Social Skills Therapy for Youth

1. Social Skills Therapy for Youth Larry L. Lambert, NCC, LPC, ACS American Counseling Association March 22, 2009

2. Anger Management Problem Solving Relaxation Skills Assertiveness Following Rules Self-Talk Conflict Handling Respect for Authority Meet Marcus Marcus is waiting to see the principal. He’s still mad. “I don’t have to take this,” he says. “Mr. Jones can’t just put me out. I was just expressing myself, and he gets all up about it. Then when he told me I was interrupting his class, interfering with others, and to raise my hand before I speak.” I told him, “Nobody else raises their hand so why are you always putting this on me.” I let him know what I thought. “This is a joke, I’m not learning anything, and you’re wasting my time.” That’s when he said he had heard enough from me, and sent me to the office. Man, this is messed up; it’s the third time this month, he has done this to me. Marcus continues to fume while he waits for the principal. The principal opens the door and directs Marcus to take a seat. Marcus slumps in his chair with a bored look on his face. The phone is ringing, the secretary hands him some papers, and reminds him of an appointment at the Board. He turns to Marcus. Mr. White I see you are back again. What’s the problem?

3. Presentation Goals 1. Identify the spectrum of social skills considered in treatment planning. 2. Describe approaches to constructing experiential interventions for children and youth with evidence-based practice in mind. 3. Discuss direct instruction and experiential learning in teaching social skills. 4. Consider other intervention strategies and their appropriate use. 5. Discuss ways of using interventions for individual therapy, day treatment, and other family members.

4. Social Skills Ways to foster cooperation, exchange and high self-esteem. Some social skills are simple interpersonal strategies and habits. Ex. “Stop and Think”; “Count to 10” strategies and responses Others are more complex. Ex. Offering a sincere apology. Some social skills recur across a number of treatment concerns – anger, conflict, and stress management, communication skills, low self-esteem, etc. Social skills are often based on psychological principles or cultural practices that are neither simple,concrete, or apparent to young people.

5. Bothersome Behavior Behavior that annoys others or disrupts social or interpersonal activities to gain attention, take control, or express negative energy. • Who is bothered by what, where to what effect? • In the home • In the classroom • At play with peers • In public situations • Youngsters frequently become symptomatic in novel, challenging, or unfamiliar situations • Address the inappropriate behavior as it manifests and redirect it towards appropriate responses It is bothersome because it is frequent, persistent, and unresponsive to normal interpersonal correction. The result is a person who is hard to like and harder to help.

6. Social Skills and DBD • Avoiding arguments and physical fights with peers • Positive self-statements (self-talk) • Establishing and maintaining friendships and group relations • Showing respect and cooperation • Perspective taking • Expressing anger appropriately • Communication and assertiveness skills • Showing empathy, kindness, or sensitivity to others • Sex education • Personal organizational skills • Study skills and test-taking • Knowledge symptoms and medications • Listening and following directions • Mediation, biofeedback techniques, and self-control strategies • Reflection and critical thinking • Negotiating rules, boundaries, commitments and consequences • Problem-solving and conflict handling skills • Accepting responsibility for behavior Source: Jongsma, A.E., Peterson, L.M. and McInnis, W.P. 1996. The Child and Adolescent Psychotherapy Planner. New York: John Wiley & Sons, Inc.

7. Experiential Learning 1. Experience - having/doing some sort of activity such as self-assessment, role-play, problem solving, or recreational event 2. Publish - sharing reactions to the experience - including observations, feelings, thoughts, fantasies, etc. and posting data for the next phase 3. Process - helpingmembersmake connections withthe data 4. Generalize - considering the relevance ofinsights gained to the outside world and preparing to utilize 5. Apply - individuals implementing their learning through thinking, perceiving and behaving in the outside world

8. Structured Experiences Social skills units have a similar structure. Material (vocabulary and principles), written at 5th grade reading level supported by a series of activities. • That help clients acquire the concepts and skills. • Presented in first person narrative format • Journaling, role-plays, self-assessment, worksheets to personalize, support and reinforce • To reinforce prosocial behavior and high self-esteem • Foster critical thinking and problem solving by (crossword puzzles, word search, jumbles, mazes) • And require clients to read, write, speak, solve problems and create.

