Counseling and intervention strategies: Externalizing disorders
Intervention strategies
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Transcript of Intervention strategies
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INTERVENTION STRATEGIES Constance J. Fournier, Ph.D.
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GOAL AND OBJECTIVES Goal: to review or develop new
strategies for counseling in the school setting
Objective: TLW select social competence strategies for the school setting
Objective: TLW be able to use active listening in a role play activity
Objective: TLW be able to use the stoplight strategy in a role play
Objective: TLW be able to share additional strategies with each other
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LEVELS OF INTERVENTION Prevention
General populationAge appropriate
Risk reductionSelf selection (older children)Teacher referralAreas that might be of concern later
(parents divorcing; parent deployment; itinerant families)
Early intervention Individual or small groupSimilar issues (ADHD, test anxiety)
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LEVELS OF INTERVENTION Treatment
Specific targeted therapy (e.g., Cognitive Behavioral therapy; protocol treatment for depression)
MedicationOther specific treatments
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DEVELOPING SOCIAL COMPETENCE Identify children early (teachers are your
resource) Provide positive focused interventions Look at rehabilitation instead of
punishment Promote caring relationships between
adults and children Encourage engaged learning in the
classroom Encourage family involvement McNamara, K. Best practices in Promotion of Social Competence in the Schools, Best
Practices in School Psychology
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DEVELOPING SOCIAL COMPETENCE Identify children early
Teacher with experience can identify the children who are outside the typical range Evaluate for depression, anxiety, ADHD, or other
concerns Help facilitate outside treatment as needed Use your school nurse as an ally
Discipline referrals can be a good source of identification
Check with your school nurse
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DEVELOPING SOCIAL COMPETENCE Provide positive focused interventions
Work on strengthening positive behaviors with positive reinforcement
Provide the safe place where the children can be appreciated
Let children be a referral source as well
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DEVELOPING SOCIAL COMPETENCE Look at rehabilitation instead of
punishment Instead of punishing, look at developing
positive replacement behaviors Example: instead of punishing for talking
inappropriately in class, assign the student as a tutor for another child
Example: instead of sending the child to the office for bad behavior, send for good behavior
use self-monitoring programs Happy face monitoring Tracking with graphs
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SELF MONITORING IDEAS Happy face : ) : ~ : | : (
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EXPLAIN THE PROGRAM TO DON Three people in a group, one is the
counselor, one is the observer, and one is Don.
Observer: give feedback of what the counselor did well, and what they might do better
Don: ask questions when you don’t understand
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SELF MONITORING IDEAS Mark in the number of times a specific
behavior has occurred Raising hand before calling out
Science Math Reading
SS LA
X X X XX X X XX X XX X
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EXPLAIN THE PROGRAM TO LYDIA Three people in a group, one is the
counselor, one is the observer, and one is Lydia.
Observer: give feedback of what the counselor did well, and what they might do better
Lydia: ask questions when you don’t understand
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DEVELOPING SOCIAL COMPETENCE Promote caring relationships between
adults and childrenHave “I caught you being good” days where
both children and adults can give out stickers.
Encourage positive talk among teachers in the lunch room.
Encourage times where adults can be seen as caring ( meeting with students before or after class; working with clubs; going to student events)
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DEVELOPING SOCIAL COMPETENCE Encourage engaged learning in the
classroomThe more engaged children are in learning,
the less inappropriate behaviors will occurGive teachers reinforcement for having
engaged learning going on in their classrooms
Encourage student leadershipEncourage student input and choices
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DEVELOPING SOCIAL COMPETENCE Encourage family involvement
Families come when they have to and when they want to Make the ‘have to’ times positive and pleasant Make opportunities for the ‘want to’ times
Make sure communication is accessible to parents English and Spanish Parent friendly language
Group Question: What does or can your school do to encourage parent interaction?
