Tough Kids, Cool Counseling (and other stuff)

1. Tough Kids, Cool Counseling (and other stuff) John Sommers-Flanagan, Ph.D. University of Montana ETOC – Workshop October 11, 2013 – Columbus, OH Email: John.sf@mso.umt.edu Blog: johnsommersflanagan.com

2. Workshop Overview • This workshop is rated “R” • A blend of personal discoveries and empirical evidence • Caveats and excuses • Opening survey • Opening story – 20 minutes

3. Newsflash • Young People Can Be Difficult • “Our civilization is doomed if the unheard-of actions of our younger generation are allowed to continue” • (from a 4,000-year-old tablet discovered while excavating the Biblical city of Ur, quoted in Lauer, 1973, p. 176). • But young people are also going through difficult times

4. What We’ll Cover • Relationship • Techniques • Application • Lots of focus on rapport and connection • Some focus on resistance-busting • Lots of focus on brief cognitive, emotional, and constructive counseling techniques • Some focus on suicide assessment/intervention • Some focus on working with parents • Be thinking about how to apply what we cover in your specific situation

5. Participation Guidelines • This is YOUR workshop • Input is welcome, not mandatory • Be open to new and old ideas • Communicate respectfully • It’s okay to critique what you see • Have as much fun as you can while learning

6. Openings • 30 Minutes of Profanity (later) • Visualizations

7. The Counseling Relationship • Still puzzling . . . After 28 years • Case: Ty and the Big Trauma Boy • One BIG hurdle is ANXIETY • How do we get reluctant students, parents, and teachers comfortable “in the room” with us?

8. Meeting Jesus at the VA Hospital

9. The First Relationship Principle If you want genuine cooperation Be less threatening

10. The Amazing Mary Cover Jones

11. What did Jones use with Peter in 1924? • TRIVIA 1 ANSWER = COOKIES! • Challenging students (TOUGH KIDS), parents, and teachers are aversively conditioned to counseling . . . and counselors!

12. The Second Relationship Principle We also should use counterconditioning to get people comfortable with us

13. 3 Minute Discussion • Consider these two relationship principles: (1) Be less threatening and (2) Use counterconditioning and then discuss: • How do you. . . • How can you. . . • How will you. . . • . . . get students, parents, and teachers comfortable with you?

14. The Top Techniques [see handout supplement] 1. Acknowledging Reality [AKA: Congruence or Transparency = ES = .43; Kolden et al, 2011] 2. Sharing Referral Information Principle: Students need to know what you know about them • Include referral information • Frame your purpose and explain your goals • Other realities?

15. Case #1: Megan • She says she’s got a terrible temper • Watch for: • Your reaction to her • Specific opening techniques • The affect bridge and emotional discussion

16. 3 Minute Reflection • Turn to your neighbor and briefly discuss: • What you saw/heard • What you liked/disliked • Your reactions to Megan

17. The Top Techniques 3. The Affect Bridge and Early Memories 4. Reflection of Emotions and Emotional Education (part of emotional education can involve connecting symptoms and emotions to experiences; e.g., insomnia and trauma) Principle: Emotional states and emotional reactions are complex – students need help in understanding their emotional lives.

18. The Top Techniques 5. What’s Good About You? Principle: Reflecting on strengths, although difficult, can be emotionally soothing and help with emotional regulation—it also provides informal assessment data

19. Case #2: Kristen • Refers to self as a “Bitch” • Reports self-esteem and mood management problems • Watch for: • Content and process • Her reaction to positive feedback

20. Practice • Explain the procedure • Get out paper • Keep the list for your partner • Ask: “What’s good about you?” • Say: “Thank-you” and repeat back the strength

21. The Top Techniques 6. Asset Flooding Principle: Addressing attachment insecurity requires support, not criticism • Case examples

22. The Top Techniques 7. Generating Behavioral Alternatives Principle: When possible, we should help young people reduce their cognitive rigidity and emotional agitation while increasing mental flexibility

23. Case #3 -- Pete • Pete is angry at a boy who tried to rape his girlfriend • Watch for: • How brainstorming proceeds • Pete’s affective changes • John’s risky suggestion

24. 3 Minute Reflection • Turn to your neighbor and briefly discuss: • What you saw/heard • What you liked/disliked • Your reactions to Pete

25. Case Application • You’re working with a 9-year-old who’s getting bullied (on the playground, at the bus stop, online) • You ask him/her: “What are some of the things you’ve thought of doing when you’re getting bullied?” • S/he says, “Ignore them” • You ask, “What else” • S/he says, “Get a gun and shoot them” • Get with a partner and try problem-solving with that situation [Review steps and keys to problem-solving]

