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.eduBlog: 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