Johnny RiderTiffany Poon

General Functional Group Model Protocol:

Name of Group: “Express Yourself”

Time/length of meetings: 1 hour a week meeting for a 24 week period. -Rationale for 24 week period comes from evidence demonstrated by Singh, et al., (2007) where they taught mindfulness-based strategies to help adolescents with Asperger syndrome control their aggressive behavior for a 17-24 week period. They saw no instances of aggressive behavior during the last 3 weeks of mindfulness practice. Because of this evidence and the timeline demonstrated as well as our review of similar studies, we chose to run our group for 24 weeks.

Place/Location: Community Mental Health Clinic

Group Format: This group is designed specifically for adolescents with autism struggling with communication and managing their anger. For the group meetings to be successful all members must have a common goal and having a closed group of members with shared experiences and frustrations creates group solidarity. We want the members to feel safe and know that there will not be surprises or additional stress when it is already hard for them to communicate. We also want the members to feel secure in this closed group to promote continuity of attendance and continuity of skills-building together. (Type: Project Group)

Statement of rationale for group: This group will provide an environment for adolescents with autism to initiate and respond to communication with other individuals with similar goals and skill level. Group interaction will facilitate appropriate communication, turn-taking, social norms, and elicit adaptive responses from members encouraging participation. Members will participate in functional activities to help regulate emotions and control anger. Members will also participate in “Meditation on the Soles of the Feet” as a method to calm themselves and control aggressive outbursts. Also, this group will promote success in school and maintaining relationships in life.

Frame of reference or practice model. ¢

Cognitive Behavior frame of reference will be used. Using the member’s cognitive function to influence and change their behavior through self-reflection, practice, role-playing, self-monitoring, and understanding how to manage emotion appropriately during emotionally charged situations. Social cognitive theories fall under the cognitive behavior frame of reference and posit that adolescents learn concepts by using: observation, imitation, role playing and interaction with others. It is expected

that both self-efficacy and motivation will increase when adolescents learn the concepts stated above.

Group goals:Primary Goals (behaviors you wish to increase/decrease):

By the fourth month incidents of aggression will be decreased by 50% and will be documented in a daily log. (Group members will establish a baseline for aggression incidences during the first month of the group)(Daily log can be found in Appendix A.)Group members will communicate during group through initiating a conversation by asking how the other person is doing and responding appropriately with a peer or group leader once during each session. Group members will verbally communicate what makes them angry within the group at least once during each session.

Secondary Objectives (shorter term and leading up to goal achievement):Group members will call a friend once per week and share the experiences in class the following week.Group members will contribute verbally to the group at least one time per session by introducing his or herself, asking a question, expressing his or her thoughts and feelings in a positive manner to another group member or commenting to the group leaders about an activity. Group members will participate in “Meditation of the Soles of the Feet” in sessions each week and in home daily, documented in a daily log.

Rationale for goal selectionMany of the group members struggle with controlling their anger and resort to verbal

and/or physical aggressions. By establishing a baseline for their aggression incidences and monitoring them we can better understand which techniques or strategies taught in group are effective. Expressing themselves verbally is another challenge and practicing both inside and outside of group will help them get more comfortable communicating with others and better understand the turn-taking and initiation of conversations. Modeling and role-playing will allow them to practice with feedback and in turn help them initiate conversation outside of the group. (Singh, et al., 2007)

Outcome criteria for successful goal attainment in session(s) stated in behavioral termsFor every session, each member will be able to name one new anger management strategy, feel a sense of control over their feelings of anger, and be able to understand which situations cause certain feelings of anger. Each member will participate in meditation and activities to the best of their abilities. Each member will initiate and participate in dialogue with another person each session.

Group composition or criteria for selecting members. The group comprises of adolescents with autism between the ages of 16 and 19 wanting to improve their social skills, specifically communication with others and managing their anger.

Leadership roles and functions. To establish a group structure that encourages social participation and communication between group members.To encourage communication skill development in team members.To identify strategies to manage anger.Modeling desired group behavior including: listening, verbally participating, asking for help, being supportive of everyone and giving appropriate feedback.

Characteristics of group contract, if using. Rather than using a group contract we chose to have rules for our group. They are simple and straightforward to fit the needs of our group members. These rules will be explained to group members on the first session. Rules will be displayed on a poster in front of the room and we will review the rules as part of our introduction to the session each time we meet.

1.) Respect everyone in the group2.) Cooperate during group activities3.) Use only kind language towards each other4.) When others are talking to you please listen and then respond5.) It is ok to talk about what makes you angry during class and share your feelings6.) Raise your hand when you have something to say or need help

Group methods and procedures to be employed: Briefly describe or list methods, techniques, modalities.

Group meditation lead by therapists. Partner activities requiring initiating and maintaining interaction. Self-reflection and group sharing of feelings. Role-play activities in front of group.

