss, or you know ah… behavior toward other people, whatever it maybe. Do you have any ideas that… that… that are common?
23:15Dr. Reid Hester Well we're going to be doing an exercise later…
23:20Tim Okay.
Dr. Reid Hester …on setting up specific rewards. Ah but the first thing we'll be talking about is goal setting and losing five pounds in two weeks puts you at risk for putting it right back on.
23:30Tim Right.
Dr. Reid Hester Because to do that you have to go on such a calorie restriction or such an intake restriction that your body is just not used to that kind of deprivation.Okay. You know your little chocolate senses are going give me, give me, give me.
23:45Tim Right.
Dr. Reid Hester You know whereas you need to kind of start those slowly, so that they can kind of get used to not having as much chocolate in the system.
23:55Tim Alright.
I have a question about that then, I mean if… if you're trying to do these things based on a reward system of sort isn’t that kind of… won’t… won’t it be then become about not necessarily changing that behavior but it will become about doing this so you can get what's at the end, you know so you can get the reward rather than changing your thinking about it to begin with. You know it’s like if… if your… if your idea is to quit smoking or… or lose 5 pounds whatever and your reward is whatever. You know then you're not going to be doing it for your know health reasons to feel better. You're going to be doing it to get your reward. It's like to get to that. I suppose to you know trying to learn how to change how you think about it. I don't know I mean does that make sense?
24:40Dr. Reid Hester Well, I think it’s a good question you know. Does the reward supersede the value of the change itself? Ah… And the way I look at setting of a reward system is as a compliment. It’s an additional… it’s an adjunct to what you're trying to do. Think of it this way ah… let’s say that you're at work and you've had a project you know put on your desk and you have to… to really double your efforts and really you know put tremendous amount of energy and to get this project done by its deadline and as you're working your tail off to get that done, your boss comes along and pats you on the back and says you know I really appreciate what you're doing. This looks great. It's fabulous. What impact does that have on you?
25:25Okay what I'm thinking in my case that if I'm… if my deal is like I procrastinate to like (inaudible ) and I would think that okay say I set a goal or a deadline to have whatever this particular project done by certain date and I'm thinking when it’s done my reward will be I can just lay around all there.
25:45Dr. Reid Hester No, procrastinate more.
Yeah.
Dr. Reid Hester That’s like… That’s like eating after yourdiet.
25:50Yeah. After you have completed the project on time and you didn’t wait to the last minute and you're like you could take a data just lounge around or watch movies or whatever. I'm going to resent the fact that I had… that I had to bust my (inaudible ) more to like it that stuff done on time. Do you… know what I am saying?
26:05Dr. Reid Hester Correct and that’s like rewarding yourself from moderating your drinking by drinking heavily.
26:10Hmm…
Dr. Reid Hester Yeah.
So what would be the appropriate reward then? Cos what you really want to do is lounge around to begin with. So what would be the appropriate reward?
26:20Dr. Reid Hester And you're ambivalent about changing that. You know you… you have you know there's this yes spot, yes I'd like to be more efficient but I really like being lazy. I really like you know just kind of let that stuffs slide to absolutely positively has to be done and then I work well under pressure. You know.
26:35I just work under pressure.
Dr. Reid Hester Uh-uh.
I don’t know how well. But I think it’s not that I like wait until last minute. I just like not doing anything really.
26:45Dr. Reid Hester Uh-uh, okay.
So…
Dr. Reid Hester Uh-uh, you like that?
26:50Yeah absolutely.
Dr. Reid Hester Uh-uh.
So what would be inappropriate reward for that then?
Dr. Reid Hester Well there's… there's… there's a preceding question here of motivation. Do you really want change? And you know if the balance is tipped in favor of not changing then you know umm… any efforts that you put into it are not going to work.
27:10Dr. Judy Lewis So if you don’t really want to do it that much if you really… if you really aren’t that interested in making the change then the greatest reward in the world wouldn’t do it wouldn’t work.
27:15Dr. Reid Hester Correct.
Okay.
27:20Dr. Jon Carlson So many good questions here.
Dr. Reid Hester Hmm… hmm… yes there are.
Dr. Jon Carlson I think we're all in the right place. Why not get started with our first activity where you can maybe you can show us how to begin with goal setting.
27:30Dr. Reid Hester Sure. Hmm… hmm… okay.
27:35Exercise 1 Goal Setting
27:45Dr. Reid Hester Goal setting. Goal setting is more than just your new year’s eve resolutions. Ah… On your hand out there are some of the specific issues to consider when you're trying to set some goals for yourself. The first one is to specify the behavior. It’s one thing to say you know I wanna be happier. Well, what exactly are you going to do to ensure that you have more happiness? Ah… Its… It’s a specific behavior might be to cut your smoking down from 30 cigarettes a day down to 10 or to moderate your consumption to non-hazardous levels. Ah… But when you… when you wanna set a goal, you need to set a specific behavior; how much, in what period of time, or if you are gonna set a quick date what sort oftimeline are you talking about. So you can start preparing for that date. Ah… If you're engaging in that behavior that you wanna change right now, how much are you doing it? Where are you doing it? When are you doing it? So having an understanding of how much you're drinking, where are you drinking, who are you drinking with? Okay. Ah… And in what sorts of situations you're drinking maybe more or less. So understanding your current behaviors will be helpful so you can track your changes as you make them. Ah… Where do you wanna be in two months? Ah… Do you want to have stopped smoking entirely? Do you want to have completed your moderateconsumption reduction so that you're drinking moderately at the end of two months? Do you want to have your exercise routine go from none to five days a week, half an hour at a time? Ah… So, what are some short-term goals for yourself and also what are some long-term goals for yourself? What would you like to be in a year? Ah… Now you need to be specific. Okay. So to give you an example of how to how to do this ah… I would like to volunteer from the audience about somebody would like to change your behaviors.
30:05Sure.
Clayton Brown Hi my name is Clayton Brown .
30:10Dr. Reid Hester Clayton .
Clayton Brown Uh-uh.
Dr. Reid Hester What specifically would you like to change?
30:15Clayton Brown Well on weekends I drink heavily. Ah… After (inaudible ) I usually do it just like celebrating, getting done with a project or finishing a course or class or something.
30:25Dr. Reid Hester Hmm… hmm…
Clayton Brown So I would… I would go and get ah… if the bottle doesn't have a hand alone and I have want anything to do with it so I drink really heavy and Crown Royal is my favorite.
30:35Dr. Reid Hester Okay. So you're drinking spirits that's hard liquor and Crown Royal is 80 proof or 86 proof?
30:40Clayton Brown It’s… It’s some kind of (inaudible ) numbers.
30:45Dr. Reid Hester You are not sure?
Clayton Brown I'm not sure.
Dr. Reid Hester Okay, okay. Ah… So do you have any sense of how much you're drinking in an evening right now?
30:55Clayton Brown Ah… pretty much almost half of the whole bottle and I mean it’s like half a gallon that I buy.
31:05Dr. Reid Hester Hmm… hmm… It’s one of those double bottles it’s like a 1.75.
Clayton Brown Yeah its one of those.
31:10Dr. Reid Hester Uh-uh. Or one I guess is I think they're 1.5 liters. They're 1.5.
Clayton Brown Yeah I think so.
31:15Dr. Reid Hester Uh-uh.
Clayton Brown It’s like a gallon or half a gallon. Anyway we… I'll… I'll drink almost half of that by myself you know.
31:20Dr. Reid Hester Uh-uh.
Clayton Brown And I really want to reduce. I want to cut that down.
31:25Dr. Reid Hester Yeah that's… that is a lot. Ah… That’s and that level of consumption is putting you up probably in the 99% in terms of US adult males.
31:35Clayton Brown Yeah.
Dr. Reid Hester Yeah. Let me describe to you what moderate drinking would be, you tell me if that's a realistically in terms of eventually getting down to that point.
31:40Clayton Brown Okay.
Dr. Reid Hester Ah… It would be ah… two or three standard drinks ah… with the course of an evening and a standard drink is one and half ounces of Crown Royal.
31:55Clayton Brown That'd be nice.
32:00Dr. Reid Hester Currently you're… you're drinking approximately 24 ounces…
32:05Clayton Brown Yeah.
Dr. Reid Hester …of Crown Royal in a night and this would be a reduction down to three to four and a half ounces.
32:15Clayton Brown Yeah, I would like to get down to something like that to be able to… be able to drink and enjoy myself to be (inaudible ) on drink and not drink and be (inaudible ) you know what I mean. It’s a difference I'd like to just be able to have a few cocktails and let that be done. But as long as the bottle is there I'm going to drink it. You know what I mean.
32:35Dr. Reid Hester Uh-uh.
Clayton Brown So, I hope you can help me with that.
Dr. Reid Hester So, does that seem… does that seem like a realistic goal to you to cut down to between three and four and a half ounces total over course of an evening?
32:50Clayton Brown In one night?
Dr. Reid Hester Yes.
Clayton Brown That’s like ah… shot glass from what it sounds like to me is like a little shot glass.
32:55Dr. Reid Hester The little shot glass is usually a ounce and a half. So that would be two or three of those.
33:00Clayton Brown Oh it would be like two or three.
33:05Dr. Reid Hester Uh-uh.
Clayton Brown That could be realistic for me but ah… I had to (inaudible ) myself down to that level.
33:10Dr. Reid Hester And you may… you may have to go for it if you gonna be successful with that and you may not, to be honest with you. You may have to go from 24 down to 12 down to 8 down to…
33:20Clayton Brown To four.
Dr. Reid Hester Three or four.
Clayton Brown Three, four.
33:25Dr. Reid Hester That’s right. Uh-uh.
Clayton Brown Okay. You know that sounds like it could be realistic for me.
33:30Dr. Reid Hester Okay.
Clayton Brown Uh-uh.
Dr. Reid Hester Okay. Ah… do you have any sense of whether you're going… whether you're gonna need to collapse the amount of time that you spend drinking?
33:40Clayton Brown Ah… Not really. I don’t drink all the time.
33:45Dr. Reid Hester No I mean on the weekends.
Clayton Brown Oh, on the weekends?
Dr. Reid Hester Yeah.
33:50Clayton Brown Then you have probably will have to collapse the time.
Dr. Reid Hester Uh-uh.
