Bridging behaviorism: A new approach to employee engagement

transcript

Bridging Behaviorism A New Approach to Engagement

Speakers:

• Dennis Richling, MD, Chief Medical and Wellness Officer, HealthFitness (moderator)

• Edward Framer, Ph.D., Director, Health & Behavioral Sciences, Science and Analytics, Health Fitness Corporation

• Fred Hanna, Ph.D., Professor of Counselor Education, University of Northern Colorado; author, Therapy with difficult clients: Using the precursors model to awaken change

Two Models, One Goal: Sustained Engagement Dennis Richling, MD, Chief Medical and Wellness Officer, HealthFitness (moderator)

Engagement

• A Pledge, or a Promise

…is a marriage -an alignment of purpose and values

Participation

How Do We Engage People?

Educate

them…

Incent them… Reframe

the message…

Open a

Motivation is Important to Change Behavior

Goal: Adopt Healthy Behaviors for the rest of their life

How much motivation do we need?

• A new behavior model…

Dr. BJ Fogg Stanford Persuasion Technology Laboratory

B = M A T M

otivation

High Motivation

Low Motivation

Hard to do Easy to do Ability

Fogg Behavior Model Behavior Shaping

Desired Behavior

Exciting New Research?

Yes, but...

When Do Behaviors Change?

• Epiphanies

• Change of context

• Psychological processes

• Make it easier

Bridging Science to Increase Engagement

10% 10% Motivated with Risks

Little Motivation andRisks

No Motivation andRisks

No Risks

Bridging Behaviorism

Radical Behaviorism

Fogg Behavior

Precursors Model

Transtheoretical Model

A New Look at What Radical Behaviorism (Behavior Analysis) has to Offer Health Promotion and Engagement

Edward Framer, Ph.D., Director, Health & Behavioral Sciences, Science and Analytics, Health Fitness Corporation

Behavioral Approach?

• Emphasis on measurement

• Emphasis on observable results

• Criteria = behavior change

• Justification

How the conversation got started

1. Can we work together to improve how HealthFitness builds it intervention models?

2. Engagement is critical to the success of health promotion and in fact all therapeutic change

3. Schools of psychotherapy, coaching and health behavior change, including even the Eastern thinking of yoga psychology

4. Why behaviorism is often the odd man out

5. Assertion: Radical behaviorism also deals with consciousness, thoughts and feelings

6. How can we use these various approaches, together, to improve engagement?

7. How can we use the various approaches, together, to improve health behavior change?

Radical Behaviorism

Fogg Behavior

Precursors Model

Radical Behaviorism

• Skinnerian behaviorism or operant psychology

• Why radical?

– Methodological behaviorism only what is observable from the outside?

– Radical behaviorism accepts consciousness

– Thoughts are behaviors, too

– The same rules that apply to learning to stop a car when the light turns red apply to learning to have or change thoughts or statements

Radical Behaviorism and Health Promotion

• What does behaviorism, and especially radical behaviorism, have to offer the health promotion/wellness field that most of us have come to love?

– An analytic framework

– Behavior change technologies

– A way to clarify the intrinsic/extrinsic incentives fight

– Both individual-clinical and population-culture approaches

Incentives, Rewards, Reinforcers

• Incentive

– “…the expectation of reward that induces action or motivates effort.” (www.thefreedictionary.com)

• Reward

– “Something given or received in recompense for worthy behavior….” (www.thefreedictionary.com)

• Positive Reinforcer

Don't Shoot the Dog! The New Art of Teaching and Training.

By Karen Pryor

Strengthens behavior it follows

Example: Timeframes for Incentives, Rewards & Reinforcers

Incentive Reward Reinforcer

Long-term Intermediate Brief

$650/Yr $10/Wk $0.05/Min

500 pts/Yr Movie ticket 1 pt/20 steps

Two Types of Learning/Conditioning

• Pavlovian or Classical Conditioning

• Operant Conditioning

http://psychology.about.com/od/behavioralpsychology/a/classical-vs-operant-conditioning.htm

Discriminative Stimulus

• “When a stimulus signals the availability of reinforcement it is called the SD, or discriminative stimulus. …it reliably signals the availability of reinforcement.”

• “Stimulus control is said to occur when an organism behaves in one way in the presence of a given stimulus and another way in its absence.”

• In plain English: A reliable cue or trigger

http://en.wikipedia.org/wiki/Stimulus_control

Subtle reminders to make healthy choices easier

Jim Rogers

Chairman & CEO

Eastman Chemical Company

Case Example: Eastman Chemical Company As part of the company’s health management efforts, Eastman leadership told employees the company was placing green spoons in the cafeteria’s healthy food choices and red spoons in the less healthy foods. “Hopefully, over time, we’re going to find ourselves reaching for the green spoon a lot more than the red spoon.”

