john e. lochman, phd, abpp the university of alabama
DESCRIPTION
Effective Interventions for Children with Externalizing Behaviours : Implementation in the Real World. John E. Lochman, PhD, ABPP The University of Alabama Box 870348, Department of Psychology, The University of Alabama Tuscaloosa, AL 35487 205-348-7678; [email protected] - PowerPoint PPT PresentationTRANSCRIPT
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Effective Interventions for Children with Effective Interventions for Children with Externalizing Behaviours: Implementation Externalizing Behaviours: Implementation
in the Real Worldin the Real World
John E. Lochman, PhD, ABPPThe University of Alabama
Box 870348, Department of Psychology, The University of AlabamaTuscaloosa, AL 35487
205-348-7678; [email protected]
Dublin, Ireland – 10/22/09
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This presentation’s topics:This presentation’s topics:
Risk factors for children’s aggressive behavior: a contextual social-cognitive model
Cognitive behavioral intervention child and parent components
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Risk Factors on the Developmental Risk Factors on the Developmental Trajectory for Children’s Aggressive Trajectory for Children’s Aggressive
BehaviorBehavior(Coie & Dodge, 1998; Hawkins, Catalano & Miller, 1992; Loeber & Farrington, 2001; Pennington, 2002)(Coie & Dodge, 1998; Hawkins, Catalano & Miller, 1992; Loeber & Farrington, 2001; Pennington, 2002)
Child Factors: biology and temperamentFamily ContextNeighborhood ContextPeer ContextLater Emerging Child Factors: social cognitive
processes and emotional regulation
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Hostile Attribution Bias
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Social Cognitive Processes in Social Cognitive Processes in Aggressive Children: Appraisal StepsAggressive Children: Appraisal Steps
(Crick & Dodge, 1994; Lochman, Whidby & FitzGerald, 2000)(Crick & Dodge, 1994; Lochman, Whidby & FitzGerald, 2000)
1. Cue encoding difficulties, by excessively recalling hostile social cues
2. Hostile attributional biases, and distorted perceptions of self and other in peer conflict situations
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Problem-Solving Measure for ConflictProblem-Solving Measure for Conflict(Lochman & Lampron, 1986; Dunn, Lochman & Colder, 1997)(Lochman & Lampron, 1986; Dunn, Lochman & Colder, 1997)
Story 1:Some of Ed’s friends borrowed his soccer ball during the lunch period, but they did not return it. When Ed came out of school at the end of the day, the other boys had already started playing with it again. Ed was supposed to go right home after school, and he wanted to have his soccer ball back // The story ends with Ed walking home with his soccer ball. What happens in between Ed not having his soccer ball, and later when he walked home with it?
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PSM-C
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PSM-C Content CodesPSM-C Content Codes
Verbal Assertion (Regular and Negative)
Direct Action (Regular and Negative)
Help-seeking Non-confrontational
Physical Aggression Verbal Aggression Bargaining Compromise
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PSM-C Story 1 Solutions : James PSM-C Story 1 Solutions : James (12 year old)(12 year old)
1. Ed went up and act like he was fixing to play with the soccer ball, but took the ball and walked away with it.
2. He could have just took the soccer ball without playing with them
3. He could have went home and next morning seen them playing with it, and gone up to them and taken it without asking
4. Next morning if it’s in the locker he could have went in the locker and took it out
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PSM-C Story 1 Solutions: DavidPSM-C Story 1 Solutions: David (11 year old)(11 year old)
1. He told them to give him back his soccer ball so he could go right home
2. Started a fight
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PSM-C Story 1 Solutions: Mark PSM-C Story 1 Solutions: Mark (16 year old)(16 year old)
1. They won’t let Ed have the soccer ball, right? So went to the principal, told him the situation, he went back to kids and told them to give Ed’s soccer ball back. And if they messed with Ed, they would be expelled from school. See, Ed is the kind of person who doesn’t like violence or to fight, and has values and stuff.
