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Binge Working and Procrastination: Your Experience

Posted on by by Posted in Achieving Goals, Health Decisions, Procrastination, Productivity, Time Management, Stress Management

Last-minute stress and binge working will improve your future procrastination as much as a hangover will improve your drinking habits.

At least that’s my hypotheses.

Guilt, Binge Working and Procrastination

Or what do you think? I’d love to hear about your experience. Do you sometimes work in somewhat excessive “binges”, for example through the night or throughout a weekend? If so, is this productive for you in the long run, or does it lead to the vicious circle in the image?

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Decision Skills Matter

Posted on by by Posted in Financial Decisions, Health Decisions, Intuition, Risk and Uncertainty

To what extent do decision skills matter in real live? Do these skills actually lead to better decision outcomes and fewer unpleasant life events?
Decision Skills Matter
Or, more specifically: do people who perform better on hypothetical decision tasks also make better real-world decisions, to the extent that they experience better outcomes over the course of their lives?

Let’s take a step back. Based on all the different theories of what counts as a “rational” choice, we know that some people perform better in the kinds of choices that are typically presented in research studies. There are people, for example, who are less affected than others by the way information is presented to them (in other words, they are better able to resist framing effects). Or, while most people are overconfident most of the time, some people actually have a pretty accurate level of confidence into their own judgments. There are also people who are better able to abandon a bad plan that involves sunk costs, while others are more prone to keep throwing good money after bad. We also know that these decision skills are related to other cognitive abilities, and that they can be taught and improved with explicit instructions and practice. (Check out the list of references below for just a sample from a large body of research.)

The question is though: do people who perform better on those sorts of tasks also make better real-world decisions? And most importantly, can those better decisions be measured by better outcomes? Are “skillful” decision-makers, as defined by those measures, perhaps better able to avoid bad life events?

Apparently, the answer is a robust YES, across different ways of measuring the quality of decisions and the quality of decision outcomes.

For example, in one study, the researchers gave people hypothetical tasks to measure their decision skills. The test they used is called A-DMC, for Adult Decision Making Competence, and it measures skills such as resistance to framing effects, ability to disregard sunk costs, over- and under-confidence, or the ability to process complex information in a decision.

The researchers then asked people about a variety of stressful life events that could result from poorly made decisions. The events ranged from serious (declaring bankruptcy, being diagnosed with Type 2 diabetes) to minor (getting blisters from sunburn, throwing out groceries you bought because they went bad). Other examples of stressful life events included missing a flight, getting kicked out of a bar, having your driver’s license revoked, or having spent a night in a jail cell.

It turned out that people who performed better in hypothetical decision tasks (as seen in high A-DMC scores) were indeed less likely to have experienced such negative life events.

Other research has also linked performance on decision-making competence tasks to better real-life outcomes, such as fewer suspensions among students.

It is important to note that not everyone is dealt the same hand when it comes to avoiding stressful life events. For example, people from disadvantaged socio-economic backgrounds are exposed to more negative life events. Also, poor decision outcomes are more common among younger people. However, the relationship between decision-making competence and better decision outcomes was still significant even after the researchers controlled their analysis for socio-economic status and age.

Granted, even the soundest decision-making processes cannot guarantee good outcomes. Given all the uncertainties in life, unpleasant surprises are often inevitable, even to skilled decision makers. However, what these studies confirm is that across time, people, and decisions, good decision processes predict good decision outcomes on average.

After knowing this, it bears repeating: decision-making competence can be taught and improved. Several independent research groups across different countries, using different types of interventions at schools, have shown clear improvements in decision skills as a result of targeted decision education.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR

