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Page 1: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Eunice Lerma, Ph.D, LPC, CSCRichard J. Ricard, Ph.D, LPC-InternCourtney Heard, M.A., LPC-Intern

Troy Tillmon, M.S

Page 2: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Teen Talk Program Partnership between DAEP and Texas A&M

University-Corpus Christi; Department of Counseling Education & Psychology; Counseling and Training Clinic.

Students meet twice a week in same gender, small group or individual counseling sessions to discuss topics relating to teenagers of today.

These counseling sessions are conducted by counseling interns and counselor education doctoral students from Texas A&M University-Corpus Christi.

Page 3: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Overall Program Objectives1. Create a positive counselor/student relationship

that emphasizes the role of the counselor as a helper interested in each student’s overall health and wellness.

2. Mental health counselors in training will have the opportunity to work with at-risk youth while building an understanding of the school system.

3. Students will receive appropriate responsive counseling services specifically based on their needs

Page 4: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Group and Individual Topics Determined during the first initial meeting by the

student and counselor.

Topics often include: anger managementconflict resolution coping skills date violence building healthy relationships social skills griefteam building self-efficacy/self-esteemenhancing intrinsic motivation

Page 5: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Dialectical Behavioral TherapyA goal of DBT is to enhance client coping skills and

facilitate an awareness and acceptance that change is constant.

DBT aims to replace maladjusted emotional and behavioral responses to change with behaviors that will reinforce non-emotionally and behaviorally charged adaptation.

DBT is shown to be effective in treating a variety of clinical diagnoses included eating disorders, substance abuse, and emotional and behavioral problems (Feigenbaum, 2007; Nelson-Gray et al., 2006; Rakfeldt, 2005).

Page 6: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 1:Group goals and guidelines; norms and individual goals; validation of members

PurposeGroup goals and

guidelineNorms and ind.

GoalsValidation of

members

Activities Confidentiality Group normsEstablishing

counseling relationship

Page 7: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Building Group Cohesiveness

Page 8: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Skittles Game Red…What is your favorite

color?

Orange…If you can travel anywhere where would you go?

Yellow…Name one thing people may not know about you?

Green…Who is your favorite artist?

Purple…Name two things that help you relax?

Page 9: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Validating Conversational PartnersStudents practice listening and responding to

conversational partners using appropriate ParaphrasingClarifications and questionsReflection of feelings

Students participate in structure role plays with counselor and group members act as coaches.

Page 10: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 2: Being Responsible; Knowing my thoughts, feeling my feelings and choosing my behaviors

PurposeAcceptance of my

thoughts, feelings and behaviors

Activities Exercise in mindful focus

of attentionValidation of student

perceptionsPsychoeducation on the

distinction of thoughts, feelings and behaviors

Practicing in choice of behavioral response

Radical Acceptance

Page 11: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Thoughts/Feelings/Behaviors/Events

Page 12: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Robot

Page 13: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 3: Describing how I feel

Purpose Learning how to

contact, describe, express emotions

Emotional regulation

ActivitiesGlossary of feeling

wordsTalking about our

internal states Awareness of body

sensations

Page 14: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Mood Charades

Page 15: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Mood Jenga

Page 16: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Mind your own business…1. Interpersonal sense? Individual Sense?2. We have internal business.*

What we think What we feel What we believe How we each make sense of the world

Page 17: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 4: Dealing with powerful feelings

PurposeLearning to manage

difficult emotional experiences ( distress Tolerance)

ActivitiesMindful coping

strategiesRiding the wave of

emotional experiences

Page 18: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Riding the Emotional Waves Tolerating difficult or

overwhelming feelings involves accepting that Emotions Ebb and Flow

Ride out emotional highs like waves. Crashing waves are followed by flow of calm and recovery.

Resist the temptation to fight emotional experiences. Metaphors of Rip tide and negotiating currents at the beach are introduced.