2. He could have went up there, say if he had a knife or something; he could have cut one of them up
3. He could have come over to the school with his mom; his mom could have got the ball back
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Social Cognitive Processes in Social Cognitive Processes in Aggressive ChildrenAggressive Children
(Crick & Dodge, 1994; Lochman, Whidby & FitzGerald, 2000)(Crick & Dodge, 1994; Lochman, Whidby & FitzGerald, 2000)
1. Cue encoding difficulties, by excessively recalling hostile social cues2. Hostile attributional biases, and distorted perceptions of self and other in
peer conflict situations3. Non-affiliative social goals4. Generate less competent problem solutions, with fewer verbal
assertion, compromise and bargaining solutions5. Expect that aggressive solutions will work, and value aggressive
solutions more6. Poor enactment of solutions, due to weak social skills
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Outcome Expectations: Aggression can work for him
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Contextual Social-Cognitive ModelContextual Social-Cognitive Model Background ContextBackground Context Mediational ProcessesMediational Processes OutcomesOutcomes
Community Context Neighborhood Problem
Family Context Maternal Depression Low Social Support Marital Conflict Low SES
Parenting Practices Context
Child Social Cognition and Self Regulation
Child's Perception of Peer Context
Proximal Aggressive Behavior
Substance Abuse
Delinquency
Academic Failure
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Cognitive Behavioral InterventionCognitive Behavioral Intervention
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting
Organizational and study skills Accurate awareness feelings
related to anger and vulnerability Anger management training,
including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving in a variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Goal SettingGoal Setting
Structure: Weekly goals are set by children in consultation with
staff and teachers/parents. Goals are written on a goal sheet which is signed daily
by the teacher/parent or other adult. Reward incentives are offered for meeting goals.
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Goal SettingGoal Setting
Purposes: Parents or teachers monitor children’s behaviors and
provide daily feedback to children about their behavior Provide weekly feedback to clinician concerning the
child’s behavior Encourages reinforcement of children’s behavioral
improvements in their real-world settings
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Goal SettingGoal Setting
Presentation of goal setting to children: Define goal: “Something you work towards or “Something
you are working for.” Goals should be defined in terms of observable behavior. Children should be responsible for goal sheet. Encourage children to discuss goals with parents and/or
teacher Set out rewards for reaching weekly goals.
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Goal SettingGoal Setting
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Goal Sheet
For: Joan Barth
W eek of: 6 / 4/ 01/
M onday Y N J ohn Lochman
Tuesday Y N J ohn LochmanW ednesday Y N .Thursday Y N J ohn Lochman
Friday Y N J ohn Lochman
M et Goals1-2 Days = 1 point3-4 Days = 2 points5 Days = 3 points
Goal: I w ill keep myhands to myself duringlunch time .
I, Joan Barth , have chosen the above goal and am responsible fordoing my best to meet this goal and having my teacher sign this sheetdaily.
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No or low-cost incentivesNo or low-cost incentivesIn therapy room Play on therapist’s computer for last 5-10 minutes of session Play board game for last 5-10 minutes of session (Jenga, Sorry, Hangman, Paper Airplanes) Singing/dancing/joke-telling time Reduce frequency sessions/need for treatment in future
At home Special time with parent in activity of choice (manicure, throw football, go to movies) Extra time on computer/video game at home Pick what is for dinner or eat at restaurant
School Read morning announcements over loud speaker Sit in seat backwards day Free homework pass Lunch with teacher Computer time Student vs. teacher basketball game Vice principal for the day Cut in line pass
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Point Tracking FormPoint Tracking Form
Start with easy to moderate goals to stimulate children’s motivation
Provide quick, honest feedback about point attainment at end mtg.
Points and prizes motivate children in and out of session
Can also provide long-term incentive
Chris B. 9/8 9/15 9/22 9/29
Group Rules
1 0 1 1
Partici-pation
1 1 1 1
Goal _ 1 1 2
Current Points
2 1 4 0
Total Points
2 4 7 11
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Points System for Goals and Group Points System for Goals and Group Behavior: Price ListBehavior: Price List
ITEM POINTS
Pencils, markers 2
University stickers 2
Matchbox cars 4
Baseball cards 8
Comic books 12
Water bottle 15
Basketball 30
Have a set of small, changing items to provide quick rewards for behavior change
Have larger rewards to encourage delay of gratification and planning
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Goal Setting: Common Problems Goal Setting: Common Problems for Childrenfor Children::
Forgetting to return goal sheetsNot taking responsibility for getting
goal sheet signedLacking motivation to work on goalsSocial anxiety/sense of failure
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Goal Setting: Common Problems Goal Setting: Common Problems for Teachers/Parentsfor Teachers/Parents
Believing goals are inappropriate or too easyNot understanding the importance of
shaping new behaviors in small stepsFeeling group members are reinforced for
negative behaviorsDisrupting class/home tasks
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Setting Long and Short Term Setting Long and Short Term Goals Goals
Help child identify goals he/she wants to achieveHelp child understand the importance of setting
long range goals and the steps (short-term goals) needed to attain them
Help child identify barriers to achieving goals and how to overcome them
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Goal Setting with Child Goal Setting with Child Examples of long-term goals To get along better with the teacher and other students in the classroom. To feel better about my time with my parent(s)’ at home. To get along better with my sibling(s).