Clayton Brown And it would probably… it wouldn't take me that long though because if I don’t need it until only the weekends I know I can tell my mind that you know you don't need till the weekend then just work on the… the goal setting.
34:10Dr. Reid Hester Uh-uh.
Clayton Brown You know and then over a period about two or three months I know I can get down to that level,but from right now where I stand like after the final exam that’s coming up I'm gonna wanna go and get half a gallon of Crown Royal and I'm gonna wanna drink it. But I remember what we're talking about now and then it'll make me keep that in mind and then I'll probably just get a pint.
34:30Dr. Reid Hester Well and that’s that is you know that’s one way to that sort of stimulus controls one way to do that.
34:40Clayton Brown Yeah.
Dr. Reid Hester Okay. Ah… If you… If you buy half a pint and that’s all you have at home that’s all you can drink.
34:45Clayton Brown That’s all I can drink. (inaudible ).
34:47Dr. Reid Hester Uh-uh okay. Well thank you. We'll talk more about this as we get into the self-monitoring and all.
34:50Clayton Brown Okay.
34:55Dr. Reid Hester John do you want to talk about your cigarette reduction?
John Yes.
Dr. Reid Hester Okay. Come on up here. So you're smoking about how much now?
35:05John Thirty cigarettes a day approximately some days it's more some days its less.
Dr. Reid Hester Okay. Do you have any sense of… of… timeframes more in the morning after meals or is it just pretty much steady from the time you get up the time you go to bed?
35:15John Pretty much steady.
Dr. Reid Hester It is?
35:20John Uh-uh.
Dr. Reid Hester Okay. Uh… And what would be an realistic goal for you to set?
35:25John In terms of?
Dr. Reid Hester Cutting back.
John Cutting back?
Dr. Reid Hester Uh-uh
John Well, I could see myself cutting back over a period of you know a month or a couple of months, maybe from 30 down to slowly down to 20 then on down to 10.
35:40Dr. Reid Hester Uh-uh.
John I think it might be difficult to go beyond 10 and let’s say you stop.
Dr. Reid Hester Uh-uh. (inaudible ) Uh-uh. But you… you said earlier that you gone from 60 down to 30.
35:50John Yeah.
Dr. Reid Hester So you may be able to you know stop at ten or even cut down below 10 and stay there for some pretty time.
35:55John Yeah, I don’t think so. Well mainly because that’s you know it’s sort of a rogue habit. I mean it’s something I do.
36:00Dr. Reid Hester Hmm… hmm…
John You know and like when I wake up that’s the reason to start smoking.
36:05Dr. Reid Hester Hmm… hmm…
John Means when I wake up when I have coffee after I eat, when I'm nervous, when I'm happy, when I'm tired, when I'm sad. Keeps going.
36:15I know (inaudible ).
36:20Dr. Reid Hester Yeah. Unfortunately you're pretty heavily addicted.
John Yes, unfortunately.
36:25Dr. Reid Hester Uh-uh. So cutting back to 10 cigarettes a day ah… and doing it going from 30 to 10 over a course of may be four to eight weeks.
36:30John I'd see I’d wanna go for eight.
36:35Dr. Reid Hester Uh-uh.
John I mean is that reasonable. (inaudible ) too long too short?
36:40Dr. Reid Hester I think that’s reasonable, you know. Ah… Part of that is… is just deciding what you think you're capable of doing, you know.
36:45John Okay.
Dr. Reid Hester Ah… And what is unrealistic to you. Okay.Are you gonna try and restrict your smoking to say that you're not smoking during some periods of the day. You just have to try and space it out evenly across it.
37:00John Space it out ah… more evenly kind of throughout the day and I think I am… instead of just grabbing a cigarette as I am talking on the telephone…
37:10Dr. Reid Hester Uh-uh.
John Almost plan(ph).
37:15Dr. Reid Hester Uh-uh.
John Well I'm going to have a cigarette. I mean does that make sense? I mean I… I mean I because I'll just pick a cigarette it rings ping, put cigarette in the mouth light it up.
37:20Dr. Reid Hester Uh-uh, that’s right. So, yes I think it's a wise idea is being very conscious of your behaviors as you're trying to change them and keeping track of them which is what we're going to talk about in the next little exercise. Uh-uh. I think that’s realistic.
37:35John Okay.
Dr. Reid Hester Yeah, great.
John Thank you.
Dr. Reid Hester Sure. Why don't you all take a few minutes and you at home take a few minutes to ah… write down some goals that you would like to pursue in yourself. Ah… make them specific behaviors. Ah… take a few minutes and describe what it is that you're doing now and where you would like to see yourself you know going in the next eight weeks or so and also where you'd like to be more in long-term. Ah… So be specific and we'll come back and see what you've come up with. Okay. You too at home do the same.
38:15It's Your Turn goal setting 1. Specify a behavior you want to change. 2. Describe that current behavior. 3. What is a short-term gal for change? 4. What is a long-term goal for change? Please turn off video & proceed with exercise. Return to video when you feel ready.
38:35[sil.]
38:45Exercise 1 Wrap-up
38:50Dr. Reid Hester So what you've come up with?
38:55Tim Well I have a… a personal favorite its… its binge eating. I will starve myself all day thinking that I'm on somesort of a good diet and then have a salad maybe for dinner and then a bag of cookies and a half gallon of milk until I eat myself sick.
39:10Dr. Reid Hester And then you hit the Ben and Jerry's.
39:15Tim Ah no well sometimes you know yeah. It getsoutrageous. You know 5000 calories just before I go to bed you know ah… it's just, is not right.
39:25Dr. Reid Hester Uh-uh.
Tim But somehow in my mind I just can't stop that behavior right now.
39:30Dr. Reid Hester So what goal do you have then?
39:35Tim Well my goal is I mean I know what proper nutrition is I know ah… you know three meals a day if you have a snack make it something nutritious you know at least, not garbage.
39:45Dr. Reid Hester Uh-uh.
Tim Watch your calories you know begin to exercise.That’s my goal. At least get the three meals a day.
39:50Dr. Reid Hester Uh-uh.
Tim Wanna start off with that.
Dr. Reid Hester Uh-uh.
39:55Tim And then will start working on the nutritional content of those of those meals.
Dr. Reid Hester Okay good good.
40:00Tim Ah and then from there…
Dr. Reid Hester Let me just stop you there. That’s a good stepwise approach. You take okay the first most realistic thing is to try and get those three meals a day in.
40:10Tim Right.
Dr. Reid Hester Ah and then you gonna start working on health… healthy aspects of it and then you'll start putting in the exercise. That’s more realistic than trying to do it all at once.
40:20Tim Exactly.
Dr. Reid Hester Good idea.
Tim I know myself. Very well I've tried it too many times.
40:25Dr. Reid Hester Anyway actually if you wanna just try and do three meals a day like two-three times in the next week…
40:30Tim Hmm… hmm…
Dr. Reid Hester And then gradually build up to the number of days because you're trying to build the new habit.
40:35Tim All right. That’s a very good idea.
40:40Dr. Jon Carlson Whose next?
Mary Ann What I'd like to do is be able to start exercising more consistently and conventionally be able to run a mile a day. What I'm doing now is I'll say okay fine I'm going to start walking a mile a day which is not really difficult, but then I get bored with the walking because running is more fun and I start pushing myself and then putting myself and then I don’t do anything.
41:00Dr. Reid Hester Uh-uh.
Mary Ann And then it’s like I get depressed and won’t do it. So that's what I would like to be able to do. I'm thinking that if I you know start to the walking a mile a day until that was really-really easy and then just add walk running and eventually get to the point where I am running the mile a day and I have a long-term goal of running the five k to Park Forest.
41:25Dr. Reid Hester Good for you.
Mary Ann (inaudible ).
41:26Dr. Reid Hester So the short-term goal is to be able to run a mile in the next within the two months or something?Okay. Then you might wanna take and you can walk a mile right now.
41:35Mary Ann Right.
41:40Dr. Reid Hester Okay. So then you might wanna take maybe the middle section of that mile, middle (inaudible ) and start to jog a portion of it and then everyday jog another minute.
41:50Mary Ann Okay.
Dr. Reid Hester So you're timing yourself.
41:55Mary Ann Hmm…
Dr. Reid Hester So let’s say it takes you eight minutes to get to that first third of a mile and then you run for a minute one day, run for two minutes the next day, run for three minutes the next day and before you know it you're gradually gonna be working up your body (inaudible ) up to doing a mile.
42:10Mary Ann Okay.
Dr. Judy Lewis Now that keeps that walking that mile from being boring what she was talking about too.
42:15Mary Ann Right.
Dr. Reid Hester Uh-uh.
Mary Ann Yeah that's biggest problem is that.
Dr. Jon Carlson You won’t get hurt if you go and (inaudible) if you go you know pace yourself.
42:20Mary Ann Right and I think it’s a good idea, thanks.
Dr. Reid Hester Fine is taking small steps you know ah… that movie What About Bob, you know taking baby steps that… he… he had it right you know, taking small steps. Changing something that’s big is the most effective way to get there.
42:35Mary Ann Thank you.
Dr. Jon Carlson Who else?
42:40I have a behavior, I've been trying to adopt for probably three years. I'm a recovering alcoholic. I don't smoke anymore.
42:45Dr. Reid Hester Good for you.
Ah I work out pretty regularly, but what I've been trying to do is rather than trying to hit the gym on the way home is get up an hour early two or three mornings a week. I cannot do it. I have set my light on a timer. I have set three alarms. I can’t literally can’t get up out of bed an hour early.
43:05Dr. Reid Hester Uh-uh.
Ah… and what other things I put down here was to just try it maybe one day a week you know and start out small like that.
43:15Dr. Reid Hester Uh-uh.
I get sort of discouraged to discuss it with myself that… I mean if I had to get up and go to at work an hour early I would be able to do that. You know at the very last minute or get up out of bed I know how much time it takes me, but I can’t do it to try and change my routine that would be more beneficial for me.
43:35Dr. Reid Hester Uh-uh and so maybe starting one day aweek ah… might be the best way to do that. You know that might be an intermediate goal for you and try and pick a day that’s the… that might be the easiest day for you toget up that might be Saturday. That might be Friday. Don’t know.
43:55It’s a good idea too.
