Now that we have tools for analyzing what works and what doesn't. Let's think about what we'll do once the behavior has changed. What do we do once we're in a good habit or a new way of doing things to keep it that way. One option is to make a relapse prevention plan. This is a term borrowed from the substance abuse treatment tradition, but it works for any type of behavior change. A relapse prevention plan can take the form of a conversation or written document to consolidate the learning that has taken place during therapy. Or that an individual has uncovered during their own self examination of their behavior. Writing the plan down is recommended as it's much more likely to be remembered this way. A relapse prevention plan is usually made up of first some reflection and thinking on the circumstances that were most characteristic of the problem behavior. So if we are talking about the example of overeating perhaps things like who did you tend to overeat with? What types of food were you most at risk overeating? When did a relapse occur before? What was going on? Where there's certain types of day that are more risky? The next part is creating what we call a cope ahead plan. This is just like what it sounds thinking okay now when things are going well, when I've been focusing a lot on this behavior and having a lot of success, what challenges might lie ahead? And then problem solving ways to cope with them. This allows us to have a plan beforehand rather than being blindsided in the moment. So for example, if I have gotten a handle on my road rage, during my daily commute and my drives around town and things have been going well. I've been driving calmly and not having that rage reaction, but I realized I had a beach vacation coming up. I might think through what situations I anticipated might arise. Things like getting lost, being stuck in traffic and then I might plan ahead for how to cope with them in the moment. This plan could include specific problem solving ideas like leaving extra time, printing out maps or bringing soothing music. It could also include me visualizing myself coping successfully in these novel situations. The goal with the cope head plans can be thought of in our original behavioral terms. We are now trying to generalize our new learning from specific situations like my drive to and from work to a novel situation. The highway drive to the beach. Finally, the plan might include identifying some warning signs that would let us know a relapse was imminent. So what are the things that tend to happen right before my behavior terms? So if we go back to the overeating example, perhaps it's buying a risky food and stocking it in my fridge. Or for the road rage example, maybe I noticed that I'm feeling really tense when I get out of the car each day, for an exercise routine. Maybe it's when I start missing a day or a couple days a week of going to the gym. These are all signs that you want to be aware of. So, it's time to implement some of your strategies from your cope ahead plan. Another point that's really important to understand when thinking about relapse prevention is the abstinence violation effect. The abstinence violation effect is a series of thoughts and emotions that tend to take hold when someone slips up. That is they take a drink after five months of sobriety, or they have a road rage episode after weeks of responding calmly, commonly people will feel great guilt, shame, frustration, and anger when they have a slip up. They also often have catastrophic or black and white thoughts like we'll never be able to do this. I'm a failure. I might as well give up, these thoughts and these emotions can then lead people to just throw in the towel and turn that slip up into a full relapse. So for example, instead of having one drink, catching oneself and stopping if the abstinence violation affects thoughts and feelings kick in, the individual might go on to drink the whole bottle of wine and then even more, the farther someone's behavior changes back to old patterns, the harder it is to get back in the wagons, so to speak, or to get back to their behavior change. So this is one reason that we try to distinguish between the laps and the relapse. When a lapse occurs, a person is very briefly or to a small degree returns to the old behavior. So again, for example, they have one drink. They skip one day of exercise, they yell once at another driver. Usually the person notices quickly what's happening. They immediately stop, often they feel regret and they don't tend to return to the problem behavior if they can kind of catch what's happening. In fact, these lapses sometimes even result in strengthening or renewing the desire to stick with the new behavior. A relapse, on the other hand, is characterized by returning fully to the old pattern and is often characterized by those feelings of shame and guilt. When the slip up can be recognized early and treated as a lapse, rather than devolving into a full blown relapse, it's much easier to get back on the behavior change plan. So throughout this course, we've learned about understanding how human behavior develops and change. But we've really focused on what we, as individuals or friends or therapists have the most immediate control over ourselves. But I would be remiss if I didn't mention some other powerful tools for behavior change, ones that lie outside ourselves. So to introduce these, please watch the next 15 minute video from Dan Ariely, a professor of psychology and behavioral economics at Duke University. And then we'll come back together and discuss them more.