26. The Top Techniques 8. Using Riddles and Games Principle: We need to engage young people when making therapeutic points • Volunteer demonstrations • Clayton clip on punishment as an ineffective strategy

27. The Techniques 9. Food and Mood Principle: Never do counseling with hungry children • Healthy snacks • Hot drinks • Sharing

28. The Top Techniques 9. A Multicultural Opening 10. Noticing Process and Making Corrections Principles: We can ask students about their experiences – but not completely rely on them for cultural information. We need to acknowledge and take back our inaccurate reflections

29. Case #4: Michael • Referred for PTSD symptoms and gang affiliation behavior • Watch for: • Your reaction/response to Michael • Michael’s response to paraphrases • Your reaction to counselor spontaneity and self-disclosure

30. Michael - Discussion • I’m not getting it • Making a recipe? • Incorrect gang affiliation • What do you think of the spontaneous disclosure? • Sometimes we push kids too hard to accept our reality (RAD example)

31. The Top Techniques 11. Four Forms of Relaxation Principle: Young people can benefit from exploring methods of self-soothing and self-control • Demonstrations

32. 16. Cognitive Storytelling

33. The Top Techniques 12. Cognitive Storytelling Principle: Students need a rationale to understand cognitive interventions • My Stories • Your Stories

34. The Principle It’s not what happens to us . . . But what we think about what happens to us . . . That causes us misery

35. 13. The Satanic Golden Rule

36. Trivia Question #2 • What is a significant problem or flaw associated with the Satanic Golden Rule?

37. Possible Trivia 2 Answers • Revenge begets revenge – It never ends • You give away your power and become a negative follower instead of a positive leader

38. The Top Techniques 14. Alternatives to Suicide 15. Neodissociation Principle: Collaborate (especially with the student’s healthy ego state) on exploring options to self-destructive behavior Free Suicide Resources: johnsommersflanagan.com

39. The Top Techniques 16. Note-Passing Principle: Sometimes a change in communication modality is helpful • Case example – see the book • Question: Are there ethical alternative note-passing strategies available using technology?

40. Termination Tasks • Identify goals • Reflect on progress • Reminisce as appropriate • Ask for feedback • Write a note – give a final consolidation gift? • Hope for the future • Adjust the door

41. Working with Parents Philosophy • Because parents are vulnerable . . . • We are supportive, positive, and validating • We work to see the positive goals and love underneath anger and imperfect parenting • We join with even the most difficult parents to help them support their children’s education

42. Self-Preparation • Preparing for button-pushing: Just like with challenging students • Responding to questions about your credentials or competence • Self-disclosure: When and how much and what kind? [Joining, empathic]

43. Initial Contact, Connection, and Assessment • Meet, greet, and comfort • Role induction: As needed, explain the terrain • Share power through collaboration • Honoring the parent as expert • If needed, obtain and provide a problem description (homework, classroom behavior, etc.)

44. Video Clip 1 • Watch for: • Anything that seems comforting or reassuring • Complimenting • Goal-setting • Parent-child dynamics (e.g., backward behavior modification)

45. Empathy • Two forms of empathy with parents • General – It’s hard to be a parent; parents are judged • Specific – Clean your room story • Some parents will REALLY NEED to tell you a parenting story

46. Radical Acceptance as Attitude • Radical Acceptance as an Attitude (from DBT) “I completely accept you as you are and am fully committed to helping you change for the better” • We use this especially when parents say something extreme

47. Radical Acceptance as Skill • Parent Volley: “I know it’s not popular, but I believe in spanking. When I was a kid, if I talked back I’d be picking myself up off the floor. Kids don’t have any discipline these days and as a parent, I have a right to parent my kids any way I want.” • Teacher/Counselor Return: “Thanks for being so honest about what you’re thinking. Lots of people believe in spanking and I’m glad you’re being straight with me about your beliefs.”

48. Radical Acceptance Follow-Up • Parent Response: “Yeah. Okay.” • Teacher/Counselor Return: “But I’m not all that positive about the picking yourself up off the floor thing.” • Parent Response: “Oh no. I didn’t mean I think that’s right.”

49. Practicing Radical Acceptance • Group participation – Volunteer example • Thank you . . . because . . . • Practice with a partner

50. Practical Parenting Interventions • The new attitude (eliminate the dread) • Grandma’s Rule and passionate rewards and boring punishment (direct power) • Character feedback (indirect power) • Seven magic choice theory words (relationship power): “I want you . . . but it’s your choice . . . • Mutual problem-solving (problem-solving power)