Examples of short-term goals Determine what the teacher thinks I need to do. Stay in my seat during class. Do not fight with other kids in class or at home. Do not argue all the time with parent(s). When parents or teacher asks me to do something, do it without talking
back.
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Short Term and Short Term and Long Term GoalsLong Term Goals
Make the basketball team
Keep hands and feet to myself in P.E.
Resolve problems without fighting
Reduce suspensions so eligible to play
Get in fewer fights this week
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting
Organizational and study skills
Accurate awareness of feelings related to anger and vulnerability
Anger management training, including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Positive and Negative Study Skills ActivityPositive and Negative Study Skills Activity
Study Skills for Home and SchoolPrior to the session create a set of index cards with
positive and negative study skills. On each index card, write down either a positive or negative study skill/habit
Have the child sort the cards into two piles indicating whether it would be useful or not
Ask child to suggest additional skills
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Positive and Negative Study Skills ActivityPositive and Negative Study Skills Activity Study Skills for Home and School:
1. do math in the living room
2. listen to the radio while working
3. study in a quiet place
4. take notes in class
5. answer the phone when someone calls
6. double check your answers
7. ask questions in class
8. just try to keep everything in my head as I am reading
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Positive and Negative Study Skills Positive and Negative Study Skills ActivityActivity
Sort cards into those useful for studying or notAny additional skills?How could children use the ideas in the “useful”
pile to learn more effectively
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HOMEWORK CONTRACT Begin with Negotiation – Work Things Out Together
The following are suggested areas where students can have input: time, place and rules. Ø Decide on when and where homework will be done. Times may vary depending on individual schedules. A daily schedule may be a helpful reminder. Identify a place where homework will be completed. § Time________________________Place________________________ Ø What materials are needed for homework completion? Ø What rules are in place during homework time? Ø What monitoring methods will be implemented during homework time? Ø What steps can you take to make sure your long-term projects are completed on time? My child and I have discussed and agreed to the following homework plan. _______________________ __________________________ Student’s Signature Parent’s Signature
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting
Organizational and study skills
Accurate awareness of feelings related to anger and vulnerability
Anger management training, including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Different Emotional StatesDifferent Emotional States
Brainstorm list of emotionsDiscuss what makes a person feel a certain
emotion ie., “I get scared when I enter a dark room”.
What triggered the emotion?How do I feel inside? What can people see?What are the thoughts inside my head?
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Identification of Feeling States:Identification of Feeling States:EMOTION = ANGRYEMOTION = ANGRY
What People What You Feel Thoughts In
Can See Inside Your Body Your Head
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Cues of Anger Cues of Anger
Review the physiological cues of angerHow does your body feel when you become angry?What is the first thing you notice in your body when
you are becoming angry?Can then use this cue as signal that are becoming
angry, and to stop and think about how to handle the situation
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Physiological cues of anger and Physiological cues of anger and coping statementscoping statements
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Anger Awareness:Anger Awareness:Physiological CuesPhysiological Cues
Awareness of Signs of Anger1. Facial Expression2. Tone of Voice3. Body Position/Movement4. Internal Body States
– Increased Heart Rate, Rapid Breathing, Feeling Flush
– Sweating Palms, Tight Muscles, Clenched Fists
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Anger Awareness: Anger Awareness: Anger ThermometerAnger Thermometer
Enraged, Furious
Steaming Mad
Irritated, Annoyed
Frustrated
•Using thermometers, children label own levels of anger, and of their triggers at each level
•Can better problem solve at low to moderate levels of anger
•Use large version of thermometer on the floor to show anger changes during role-play activities
•Aggressive children tend to report their anger in “on-off” terms as “angry” or “not-angry”
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WORDS OF ANGER
Out r aged
A nnoyed
Upset M ad
E nr aged F umi ng
F ur i ous
F r ust r at ed
Bot her ed
F lust er ed
Upset
I r r i t at ed
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Anger Thermometer
INTENSITY
VERY HIGH
HIGH
MEDIUM
LOW
VERY LOW
WORDS FOR
ANGRY
__________
__________
__________
__________
__________
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ANGER THERMOMETER RECORD FORM
MONDAY
TUESDAY
WEDNESDAY
INTENSITY (CIRCLE)
VERY HIGH
HIGH
MEDIUM
LOW
VERY LOW
WHY AM I ANGRY?