Specific Functional Group Model Session Plan Protocol:

Name of Group: “It Will Be Ok”

Date to be led: January 28th, 2014

Stage of Group Development: (Group formation, Building of relationships, Deciding aims and procedures, Accomplishing tasks, Terminating)

Building of Relationships

Specific goals for the group session:To build group cohesiveness while assisting members to identify their anger management issues and help strategize ways to cope with anger. Members will:

• Identify at least one situation that involved anger outbursts and identify alternate outcomes

• Learn calming strategies through meditation• Identify areas that causes anger • Identify strategies to cool off• Identify self-control goals• Communicate feelings of anger with other group members• Learn to express feelings of anger

Specific goals for group members if different from those mentioned already and goals for each group member

N/A

Description and rationale for methods and proceduresMeditation: The group leader will lead everyone in meditation exercises for 10 minutes in the beginning of session. Group members will be able to independently carry out meditation techniques at home once daily to be able to better control their anger. Coping mechanisms using meditation learned in class will be discussed. Expressive anger management activities: Group members will participate in two activities: M&M activity and conflict choice activity. In the M&M activity, members will identify times they have been angry, how they have reacted, and what they could have done better. They will also be sharing these thoughts with a partner from the group which will promote social skills such as initiating conversation with a peer. In the conflict choice activity, members will identify only one specific conflict that has caused anger issues recently and with this particular conflict, they will have to label different possible responses to the conflict and what would be a likely response to that conflict. This activity will allow the members to increase their awareness of possible consequences that could potentially be worse or would have a better outcome than others. Members

will then share what they wrote on their conflict choice activity paper promoting appropriate communication skills and proxemics. Role playing scenarios: With this role playing activity, members will engage with other group members in possible groups of 2-4 members. They will all have to brainstorm and come up with a conflict and be able to act it out with possible outcomes/consequences. This will promote members to think of situations where they could improve on controlling their anger problems and also become more aware of their emotions. Role playing also promotes a high level of social skills and interaction. These scenarios will be shared with the entire class.

Description and rationale for leadership roleEncourage expression of anger triggers and ways to cope with those feelings either through verbal expression or non-verbal strategies.Support and facilitate member communication as much as possible. Lead each activity by explaining clearly, with simple language, and help group members transition during the session.

Describe necessary preparationsPreparation for teaching “Meditation on the Soles of the Feet” and training materials.Make copies of the “Choices” worksheet for each group member and some extra copies. Bring pens/pencils for everyone to use.Prepare role-play scenarios for backup in case group members can’t think of any.Buy enough M&M’s for each group member to have a handful.

List material, equipment and budget neededLarge bag of M&M’s ($5) Copies of the choices worksheet for each group member ($1)

Time and sequence outline for sessions, including what you will do and say as leader and what the group will do; consider both content and process

o Introduce today’s session and each other, review rules (5 min) (Tiffany)o Discuss Anger and how it affects us (2 min) (Johnny)

Group will actively participate in the discussion of angero Teach “Meditation on the Soles of the Feet” (Johnny) (10 min)

Group will actively participate in meditation o M&M Activity (Tiffany) (10 min)

Group will actively participate Activity will be done with a partner

o Choices Activity and share with group (Johnny) (10 min) Group will independently fill out the worksheet Members will individually share the worksheet with the group members

o Role play (Tiffany) (10 min) (If time is left) Group will actively participate with a partner or in a group of three

o Wrap up session and reminder of homework (daily log) (Johnny) (3 min)

Other information pertinent to the specific session: for example: Will there be any new members, co-leaders, or guests? Is there an unusual tone on the unit or special event that is about to occur or just occurred for the individual member or group?

No special circumstances for this group session.

Appendix A

(Singh, 2011)

References

Singh, N.N., Lancioni, G.E., Winton, A.S.W., Adkins, A. D., Wahler, R.G., Sabaawi, M., & Singh, J.

(2011). Meditation on the soles of the feet for anger management: A trainers manual. Raleigh,

NC: Fernleaf Publishing.

Singh, N.N., Lancioni, G.E., Winton, A.S.W., Adkins, A. D., Wahler, R.G., Sabaawi, M., & Singh, J.

(2007). Individuals with mental illness can control their aggressive behavior through mindfulness

training. Behavior Modification, 31, 313-328

Singh, N.N., Lancioni, G.E., Winton, A.S.W., Adkins, A. D., Wahler, R.G., Sabaawi, M., & Singh, J.

(2007). Mindfulness training assists individuals with moderate mental retardation to maintain

their community placements. Behavior Modification, 31, 800-814

Singh, N.N., Lancioni, G.E., Winton, A.S.W., Adkins, A. D., Wahler, R.G., Sabaawi, M., & Singh, J.

(2011). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control

their aggressive behavior. Research in Autism Spectrum Disorders, 5, 1103-1109.