Antecedent(s), Behavior & Consequence

Antecedent(s)

•Doctor says I need to exercise more

•Worksite Health Coach asks about my doctor’s exercise rec.

•Plan results in 10 daily 1 minute calls from my coach in 3 weeks

Behavior

•I wonder how I, someone who hates exercise, will do that.

•I get upset, but admit that I need help

•With each cue I get up and walk at least 100 steps. I also try to get 100 steps on non call days. (Use Outlook)

Consequence

•I feel bad, but do nothing. I don’t think about PA.

•Coach praises my honesty and offers to help me setup a plan.

•I earn regular praise from my coach and even begin to praise myself. I also start to feel more relaxed.

• Positive Reinforcer

Don't Shoot the Dog! The New Art of Teaching and Training.

By Karen Pryor

Strengthens behavior it follows

Negative Reinforcer; Punisher

• Negative Reinforcer or Reinforcement (strengthens behavior)

• Punisher or Punishment (weakens behavior)

Escape and Avoidance Behavior

ESCAPE: perform an operant response that gets you away from an ongoing punishing stimulus. “Get me out of here” AVOIDANCE: perform an operant response that prevents the occurrence of a punishing stimulus. “Prevent pain/discomfort”

Escape and Avoidance Shuttle Box

www.themezoom-neuroeconomics.com

Summary

• Many more principles that have application to health promotion

• Attaches to so much else in the field, including the work Dr. Hanna will speak about next and the introductory material that Dr. Richling used to set up our discussion.

Precursors Model: Foundations for Successful Engagement and Change Fred Hanna, Ph.D., Professor of Counselor Education, University of Northern Colorado; author, Therapy with difficult clients: Using the precursors model to awaken change

Three Levers for Engagement

Motivation

Perseverance

Involvement

Engagement

Involvement • Dedication to a task or undertaking that often

includes strong interest, devotion, fascination and/or commitment.

Motivation • The desire to attain a goal; includes the exertion

of effort and willpower toward achieving that goal.

Perseverance • Sustained drive and energy toward a desired

goal; includes the determination to break through any barriers.

Defining the Levers

Maintenance

Action

Preparation

Contemplation

Precontemplation

Stages of Change and Engagement

Bridging Behavior, Cognition and Affect

The dynamic Interplay of Self, Mind, Body and Therapeutic Change

Source: Fred J. Hanna, PhD

Precursors and Change

Precursors Assessment

Problem or Issue:

Precursor and its Markers None (0) Trace (1) Small (2) Adequate (3) Abundant (4)

1. Sense of Necessity • Expresses desire for change

• Feels a sense or urgency

2. Willing for Anxiety or Difficulty • Open to experiencing emotion

• Likely to take risks

3. Awareness • Able to identify problems

• Identifies thoughts, feelings

4. Confronting the Problem • Courageously faces the problem

• Sustained attention toward issue

5. Effort toward Change • Eagerly does homework

• High energy; active cooperation

6. Hope for Change • Positive outlook; open to future;

• High coping; therapeutic humor

7. Social Support for Change • Wide network of friends, family

• Many confiding relationships

Radical Behaviorism

Fogg Behavior

Precursors Model

• Dennis Richling, MD, Chief Medical and Wellness Officer, HealthFitness (moderator)

• Edward Framer, Ph.D., Director, Health & Behavioral Sciences, Science and Analytics, Health Fitness Corporation

• Fred Hanna, Ph.D., Professor of Counselor Education, University of Northern Colorado; author, Therapy with difficult clients: Using the precursors model to awaken change

Appendix

Antecedent(s)

• Stop light turns from green to yellow

• Stop light turns from yellow to red

• Stop light turns from red to green

Behavior

• Foot moves from gas pedal to brake pedal

• Foot presses harder on the brake pedal

• Foot moves from brake to gas pedal and presses down

Consequence

• Car begins to slow down

• Car slows to a stop

• Car begins to speed-up

Antecedent(s)

• Girl in class smiles at me

• My watch alarm rings 3 times per hour

• A new girl in class smiles at me

Behavior

• I look away thinking: “She probably doesn’t really like me”

• Each time I try to think: “When someone smiles at you, smile back”

• I smile back at her and introduce myself

Consequence

• Next time the girl and I look at each other, neither of us smiles

• When I think this 10 times, my Mom gives me $1.00 extra

• She says “I’m Sue and I just transferred here

Bridging behaviorism: A new approach to employee engagement

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