____________________ ____________________ ____________________ ____________________ ____________________
INTENSITY (CIRCLE)
VERY HIGH
HIGH
MEDIUM
LOW
VERY LOW
WHY AM I ANGRY?
____________________ ____________________ ____________________ ____________________ ____________________
INTENSITY (CIRCLE)
VERY HIGH
HIGH
MEDIUM
LOW
VERY LOW
WHY AM I ANGRY?
____________________ ____________________ ____________________ ____________________ ____________________
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Assignment: Monitoring AngerAssignment: Monitoring Anger
Jeff made fun of my mom (Thurs)
The teacher yelled at me in front of the class (Tues)
I have lots of homework (Mon)
I can’t figure out this math problem (Wed)
Enraged, Furious
Steaming Mad
Irritated, Annoyed
Frustrated
Trigger
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Anger Triggers Anger Triggers
Identify triggers for each level of thermometer
What do others do that makes you angry?
What do you do that makes others angry? (to illustrate reciprocity of anger)
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting
Organizational and study Skills
Accurate awareness of anger and feelings related to vulnerability
Anger management training, including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving, using a PICC model, in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Anger Management TrainingAnger Management Training
Key points and activities during sessions:Easier to cope with problems if we don’t feel so
angryHow can we reduce our feelings of anger?
– Distraction, focusing attention on something else (e.g. fun things to do later in the day)
– Deep breathing– Self instruction or self-statements
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Anger Management Training: Anger Management Training: Sample Self-StatementsSample Self-Statements
Stay calm. Just relax.As long as I keep my cool, I’m in control.What she says doesn’t matter.I’ll grow up, not blow up.It’s too bad he has to act like this.I don’t need to prove myself to any one
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Anger Management Training: Anger Management Training: Practice Using Self-StatementsPractice Using Self-Statements
A Sequence of ActivitiesA Sequence of Activities
Memory Game – using deck of playing cardsDominoes- build a tower using one handPuppet Exercise – puppets tease each other Self-control “taunting exercise” – children in
center of circle for 30 seconds, coping with peers’ teasing (Goodwin & Mahoney, 1967)
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Anger managementAnger management
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Discussion QuestionsDiscussion Questions
What was the puppet thinking or saying to himself/herself?
What level of anger did the puppet experience during the teasing?
What skills did the puppet use to maintain control over her/his anger?
Did the puppet use different coping statements for different levels of anger?
What other feelings did the puppet experience?
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Anger Management Training: Anger Management Training: Rules for Self-Control ExercisesRules for Self-Control Exercises
Cannot curse or swear.No racial comments.No physical contact.No “Your Momma…” taunts.
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Anger Management Training:Anger Management Training:Tips for Self-Control ExercisesTips for Self-Control Exercises
Leaders model first Leaders can serve as coaches in the circle Peer buddies can serve as coaches Prohibit certain teases/taunts which are related to triggers at
the very top of the anger thermometer (a physcial defect, etc) Can reduce time of the role-play, when child is excessively
aroused Can have child face away from taunters Can have group members tease in turn, versus all at once, to
reduce arousal
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Anger Management: Abdominal BreathingAnger Management: Abdominal Breathing
When people are relaxed they breathe more deeply from their abdomen. When people are angry or fearful, they tend to breathe more shallowly and from the chest. They also tend to hyperventilate.
Quick shallow breathing can induce physical changes that can increase anxiety and anger. Likewise, deep abdominal breathing can trigger a relaxation response and improve concentration.
Have the child sit comfortable with both feet on the floor
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Anger Management: Abdominal Breathing Anger Management: Abdominal Breathing
Instructions for Abdominal breathing Inhale slowly and deeply through your nose and into the
bottom of your lungs – send the air as low down as you can. Your chest should move only slightly
When you have taken in a full breath, pause for a moment and then exhale slowly through your nose or mouth, exhaling fully. As you exhale, let your whole body go (visualizing like a rag doll)
Do 10 slow abdominal breaths, keeping breathing smooth and regular
slow inhale…pause…slow exhale (count “one”) slow inhale…pause…slow exhale (count “two”),
etc.