Dr. Jon Carlson This has been really interesting. The next piece that we're going to move into is you're going to show us how to maybe monitor the change to do some self-monitoring and then to move into actually bringing about how to modify behavior.
44:10Dr. Reid Hester That’s right, because if you don’t modify, if you don’t keep track of what you're doing, if you don't observe it, it won't change and that takes some energy.
44:20Dr. Jon Carlson I can hardly wait.
44:25Exercise 2 Self Monitoring
44:40Dr. Reid Hester Now you've set some goals for yourselves, we need to help you with the next step in the process which is self-monitoring. In front of you, you have a form ah… and for those of you at home it'll come up in the screen in a moment, ah… which will… giving you an example of a self-monitoring form. You'll notice that there are number of columns across the column ah… that enable you to keep track of the specific behavior that you're trying to modify either increasing or decreasing. First you have the date. Then there is the time. If it’s a consummatory behavior like drinking or smoking, how much are you smoking, a half cigarette or a full cigarette or you're having a standard drink or a double drink? Ah… Where are you when you're having this? Who are you with? And what is your mood? Now by keeping track of all these little details what you'll observe is that as you accumulate this data overtime you may start to see patterns in your drinking or your smoking or you're exercising or whatever behavior you're trying to monitor. Ah… That… That pattern of… of behavior that in turn can give you hints as to how you can go about modifying those behaviors. Ah… For instance some people ah… tend to drink more heavily when they're with certain people or in certain places or in certain times of the day, days of the week, that sort of thing. Ah… So, the self-monitoring not only tells you how… how you are making progress towards where you want to go but also it… it helps you to start see patterns in your behaviors that you might not have… have those prior to this. Ah… Keeping track of your mood, also then gives you some notion in terms of setting up your own you know change plan because if you realize that when you're more anxious you tend to drink more and when you're more depressed you tend to drink more. Then developing some ways to deal with being anxious or depressed will help you to cut back on your consumption. Ah… Now when you… once you start to self-monitor your behaviors ah… then you actually need to start changing those behaviors and let’s take drinking first for instance. Ah… Ways to do that involvevery specific and… very specific changes in the drinkingbehaviors. For instance, you might want to limit the amount of time that you spend drinking. Ah… If you normally started at 5 o’clock it would go till… 5 o’clock in the evening, go till 11 o’clock at night, you might limit that from 5 o’clock to say 6:30 and stop at 6:30 and go someplace else do something else. Ah… Now that’s notgoing to work if at the same time that you just compress all the drinking that you've done into that very brief period of time. Ah… So, another option is to limit the places that you drink or smoke, okay and if you limit them to places that aren’t your most comfortable enjoyable places that may also help you to cut back on that consumption. Ah… Switching to less potent forms ah going to lower tar and nicotine cigarettes, going to less you know say you're a beer drinker ah… and you switch to a low alcohol beer that will immediately cut your alcohol consumption in halfwithout doing anything else. But that will only work if at the same time you maintain these other behaviors if you don’t increase the amount that you drink, if you don't inhale more deeply or smoke more cigarettes. So going to those less potent forms will also work in that sense. Ah…Switch to a less desired brand. If you really like one kind of whiskey drink scotch instead. If you really like one kind of beer drink another beer that you don’t care for as much. The difference in taste may help you to not drink as much.And also spacing either your drinks or your smoking across time so that you have more periods of time in which you are not drinking or not smoking. If for instance right now you're having a cigarette every approximately every half an hour on average if you can stretch that out to an hour, its cut your consumption in half. Okay. That may involve with drinking for instance ah… alternating alcoholic with non-alcoholic drinks, okay and that’s the strategy that some folks use. Ah… So, what I'd like to do now ah… is to maybe have you Clayton come on up and we'll talk about how you can monitor your drinking behaviors we talked about just a little bit ago.
49:55Clayton Brown Okay. Well like I said I drink heavily onweekends ah… in order for me to make a change instead of drinking the entire weekend, I can probably drink on Friday and not drink as much on Friday. Instead of drinkinghalf of a whole half a gallon I could just try using ah… what you said a ounce and a half.
50:20Dr. Reid Hester Uh-uh.
Clayton Brown Probably three drinks and see how that works for me.
50:25Dr. Reid Hester Uh-uh.
Clayton Brown You know instead of drinking Friday and Saturday and feeling lousy Sunday.
50:30Dr. Reid Hester Uh-uh.
Clayton Brown I could drink Friday, the couple of drinks and see if that works.
50:35Dr. Reid Hester Uh-uh. Now one thing you might considerClayton , ah… is because you are gonna be making a very large change in your drinking behaviors ah… and some people find it helpful to actually make a very distinctive break between the old habits and the new habits.
50:50Clayton Brown Uh-uh.
50:55Dr. Reid Hester Uh… And so and by doing in your case what that would be involved would be to take a vacation from drinking entirely. Just for 30 days.
51:05Clayton Brown Oh-oh.
Dr. Reid Hester Okay? Just for thirty days.
Clayton Brown Uh-uh.
Dr. Reid Hester And during that time what you're gonna find is that you need some other ways to you know to relax and to kick back, that sort of thing. It will very… It will bring that to the forefront.
51:15Clayton Brown Uh-uh.
Dr. Reid Hester We will be talking about that in the new roads exercise at the end here, but there is something for you to consider. Now when you ah… when you self-monitor ah… it's important that you take your form and for those of you at home ah… and for those of you here in the audience we have some self-monitoring forms which are available on our website. Ah… Actually there is a little software program that runs in excel which is a spreadsheet that you can download for free. Ah… The web address for that is behaviortherapy.com and it's in our software section. So if you wanna access that site and download that free self-monitoring software for drinking,you're welcome to do so.
52:00Clayton Brown Okay.
Dr. Reid Hester Ah… Some of the important things on theself-monitoring cards is that is to keep track of every single drink that you have and to write it down before you actually have the drink.
52:15Clayton Brown Okay.
Dr. Reid Hester That way having the drink acts as a bit of a reinforcement for the self-monitoring because this is a new behavior.
52:20Clayton Brown Yeah, yeah okay.
52:25Dr. Reid Hester So you keep track of the date which would be say this Friday.
Clayton Brown Uh-uh.
52:30Dr. Reid Hester The time that you start. Okay so if it would be say 5:30 in the evening.
Clayton Brown Uh-uh.
52:35Dr. Reid Hester Okay. What you're having which is you know…
Clayton Brown Crown Royal.
Dr. Reid Hester Say Crown Royal and you might try something else, something that’s less favorite brand as a way to also cut back on that. Okay.
52:45Clayton Brown Cheap stuff.
Dr. Reid Hester Or some other brand that you don’t care for as much.
Clayton Brown Okay.
52:50Dr. Reid Hester Ah… Where you are?
Clayton Brown Uh-uh.
Dr. Reid Hester Okay. Who you're with? And what your mood is?
52:55Clayton Brown And how much I use?
Dr. Reid Hester And how much you use? And you need to measure it.
53:00Clayton Brown By shot glasses or…
Dr. Reid Hester Well, shot glasses you know littlemeasuring glass or some sort of standard measure so that you know how much you're getting.
53:10Clayton Brown Yes, this is gonna be really be like a big drastic change.
Dr. Reid Hester Yes it will.
Clayton Brown It will.
Dr. Reid Hester Yes it will. That’s right uh-uh. But by… But only really by measuring ah… can you keep track of how much it is that you're using.
53:25Clayton Brown Uh-uh.
Dr. Reid Hester You know. Ah… And… And I don’t mean you know three fingers you know three fingers in a glass.
53:30Clayton Brown Oh Yeah.
53:35Dr. Reid Hester You may have usually drank in a glass this big, you know in a glass this big and you put three fingers in and you know…
53:40Clayton Brown Yeah yeah.
Dr. Reid Hester …or two fingers.
Clayton Brown Yeah.
Dr. Reid Hester You know. So you have to measure. That’s right.
53:45Clayton Brown You know I drink out of a mug.
53:50Dr. Reid Hester Uh-uh.
Clayton Brown Yeah. So, if I go from a mug to a regular cocktail glass, the size is gonna be different.
53:55Dr. Reid Hester But if you always measure it doesn't makethat much difference.
54:00Clayton Brown Okay. So I'll get a shot glass and I'll try it.
54:05Dr. Reid Hester Try it.
Clayton Brown I will try.
Dr. Reid Hester Uh-uh, Uh-uh.
Clayton Brown And if I don't do it the first time I'm not going to (inaudible ) about it, I'll call you, you know. That I just couldn't do it but I'll try harder the next time, you know.
54:15Dr. Reid Hester Well you always wanna try and write it down and write down your mood and what you'll see ah… I think will be very helpful for you in terms of how your mood may change…
54:25Clayton Brown Uh-uh.
Dr. Reid Hester …ah… over the course of the evening and drinking and also what kind of moods may trigger, heavier drinking and less heavy drinking.
54:35Clayton Brown Okay.
Dr. Reid Hester Okay?
Clayton Brown Usually when I start it I’ll be in… I'm in a mood of ah… completion. I've completed a project then I want to reward myself so I have a drink.
54:45Dr. Reid Hester Uh-uh.
Clayton Brown But then after I'm done drinking and everything and it wears off, the mood is really lousy.
54:50Dr. Reid Hester But… But I'm talking about what it’s like just before you start.
Clayton Brown Write before I start up.
Dr. Reid Hester Uh-uh.
Clayton Brown Okay.
54:55Dr. Reid Hester And see if that’s different on different days like on Friday versus Saturday.
Clayton Brown Okay.
Dr. Reid Hester Okay?
55:00Clayton Brown Yeah.
Dr. Reid Hester Ah… Now in terms of let’s see, changing the behaviors… yeah try those different strategies you may find that some of them work and others don’t.
55:10Clayton Brown Hmm… hmm…
Dr. Reid Hester Ah… So it’s kind of an ongoing experiment for you.
Clayton Brown Okay.
Dr. Reid Hester Okay.
55:15Clayton Brown So I limit the time that I use and limit the places and use less potent or try other brands
55:20Dr. Reid Hester Hmm… hmm…
Clayton Brown And space out…
Dr. Reid Hester Space them out for the first time.
55:25Dr. Jon Carlson And don’t use for 30 days.