Selected References:
Blais, A.-R., Thompson, M. M., & Baranski, J. V. (2005). Individual differences in decision processing and confidence judgments in comparative judgment tasks: The role of cognitive styles. Personality and Individual Differences, 38(7), 1701–1713.
Brady, S. S., & Matthews, K. A. (2002). The influence of socioeconomic status and ethnicity on adolescents’ exposure to stressful life events. Journal of Pediatric Psychology, 27(7), 575–583.
Bruine de Bruin, W., Parker, A. M., & Fischhoff, B. (2007). Individual differences in adult decision-making competence. Journal of Personality and Social Psychology, 92(5), 938–956.
Del Missier, F., Mäntylä, T., Hansson, P., Bruine de Bruin, W., Parker, A. M., & Nilsson, L.-G. (2013). The multifold relationship between memory and decision making: An individual-differences study. Journal of Experimental Psychology: Learning, Memory, and Cognition, 39(5), 1344–1364.
Jacobson, D., Parker, A., Spetzler, C., Bruine de Bruin, W., Hollenbeck, K., Heckerman, D., & Fischhoff, B. (2012). Improved learning in U.S. history and decision competence with decision-focused curriculum. PloS One, 7(9), e45775.
Levin, I. P., Gaeth, G. J., Schreiber, J., & Lauriola, M. (2002). A New Look at Framing Effects: Distribution of Effect Sizes, Individual Differences, and Independence of Types of Effects. Organizational Behavior and Human Decision Processes, 88(1), 411–429.
Lui, V. W. C., Lam, L. C. W., Luk, D. N. Y., Chiu, H. F. K., & Appelbaum, P. S. (2010). Neuropsychological performance predicts decision-making abilities in Chinese older persons with mild or very mild dementia. East Asian Archives of Psychiatry, 20(3), 116–122.
Marin, L. M., & Halpern, D. F. (2011). Pedagogy for developing critical thinking in adolescents: Explicit instruction produces greatest gains. Thinking Skills and Creativity, 6(1), 1–13.
Parker, A. M., Bruine de Bruin, W., & Fischhoff, B. (2015). Negative decision outcomes are more common among people with lower decision-making competence: an item-level analysis of the Decision Outcome Inventory (DOI). Cognition, 6, 363.
Parker, A. M., de Bruin, W. B., & Fischhoff, B. (2007). Maximizers versus satisficers: Decision-making styles, competence, and outcomes. Judgment and Decision Making, 2(6), 342–350.
Reyna, V. F., & Farley, F. (2006). Risk and Rationality in Adolescent Decision Making Implications for Theory, Practice, and Public Policy. Psychological Science in the Public Interest, 7(1), 1–44.
Stanovich, K. E. (1999). Who Is Rational?: Studies of Individual Differences in Reasoning. Psychology Press.
Stanovich, K. E., Grunewald, M., & West, R. F. (2003). Cost–benefit reasoning in students with multiple secondary school suspensions. Personality and Individual Differences, 35(5), 1061–1072.
Stanovich, K. E., & West, R. F. (2008). On the relative independence of thinking biases and cognitive ability. Journal of Personality and Social Psychology, 94(4), 672–695.
Teuscher, U. (2003). Evaluation of a Decision Training Program for Vocational Guidance. International Journal for Educational and Vocational Guidance, 3(3), 177–192.

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New Productivity Coaching Group

Posted on by by Posted in Achieving Goals, Career Development, Coaching Practice, Health Decisions, Procrastination, Productivity, Time Management, Self-Assessments

Productivity Coaching Group
Time is our most precious resource – are you getting the most out of yours? Or are you ready for a change? 

My next productivity coaching group will come in a new format, starting with one-on-one sessions and an in-depth assessment before the group meetings.

It is a 3-month package that includes:
  • Two individual coaching sessions of 50 min each and an initial in-depth assessment of your goals, your individual style, your situation, and your personality along the Five Factor Model (FFM). A part of the assessment will happen during our sessions together, and a part of it will be homework for you in between our meetings.
  • A copy of the workbook: “Increasing Personal Productivity in Healthy and Sustainable Ways” by Ursina Teuscher. (Look inside and check out the reviews on Amazon.) Based on recent findings in neuroscience and psychology, you will learn how to improve cognitive functioning, make better decisions, and increase focus. The workbook will help you apply these insights to your own work style and needs.
  • Four small-group sessions of 90 min each. After our one-on-one work together, you will join a coaching group consisting of ~3-5 other participants. The group sessions will give you the positive support of others who may face similar or different challenges. Being held accountable to your goals and getting encouraged by others is a very powerful help in this process.
  • Individual phone and online support between sessions as needed. Throughout the three-month period, we will add regular phone check-ins or other personal online support. This may include working with shared online tools, documents or apps, depending on your goals and work style.

Cost: $650.

Location:
522 SW 5th Ave
Portland, OR 97204

 


Numerical Skills for Financial Decisions

Posted on by by Posted in Financial Decisions, Health Decisions, Risk and Uncertainty

Relatively few people own private long-term care insurance, even though long-term care is one of the largest financial risks currently facing older people. A new study suggests that poor numerical skills may explain a part of that phenomenon: people with better numerical skills (even after controlling for education and cognitive function) are more likely to hold long-term care insurance.

Given the complexity of this particular financial decision, it is not surprising that a lack of numerical skills would create barriers. Assessing the value of a private long-term care insurance policy involves a variety of calculations, such as determining the probability of needing care, evaluating the likely lifetime expense of premiums against the payments one could expect to receive, and comparing the costs and benefits of insurance against other strategies to manage the same risks. It is easy to feel overwhelmed by all this. A lack of skills to deal with all those numbers would certainly prevent people from making the best decisions for themselves.

