Long-Term and Short-Term Reinforcement

When I was an undergraduate student, I took a class on learning and behavior. I do not recall if it was required for the psychology major or an upper-level elective that I chose, but it was a fascinating course. The professor ended up advising me for my capstone project teaching rats to push buttons.

It was incredibly meta to learn about how we learn. But learning is not just about facts or skills – our brains learn what activities lead to desirable consequences, and we want to do those things again.

Photo by Andrea Piacquadio on Pexels.com

Do things that lead to consequences you want, and avoid things that lead to consequences you do not want. It sounds so simple, right? So, why would anyone engage in a behavior that could be seen as self-sabotaging? Why would anyone make a choice when they know it will have a negative consequence?

The answer is, there is a massive difference between short-term and long-term reinforcement. We learn best from immediate reinforcement, so we are wired to seek choices that give us the fastest reward.

The chemical that gives us that positive reward feeling is called dopamine, and our brains want to do the activity that gives us dopamine the fastest.

Graph: the relationship between how far away something is and how important it seems

The graph above shows how important something seems to be based on how long we would have to wait for reinforcement. Say you have a test next week, and you want to do well. The purple line is doing well on the test – it is very important to you, so you are motivated to study. But if the test is still several days away, it is difficult to anticipate the reinforcement and be motivated to study. The farther away the test is, the less important studying feels.

Let’s say it’s Friday night, and you could study for the test, or you could go out with friends. The blue line represents going out – in the long-term, you can see that it is more important to do well on the test than to go out. But in the moment, on Friday night with the test several days away, going out feels more important. That reinforcement is sooner, even if it is smaller in the grand scheme of your life.

Although being aware of this tendency does not make it less tempting to blow off studying, this knowledge could help you be more mindful of the choices you are making and how they will affect you.

Of course, relaxation is important, and it would not be healthy to lock yourself in your home and never socialize again. But noticing the tendency to go for short-term rather than long-term reinforcement can help in balancing working towards your future goals and enjoying the now.

App Review: Breathe 2 Relax

Today’s mental health app was developed by the Defense Health Agency: Breathe 2 Relax. I love that there seems to be no shortage of apps to teach coping skills, deep breathing, and mindfulness – you can try them all out and see which one is the best fit, which one uses language that you resonate with most, and the aesthetic you enjoy.

Breathe 2 Relax home screen

There are some helpful videos to teach users about stress and the benefits of breathing exercises.

Diaphramatic breathing, education about stress, practice breathing sessions

The breathing exercises on the app all start with rating your stress level. Instead of ranking your stress on a numbered scale, there is a slider from “Relaxed” to “Stressed.” Although I personally find numbers helpful, I have noticed that some have trouble choosing which number best represents their stress level, and this simplifies the process.

After documenting your stress level, the app takes you through a deep breathing activity with some lovely visuals. You can tailor how long the inhales and exhales are, making this app more customizable than other breathing apps I have reviewed before. You can determine the breath length that works best for your body.

Rate your stress

After the exercise, you are again prompted to rate your stress level. Over time, the app graphs your response to using the relaxation exercises. You get to see a visualization of how the breathing exercises reduce your stress level.

This is another great app to reinforce relaxation and coping skills anywhere, any time. What are your favorite mental health apps? Tell me so I can share them!

Telehealth Resource: Board Game Arena

Today’s telehealth resource is not a specific activity but a platform with a whole bunch of games to choose from. Board Game Arena even has some games I have shared before on a new platform with different options, which is great for tailoring activities based on individual needs. For instance, I talked before about how the telehealth version of Connect Four that I use has a timer that stresses kids out, and the Board Game Arena version doesn’t use a timer.

Photo by Pixabay on Pexels.com

To use this platform in telehealth sessions, I recommend making an account. I made one connected to my personal email address, and it allows me to create private game rooms with clients playing as guests. It only took a minute to set everything up.

When you log in, follow these steps:

  1. Under “Select Game Mode,” choose Simple Game.
  2. Under “Select a Speed,” choose Real-Time.
  3. Under “Play With,” choose “Play With Friends.”

It asks, “Will both you and your friend share the same screen?” You could choose “yes” if you are going to share your screen and take turns with remote control, but there are more game options if you do not share your screen. If you choose not to share your screen, you will get a link to share with your client that brings them into your private game room.

The site then asks if your friend is registered to the site – I ask my clients not to register, since they can play as a guest anonymously. Send them the link via the chat feature on your telehealth platform, and they can choose a guest display name.

Scroll down, and you can either search for a specific game or click “show me all the games.” If you browse all games, you can filter by number of players, play time, and complexity based on preferences, treatment goals, client interests, and client developmental level. You can save games you use a lot as favorites to save time.

When you finish your session, return to the lobby screen. Guest players remain in the room even after they have logged off, so you have to “kick” them from your lobby by selecting the X next to their avatar.

This is great for groups too, since you can have multiple players in your room at a time. The platform is also helpful for kids who are not the most tech savvy, since you can switch between games without sending a new link. I talk the parent or guardian through helping the child get into the room, and then they can navigate the rest of the session independently.