Clayton Brown And don’t use for 30 days.
Dr. Reid Hester Yeah, consider it, you know.
Clayton Brown Okay.
55:30Dr. Reid Hester Okay.
Clayton Brown I’ll try it.
Dr. Reid Hester Okay. You sir.
55:35[sil.]
55:40Dr. Reid Hester Smoking.
John Yes.
Dr. Reid Hester Cutting back from 30 to 10. Is that right?
John That’s correct.
55:45Dr. Reid Hester Okay. How do you think well I… well I've just you know discussed with Clayton , how can you think you could implement that in terms of monitoring your smoking?
55:55John I was thinking about asking you some questions for example ah… would it make sense to say okay one an hour or something like that, I mean it’s a really disciplined program. I don’t like that word discipline. I didn’t like the word.
56:05Dr. Reid Hester Uh-uh.
John That alone doing it. But does that work?
56:10Dr. Reid Hester Gosh you know, it’s kind of interesting. You are so disciplined with your sobriety.
56:15John Yeah.
Dr. Reid Hester You are so disciplined with your sobrietyand ah… this nicotine is one nasty drug isn’t it?
56:20John Yes.
Dr. Reid Hester Uh-Uh.
56:25John Considerably harder for me to give up.
Dr. Reid Hester Uh-uh, uh-uh. Do you enjoy exercising that control your drinking?
56:30John I don’t look it as control over my drinking.
56:35Dr. Reid Hester It isn’t?
John No, well it maybe, but I don’t look at it that way.
Dr. Reid Hester How do you look at it?
John I look at it as being giving a gift and you know it's sort of like God's part we can’t do our part God wouldn’t.So I got a gift long time ago actually and I had it through people helping me get to sobriety and now I have to do my part and I just really willing do my part which is go to AA.
56:50Dr. Reid Hester That’s great.
56:55John You know mainly go to AA and (inaudible ).
56:57Dr. Reid Hester Uh-uh, okay.
John So it’s you know that’s control yep, I just don’t look at it that way.
57:00Dr. Reid Hester Okay. Ah… Well, I think that getting back to your question about making you know a very disciplined approach to your smoking.
57:10John Uh-uh.
Dr. Reid Hester May well work for you.
John Okay.
Dr. Reid Hester What you'll have to do then is to ah… address the issues of (inaudible ) urges and cravings,because chances are you're going to start experiencing them.
57:20John (inaudible ) often.
57:25Dr. Reid Hester Well, you know…
John Just (inaudible ) often.
57:27Dr. Reid Hester The more… The more often you cheat the less successful you're going to be.
57:30John Right.
Dr. Reid Hester You know that’s up to you.
John Right.
Dr. Reid Hester But you… I can guarantee that you will bedealing with ah… ah anxiousness and urges and cravings.
57:35John Uh-uh.
57:40Dr. Reid Hester Ah… But you've dealt with that before.
John Yeah. But you know I think with you know with alcohol my life was messed up, really messed up. Smoking just just kills me slowly. But you know I'm not going to get kicked out of my house or I already have been kicked out of my house for smoking. I just don’t smoke inside, but once was kicked out
57:55Dr. Reid Hester Uh-uh.
John My wife (inaudible ) not to.
57:56Dr. Reid Hester Uh-uh.
John okay. But she kicked me out (inaudible ) drinking that’s what got me in the sobriety. Alright, I'm not gonna lose the job.
58:00Dr. Reid Hester Hmm… hmm…
John Unless I smoke in the wrong spot, you know I get okay.
Dr. Reid Hester Okay.
58:05John And I'm probably not going to have well unlike I did have a heart attack when I was 32, (inaudible ) smoking and drinking, few other things.
58:10Dr. Reid Hester Uh-uh.
John Ah… but you know the consequences of smoking are not nearly as apparent as my consequences of drinking.
58:15Dr. Reid Hester You're right.
John Alcoholically.
58:20Dr. Reid Hester You're right.
John So that’s a big difference in my… in my mind.
Dr. Reid Hester And that effects your motivation.
58:25John Yes. Uh-uh. Yes.
Dr. Reid Hester I understand.
John See now is how important is the self-monitoring because this… this is a pain in the rear end as far as I am concerned.
58:30Dr. Reid Hester Yes it is, yes it is.
John Really.
Dr. Reid Hester Yes it is.
John To do this but if it’s really important may be I'll try it.
58:35Dr. Reid Hester Yes it is. It is really important.
58:40John Yes.
Dr. Reid Hester Yes, it reverts you to your behaviors, it makes you conscious of your behaviors and it also shows you whether you're making progress or not and seeing whether you're making progress is so important.
58:50John Okay.
Dr. Reid Hester You know…
58:55John I mean just in terms of maintain or achieving maintaining perpetuating the motivation, stop.
59:00Dr. Reid Hester Yes, I mean you're trying to achieve the goals that you've set for yourself.
John Uh-uh.
59:05Dr. Reid Hester If you don’t keep track of your behaviors, you don’t know how you are doing with respect of.
John So that’s the most important thing I can do.
59:10Dr. Reid Hester Aside from goal setting… Aside from setting the goal of cutting down to 10 cigarettes and then ah… you know evaluating that from time to time to see if that’s really gonna work for you or not. Keeping track of your behaviors is the next most important step and then changing those behaviors like you say down to one cigarette at a time or at an hour.
59:30John Okay, our goal setting and this is important in terms of reducing and then ultimately stopping smoking as going to meetings is for me in terms of sobriety. I mean that’s for me that’s A number one, go to at least one meeting a week. I don’t know why it works, but works.
59:45Dr. Reid Hester For many people that will be as important.
John Okay.
59:50Dr. Reid Hester Okay?
John Uh-uh.
Dr. Reid Hester Great.
John Right, thank you.
Dr. Reid Hester Sure. Okay. Any other questions? What I'd like you to do now and you all at home is to take the goals that you set for yourself and… and ah… if it’s toreduce a certain behavior that you've got ah… think back to the last time that you engaged in it. Smoked, drank and just start writing out what it is that you did and when you did it. So you start to kind of get in the habit of doing that.Okay. So, I wanna let’s… give you a few minutes and let you do that right now.
01:00:25It's Your Turn self monitoring Take a look at the behavior or habit you want to change. Using the self-monitoring card fill in the information based on the last time you engaged in the habit or behavior. Please turn off video & proceed with exercise. Return to video when you feel ready.
01:00:40[sil.]
01:00:50Exercise 2 Wrap-up
01:01:00Dr. Reid Hester So Linda , what did you… what did you self-monitor in that?
Linda Ah… My cigarette smoking and… I find it much harder to manage on myself with something like this than I do alcohol. Ah… I don’t have a problem walking away from alcohol at any point in time because of the repercussions of you know obviously alcohol I am gonna feel bad the next day. There is a instant reward for me not to drink too much. You know I feel better that night, I feel better that morning, but with cigarette smoking I'm not feeling any instant side-effects from smoking ah… even with monitoring myself the reason is the same pretty much all the time as to why I smoke? Ah… I don’t know if I should zero in on that. It seems to be that I'm smoking out of boredom ah… and what do I do just start focusing in on… on that type of behavior that I'm bored and that's why I'm smoking or I guess I'm looking for some way to cutback even on my cigarette smoking in the monitoring, I don’t see how that's going to help.
01:02:05Dr. Reid Hester Well, if you set a goal to reduce your… your cigarette… cigarette consumption ah… whether it’s to eventually quit or just to maintain a little lower level, ah… some people find it very handy to have that self-monitoring card actually wrapped around that cigarette pack so they have to pull it out before they actually can get a cigarette out. Ah… And what you may discover is that there are some patterns that you may not have noticed before in terms of your smoking behaviors, but if boredom is a significant predictor of smoking for you ah… then the… the exercise we're gonna do a little bit on finding alternatives would be right down you (inaudible ).
01:02:52Dr. Judy Lewis So is this right Reid , it sounds like one of the reasons that the self-monitoring is so important is that that gives you clues about what the methods are that you can use to actually change the behavior.
01:03:05Dr. Reid Hester Correct.
Dr. Jon Carlson Uh-uh.
01:03:10Dr. Reid Hester Any other examples?
Tim Example… regarding eating. Ah… I mentioned before that I tend to starve myself all day and then try and have a decent salad at dinner and then I end up binge eating on you know crap you know and I actually tried to implement what we had talked about earlier this morning.
01:03:30Dr. Reid Hester Hmm… hmm…
Tim Ah… I had breakfast which good portion of fruit which I enjoy and whole wheat (inaudible ). You know that’s for me who would be even growing up as a child never eat breakfast is a good breakfast and I think I feel better this morning than I would have if I didn’t which is strange ah…and you know I just need to constantly remember to do that. For something like eating I think the self-monitoring will be a lot easier because I can put it on the refrigerator, I can have a plan for breakfast and supper at home and then lunch time wing it ah… and you know most of the time you go out to eat so at least have something a bowl of soup or something and realize that maybe I perform even better, so.
01:04:20Dr. Reid Hester Consider taking the self-monitoring card with you so that you can… so that you can reinforce yourself at lunch time by seeing yes I've had breakfast, yes I've had lunch this reduces the chances of my bingeing after dinner.
01:04:35Tim Uh-uh, that’s a good idea too to complete the food group the nutritious portion of what I'd like to accomplish.
01:04:45Dr. Reid Hester Hmm… hmm… hmm… hmm…
Dr. Jon Carlson Okay. How was this activity for you? I mean do you think you'd be able to use this self-monitoring?
01:04:55Clayton Brown I know I’ll be able to use it. Matter of fact I was thinking he was saying to put it on the refrigerator or take the card with him, I can put it over the cabinet where I keep my glasses and before I reach for the glass, I'll look at the card and it'll remind me all right before you go and take that drink write it down. So I know how and then by doing that it'll give me you know a pattern of constantly using this and then I can actually see what's causing or what you know how many times I've been using you know.
01:05:30Dr. Judy Lewis So really…
Dr. Jon Carlson It will break the pattern up too by just taking time to write that out it might change your mind.
01:05:35Clayton Brown Yeah yeah.
Dr. Judy Lewis And amount of it is about being consciousof it isn’t it instead of things instead of behavior being automatic you just take that split second to be conscious of what you're doing and that can make a lot of difference to (inaudible )?
