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Operant Conditioning – Chapter 8 Some Practical Applications…

Operant Conditioning – Chapter 8 Some Practical Applications…. Theories of Learning October 17, 2005 Class #24. Some “antismoking” ad campaigns invite children to smoke. Hook the child and you have a lifelong smoker….

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Operant Conditioning – Chapter 8 Some Practical Applications…

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  1. Operant Conditioning – Chapter 8Some Practical Applications… Theories of Learning October 17, 2005 Class #24

  2. Some “antismoking” ad campaigns invite children to smoke

  3. Hook the child and you have a lifelong smoker…

  4. Nicotine, heroin and alcohol addicts have the same relapse rate of about 80%J Clin Psychology 1971;27:455

  5. Want To Quit • Ask: smoking status is a vital sign • Advice: to quit in a clear, strong and personalized way • Assess: willingness to quit • Assist: the patient, set a quit day, anticipate challenges, remove tobacco products • Arrange follow-up or refer

  6. Do Not Want To Quit • Relevance: why quitting is important be clear, strong and relevant • Risks: explain short term and long term risk • Rewards: improve health, save money, feel better, look better, provide a good example • Roadblocks: withdrawal symptoms, weight gain, fear of failure • Repeat: every time patient returns to office

  7. Quit recently • Congratulate • Reinforce: use open ended questions such as “how has stopping helped you?”

  8. How Smokers Try To QuitAmerican Lung Association survey 1998 • 73% cold turkey • 44% gradual withdrawal • 39% confused about medicinal help • 70% believe nicotine replacement and behavior modification therapies help • 35% think they need a Rx for the patch • 20% think they need a Rx for the gum

  9. Cold Turkey • Cold Turkey can be be effective for some… • Choose a symbolically important day for quitting • Tell everybody that you are quitting and ask for help • Have a non-smoking ceremony the day of quitting

  10. Gradual withdrawal • Aversive therapy • Curtis, 1976; Barske, 1977 • Rapid puffing until side effects (nausea) success rate around 20% • Fading • Becona & Garcia (1993) • Identify and eliminate the cigarettes you can do without • 57% and 41% success rate in 6 and 12 months • Behavior Modification • Cinciripini (1994)

  11. Behavioral Therapies

  12. Behavior Modification • Behavior modification is more effective than group therapy, and relaxation training. • Successful programs follow the rules of operant conditioning developed by BF Skinner in the 1950s

  13. Operant conditioning rules • Contract with the patient regarding what is appropriate and inappropriate behavior. • Keep objective records • Develop a program of positive and negative reinforcements and positive and negative punishments to strengthen and weaken appropriate and inappropriate behaviors • Study results • Alter the program

  14. Objective records • Food and smoking diary • Activity diary • Medical management diary

  15. Diary

  16. Activity diary

  17. The behavioral chain Cut the weakest link, replace, reinforce Buy cigarettes cigarettes in house Watching TV Smoke Smoke Out with Smoking friends Smoke Snacking Smoke

  18. Positive Reinforcement A method of reinforcing a behavior by rewarding such behavior Examples • Deposit the money you saved by non-smoking in a vacation saving account • Praise your relative for not smoking

  19. Negative Reinforcement A method of reinforcing a behavior by removing an unpleasant stimulus Examples • If you don’t smoke you give a good example to your children • If you don’t smoke you feel better

  20. Positive punishment A method to reduce a behavior by delivering an unpleasant stimulus such as: If you are going to smoke eat the butt or over-puff

  21. Negative punishment A method of reducing a behavior by removing a pleasant stimulus: If you cannot party without smoking don’t party

  22. Reinforcements and support • Biological: Pharmacology • Social: intra-treatment (group therapy) extra-treatment (internet sites, support groups) • Family: other smokers in household  lower abstinence rates. Encourage significant others to quit along with patient • Personal: frequent follow-up visits, telephone calls, buddy system

  23. Extinction • The weakening and eventual disappearance of a learned behavior • Partial reinforcements produces behavior with greater resistance to extinction when the reinforcement is discontinued.

  24. Example of behaviors that help to stop smoking • Choose a goal: ExampleExercise 5 days a week, quit smoking in 2 weeks. • Keep a diary: Easier to achieve your goals if you keep a diary. • Ask friends and family to help. • Do not buy cigarettes. • Join a smoke cessation program. • Take your medications daily.

  25. Example of behaviors that help to stop smoking 7. Avoid alcohol. 8. Ask for non-smoking tables and rooms 9. Open a no-smoking saving account. 10. Get involved in the no-smoking campaign. 11. Make a list of the benefits of smoking. 12. Make a list of the problems associated with smoking.

  26. Be careful…

  27. Behavior modification summary • Behavior and activity diary • Analysis of the behavioral chain • Action • Follow-up • Social and psychological rewards and support

  28. Credits: • http://www.vsrc.org/Smokingcessation.ppt

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