I love finding new telehealth platforms, new versions of games I have been using for a long time. It allows me to tailor the session to the client’s needs, which is what I am there for, after all!

The Weekly Mews with Armani

Hello and welcome to another edition of the Weekly Mews! Armani is so happy you are here.

Say cheese!

Armani was so brave getting his blood drawn on Tuesday. He was so brave, in fact, that he tried to fight the vet tech. He is so big and strong! He really hopes he does not have to go back to the vet any time soon, and we have our fingers crossed for him.

Brave boy who will fight you

Unfortunately, the results have not come back yet, so we don’t know what Armani’s blood work showed just yet. For now, he is still on the minimum dose of insulin while we wait. He has all his energy and has been jumping higher than he was before. Not as high as before he got sick last year, but the highest I have seen him jump since then.

Happy kitty

Armani is so excited to share his upcoming children’s book with you, once I learn how to navigate the self-publishing world when it comes to children’s books. KDP has great options for the ebook, but it is giving me trouble with a paperback copy. I am looking into other platforms right now (but let me know if you’ve been there and have any insight!).

In the meantime, Armani will keep getting stronger and hanging out in his paper bag fort.

Armani in his paper bag fort
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Proceeds from Armani’s mewsletter help pay for his insulin and vet costs. He also shares 50% of each donation with organizations that help pets.

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Co-Parenting: Some Thoughts

There’s a letter that Judge Michael Haas wrote back in the 1990s to divorcing parents. In the letter, he reminds them that their children are “one-half of each of you.” That “every time you tell your child what an “idiot” his father is, or what a “fool” his mother is, or how bad the absent parent is, or what terrible things that person has done, you are telling the child half of him is bad.”

Photo by Tatiana Syrikova on Pexels.com

I love this, and I reference it all the time at work. People who share a child but are not together separated for a reason. I say all the time, “If you got along great with each other, you probably would not be divorced.” It’s okay to not like each other. It is not a requirement, but it is understandable.

Believe it or not, I have met parents who are not together but are on good terms. In every case, it was not easy to get to that point, but they were able to get on the same page for the sake of their children. There are exceptions, of course (for example, in cases where a parent is a child’s abuser), but in the majority of cases, it is in a child’s best interest to have a relationship with both parents.

Kids pick up on stress and conflict even if they are not told directly about it. A child will be aware if exchanges are tense, or if the parents will not be in the same physical place for these exchanges.

You do not have to think the other parent is fantastic. You don’t even have to like them. The goal is to be on amicable, civil terms for the sake of your child. But how do you get there when you are hurt and angry?

Co-parenting classes exist for this reason. Crossroads of Parenting & Divorce is one program offered in the Sioux Falls area, and you can search for classes available in your area.

In instances of high conflict, you might need co-parenting counseling. This is similar to marriage counseling but focused on helping people who are no longer together co-parent in a healthy way. You can ask your therapist or attorney for a referral for co-parenting counseling, or you can search providers in your area.

Put simply, divorce sucks. Sometimes it is the best, healthiest option for all parties involved, but it is a stressful experience that no one wants. Co-parenting is a challenge that can be overcome with the right support.

Telehealth Activity: Virtual Roller Coaster

I continue to be amazed by the new doors that telehealth opens for me in my practice. Virtual backgrounds, Google Earth vacations, and Minecraft are just three things I never would have thought to use in my sessions before I went online. Necessity breeds innovation, as they say.

I am sure you have heard about virtual reality headsets – a way to immerse yourself more fully in a digital world. When I was a graduate student, I did a practicum rotation at a CBT clinic where we used VR to do exposure therapy for people with phobias of airplanes. It was effective, though the VR I have been using in my sessions is a lot more fun.

Photo by Athena on Pexels.com

You do not need any fancy VR equipment to do this activity, but if your client has access to a headset, that could enhance the experience. I recommend using this on devices the size of a tablet or larger to make it more realistic, preferably a laptop.

There are dozens of first-person videos of roller coasters available to use for free! If a client has a favorite amusement park, you can search for specific options.

This is a great activity to practice body awareness (What do you feel, and where in your body do you feel it?), big breath activities (Inhale going up, exhale going down), or give you a more concrete version of a guided visualization activity (Did you know 1-3% of the population can’t visualize things in their mind?)

Have you ever wished you could do a therapy field trip to an amusement park? Through the power of telehealth, you can…virtually!

Ap Review: Amaru

As you probably already know, I test run all the aps that I review on this blog. I still love the feedback I get from others who try them out, though, because a lot of them are created for issues that I do not personally experience. For example, I’m glad people found my review of Curable helpful, even though I do not personally experience chronic pain.

The ap I have to share with you today is one I have been using because I have personally found it helpful. It is called Amaru, and it features a virtual flying cat pet who teaches you about self-care. What could possibly be more adorable than that?

Welcome to Amaru home screen

There is a paid version that unlocks more features, and to be honest, I am seriously considering revising my “I don’t pay for aps” policy and upgrading. So far, though, I have stuck with the free version so that I can keep my commitment to only recommending aps that my readers can use for free.