01:05:50Dr. Reid Hester Yes it can.
Dr. Jon Carlson Uh-uh.
Linda Well I'm thinking also personally after a while I'm (inaudible ) become bored with writing all this down but by that point in time it should already be a pattern for meto stop and think what am I doing, I'm lighting another cigarette. So I mean I know my own personal goal is maybe I'll do few sheets of these and then after that no I'm already into the pattern that I've reduced my smoking and every cigarette I light, I need to think about.
01:06:20Dr. Reid Hester Uh-uh.
Dr. Judy Lewis Let me ask that about what Linda just said that she would be monitoring for a while and then she's saying herself not needing to keep on with the monitoring anymore. Is that ah… Is that how it goes?
01:06:30Dr. Reid Hester Some people can do that. Ah… It… It really depends on the individual. We recommend when people are cutting back on their drinking that they keep track of their drinking at least for six to eight weeks until there's a good initial ah… beginning of a new habit ah… and some people continue that because they… because they find it so helpful and keeping themselves mindful of it.
01:06:55Dr. Judy Lewis Hmm… hmm…
01:07:00Dr. Reid Hester Other people are… are much more ah… into patterns like that. They can initiate a pattern like that quickly, whatever works for you.
01:07:10Dr. Jon Carlson Hmm… hmm… It’s almost like its (inaudible ) learning. I mean you start and you've got the chart, you fill it all out and then pretty soon you can remove it a way back if you start to learn how to sing and you have the music there and you've got the sheets with the words on it you need all of it and you just sort of take it away bit by bit. You may only need the words and then you maybe only need the (inaudible ), pretty soon you cansing it (inaudible ) you know like I was thinking of that as you were going through.
01:07:35Dr. Judy Lewis Right but you don’t insist for yourself that you use the words and you use have the music in front of you one time and then…
01:07:40Dr. Jon Carlson Right.
Dr. Judy Lewis …insist to yourself that you have to do itwithout the music immediately.
01:07:45Dr. Jon Carlson No, not at all.
Dr. Judy Lewis You gotto give yourself the break.
Dr. Jon Carlson Sometime, it’s a nice prop. Yeah.
01:07:50Well, for me I think this right here would be a big amount(ph) for me. I think what will work better for me is like (inaudible ) and I told you at least 20 cigarettes a day and then we get to say well maybe start with 15, leave some in the home and… and take it work like that. So I think that problem will work better. I mean…
01:08:10Dr. Jon Carlson Uh-uh.
I really liked ah… when you talked about regarding baby steps, anything that’s what you know a lot of us were talking about here and I think we're more successful if we don’t beat ourselves up ah… in… in like what Judy was just saying if we try to read the music and then play without you know doing these small steps we won’t be successful and I like the idea that you've given us permission to do just a little bit at a time, maybe to rather than cut from 20 to 10, cut from 20 to 15 ah… or in my case trying to get up in the morning to work out start with one day rather than you know go head long into it.
01:08:50Dr. Judy Lewis So you really want to build in some successes don’t you?
01:08:55Dr. Reid Hester We wanna make your goals moderately challenging not impossible.
Dr. Judy Lewis Yeah.
Dr. Reid Hester But also not so easy that ah… they don’t mean anything to you.
01:09:05Dr. Jon Carlson Well I liked the journey we're on, you know starting out with the goals and moving on to the self-monitoring and then next you're going to show us how to reward ourselves.
01:09:15Dr. Reid Hester Correct, you maintain that motivation that you have for change.
01:09:20Exercise 3 Rewarding Yourself
01:09:35Dr. Reid Hester The next step that I'd like you to consider in helping you to change your behaviors is to set up a system of rewards. Now what do you mean… what do you think I mean by rewards?
01:09:45It’s something that feels good.
Dr. Reid Hester Something that feels good.
01:09:50Cash prizes
Dr. Reid Hester Cash prizes, okay.
Pleasant.
01:09:55Dr. Reid Hester Something as pleasant.
Tim Rewarding yourself with the behavior you're trying to restrain.
01:10:00Dr. Reid Hester Well that’s a good idea. Yes. Ah… You know if you're trying to cut back on your sugar consumption for instance being successful and then rewarding yourself with cheesecake you know is…
01:10:15Defeating the purpose.
Dr. Reid Hester Sometimes its defeating the purpose, that’s right. Uh-uh.
Clayton Brown Sort of trying to reward myself for not drinking would not be to go and have a drink.
01:10:20Dr. Reid Hester Correct.
01:10:25Clayton Brown But then what would I do?
Dr. Reid Hester Find something else.
Have a cigarette.
01:10:30Dr. Reid Hester Have a cigarette. Uh… I… I would like to urge you or you know ask you… ask you and the folks at home to consider setting up some rewards for to help maintain your motivation for change. Uh… What you're asking of yourself and what you're considering doing is not an easy thing and its and… and so to have some adjuncts, some assist in this process ah… can be helpful.Uh… Now some people say that you know I shouldn't reward myself because this is something I should be doing. Should, should, should. Well that doesn’t really help you to maintain your motivation. Does it? Yes.
01:11:10Well, I think you gonna look at it as a rewarding yourself to have the courage and the strength to change the old behavior.
01:11:20Dr. Reid Hester Yes. That’s right. Hmm… hmm… Ah… you know we all like to be appreciated and we all like to be respected ah… and we all like to be accepted and when you can provide that to yourself ah… and or have significant other help provide that for you, it just helps to kind of keep your motivation up for doing something that’s difficult. That can be truly challenging. Ah… The quitting cigarette smoking is maybe one of the most difficult ah… challenges you've ever faced John .
01:12:00John Right.
Dr. Reid Hester Uh… And so everything that you can do to kind of bolster that effort okay is a good thing. Ah… Now there are number of things that you wanna take into consideration ah… when you're thinking about what kind of rewards to provide yourself. Ah… first you wanna make a timeline for getting that reward a reasonable one. It maybe four-five days or a week as opposed to several months. You need to make it a period of time that’s long enough for you that is moderately challenging to… to achieve that goal, okay. Ah… You know for instance its Thursday right now ah… let’s say if you kept your smoking ah… within the limits that you set for yourself John until Sunday afternoon, that’s Friday Saturday Sunday, ah… then that might be an appropriate length of time for you then to provide yourself with some reward for having accomplished that. So you need to think of a time spanthat’s reasonable. Uh… You need to think of rewards that are meaningful to you and that is critical. What is meaningful to you may not be meaningful to me. I can’t tell you what's gonna be rewarding to you. For me to have time off from my work, my responsibilities that’s veryrewarding to me, but it may not be something that is highly motivating for you. Ah… Getting the latest Julio Iglesias CD maybe very rewarding to someone and someone else go uh… I don’t think so. Ah… So each of you needs to think of something that is specific and rewarding to you ah… that doesn’t necessarily cost a whole lot of money. It can be something as easy… as simple as time off, timeout to do exactly what you wanna do. Read a book, take a nap, go for a run, go skiing for the afternoon, whatever uh… that maybe rewarding to… to some people, but not to others. Uh… It needs to be realistic ah… some people certainly can't take a half a day off in the middle of the week to go skiing okay, but they may be able to take an hour off after work on a Friday afternoon before they go home to… to go by at the health club, just to go sit in the sauna or the spa. If that’s a meaningful reward to you and that’s a reasonable period of time to take that off, then that could be useful for you, okay. Uh… Another way to… to provide yourself some rewards and it may sound a little corny and hokey, but is really to give yourself a verbal pat on the back. Uh… You know if you think of when you're working hard at on a project at work or at home and someone comes along and… and says something that’s appreciative of your efforts, you know says hey you're doing a great job I really appreciate it. That helps when you are struggling to get something done. Ah… And providing that to yourself isone way to keep your motivation up. You know, you did it, you got it done, you achieved what you set out to do you know. Three cheers to you. So, providing a sort of verbal self-support yourself can be one a very inexpensive way to go and it may seem a little awkward at first, but there's something that ah… with some practice it comes more easily and we do encourage you to talk to yourself. Uh…
01:15:55(inaudible ).
01:15:57Dr. Reid Hester Support from others. Uh… If you have family members who are interested in… in helping you to ah check(ph) make these kinds of changes ah… you may find them very interested in being willing to… to help you with your efforts; 01:16:15]one to provide verbal support, and two to do some nice things for you to help you celebrate accomplishing your goals. That maybe ah… preparing a special dinner for you on a Friday evening,uh… that maybe taking care of the kids so that you canget away for a couple of hours and just go do whatever it is that you wanna do. Uh… But that person that… that spouse or a boyfriend or a girlfriend ah… shouldn’t be a policemen. You don’t want them to be a policeman, you wanted to be a cheerleader, not a cop okay. Uh… So, if your relationship right now is more of a… of a policeman and you don’t… you wanna consider doing something else.
01:17:00But that'll be pressure to. They could drive you to keep you know the same behavior that you got back, pressure on you so much then leave it alone you know. So they really could be more damaged than they can be helpful.
01:17:10Dr. Reid Hester When they are a cop. If there a cheerleader is saying you know I appreciate, I know what you're going through, I appreciate your efforts and I… and I think that you know you're making progress and you’re telling me that you're making progress that's great, you know. That’s a very different position. Now what I'd like to do is to ask you to take a couple of minutes and the home audience too to think of some specific rewards that you might be able to provide yourself and for achieving some short-term goals. So why don’t we just take a few moments to think about that and then we'll come back and see what you've come up with.
01:17:50It's Your Turn rewarding yourself 1. Use short-term goal list from Exercise #1. 2. Create rewards for each short-term goal. Please turn off video & proceed with exercise. Return to video when you feel ready. Exercise 3 Wrap-up
01:18:20Dr. Reid Hester Any… rewards that you came up with? Mary Ann .
01:18:25Mary Ann Ah… My goal was to increase my running until I can eventually get up to a mile a day and I thought two things that I really like to do I like to play computer games.So if I reach a goal I set for myself I'm going to allow myself to play a couple of computer games and I'm also going to buy new running clothes where I can fit into the running clothes.
01:18:45Dr. Reid Hester Great. So the short-term goal is… is to…to play some computer video games ah… after what time span?