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting Organizational and study skills Accurate awareness of feelings
related to anger and vulnerability Anger management training,
including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Perspective TakingPerspective Taking
Role-play situations in ambiguous pictures, leading to different views of same situation:
1. After brief role-play action, “freeze” the scene
2. The child serves as a local TV reporter who happened on the scene and interviews the characters in the picture about what they saw, and why they thought it happened
3. Summarize the differences in perception
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Why is he sitting there and not playing ?
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Why is he walking by and not stopping ?
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Perspective TakingPerspective Taking “Motive in the Hat” activity:1. Identify possible reasons for a behavior (e.g. walking past other kids
inviting him to play)
2. Write them on slips of paper3. Have child/therapist select one “motive” from a hat (e.g. I need to
get home; it was an accident; doesn’t like them)
4. Have the child/therapist briefly enact the motive5. Have the other person vote on which motive he/she thought
was present6. When votes are inaccurate, discuss how it is sometimes
difficult to quickly determine the reason for another’s behavior; goal is to move from inferred hostility to “don’t sometimes know”
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Perspective TakingPerspective TakingTeacher interview tapping teacher expectations
and goals in handling classroom issues:1. Child interviews teacher about what school was like for the
teacher when she/he was in 5th grade (e.g. teacher’s favorite teacher, and why; teacher’s memory of working with others on a class project)
2. Child interviews teacher about what she/he most likes to teach now, and what the teacher’s goals are when the teacher is leading a math class (e.g. to provide useful information to all of the students) or trying to restore order in the classroom (e.g. to promote all students’ learning)
3. Permits child to hear that teacher’s intentions are not to get students in trouble, and promotes a positive interaction between teacher and student
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Foci for Child ComponentFoci for Child Component
Behavioral and personal goal setting
Organizational and study skills
Accurate awareness of anger and feelings related to vulnerability
Anger management training, including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving, using a PICC model, in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups
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Social Problem-Solving:Social Problem-Solving:The PICC ModelThe PICC Model
Problem
Identification
Choices
Consequences
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Problem Solving - PICC Model
PROBLEM IDENTIFICATION (P.I.) (a) Perspective Taking
Identify what the problem is based on each person’s perspective of the situation.
No blaming, name-calling `or put-downs in stating the problem.
(b) Individual Goals
Identify your goal in the situation. Identify the other person’s goal in the situation. Look toward cooperation and compromise.
IDENTIFY CHOICES (C)
Brainstorm all possible solutions to the problem. What are your choices?
Do not evaluate the solutions in terms of outcome just list all possible choices.
IDENTIFYING CONSEQUENCES (C)
Identify what the consequences would be for each solution. Provide ALL possible consequences, both positive and
negative. CHOOSE THE BEST SOLUTION
Choose the best solution based on a review of all the consequences.
Weigh out the positives and negatives choose the one that has the fewest negatives.
Choose a backup solution in case the first solution does not work.
Try out your solution.
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Social Problem-Solving:Social Problem-Solving:The PICC ModelThe PICC Model
Problem Identification:
What is my goal?
How am I feeling?
Choices Consequences
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Social Problem-Solving:Social Problem-Solving:Applying the PICC ModelApplying the PICC Model
Problem Identification:
John pushes ahead of me in line at a kickball game.
What is my goal? I want my place back in line
How do I feel? I’m a little angry
Choices Consequences
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Choices:1. Call him names .
2. Kick him.
3. Tell him to move back.
4. Talk to the teacher.
Consequences
Problem Identification: Problem Identification: John pushes ahead of me in line at a John pushes ahead of me in line at a kickball game.kickball game.
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Choices:1. Call him names .
2. Kick him.
3. Tell him to move back.
4. Talk to the teacher.
Consequences1. John will yell back and
push. We will both get into trouble.
2. John will kick back. I will be suspended.
3. John might move.
4. John might get into trouble and be mad at me.
Problem Identification: Problem Identification: John pushes ahead of me in line at a John pushes ahead of me in line at a kickball game.kickball game.
