John Sommers-Flanagan, Ph.D.University of Montana
ETOC – Workshop October 11, 2013 – Columbus, OH
Email: [email protected]: johnsommersflanagan.com
This workshop is rated “R”
A blend of personal discoveries and empirical evidence
Caveats and excuses
Opening survey
Opening story – 20 minutes
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
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
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
30 Minutes of Profanity (later)
Visualizations
• 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?
If you want genuine cooperation
Be less threatening
TRIVIA 1 ANSWER = COOKIES!
Challenging students (TOUGH KIDS), parents, and teachers are aversively conditioned to counseling . . . and counselors!
We also should use counterconditioning
to get people comfortable
with us
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?
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 informationFrame your purpose and explain your goalsOther realities?
She says she’s got a terrible temper
Watch for:Your reaction to herSpecific opening techniquesThe affect bridge and emotional
discussion
• Turn to your neighbor and briefly discuss:
–What you saw/heard
–What you liked/disliked
–Your reactions to Megan
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.
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
Refers to self as a “Bitch” Reports self-esteem and mood
management problems Watch for:
Content and process Her reaction to positive feedback
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
6. Asset Flooding
Principle: Addressing attachment insecurity requires support, not criticism
Case examples
7. Generating Behavioral Alternatives
Principle: When possible, we should help young people reduce their cognitive rigidity and emotional agitation while increasing mental flexibility
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
Turn to your neighbor and briefly discuss: What you saw/heard What you liked/disliked Your reactions to Pete
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]
8. Using Riddles and Games
Principle: We need to engage young people when making therapeutic points
Volunteer demonstrationsClayton clip on punishment as an
ineffective strategy
9. Food and Mood
Principle: Never do counseling with hungry children Healthy snacks Hot drinks Sharing
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
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
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)
11. Four Forms of Relaxation
Principle: Young people can benefit from exploring methods of self-soothing and self-control
Demonstrations
12. Cognitive Storytelling
Principle: Students need a rationale to understand cognitive interventions
My Stories Your Stories
It’s not what happens to us . . .
But what we think about what happens to us . . .
That causes us misery
What is a significant problem or flaw associated with the Satanic Golden Rule?
Revenge begets revenge – It never ends
You give away your power and become a negative follower instead of a positive leader
14. Alternatives to Suicide15. Neodissociation
Principle: Collaborate (especially with the student’s healthy ego state) on exploring options to self-destructive behavior
Free Suicide Resources: johnsommersflanagan.com
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?
Identify goalsReflect on progressReminisce as appropriateAsk for feedbackWrite a note – give a final
consolidation gift?Hope for the futureAdjust the door
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
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]
Meet, greet, and comfortRole induction: As needed, explain
the terrainShare power through collaborationHonoring the parent as expertIf needed, obtain and provide a
problem description (homework, classroom behavior, etc.)
Watch for: Anything that seems comforting or
reassuring Complimenting Goal-setting Parent-child dynamics (e.g., backward
behavior modification)
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
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
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.”
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.”
Group participation – Volunteer example
Thank you . . . because . . .
Practice with a partner
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)
Watch for: Who’s talking now What parent-child dynamics are being
addressed Mutual problem-solving
Whispering and plans (be proactive)
Simultaneous empathy and limit-setting
Developing a new attitude and a new plan for limit-setting
What will you remember?
What principles, strategies, or techniques could you start using right away?
Use Radical Interest: Make sure there is no other place you’d rather be in that moment
Use Radical Acceptance: Communicate – I accept you as you are and am completely committed to helping you improve yourself
Use a Counterconditioning Stimulus – Cookies or ???
You can be directive within the context of a reasonably positive relationship
Angry dad story