As for so many problems, investing into education seems a good idea if we want to empower everyone to prepare well for their own future. In addition though, I think it’s important to directly offer people help with some of those complex decisions processes.

What do you think? How do you navigate such a complex financial decision? 


Reference:
McGarry, B. E., Temkin-Greener, H., Chapman, B. P., Grabowski, D. C., & Li, Y. (2016). The Impact of Consumer Numeracy on the Purchase of Long-Term Care Insurance. Health Services Research, n/a–n/a (article first published online: 22 JAN 2016). http://doi.org/10.1111/1475-6773.12439

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Instead of a Book Recommendation

Posted on by by Posted in Book Recommendations, Health Decisions, Risk and Uncertainty

This month I’m recommending an article instead of a book, by Gigerenzer and his colleagues, who have been pioneers in advocating for statistical literacy:
Gigerenzer, G., Gaissmaier, W., Kurz-Milcke, E., Schwartz, L. M., & Woloshin, S. (2007). Helping Doctors and Patients Make Sense of Health Statistics. Psychological Science in the Public Interest, 8(2), 53–96.

The article shows impressively how not only patients, but also journalists and physicians lack a basic understanding of health statistics, which can have serious consequences for healthcare and medical decision making.
The authors make a very strong case that this confusion is not necessary: it is created by nontransparent presentation of information (intentional or not), and the skill of thinking about these statistics and probabilities could relatively easily be taught – but isn’t.

Please let me know if you are interested in reading the article but don’t have access to the full text here.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Medical Decision: What Would You Do?

Posted on by by Posted in Health Decisions


Medical Decisions: How to Judge Risks

Posted on by by Posted in Health Decisions, Risk and Uncertainty

Thanks for submitting your answer to the poll!

The question was: Would you get a cancer screening done if it reduced your chance of dying from this type of cancer by one third?

If you were undecided, you may have wanted more information about the type of cancer. But there is a more important reason why you should not have decided based on the information you got in this scenario: the number (risk reduction by “one third”) is not meaningful at all, because it only gave you information about relative risk reduction, rather than absolute risk reduction. If you get this kind of information from your health care provider, you should ask: “Ok, and what are my chances of dying from this type of cancer without the treatment?” Or more generally, ask for your base risk: your risk without the treatment. Only with that information can you judge the benefit of a treatment. For example, if my initial risk of getting this type of cancer is 6%, the screening will reduce my risk to 4% (the absolute risk reduction would be 2% in that case). If my initial risk is 0.3%  (in other words, if only 3 in 1,000 people from my risk group are developing this cancer), the screening would reduce my risk to 0.2%, which means the absolute risk reduction in that case is only 0.1%. In other words, only 1 in 10,000 people would benefit from the screening in that case. In this second case, the screening would have a much smaller benefit, even if it also reduces my relative risk by one third. (Notice, however, how even the assumption of a base risk of 6%, which would be a very high base risk for any specific type of cancer, makes the treatment seem less urgent than it seemed in the original question.)

Here are different versions of how the information can be presented to you.

  • Relative risk reduction: “If you have this test every 2 years, it will reduce your chance of dying from this cancer by around one third over the next 10 years.”
  • Absolute risk reduction: “If you have this screening test every 2 years, it will reduce your chance of dying from this cancer from around 3 in 1,000 to around 2 in 1,000 over the next 10 years.”
  • Number needed to treat: “If around 1,000 people have this screening test every 2 years, 1 person will be saved from dying from this cancer every 10 years.”

For all those questions, the benefits of the test are identical, except that they are expressed either as a relative risk reduction, as an absolute risk reduction, or as the number of people needed to be treated (screened) to prevent one death from cancer.

Unfortunately, studies overwhelmingly show that many patients do not understand this difference between relative and absolute risk reduction, and that they do indeed evaluate treatments much more favorably if the benefits are presented as relative risk reductions.

What is even more concerning is that doctors and other health professionals (including nurse educators, and even reviewers of grant proposals), succumb to the same bias. Multiple studies have shown that health professionals, just like patients, get confused by numbers about risk reduction, and rate the effectiveness of a treatment much higher when the benefits are described in terms of a relative risk reduction, rather than as an absolute risk reduction or a number needed to treat.

It is therefore quite clear that reporting relative risk reductions without clearly specifying the base rates is bad practice, because not only is the information so incomplete as to be meaningless, but it also leads people – patients as well as providers – to overestimate the benefits of treatments.

Yet unfortunately, this bad practice is still very common, as Gerd Gigerenzer and his colleagues report in an enlightening article. [Please get in touch if you would like to read it and don’t have access to the full text]. According to their review, even articles in leading medical journals often only report relative risk reduction. So do brochures and pamphlets that provide information for patients, although this is perhaps less surprising when the brochures are issued by those who benefit financially from providing treatments.