01:18:55Mary Ann Ah… After I've consistently, you know say like after five days of consistently going out there and walk, running, jogging, I'm going to allow myself to playcomputer games.
01:19:05Dr. Reid Hester Okay.
Mary Ann And then you know when I start seeing the physical difference that I'm starting to lose weight again then the reward will be to go out and buy new running clothes that I can fit into.
01:19:15Dr. Reid Hester Uh-uh. So, that’s good you got a short-term goal that you could actually implement in the next five days and then you've got a longer term goal that will maybe a month or month and a half down the road. Uh… And if during that time that you've initiated these… these ah… five days and then play computer games then you are going to do another five days and then play more computer games, okay great.
01:19:35Mary Ann And… And maybe increase it to like maybe make it more or like 10 days and do a computer game when you know something like that.
01:19:45Dr. Reid Hester No, no, no. I would suggest that it’s better to have more rewards more frequently.
01:19:50Mary Ann Okay.
Dr. Reid Hester Rather than stretching up the length of time.
01:19:55Mary Ann Okay.
Dr. Reid Hester You know. Otherwise it just gets to be ah… less reward it’s just too far distant.
01:20:00Mary Ann Okay
Dr. Judy Lewis But what Mary Ann just had was a kind of asmaller reward for her, short-term goals and then a bigger reward for her long-term goals. So that’s pretty typically what people should do?
01:20:15Dr. Reid Hester Well, you know its… it’s kind of whatever fills your sails.
Dr. Judy Lewis Okay.
01:20:20Dr. Reid Hester Whatever fills up your boat, uh-uh. Other rewards.
01:20:25Well, I say after about a week if I could uh… break the cigarettes down to 15 a day instead of 20 a day then, maybe at the end of that week I would ah… maybe love to go on a shopping spree. Then again I say maybe but need to like say that… say that after I have maybe got to the point where its five or ten cigarettes a day. You knowmake the reward more greater after I've accomplished a bit more. You know I am gonna get a good body massage or treat myself to dinner.
01:21:05Dr. Reid Hester Okay. Do consider putting in some short-term rewards for short-term goals. For four-five-six days at a time, because otherwise you are going to get very discouraged. It’s too… It’s too far down the road.
01:21:15Okay.
01:21:20Dr. Reid Hester And you can do that by… by you know restricting your shopping spree. You know say you're going to take only 25 dollars instead of a 100 dollars.Okay.
01:21:30Well maybe for the big shopping spree that will be uh…the last big treat that’s maybe (inaudible ) I've completelystopped smoking. Then I'll treat myself too.
01:21:40Dr. Jon Carlson What would happen if each day you puttwo dollars towards the shopping spree that you're successful and just watch that balance grow.
01:21:50That’s a good idea too.
Dr. Jon Carlson And then at the end of a set time you could actually go.
01:21:55That’s good. I like that one.
Dr. Reid Hester That’s a good idea.
01:22:00Dr. Judy Lewis I was wondering about that to because you can estimate how much money you're saving…
Dr. Jon Carlson Right.
Dr. Judy Lewis …by not buying the alcohol and not buying the cigarettes and then you could use… you could put that towards your reward, right.
01:22:10That’s real good. I like that. I like that one even better.
Dr. Reid Hester And if you have a short-term shorter timeframe ah… and you're spending enough money on drinking or cigarettes ah… that… that savings can still be enough to buy a CD to get a massage.
01:22:20Dr. Jon Carlson Or a house you know.
01:22:25That’s true. That years span the amount of money you spend on cigarettes, they're four dollars a packet.
01:22:30Clayton Brown But that was, I'm sorry that was my reward buying a CD. I DJ, I like music and that’s what relaxes me so my reward would be after I get down to my drinking level, come my drinking level down to go out and buy records like you say because with that money instead of spending it on the liquor, I can take that money and put itin… in my records. So that’s… that’s exactly what I was gonna write as my reward.
01:23:00Dr. Reid Hester And some people find that it is even helpful as Jon said that to take that money and put it in the jar.
01:23:05Clayton Brown In a jar.
Dr. Reid Hester You know. Take and put it somewhere where you can see it you know and see that moneybuilding up and you say you know I really need to… to relax, kick back, I'm gonna get a new jazz CD.
01:23:15Clayton Brown Hmm… Hmm… okay.
01:23:20Dr. Reid Hester Others?
Tim Ah again mine is really eating a nutrition is the basis of it and I feel that if… if I eat properly maintaining my diet eating three meals ah… despite the fact of what they maybe, but trying to be good about it. Usually aroundThursdays during a work week is when I really start that, feel a little overloaded and I've set as my goal Thursday evening to really take time for myself. That’s another problem I have. There is always something or someone else that needs to be done whether its bills or helping aneighbor or work that I find I never actually just sit down and do absolutely nothing and decide that I want to pick up a book for my own personal enjoyment. That is a reward I'm going to give myself every Thursday.
01:24:10Dr. Reid Hester Excellent.
Tim And further out you know every couple of weeks I get a haircut. It’s in one particular place I like to get a haircut, best haircut I ever get, but they're expensive. I think I should reward myself with that.
01:24:25Dr. Reid Hester Hmm… hmm…
Tim And then further down the road is once I have my… my eating maintained and its nutritious and normal as I would say maybe I'll look and can fit into some of my old clothes and go on a vacation uh… this winter you know something like that.
01:24:45Dr. Reid Hester Uh-uh. Short-term and long-term goals are good.
Dr. Judy Lewis I've noticed just something that’sinteresting about this is how different people are that what's rewarding for one person is a punishment for another person. The difference is I saw that so I was thinking about that especially when Mary Ann mentioned that she was going to use computer games as a reward for herself and for me playing too many computer games is something that I have to work on as a behavior that I have to change. So, I have to reward myself with maybe letting myself walk a mile. I mean it's really… it’s really interesting how to pick a reward.
01:25:20Dr. Reid Hester (inaudible ) a compulsive gamer?
01:25:25Dr. Judy Lewis Yes and so what a reward for her is aproblem behavior for me.
01:25:30Dr. Jon Carlson Would you like to talk about this?
Dr. Judy Lewis Actually what I'd like to talk is you all came up with so many really interesting ideas for rewards that I think will really work. How was this exercise for you? Did you feel that you got something's out of this that you'd be able to use?
01:25:45Clayton Brown Most definitely.
01:25:50Dr. Judy Lewis You said most definitely?
Clayton Brown Yes, absolutely.
Dr. Judy Lewis Well what was helpful about it for you?
01:25:55Clayton Brown Well, first realizing that I have a drinking problem. To me I didn't think it was a problem but now that I look at it, it is a problem. It’s a problem, it’s aproblem because my health, my diabetes and then it’s a problem because of the amount that I drink. Even if I didn’t have the diabetes that’s a awful lot of liquor to consume.So, now what I've got out of this session is about bringing my consumption level down. I will not only be increasing my health better at my health and getting control over the drinking, but now I can reward myself because I havemoney saved from not buying so much.
01:26:30Dr. Jon Carlson Yeah.
Dr. Judy Lewis Uh-uh.
Clayton Brown You know what I mean. So…
01:26:35Dr. Jon Carlson Got a drinking solution now.
Clayton Brown Yeah yeah.
01:26:40Tim I find that the… the actual structure of… of this self-monitoring card is going to be helpful. Uh… All my best intentions are in my mind, but actually putting this on paper and going so far as the rewards which you know to me before was eat well, have a big piece of cake. You know that’s it’s kind of productive, but putting it on paper seeing that… that I do have a plan and that there is a reward at the end that is logical is not harmful has been most helpful.
01:27:10Dr. Reid Hester I think you bring up an important point, write this stuff down, write it down put it on your refrigerator.
01:27:20Dr. Judy Lewis Now you'll see that when you get into the next exercise that also will build right on what you've already done because now you'll be looking at some of the effects that you've gotten from the behaviors that you're trying to change and learning some ways to get those effects and through more positive behaviors. So that’s what we'll be getting into next.
01:27:45Dr. Jon Carlson And this… And this activity is going to be called new roads and it should pull everything together as a whole.
01:27:55Exercise 4 New Roads
01:28:05Dr. Reid Hester The next exercise we're going to talk about is developing alternatives or new roads. Now I'm going to ask you to think about something's that may sound somewhat odd and unusual, but I'd like you to tell me what did you used to like or what do you like about drinking? What do you like about smoking? What do you like about eating the way that’s you have done? What do you like about procrastinating? What are the… What are the desired effects? What does it give to you? What… What good does it do for you? If it doesn't do some good you wouldn’t do it. So tell me.
01:28:45Clayton Brown Well, if drink it then makes me feel relaxed and you know alcohol just makes you feel good. You getdrunk from it well yeah you get drunk from it and uh… and it just makes you feel good. You get over any inhibitions and you just…
01:29:05Do anything.
Clayton Brown Yeah, you do anything.
Dr. Reid Hester So it relaxes you, disinhibits you. Okay well what do you like about the buzz? What is the effect? What does the buzz do? Enhance your mood?
01:29:20Tim It’s like for me it allowed me to escape or suppress some thoughts or feelings mostly. Uh… That was… That was primarily my alcohol.
01:29:30Dr. Reid Hester To zone out and escape.
Tim Exactly.
01:29:35Dr. Reid Hester Uh-uh.
Release inhibitions
Yeah.
Dr. Reid Hester Okay.
Oh yeah.
You say and do things you would have never done.
01:29:40Dr. Reid Hester Uh-uh.
(inaudible )
01:29:45Dr. Reid Hester (inaudible ).
Cigarettes uh… I guess I like it because I don’t know its… its relaxing, its… it’s a outlet. I don’t know it’s just something I turn to in stress or stress or being angry orbeing hurt or I don’t know, it’s just the… it’s just relaxing, its soothing. It’s like not having a individual person to turn to, but I can smoke the cigarette and I don’t know.
01:30:20Comfort.
Right comfort.
Dr. Reid Hester Uh-uh.
Yes.
Dr. Reid Hester Okay.
You know what are the things I noticed when I stopped smoking is that you're real angry. I'm pissed off at everything and everyone. Not 24-24, but you know like when some little thing that normal thing you try to open some it doesn’t open normally it’s like uh… but with slam up against the wall and I mean I'm so glad that nobody is home during the day to see some of my behavior when I stop smoking because it’s really immature. So I wonder what that smoking is doing as far as that anger, why… you know because when I stop that seems to be when it happens.