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Social Problem Solving ActivitiesSocial Problem Solving ActivitiesTrouble at Sea game to think about consequencesPractice evaluating consequences of potential
choices Compare choices generated automatically versus
thinking aheadRole-play alternate solutions to social problems Create video depicting competent solutions to
problems
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Trouble at Sea: Boat ActivityTrouble at Sea: Boat Activity
You are members of a fishing party on a boat that has run into bad weather and has engine trouble. Because of rough weather, the captain says the boat needs to be lighter. You crew members must decide which items to throw overboard. You need to decide as a group which items to throw overboard first.
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Objects in BoatObjects in Boat
Box of matchesRadio (ship to shore)CompassNavigational map10 gallons of water
Signal flaresLife rafts100 Feet of ropeFlashlight Life jackets
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Trouble At SeaTrouble At Sea
What was the problem in this situation?Did different people have different ideas about
which items to throw overboard?How did you decide which items to keep and
which ones to throw overboard?Did thinking about the consequences help you
decide which items to keep?
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Automatic Responding Versus Automatic Responding Versus Thinking AheadThinking Ahead
Using a DUSO Card or real life problem, ask group members to generate as many solutions to the problem situation as possible.
Using the same problem, ask the group to do the exercise once again. This time they are to first think about the consequences of each choice, and then only respond with choices that will have a positive outcome.
Discuss with students the idea that, if they are able to stop and think before responding, they will often be able to think of better solutions.
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PICC Video ProductionPICC Video Production
Create video that teaches others the PICC problem solving model
Depicts competent solutions in actionSolidifies client’s learningAllows client to be the “expert”Alternate activity: audiotape the scripted roleplay
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PICC Video ProductionPICC Video Production
Script at least 3 different alternative solutions and the consequence of each
Rehearse and film each segmentReview each segment and discuss whether it is
portrayed well or should be re-filmedScript and film concluding commentary and
credits
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Tips for Videotaping SuccessTips for Videotaping Success
Have child create a “script” before videotapingRehearse before videotapingCan use cue cards to remind child what to say or doAfter taping a sequence, review it and discuss if it
portrays the problem-solving points they were trying to illustrate. Decide whether to re-film the sequence
Remind client that rules will still be in effect; place limits on “silly” behavior, and edit silly behavior out before replays
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PICC- pencilPICC- pencil
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PICC Video - homeworkPICC Video - homework
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PICC Video - recitalPICC Video - recital
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Create PICC Picture BookCreate PICC Picture Book
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Foci for Coping Power Child Foci for Coping Power Child ComponentComponent
Behavioral and personal goal setting Organizational and study skills Accurate awareness of feelings
related to anger and vulnerability Anger management training,
including methods for self-instruction, distraction, and relaxation
Perspective-taking and attribution retraining
Social problem-solving in variety of situations (peer, teacher, family)
Resistance to peer pressure, and focus on involvement with non-deviant peer groups (Session 29-32)
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Peer Pressure: Refusal Skills Peer Pressure: Refusal Skills What Can I Do? What Can I Do?
Say No Thanks Broken Record Make an Excuse Leave the Situation Change the Subject Make a Joke Try to Use Peer Mediation
Act Shocked Flattery Suggest a Better Idea Return the Challenge Find Other Kids to Hang
Out With
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Deviant Peer Group and Group Deviant Peer Group and Group MembershipMembership
Cliques/Clubs/Groups at SchoolGroup Identification and StatusPosition within GroupJoining Positive versus negative Peer
Activities/GroupsPositive Leadership Qualities in Self and Others
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Activities Promoting Positive Activities Promoting Positive DevelopmentDevelopment
Create poster to display in schoolStrength Bombardment (identifying positive
qualities in self)Positive leadership qualities in self and
others
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Coping Power Parent ComponentCoping Power Parent Component
Group format with two co-leaders.5 to 10 sets of parents in each parent
group.16 sessions over 15-18 months.Phone check-ins.
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Foci for Coping Power Parent ComponentFoci for Coping Power Parent Component Positive attention and rewards
for appropriate child behavior. Ignoring minor disruptive
behavior. Provision of clear commands,
rules, and expectations. Use of consistent consequences
for negative child behavior (response cost, time-out, withdrawal of privileges).
Monitoring of children’s behavior in the community.
Improvement of family communication and increasing family activities.
Improvement of parents’ own stress management.