Information page

When you first create the game, you find your kitten friend scared and alone. You have to figure out how to befriend them, and the game gives you feedback. For example, I tried comforting mine with pets, and it said that they did not want to be touched right now.

Eventually, I figured out that we needed to do a breathing activity together. That allowed us to bond, and I could pet and feed them.

Anxious baby

With the free version, there are limited meditations that you can complete, including mindfulness, deep breathing, and visualization tasks. I assume the paid version unlocks more options. You can play a memory game where you remember a pattern of colors and sounds, or you can do a focus activity where you “whack” away bad critters but keep good critters.

I personally really enjoy the whack-a-mole type game and think of it as an analogy for identifying and letting go of negative thoughts that do not serve me.

Free options

The game rewards self-care by giving you gems, unlocking new items, and increasing your bond with your pet. You get rewards for things like practicing mindfulness and keeping a consistent sleep schedule. Essentially, the ap reinforces things that are healthy long-term but do not provide an immediate dopamine boost.

Amaru is adorable, fun, and a great way for people of all ages to learn more about self-care.

The Weekly Mews with Armani

Welcome to a very special edition of the weekly mews! Armani has a special announcement. Drumroll, please….

Armani has decided to use his story about getting diabetes to help others! He is writing a children’s book with my help. As those of you who follow him on Twitter know, Armani is not the best at spelling, so I’m editing/translating from Cat to English.

Armani Doesn’t Feel Well cover

I haven’t self-published a children’s book before, so I’m reviewing options and the best way to do this. If you have, I would love to hear your recommendations.

Coming soon…. But I’m not sure how soon. As always, as soon as I know something, you’ll know something.

Armani snuggles

In other news, this coming Tuesday Armani has a blood draw to check his sugar levels. As you might recall, he decided enough was enough with the Libre devices, and he started destroying them.

We have our fingers crossed that the test will bring us good news, and maybe he won’t need insulin pokes as often.

What a brave boy!

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Monthly
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Make a monthly donation

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Proceeds from Armani’s mewsletter help pay for his insulin and vet costs. He also shares 50% of each donation with organizations that help pets.

Choose an amount

$5.00
$15.00
$100.00
$5.00
$15.00
$100.00
$5.00
$15.00
$100.00

Or enter a custom amount

$

Armani thanks you for your donation!

Armani thanks you for your donation!

Armani thanks you for your donation!

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Ap Review: CBT-i Coach

I will never have to think of my own content ideas again if I just keep talking about mental health aps. This week I bring you a resource to help with insomnia: CBT-i Coach.

CBT-i Coach was developed for veterans, but it can be used by anyone who struggles with insomnia. The “about” section on the ap notes that it is not a replacement for therapy, and it has features specifically meant to be shared with your treatment team.

My Sleep, Tools, Learn, Reminders

According to the ap, CBT-i Coach “will guide you through the process of learning about sleep, developing good sleep habits, and getting rid of habits that interfere with sleep. It also provides a structured program to get your biological clock reset to make it easier to go to sleep and to sleep through the night.”

Intro page for the ap

As the name suggests, CBT-i Coach uses tenants of cognitive behavioral therapy to improve your sleep. Though, again, it is not a substitute for therapy, it can provide education and reinforce good habits between sessions. It can also help you track information that is helpful to both you and your therapist to make your treatment more productive.

Sleep diary entry

The amount of items tracked can be a little overwhelming, but you can pick and choose which areas you focus on. I appreciate how thorough this ap is and how it can bring your attention to aspects of your sleep that you might not think of. It also contains fantastic psychoeducation about why different things might be helpful, though I try to always remind people that no technique is universal – some people sleep best with absolute silence, whereas others need some kind of noise to allow their brain to wind down.

How habits impact sleep

By tracking your habits using the diary feature, you can start to notice what works best for you and get better sleep. Overall, I think this is a great resource for those struggling with insomnia, when used in conjunction with therapy and other treatment services.

Telehealth Activity: Nature Cams

I have talked before about using pets in telehealth sessions, and Felicia Nubivn shared how she created a butterfly garden for her sessions. Today I am expanding on this idea thanks to various zoos and park services around the world.

Countless nature cams are available for viewing any time and from anywhere. Some are live feeds, so the animals might not be posing when you sing on, but this can be a lesson in managing disappointment or an opportunity to pick something else.

Bears fishing

Some feeds show highlights rather than live footage, which can be more useful in a session since you know the animal will be there.

Puffin with egg

The footage can be used to stimulate creativity; for example, you could prompt your client to tell a story about the bears. You could also use it as a jumping off point for a conversation; the puffin caring for an egg could instigate conversation about the client’s relationship with their own parents. Or the feed could simply be background ambiance as you focus on something completely different for your session, like the telehealth version of having a fish tank in your office.

Jellyfish cam

Whichever direction this activity takes, I have found that these animal feeds can pull the attention of even the most distractible clients. Which one is your favorite?