Sunday, May 29, 2016

Interventions: The Screenshot

Before intervention became a household word, disseminated via television as a strategy to sober people up, therapists used it universally as any strategy designed for change.
An intervention is something a therapist uses to change behavior that doesn't work for the client. Or it might add a behavior that works much better. 
Much of therapy is about finding ways to stop something or to start something.
Here's an example, an intervention I thought up working with a client who wanted to lose weight. But  the intervention can be altered to fit any behavioral or emotional issue, too. Anything that needs reinforcement, reminders. A pretty big set. 
Just a reminder that the example below is fictitious, a variant of what really happened.

We're bemoaning the fact that at a hundred pounds overweight, the patient needs to use multiple behavioral strategies to cut down her calories, and she needs to walk every day. She does nothing but eat and sleep. The emotional reasons, the psychology, has all been discussed, purged, but the numbers on the scales still go up. Sometimes down, then up again.

Like most of us, she has a cell phone. Hers tells her when she has email.
"Can you just send me an email everyday?" she asks.
If I can't remember to call a sick friend once a month, do you really think I'll manage to do that, email you? No, this is your program, not mine.

But we come up with another idea. I print out the following, her reminder.
You want to be here to see grandchildren.
You don't want your kids to bury you in your forties. 

Print-out obesity intervention

Screenshot-obesity intervention

Then she takes a picture of the printout, and with a little effort, tries to make it a screensaver.

The Home Screen Intervention

We had to reprint it again, condense the text, make it single spaced and compact, but eventually it worked and we made it into her home screen.

Now, every time she uses her phone, the message confronts her. We're chipping away at her denial.

Time will tell, certainly, if this is going to work.

Now you have the intervention. I'm still working on what mine should say.

One thing's sure. It is cheaper than buying the many apps on the market today, and if we keep changing the words to deliberately avoid desensitization, it can't hurt, might even be, effective.



Anonymous said...

I like the idea, and the constant reminder, but this seems a bit shaming, doesn't it?

therapydoc said...

My patients tell me that previous tries, being "nice" doesn't work, and that I'm supposed to be tougher, expect more of them so that they expect more of themselves. Obviously this isn't for everyone, and we tend to tune out what we always see anyway. But for those who want to look in the mirror, past their denial, a real reminder of their personal goals can be very helpful.

Better Things-- Seeing Ghosts