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_at_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 Well 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
• Its 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 shes 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. Whats Good About You?
• Principle Reflecting on strengths, although
  difficult, can be emotionally soothing and help
  with emotional regulationit 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 Whats 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
• Petes affective changes
• Johns 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

• Youre working with a 9-year-old whos getting
  bullied (on the playground, at the bus stop,
  online)
• You ask him/her What are some of the things
  youve thought of doing when youre 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
• Michaels response to paraphrases
• Your reaction to counselor spontaneity and
  self-disclosure

30
Michael - Discussion

• Im 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

• Its 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
  students 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 childrens 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 Its 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 its not popular, but I
  believe in spanking. When I was a kid, if I
  talked back Id be picking myself up off the
  floor. Kids dont 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 youre thinking. Lots of people
  believe in spanking and Im glad youre being
  straight with me about your beliefs.

48
Radical Acceptance Follow-Up

• Parent Response Yeah. Okay.
• Teacher/Counselor Return But Im not all that
  positive about the picking yourself up off the
  floor thing.
• Parent Response Oh no. I didnt mean I think
  thats 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)
• Grandmas Rule and passionate rewards and boring
  punishment (direct power)
• Character feedback (indirect power)
• Seven magic choice theory words (relationship
  power) I want you . . . but its your choice .
  . .
• Mutual problem-solving (problem-solving power)

51
Video Clip 2

• Watch for
• Whos talking now
• What parent-child dynamics are being addressed
• Mutual problem-solving

52
Practical Parenting Interventions

• Whispering and plans (be proactive)
• Simultaneous empathy and limit-setting
• Developing a new attitude and a new plan for
  limit-setting

53
Concluding Comments

• What will you remember?
• What principles, strategies, or techniques could
  you start using right away?

54
Review The Attitudes-Conditions

• Use Radical Interest Make sure there is no other
  place youd 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
  ???

55
Conclusions and Closing

• You can be directive within the context of a
  reasonably positive relationship
• Angry dad story