Informing parents of children’s current work on social-cognitive skills (e.g., problem-solving skills) in their group, so parents can reinforce children’s use of these new skills.
Academic support at home.
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Tracking and Praise – Objectives Tracking and Praise – Objectives (Session 7)(Session 7)
1. Introduce the concept of positive consequences for good behavior.
2. Introduce specific techniques of tracking and praise, including labeled and unlabeled praise.
3. Give homework assignment.a) Monitoring and tracking their children’s good and bad
behaviors.b) Increased use of praise for good behavior.c) Parents identify the place in the house where each is going to
post the tracking sheet and state what time interval of the day they can do this tracking.
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Parent Report of Child Behavior Checklist
Negative Behavior Positive Behavior___Argues Agrees; Accepts direction
___Defiant Compliant; Obedient
___Fights with Sibs Plays with Sibs
___Hits others Solves Problems Verbally
___Hyperactive Calm; Sits still
___Temper Tantrum Accepts “No” for an answer
___Whining Uses age appropriate voice
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Ignoring Minor Disruptive Behaviors Ignoring Minor Disruptive Behaviors (Session 8)(Session 8)
Minor disruptive Behaviors are often Attention Seeking Behaviors If the child’s goal is attention seeking, then ignoring minor behaviors
will eventually lead to a decrease in these behaviors Reprimanding, scolding or talking to a child after an attention seeking
behavior actually rewards the child. Introduce the strategy
– Cut off all talking to the child– Do not look at the child– “Stick to it” even if behavior escalates– Praise the child as soon as positive behavior occurs
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Ignoring Ignoring Ignoring: effective but hard for parents to carry out Avoid discussion and eye contact; turn away Be prepared for increase in negative behavior; wait out
this period Ignore and provide distraction with new activity Move away from child but stay in the room Limit the number of behaviors to ignore
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IgnoringIgnoring Examples of ignorable behaviors: Whining, pouting Temper tantrums Swearing Facial grimaces Smart-talk Minor squabbles between children Brief crying period in the middle of the night Picky or messy eating
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IgnoringIgnoring Give back your attention as soon as possible Use subtle ignores – don’t be too dramatic
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Behavior Tracking FormNegative Behaviors to Target Prosocial Opposite
1a. 1b. 2a. 2b. 3a. 3b. •Write in the number and letter of the identified behaviors (negative behaviors or prosocial opposites) each time your child engages in them.•Put a check (X) in each box every time you praise your child for doing the prosocial opposite of your target behaviors during your monitoring time.•Put a star (*) in each box every time you ignore your child’s minor inappropriate behaviors.
Week 1 Monday Tuesday Wednesday Thursday Friday Saturday Sunday
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Giving Instructions toGiving Instructions toChildren – Objectives Children – Objectives (Session 9)(Session 9)
1. Introduce concept of giving “instructions that work” to children.
2. Discuss how to use a parenting skill already learned (praise) to improve child’s compliance.
EXAMPLES: “Curtis, take out the garbage, please.” (Curtis complies). “Thank you for taking out the garbage when I asked you to. “Sam, hang up your jacket.” (Sam complies). “Thanks for doing what I asked you to do.”
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Giving Instructions toGiving Instructions toChildren – Objectives (continued)Children – Objectives (continued)
3. Present material on “Giving Good Instructions” and “Instructions that Don’t Work.”
4. Give homework assignment.a) Begin practicing good instructions and see if their child
complies to their good instructions. If the child does comply, parents should praise that compliance. The sequence is:
Instruction----- Comply----- Reward/Praise
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Giving Good InstructionsGiving Good Instructions
1. Given as a direct statement.
2. Given only once.
3. Followed by 10 seconds of silence.
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Instructions that Don’t Work: Instructions that Don’t Work: Buried InstructionsBuried Instructions
• Instructions that are followed by too much talking on the part of the parent (i.e., explaining, rationalizing, or criticizing).
• EXAMPLE: “John, go put on your sweater, because it’s cold outside.
You know how you always get chilled and then you catch a cold. Then, you have to stay home from school, and this gets you behind in your schoolwork.”
• Good Instruction Alternative: “John, go put on your sweater.”
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Instructions that Don’t Work: Instructions that Don’t Work: Question InstructionsQuestion Instructions
• Giving the command in the form of an interrogative statement (questions) instead of an imperative statement. Conveys that the child is being given a choice and may choose to answer “No.”