I’m with Gigerenzer when he advocates for better education and better practices in medical communication. In the meantime, the take home message is simple: when offered any risk reducing treatment, always find out as much as you can about your base risk before making a decision.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Selected References:
Covey, J. (2007). A meta-analysis of the effects of presenting treatment benefits in different formats. Medical Decision Making, 27, 638–654.
Gigerenzer, G., Gaissmaier, W., Kurz-Milcke, E., Schwartz, L. M., & Woloshin, S. (2007). Helping Doctors and Patients Make Sense of Health Statistics. Psychological Science in the Public Interest, 8(2), 53–96.
Naylor, C.D., Chen, E., & Strauss, B. (1992). Measured enthusiasm: Does the method of reporting trial results alter perceptions of therapeutic effectiveness? Annals of Internal Medicine, 117, 916– 921.
Muhlhauser, I., Kasper, J., & Meyer, G. (2006). FEND: Understanding of diabetes prevention studies: Questionnaire survey of professionals in diabetes care. Diabetologia, 49, 1742–1746.
Sarfati, D., Howden-Chapman, P., Woodward, A., & Salmond, C. (1998). Does the frame affect the picture? A study into how attitudes to screening for cancer are affected by the way benefits are expressed. Journal of Medical Screening, 5, 137–140.

 

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Book Recommendation: The Upside of Irrationality

Posted on by by Posted in Achieving Goals, Book Recommendations, Health Decisions, Intuition

Dan Ariely (2011). The Upside of Irrationality: The Unexpected Benefits of Defying Logic.

Dan Ariely is a great thinker, scientist and story-teller. In this book, he weaves personal anecdotes and research findings together to help us gain insight into our own irrational minds.

Recognizing our own behaviors and thinking patterns is a great stepping stone towards improvement. But rather than assume we could do better and be more rational (which I do believe is important and possible too, at least sometimes…), Dan Ariely suggests we should find ways to make our own irrationalities work in our favor. I find this mindset very useful in practice. In particular, he suggests many methods of how the “right” choice can become the “easy” choice for us. Those are great strategies to set us up for success.

In general, I’m a big advocate of making things as easy as possible on ourselves. There will always be enough hard choices left, where we can use all the mental resources we have left.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Cravings? How To Stay in Charge

Posted on by by Posted in Achieving Goals, Health Decisions, Resources, tools

The most frequent New Year’s resolution is to lose weight. However, one thing that gets in the way of the best goals and intentions are cravings. Cravings tell us in a very clear voice what we should do, and they have tremendous motivational force. They often seem to trigger a string of actions as if we were on autopilot – we do whatever they tell us, disregarding our own previous plans.

To help with these moments, I’ve created a visual guideline (you can download it in full size as a pdf, if you click on it):

In case of a craving: how to stay in charge

At first my idea was only to create a reminder for myself, but then I realized it might be helpful for others too, so I turned it into a more self-explanatory and shareable design. It is meant as a quick guide to help you reclaim control over your own decisions – in the heat of those craving moments.

My recommendation: save the image somewhere close by (on your desktop? on Evernote? your photo app?) — wherever you can access it quickly at times you’re most likely to succumb to cravings.

Then, the next time you feel a craving (it will happen!), take a look at it and just go through those quick steps.

After you’ve done it a couple of times, it will become a more natural way of your thinking and you may not need the image anymore.

by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


Credits:
So many different sources have inspired this drawing that it’s hard to know where to begin and end citing, especially because I’ve taken the liberty to change original concepts to suit my purpose here. The most important sources are: the frameworks of acceptance and commitment therapy (ACT), and the Stop Think Do idea that is used in a variety of behavior management and cognitive-behavioral skills training approaches.


Book Recommendation: Willpower

Posted on by by Posted in Achieving Goals, Book Recommendations, Health Decisions, Procrastination, Productivity, Time Management

Roy F. Baumeister and John Tierney (2012). Willpower: Rediscovering the Greatest Human Strength.

This book is a collaboration of the psychologist and researcher Roy Baumeister with New York Times science writer John Tierney. Together, they created the kind of book I really love. It offers very practical advice, based on a lot of research. It provides very helpful insight into how we can increase our self-control, focus our strength, and better resist temptation. It is easy to read, but not dumbed down, nor diluted with unnecessary stories.

For those who are in money-saving mode after the holidays, you’ll most likely find this one in your local library. Ours (Multnomah County) even has the e-book for mobile devices, so you can borrow it from wherever you are. What I love most about those library e-books is that they return themselves – no more late fees.

Review by Ursina Teuscher (PhD), at Teuscher Decision Coaching, Portland OR


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