9. Processing Guides A set of questions to explore and consolidate meaning by drawing attention to feelings, thoughts, beliefs, choices and actions following an experience. • On multiple levels: personal, interpersonal, and group. • Aware of temporal concerns - past and present while emphasizing the immediate and longer term future. • Tailored to fit with the person’s identity and life circumstances. Processing Sequence • What happened? (facts and interpretations) • What’s important? (values and significance) • So what? (implications) • Now What? (choices and actions steps)

10. Social Stories A short, simple, detailed description a specific social situation from a child’s perspective that explains success oriented cues and responses to the situation and others involved. • The stories consist of three types of sentences: • Descriptive – tells what people do in social situations. They describe the setting, step-by-step directions for completing the activity – the five “wh…” questions. Three to five descriptive sentences to each directive sentence in a story. • Directive – states in positive terms the appropriate or desired behavior. How to act correctly and not to limit the individual’s choice. Directives are about behaviors under an individual’s control. • Perspective – tells what others are likely to think of the behavior and how they are likely to react. They peek into the minds of others (Usually, sometimes, often, etc. Avoid always) Source: The Gray Center - http://www.thegraycenter.org/index.cfm

11. Case Studies and Role-plays • Short, relevant, realistic and scaffolded incidents with unacceptable behavior cues hold attention • Correlated to the topic or skill being studied • Counselor led role plays yield more realistic responses and workable material than client directed ones • Participants respond better to conceptual material following role-plays and case studies • Providing space and time to record and share individual responses improve accountability and documentation.

12. Direct Instruction A technique for providing information or developing skills, and attitudes required for thinking, and for interpersonal or group responses. • Introduction:Getting the client’s attention, relating to the client’s experience,s providing a basis for new ideas and principles, and using examples and illustrations • Instruction:Means used to convey information and demonstrate expected behavior • Input – Information provided • Modeling – Examples to help the client become aware of expectations • Checking for Understanding – How Iknow the client understands • Guided Practice - Client works through under supervision (Praise, Prompt, Leave). • Closure - Actions or statements that bring together and make sense out of what was taught, to address confusion and frustration and to reinforce an important points. • Individual Practice – Activities that use and reinforce the concept or skill to reduce forgetting, apply the skill relevant situations, and evaluate learning. For more see: http://www.jimwrightonline.com/pdfdocs/dirinstr.pdf

13. Think Aloud Strategy A Think-Aloud models how to respond to problem situations. The therapist “works through” a personal or relational problem by sharing out-loud the inner dialog involved in appropriately responding to the problem. By slowing down, thinking out-loud, and engaging clients in the process, the therapist can show how to plan, make decisions, solve problems, resolve conflicts, act assertively, calm down, use self-control, etc. Over time, the client does more and more of the think aloud process while the therapist monitors and refines the client’s use of skills. A Think-Aloud let clients gradually internalize the process; the talk becomes their talk, the way they direct their own behaviors and arrive at appropriate, effective and satisfying responses to problems. Source: http://www.greece.k12.ny.us/instruction/ela/612/Reading/Reading%20Strategies/thinkaloud.htm

14. Cooperation and Competition Winning and Losing Self Esteem Fair Play Self-control Conflict Handling Change Recreational Activities I Am a Good Sport The ability to play games skillfully and compete fairly is important. A good sport plays to win and plays to learn to play better. Winning is the immediate objective of playing a game, but I will not play long or often, if I am not a good sport. I enjoy playing the game and the chance to use my gifts and skills to compete. So, • I know the rules, play by the rules, and make sure play is fair for everyone. • I try my best to win, but not by cheating, hurting others, or losing control of myself. • When disagreementsoccur, I let the rules or the referees decide, and then let it go. • I win without bragging or trying to make others feel bad; I lose by admitting defeat, learning from the loss, and doing better next time. • I smile, laugh, and have fun with others for this is why we play.

15. Game Box First we work, then we play. Knowing the rules and playing by them is required. Symptomatic behavior is addressed as it occurs. Processing of the activity is part of the concluding it. • Playing cards • Checkers • Ungame • Jinga • Dominoes • Spill and Spell • Pick-up sticks • Connect Four • Uno • Tangrams • Mancala • Foam Ball • Soccer Ball • Rubix cubes, etc.

16. Summarizing Principles • Relevant social knowledge (terms, concepts, principles, and common practices) • Presented in a socially sensitive manner • Flexible enough to address multiple outcomes and reusable • Presented at an attainable literacy level • Rich with activities that help to present and reinforce the skill • Interventions that can be used in individual, group, and family settings • Interventions that are replicable and portable

17. Evidence Based Practice The base of practice is built upon: • Observation (clients and environment) • Careful description and measurement(data driven) • A determination of what goes with what (matching interventions with treatment goals) • A determination of the mechanism that leads tosuccess under what conditions; with whichpopulations (treatment protocol) • Citing the specific results that can be anticipated.(outcome measures)

18. Conclusions • Social skills are important treatment goals • Experiential learning, direct instruction, and social stories, and other techniques are suited for working on social skills related goals. • Other structured, activity oriented interventions can be effectively used individual and group therapy settings. • Social skills related interventions can be developed and organized to be shared and replicated by other practitioners. Web Counseling Resources http://www.webcouselingresources.com Larry L. Lambert, NCC, LPC, ACS 1614 College St. Cleveland, MS 38732 lamb5999@bellsouth.net