01:30:50Dr. Reid Hester Uh-uh.
01:30:55It’s there all the times.
Dr. Reid Hester So it helps to suppress your anger.
It seems to. I don’t notice it till I stop
01:31:00Dr. Reid Hester Or turn down the volume.
Yeah, yeah.
Dr. Reid Hester Uh-uh, okay. So what I'd like you all to do now and you in the home audience is to take a few moments and on that first column of your handout or on a sheet of paper that you just kind of divide into three's and label it Desired Effects. I'd like you to take a few moments and just write down all the different effects not just to getting… not to getting high, but what you like about being high, the buzz. What does it do? It helps you to escape, it helps you to relax. The… You know the effects it has on you and the ones that you like, okay. Just take a few moments now and write those down we’ll come back.
01:31:45It's Your Turn new roads Using the behavior or habit that you are trying to change or correct, create a list of the desired effects you are attempting to achieve with the behavior or habit. i.e.: smoking relaxes me, it makes me calm. Please turn off video & proceed with exercise. Return to video when you feel ready.
01:32:00[sil.]
01:32:05Exercise 4 New Roads (cont'd)
01:32:15Dr. Reid Hester (inaudible ), what you’ve come up with?
01:32:17Well, I wanted to change my god procrastination. So, I put down that ah… I kind of put it more in a pathway like what leads to another, which leads to the other, which leads to the other. Like uh… first of all its like there is no immediate stress like that’s the first pay off you know or whatever desired effect I guess which then leads me to feel like I'm free from any obligation because I always feel like have to use a drag you know so I think that the procrastination for me lies in the fact that it’s something that I have to get done rather than something I want to be doing.
01:32:50Dr. Reid Hester Uh-uh.
01:32:55So the freedom from obligation only then allows me to be creative on my own time, on my own right and that’s… so then I'll get things done on my own and then I get excited and then I get motivated and then I'll be productive.
01:33:05Dr. Reid Hester Uh-uh.
It’s like that’s how it works for me it seems that that when I have to have something done that’s isn’t like I don’t know if it’s not my idea or not my, it’s something that I don’t wanna do then it’s a drag you know.
01:33:10Dr. Reid Hester Uh-uh.
If… If it’s a have to.
01:33:20Dr. Reid Hester Uh-uh.
So yeah.
Dr. Reid Hester That’s… That’s… That’s a great start. Anybody else got any desired effects from your behaviors?
01:33:30Clayton Brown Uh… What I… What I look for when I do drink is the idea of getting or being drunk and it makes me feel relaxed, uninhibited and it gives you… it gives me a feeling of feeling good.
01:33:40Dr. Reid Hester Uh-uh.
Clayton Brown That’s what I get out of being drunk.
01:33:45Dr. Reid Hester Uh-uh, feel relaxed and uninhibited.
Clayton Brown Yeah.
01:33:50Dr. Reid Hester Uh-uh, Okay. (inaudible ).
01:33:54Well I see it ah… same thing as that relaxing, comfortable, peaceful and soothing. It’s like ah… having a friend there, you know otherwise you have a friend to talk to but this kind of like takes the place. I don’t… I really can’t explain it. Oh-oh, excuse me. It’s just comfort.
01:34:15Dr. Reid Hester Okay. John .
John With the smoking one of things that having a cigarette does it turns the voice off. It’s not really a voice that I hear I don’t mean that, but something says, have a cigarette.
01:34:25Whole of the day, no.
Dr. Reid Hester I can say that you're hearing voices. Of course, the internal dialogue.
01:34:30John Yeah, I mean it’s just, there is a thought process. Is that better?
01:34:35Dr. Reid Hester And you just kind of slip in the neutral.
John You know thought process says now it’s time to have a cigarette, have a cigarette and that thought process stops. You know because I've satisfied the need. Turn the voice off. Now not a voice saying anything.
01:34:50Dr. Reid Hester You got to have a cigarette
John You got to have one.
Dr. Reid Hester Uh-uh.
John But it’s not really saying that, but that’s… that’s the way I can describe it.
01:34:55Dr. Reid Hester Uh-uh.
John It’s just that… I mean other times it is just habit.
01:35:00Dr. Reid Hester Uh-uh.
John But sometimes the body something says to me have cigarette, its time. You start the cigarette, it turns off.
01:35:05Dr. Reid Hester You're having an urge or a craving.
John Yeah, right.
Dr. Reid Hester So it reduces that anxiety okay.
01:35:10John You know it’s relaxing.
Dr. Reid Hester Uh-uh.
John You know that’s another uh… most of the day, by the end of the day it’s not relaxing, taste off.
01:35:15Dr. Reid Hester Okay.
01:35:20That’s true.
Dr. Reid Hester How about from some of the rest of you?
Mine is uh… well I talked about having a problem of being on time. I think it has a lot more to do with procrastinationas well. Uh… I was…
01:35:35Dr. Reid Hester Well her desired effects may not be your desired effects.
Well in a way they are they are kind of the same because it's about being obligated, it’s about being responsible.You know and at the time I just don’t want to be responsible. So that makes me feel good and not to beresponsible at that time I wanna to be responsible tomorrow.
01:35:50Dr. Reid Hester Uh-uh.
You know or in the next hour you know or in five minutes.
01:35:55Dr. Reid Hester Uh-uh.
You know or next week.
01:36:00Dr. Reid Hester So, it’s… its really kind of a mental freeing up.
I don’t have to do this if I don’t wanna do this. I'm in control.
01:36:05Dr. Reid Hester And you can’t tell me what to do.
01:36:10That’s right you can’t tell me what to do.
Dr. Reid Hester Uh-uh.
Damn I gotto be there in ten minutes. So.
01:36:15Dr. Reid Hester Okay, okay. Well let’s move on to the… to the next step in this process then ah… which is to look at the types of situations where you're urged to drink or smoke or procrastinate, uh… what you feel about thestrongest. Just take a minute and think about you know what are the different kinds of specific situations. Is it always going to work or is it only going to work some days of the week or when you have certain projects to do or certain meetings to go to? Is it always on… on the weekends or are there some times in the weekends when that doesn’t happen. Okay When you don’t have that urge? Uh… If it’s with respect to smoking are there some situations that give you stronger urges to use to smoke than others? Are there some situational factors that uh… produce a stronger drive to binge eat in the evening than other situational factors. Okay. Uh… So why don’t you all just take a few minutes and write down what different kinds of situations are most likely to trigger theseexcessive behaviors or these behaviors that you wanna change.
01:37:40It's Your Turn new roads - part 2 1. Think back to the behavior or habit you are wanting to change. 2. Write down reasons and/or situations when the urge for the behavior or habit is at its strongest. Please turn off video & proceed with exercise. Return to video when you feel ready.
01:37:55[sil.]
01:38:00Exercise 4 New Roads (cont'd)
01:38:10Dr. Reid Hester So situations what you've come up with?Tim ?
Tim I began very general again with my… my bingeing of cookies cake ice cream whatever the case maybe after a day of fasting, uh… at home, always at home uh… almost as if it’s a hidden sort of behavior I don’t want anyone else to see and always late at night uh… just before I go to bed or if I can’t sleep I'll get up and I'll have four or five cookies in the middle of the night, a glass of milk and go back to sleep, uh… helps me sleep. Probably because I've starved myself all day.
01:38:50Dr. Reid Hester Uh-uh.
Tim Uh… Period of stress. Uh… If I'm particularly fascinated with the rest of the world and not my problems. I mean I don’t focus on myself, I will definitely allow myself to get into that.
01:39:05Dr. Reid Hester And you don’t have that balance in your life.
Tim Right, right and if… if I don’t have personal time and really put it down and think about it schedule it in uh… you know then my thoughts begin to lead to… well I will reward myself with a box of cookies because I've hadsuch a bad day, I took care of everyone, but me so give me my cookies.
01:39:30Dr. Reid Hester Uh-uh, you deserve a break today.
Tim Right, somehow I rationalize it.
Dr. Reid Hester Uh-uh, uh-uh okay. What are some of the other situations?
01:39:35Okay I have some.
Dr. Reid Hester Okay.
Anything where I'm required to write I don’t like to do that. I'll write on my own, but I don't like any required writing, uh… anything that's ah… like a commission the project, the piece that I'm not particularly interested in like that I have no passion for it. I find that when I'm not personally interested or I don’t have something that I respond to or care about that I'm not interested in doing it.
01:40:00Dr. Reid Hester Uh-uh.
So then I don’t wanna do it. Or anything in the morning actually. I am a night person.
01:40:05Dr. Reid Hester Uh-uh.
Always been able to do a lots of work at night, but never in the morning.
01:40:10Dr. Reid Hester Uh uh.
So…
Dr. Reid Hester Okay.
That’s it.
01:40:15Dr. Reid Hester Good. (inaudible ).
01:40:16Okay I see as far as smoking uh… if I'm talking on the phone, you know I definitely want to smoke uh… right after you finish a meal you're nice and full, you know smoking it seems like it soothes and help the food digest. Ah… It just come to naturally a cigarette after being full.
01:40:35Dr. Reid Hester Uh-uh.
Uh… After sex, uh… just being at home can’t sleep or stress up like if one of my grown kids is getting ready to make a decision they'll say, mama I wanna talk to you, I'll say okay wait a minute (inaudible ). I don't know, but in cigarette let him know what I am going to hear you know so that’s gotto have to me deal with (inaudible ) so.
01:40:57Dr. Reid Hester Uh-uh.
That’s it.
01:41:00Dr. Reid Hester Okay great. Number two.
Clayton Brown I've got a list.
01:41:05Dr. Reid Hester Okay.
Clayton Brown I've got a long list though. Things that urge me or cause me to drink.
01:41:10Dr. Reid Hester No, situational fact, yeah.
Clayton Brown The situational thing like if I'm at a partyand everybody else is drinking, I got to have one. If I'm at home and people are over and they're drinking, I got to have one. If I'm at my friends house and they're drinking, I got to have one. If I'm at a club or in a bar, I got to have one like I said I DJ so… so a lot of drinking in that atmosphere, uh… at my mother's house. If she is drinking, I got to have one. I think my problem is like pre-disposure to alcoholism.