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DEVELOPING POSITIVE CLIMATE Everyone contributes to learning
The bus driver and cafeteria workers are as important as the superintendent and principal in setting mood and climate
Achievement is keyStudents need to believe they can and will
learnStudents need to connect learning to
experiences and to their future in a way that makes sense to them
Fairness Fair is not equal, fair is what is needed
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DEVELOPING POSITIVE CLIMATE Parent participation
More is better (math and science fair) Caring and sensitivity
Each staff and faculty member shows consideration of parents, students, and each other
Building and groundsLook as good as possibleCommunity clean up/beautification day
Shared resources
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SOCIAL SKILLS TRAINING Promoting skill acquisition
ModelingCoachingRehearsal
Enhancing skill performanceAnalog with peers, adultsStaged in vivo with peers and adults In vivo assessedManipulating antecedentsManipulating consequences
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SOCIAL SKILLS TRAINING Reinforcing wanted behaviors
Training adults to specific positive praiseGiving wanted reinforcersUsing negative reinforcers for change (e.g.,
wants to be sent out of class, so allow positive visits to the office; wants attention of peers, so make a peer tutor
Using what the student wants instead of what you think they like
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SOCIAL SKILLS TRAINING Add to positive behaviors in the tool box
for child Reinforce new positive behaviors Build on these behaviors for new
situations What has worked well in the past?Who have you talked to that helped you in
the past?When can you do your best? How can we set you up for success?
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STOPLIGHT ACTIVITY
Draw Write
Red--stop before you act
Yellow—think about your actions
Green—go ahead with the most appropriate action for the circumstances
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CASE OF ANNIE Annie has been referred to you by her
teacher because she has been yelling at other students for ‘messing’ with her stuff.
Three people in a group, one is the counselor, one is the observer, and one is Annie.
Observer: give feedback of what the counselor did well, and what they might do better
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CASE OF RAFAEL Rafael has been sent to you because of
several incidents of yelling at peers and teachers.
Three people in a group, one is the counselor, one is the observer, and one is Rafael.
Observer: give feedback of what the counselor did well, and what they might do better
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ACTIVE LISTENING Listen actively Reaffirm what you are hearing “So I
hear you say that…” Tell what you know about procedures DON’T make promised you cannot keep You can say “I am sorry this is
happening to you.” “You will be fine.”
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DOING GROUPS Young children
Small numberMore didacticShort amount of timeKeep personalities similarUse programs already set
Source: Linda Reddy Group Play Interventions for Teaching Prosocial Skills
Available on Amazon.com
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DOING GROUPS Older children
TimeGroup compositionTheme versus process typeStages Open versus closed
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GROUPS Time
Need time to warm up—at least 40 minutes for a group to take place
Consider timing Can’t be a same time—missing same class Can’t always be before or after school Can’t always be at lunch Consider rotating schedule
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GROUPWeek 1st 2nd 3rd 4th 5th 6th 1 X2 X3 X4 X5 X6 X7 X8 X
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GROUPGroup composition Interview students first
Do they want to be there What are they hoping to get out of group Can they keep confidentiality—if not, don’t put in
a group Consider if the timing is right—may need
individual counseling firstStack the deck in your favor
Limit personality disorder types—none at firstLimit off task students to one or two
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GROUP Composition
Keep similar age rangeKeep genders separateKeep problems in same ball park
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GROUP Theme versus process typeTheme groups are for specific similar
problems that are phase of life situations Children of divorce Children of deployed parents Children with diabetes
Can have slighty wider range of ages Can be mixed gender Will often be part therapy and part
didactic
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Process groups are for similar issues, but may be somewhat different based on individual Students need to have trust in group Need to be in same range of age, interests Should probably be a closed group, or at least
closed at times
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GROUPS Stages
Initial group(s)ResistanceWorking Ending
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GROUPS Initial groups
IntroductionsGroup rules
Confidentiality Staying safe Active listening Staying positive Apologizing for breaking rules in writing
Ease in activities What is a woman What is a man
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GROUPS Resistance
Necessary part of the process if you want buy in Goofing around Not participating Being superficial Distractions Joking
Be consistent about what the group is for Use I statements Use actions that can start conversations (family
portrait)Close open groups during this time
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GROUPS Working
Sharing ideas and feelingsGiving adviceUsing homework for beginning and endCan have a themeBe sure everyone is heard“Greek chorus” if needed
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GROUPS Ending
Voluntary as much as possibleSaying goodbye to each group member by
stating what they learned from themEach group member says what they learned
from that studentStudent affirms what they will be doing to
carry on the spirit of the group
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QUESTION How many do you think would be good
in a group for the age that you work with?Share your numbers and rationale
If you have done groups, what works well with scheduling
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CONCLUSION You make a difference. Find mentoring/partners Action plan
Create your own personal team of Mental Health Specialists and Partners in your school Consider school nurse, health education
teachers, PE teachers and coaches Also have the usual team Touch base in a regular way Consider staffing of at risk students