• EXAMPLE: “Don’t you think you should turn off the TV and do your
homework now?”• Good Instruction Alternative: “Turn off the TV and do
your homework.”
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Instructions that Don’t Work: Instructions that Don’t Work: Vague InstructionsVague Instructions
• Vague commands are not specific. They do not state exactly what the parent wants the child to do.
• EXAMPLES:
“Stop that!” “Behave yourself!” “Be good.” “Calm down.” “Grow Up!” “Act Your Age!”
• Good Instruction Alternative: “Use an inside voice in the grocery store.”
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AABBCC CHART CHARTAntecedents Behavior Consequences
Clear command. Compliance. Praise/rewards.
Clear command. Noncompliance. Time-out/
privilege removal.
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Discipline and Punishment Discipline and Punishment (Session 11-12)(Session 11-12)
Teach parents alternatives to physical punishment– Privilege Removal– Response Cost/Work Chores– Time-Out– Total reward shutdown
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Privilege Removal – Steps To Privilege Removal – Steps To FollowFollow
Give a good instruction Wait 10 seconds. (do not talk) If the child does not follow instructions in the 10 seconds,
give a warning. (“If you do not do ___, you will lose ___ (privilege).”
Wait 10 seconds again. (do not talk) If the child still does not follow instructions within the 10
seconds, say, “Since you did not do ___, you have lost___ (privilege)”
Parent then needs to immediately remove the privilege
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Privilege Removal - ContinuedPrivilege Removal - Continued The parent gives the same instruction and completes the entire
sequence using a second privilege If the child still refuses, total Reward Shutdown is put into place
immediately Remove access to reinforcers: ie. TV, phone, computer Ignore child’s protests The child remains on “total reward shutdown” until completing all
instructions given The child still loses the first and second privileges because the
instructions were not followed the first time
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Key PointsKey Points
Privileges that are removed should be things the child likes or values
The privilege should be logically related to the misbehavior
No warnings are to be given for violations of behavior rules or expectations
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Academic Support at Home:Academic Support at Home:Session Goals Session Goals (Sessions 2, 6)(Sessions 2, 6)
Discuss steps to set up homework assignment check
Provide a structure and monitoring routine wherein parents can supervise homework
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Academic Support in the Home – Academic Support in the Home – Setting Up a Homework StructureSetting Up a Homework Structure
Set expectations Set a total durationIdentify a time/place Set a good exampleRemove distractions Show an interest Review assignments Vary the structureProvide supplies Be available to help
Written contract Monitor progress
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Parent-Teacher ConferenceParent-Teacher Conference
Setting up a meeting Be sensitive to parents’ past experiences Examples of questions to askBeing proactive versus reactiveBe preparedBe on timeMake a plan for ongoing communication
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Stress Management: Session Stress Management: Session Goals Goals (Sessions 3-4)(Sessions 3-4)
To introduce topic of stress management To present a working definition of stress To use ABC chart to discuss stress and stress
management To talk about stress in parenting To introduce topic of “taking care of yourself” To introduce and practice active relaxation To present a cognitive model of stress and mood
management
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Pie Chart ActivityPie Chart Activity Please draw a large circle. Make the circle into a “pie” by separating it into ‘Life Segments.’ Make sure
to include segments for each role that you play in life, making sure to include all roles that take up your time, energy, and “space.”
Roles:
___________ ____________ ____________ _________
___________ ____________ ____________ _________
___________ ____________ ____________ _________
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Putting Time Where It BelongsPutting Time Where It BelongsKnow what needs to be done and prioritizeBlock your timeSet realistic goalsJuggle tasksImprove energy levelEnvironmental chaos! Get rid of it!Schedule time for yourself each day/week/monthJust say no – It will be okay……Really it willStop procrastinating and just get it done
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Family Cohesion Building and problem Family Cohesion Building and problem Solving: Session GoalsSolving: Session Goals (Session 13-15) (Session 13-15)
To introduce the concept of family cohesion building
To introduce rationale for family cohesion building
To discuss family cohesion building at home (family night activities, etc.)
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Family Communication: Family Communication: Questions for Discussion Questions for Discussion
Does your family currently have a way of talking with each other about problems or concerns?
How do you negotiate changing established rules? How does your family currently go about talking with
each other? How often does the family sit and talk about family
issues? Are you satisfied with the way your family
communicates?