01:41:40Dr. Reid Hester Well it maybe.
Clayton Brown It could have… could have… I don’t wanna say it right. But if I'm at the (inaudible ) and people are drinking, I drink there also.
01:41:50Dr. Reid Hester Uh-uh
Clayton Brown Uh… At weddings, after funerals, when I'm happy, when I'm sad, when I'm angry. Oh I karaoke, I also sing karaoke and you know at the bar. Karaoke. There you go. So I usually really-really get loaded at karaoke. So it helps me sing better. So… So they think…
01:42:20Dr. Reid Hester Okay. Uh… You know I… I think that… that this is giving you some… is this giving you some sense that… that you're something your behaviors at least are not just random. That there is some predictability to these things and that… that you're drinking, you're smoking, that you're over eating actually fulfills some functions, some purpose in your life and that’s one of thereasons that it’s there. Is it has some positive consequences for you, either by reducing negative emotions like anxiety or stress or worry or by ah… freeing you up from your should's and your ought to's and your must's uh… or by increasing positive emotions. Uh… Now here's the third and key component to this whole… to thiswhole picture and it’s what we call new roads. What other ways do you have or what other ways can you try to achieve those same desired effects? There is nothing wrong with the desired effects of wanting to be relaxed, be dis-inhibited, enjoying yourself, uh… escaping giving yourself a break, freeing yourself from should's and responsibility, there is nothing wrong with those desired effects. If the only way you have to achieve them is through this one behavior, be it drinking, smoking, procrastinating then when you really-really need that result, you're really high risk for using that behavior. So a creative component to this is what else you gonna do? What are some other options that you could sample, that you could recall from the past, that you could use more frequently to achieve this same kind of desired effect togive yourself… give yourself this break, to improve your mood, to reduce your stresses and that’s that maybe… that’s different things for different people, you know. Some people garden, other people's you know workout, other people ride bikes, some people listen to classical music, other people listen to jazz, some people meditate, some people you know go sit in the hot tub for 20 minutes, some people just get away and do absolutely nothing or read a book. Uh… So, what works for you may not work for other people and setting up your own and developing your own new roads is an important to have these alternatives because you need these… you need thesedesired effects from time to time. You need to relax. You need to reduce your anxiety or your stress levels. You need to enhance your mood or give yourself a break. Having some alternatives besides drinking or smoking or procrastinating, gives… increases the chances that you'll use those something else that's more healthy and adaptive and decreases the chances that you're going to use something that has other negative… other negative consequences. So I'd like you to do and you folks at home also is to take a few moments and think of somealternatives, new ways of achieving those same desiredeffects. I want you to do that now.
01:45:55It's Your Turn new roads Using the list of effects you endure from participating in your habit or behavior, create a list of alternative actions that create the same effect. i.e.: smoking relaxes me, meditation relaxes me. Please turn off video & proceed with exercise. Return to video when you feel ready.
01:46:10[sil.]
01:46:15Exercise 4 Wrap-up and Conclusion
01:46:25Dr. Reid Hester Okay. What I'd like to do now is to get some ideas of what you've come up with in terms ofalternatives to these desired effects. Craig (ph) would you want to go first?
01:46:30Craig (ph) Oh, for drinking. Ah… I find myself drinking after a stressful day at work uh… really to relax. So an alternative for me would be ah… to meditate.
01:46:45Dr. Reid Hester Uh-uh.
Craig (ph) I maybe go out to a massage therapist. Uh… Lot of times I drink to celebrate. So, in that respect I can reward myself with some kind of a small token or a gift orsomething that makes me feel good.
01:47:00Dr. Reid Hester Uh-uh, uh-uh excellent, excellent. Uh…You know I… I think that massage therapists are really busy on Thursday and Friday afternoons. So, book early and book often. But and… and that's what works for you… you know and if… if others of you have not considered it, you can you know think that that might be something you know to try yourself. It may or may not work for you and then maybe a skill that you need to acquire, but might be a valuable skill; some way to learn how to… to relax and quiet your mind and… and reduce the… the tension in your body. Who else?
01:47:45Okay, but well (inaudible ) mean I was kind of stumbling with that because I was wondering what can I put in play so that that would, you know relax me or I can get the same comfort that I get when I smoke the cigarette that I could do just as fast. So a few suggestion… suggestions was thrown at me and ah… (inaudible ) to buy me some day Nicorette gum and when I want a cigarette to just pop in a piece of that or we have a aquarium at home with turtles and fish and stuff and I find that a lot of time I'm looking at television and I have drifted out from the television because I'm concentrating on the fishes,watching them in their own world and I'm watching the bubbles go up in the water and the sound and that’s peaceful. So, if I can just do it.
01:48:30Dr. Reid Hester Yeah. Uh-uh, uh-uh. Mary Ann .
01:48:35Mary Ann I find myself not running when I see the rain. You know (inaudible ) it’s too cold or it’s raining so I can either use an indoor track or I could use a treadmill and I also said after a while if I think my muscles start hurting too much I… I give up and I can start (inaudible ) relieve the muscles and I don’t like running alone, so I could find a running buddy.
01:48:55Dr. Reid Hester Uh-uh, uh-uh Okay.
01:49:05Uh… With me I think although I… I write down theappointments and things in my daily planner I don’t always look at my planner. So, I think it would help if I maybe look that at the day before, you know or if… or if on the weekend I look for it look that at for the total for the whole week. You know and to see you know what's going on and what I have to do and then daily you know take a or keep it out you know where I can see it you know. Uh… And also ah… getting my clothes together for the week maybe on Saturday, you know iron all the clothes and you know so that would give me more time in you know in the morning.
01:49:50Dr. Reid Hester Uh-uh.
(inaudible ) me ready.
01:49:55Dr. Judy Lewis This looks really habit(ph), don’t you Reid ?
Dr. Reid Hester I think that’s some good idea.
Dr. Judy Lewis Yeah.
Dr. Reid Hester Really do.(inaudible ) you are gonna say something?
01:50:01I don’t have any exciting alternatives because I guess the bottom-line is that if I don't want any stress than just do the damn work you know. So I figure that my only alternative is that when the stuff comes up and I'm not so excited about I just need to do it and get it out of the way and it’s like I know that you know and I you know I think with a lot of these things we always kind of know the answers we're just hoping for some easier softer way and I know that, but it’s we’ll see. We’ll see if the pain is great enough to motivating me to do it.
01:50:30Dr. Reid Hester And let me suggest especially with procrastination to look ahead to use that little trick of looking ahead and thinking of how good it would feel to have it out of the way you know something that’s disagreeable and but you know you gonna have to do it sooner or later, how good it would feel when its actually done. The other things about procrastination is that you might wanna reconsider these ought-to's and have to's versus want to's and choices that you make. That’s a bit of a mental shift.
01:51:05Well looking ahead of my work from most normal people they like to live there anyways. So, I don’t have to try to… that particularly gonna work for me because I… I'll be like oh, when it's done when it's done and you almost figure it’s done already and you haven’t done it you know. So it’s like you're already living as though you've already finished the task you know, at the least you know my behavior type I do that. So that particularly that doesn’t work for me.
01:51:30Dr. Reid Hester Okay.
And then the day comes and you're like (inaudible ).
01:51:33Sure, yeah. Damn. I had two hours you know. So.
01:51:40Dr. Reid Hester Okay. See everybody's new roles aredifferent aren’t they? Anybody else come up with some ideas.
01:51:50John For smoking they you know to uh… turn the voice off if you're deep breathing, praying, meditate, you know just…
01:51:55Dr. Reid Hester Uh-uh.
John …alternate activities and its almost anything will get my mind off from the cigarette if I do it. Only thing I have to be disciplined to do it and then for relaxing I'd go on a hot tub. I like to do that.
01:52:05Dr. Reid Hester Uh-uh.
01:52:10John I can’t… There is… There is nothing that I can think of that has a same taste as a cigarette after a meal,however I can develop the habit of drinking water which somebody laughed at a minute ago, but that's all right, but water is good for me.
01:52:20Dr. Reid Hester But you like the taste of water.
John Yeah.
Dr. Reid Hester And does it… does it… okay.
01:52:25John I don’t know.
Dr. Reid Hester Uh-uh, if you try it.
John I don’t know if it… I don’t think it gives the same desired effect no but it at least it’s an alternative.
01:52:30Dr. Reid Hester Uh-uh.
John So try it.
Dr. Reid Hester Its okay.
John Something in hand chew gum. You know when I am particularly when I'm stressed out having a conversationwith my wife is getting stressful I smoke at that time. Better to have start chewing the gum at least.
01:52:45Put something in your mouth.
But then it will be so big, you just can’t speak.
01:52:50John Better with that. That may be good too.
Your wife might really like it.
01:52:55(inaudible ) talking more.
Dr. Jon Carlson (inaudible ).
01:53:00Dr. Reid Hester You know I applaud your creativity. You know I I… think that this (inaudible ) to come up with alternatives and nothing exactly you know replaces the… the drugs or the you know the (inaudible ) behavior. But some of them can be useful alternatives that will at least have some impact and… and get you to part of the way at least.
01:53:25Dr. Jon Carlson You know when we started this… this whole process of self-control, I mean everyone was kind of uh… you know they seemed too excited about it, buteveryone has really had a lot of fun with this. You know they seemed to have really enjoy the this whole process and it seems that a lot more doable now for me you know you've taken us through these steps and helped us to realize some of the I guess the (inaudible ) thinking and doing that we've been doing some of our solutions and how they really don’t help at all. We'd like to thank Reid for doing this and helping us learn about behavioral self-control. Thank you very much.
01:54:05Dr. Reid Hester Thank you.
01:54:10[sil.]
01:54:15SPECIAL THANKS TO John Cebuhar , Project Coordinator for his hard work, dedication and creativity in carrying out this project. All of the participants whose courage and generosity in sharing their personal stories made this series possible. The practicing counselors, therapists, and social workers whose participation enhanced the quality of these sessions. Addison Woodard Chair of the Division of Psychology and Counseling Diane Alexander Dean of the College of Education for their support and encouragement Virginia Lanigan - Editor for her support on this project Stephen G. Smith and David Sachotti for their support and marketing expertise
