Risk Factors for Deliberate SelfHarm among Female and Male College Students - PowerPoint PPT Presentation

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Risk Factors for Deliberate SelfHarm among Female and Male College Students

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... Activation to Treat. Bipolar Disorder. Carl W. Lejuez, ... Patient and therapist mediated rewards through monitoring of activities and depressive symptoms ... – PowerPoint PPT presentation

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Title: Risk Factors for Deliberate SelfHarm among Female and Male College Students


1
Using Behavioral Activation to Treat Bipolar
Disorder Carl W. Lejuez, PhD Center for
Addictions, Personality, and Emotion
Research University of Maryland
2
Treatment Model
Positive and Rewarding Behavior
Positive Feelings (Happiness, Fulfillment, Sense
of Accomplishment)
3
Form 1 Daily Monitoring FormCircle the day
insert the date M Tu W Th F
Sa Su Date_______________
4
Planned Relaxation Rationale and Techniques
  • Stress and tension can be overwhelming and lead
    to a desire to use substances
  • Review and Practice in Session
  • Behavioral relaxation postures
  • Deep breathing exercises
  • Homework Practice Relaxation at least 5 minutes
    per day

5
Life Areas Assessment
  • Family Relationships
  • Social Relationships
  • Intimate Relationships
  • Education/Training
  • Employment/ Career
  • Hobbies/ Recreation
  • Volunteer Work/ Charity/ Activism
  • Physical/Health Issues
  • Spirituality
  • Psychological/ Emotional Issues

6
Identifying Activities
  • Select Activities that will help you towards your
    goals in each life area and list them on the
    Selected Activities Form
  • Refer to Activity Checklist for ideas
  • Example 1
  • Goal Take my medication every day
  • Activity 1 Make sure my pills are in my purse
    before I leave for work
  • Activity 2 Set alarm on my phone to go off when
    I need to take my pills
  • Example 2
  • Goal Sleep 8 hours a night
  • Activity Practice planned relaxation when it is
    time to go to sleep

7
Creation of Activity Hierarchy
  • APPROXIMATELY 15 ACTIVITIES ARE SELECTED
  • RANK-ORDERED ON LEVEL OF DIFFICULTY
  • GOALS IN TERMS OF FREQUENCY DURATION
  • PATIENT MOVES THROUGH THE HIERARCHY 1. BEGINS
    WITH EASIER ACTIVITIES (GAIN MOMENTUM)
  • 2. WEEKLY GOALS INCREASED UNTIL FINAL GOAL IS
    ACHIEVED
  • 3. MORE DIFFICULT BEHAVIORS PROGRESSIVELY ADDED
    AS
  • EASIER GOALS ARE MASTERED
    (I.E., 3 CONSECUTIVE WEEKS)

8
Activity Plan
9
Sample Activity Hierarchy
  • LEVEL ONE LEVEL TWO
  • A. Go to work A. Make dinner
  • B. Wake up before 1 P.M. B. Attend Church
  • C. Play with the dog C. Clean bedroom
  • LEVEL THREE LEVEL FOUR
  • A. Exercise at gym A. Visit a friend
  • B. Wake up before 11 A.M. B. Write letter to a
    friend
  • C. Go to sleep before 2 A.M. C. Knit or
    crochet
  • LEVEL FIVE
  • A. Return to School
  • B. Attend karate class
  • C. Volunteer

10
Charting ProgressMaster Activity Log
  • KEPT IN THE POSSESSION OF THE THERAPIST
  • USED TO CHART WEEK-TO-WEEK PROGRESS
  • INCLUDES CURRENT AND IDEAL GOALS
  • BEGIN BY CHARTING 2-3 ACTIVITIES/WEEK
  • MASTERY CLEARLY NOTED
  • ADD NEW ACTIVITIES FOLLOWING MASTERY

11
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12
Charting Progress Weekly Behavior Checkout
  • PATIENT CHARTS DAILY PROGRESS ON BEHAVIOR
    CHECKOUT
  • PATIENT CIRCLES Y FOR EACH ACTIVITY COMPLETED
    OTHERWISE, N IS CIRCLED
  • G IS CIRCLED WHEN WEEKLY GOAL IS MET

13
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14
Charting ProgressRewards and Graphs
  • Assess activities completed on a weekly basis
  • Assess depressive symptom severity via the BDI-II
  • Patient and therapist mediated rewards through
    monitoring of activities and depressive symptoms
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