Page 19: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 5: Interacting with others. Working for what you wantPurpose

Learning how to communicate effectively with others

ActivitiesCollect Social

Interaction questionnaire

Page 20: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Social Interactive Questionnaire1. Have you had conversations or contacts, more than a quick hello, with any of the following people that were

encouraging or discouraging during the week? Bubble in one letter closest to your answer for each person or persons.

 Conversation with others: Family Members Best Friend

(a) mostly encouraging (a) mostly encouraging(b) mostly discouraging (b) mostly discouraging(c) no contact or not much contact (c) no contact or not much contact

 Friends Teacher(a) mostly encouraging (a) mostly encouraging(b) mostly discouraging (b) mostly discouraging(c) no contact or not much contact (c) no contact or not much contact Staff/Counselor Girlfriend/Boyfriend(a) mostly encouraging (a) mostly encouraging(b) mostly discouraging (b) mostly discouraging(c) no contact or not much contact (c) no contact or not much contact(d) don’t have a boyfriend/girlfriend (d) don’t have a boyfriend/girlfriend

 

  

Page 21: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Social Interactive Questionnaire2. Think about this week compared to last week. Bubble in one letter closest to

how you feel. (a) this week is better than usual(b) this week is typical (c) this week is worse than usual 3. Happiness Rating: How happy have you been this past week? Select one. (a) very happy (b) mostly happy (c) mostly unhappy (d) very unhappy 4. Think about the most significant event that occurred to you this past week.

Please write at least 2-3 sentences about it and how it affected you.

Page 22: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Role Playing Parent/ChildScenario

Your friend invited you to a party where there is going to be illegal activity. You have to report the next day to probation. What do you do?

Teacher/Student Scenario

The teacher tells you to sit down and do your work. Your friends turn around and say “She just punked you.” What do you do?

Page 23: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 6: Practicing Positive Interaction skills/conflict management

PurposeHealthy

interpersonal skills

Activities DBT Dear Man

practiceSong Lyrics

Page 24: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

DEAR MANDescribeExpressAssertReinforce

MindfulAppear ConfidentNegotiable

Page 25: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Song Lyrics “Never mind what haters say, ignore them 'til

they fade away.” Live your life by TI

“My, shoulders are strong I prove 'em wrongI ain't doing nothing but moving on…” Tie my hands by Lil Wayne

“Don’t forget that impossible is nothin’, your environment is irrelevant. Just don’t let your emotions over power your intelligent. Refuse to give up, your mistakes will define you” TI featuring John Legend Slide Show

Page 26: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 7: Coping with difficultiesPurpose

Distress Tolerance

Activities DBT Self-Soothing;

Improve the moment

Page 27: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Session 8: Figuring out what I want and committing to SMART goals in life

PurposeBehavioral Planning

based on valued goals

Close Groups

Activities Committed action

worksheetSound Track of your

life

Page 28: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Committed Action Worksheet(Olerud & Wilson, 2002)

A part of my life that I value is ______________.My intention for this part is _________________.The committed actions that I’m willing to take

include the following (be sure to note when you’ll begin these actions): ______________________________________

Page 29: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Soundtrack of your life My life now

Kobe Bryant—Lil WaynePicture World Up—Lil

WayneHeat—Lil Wayne

In the futureWho said I couldn’t

make it—TIRolling in the Deep—

AdeleI’m the boss—Rick Ross

Page 30: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

SMART GoalsSpecific—not too big or smallMeasurable— “I know when I have met

them.”Agreed/Accountable/Attainable– “I will make

myself accountable.”Realistic– “Do I really have a chance to meet

this?”Timely– “Can I do this in the near future?”

Page 31: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Evaluation of Intervention Impact on Student Behavior

Number of participants: 63

Total number of sessions: 340 (average 5 per group/individual)

Assessment: The Youth Outcome questionnaire (YOQ) (Burlingame, Wells, Lambert, 1996)—Pre and post test

Preliminary analysis (fall semester): Students participating in the counseling groups are benefiting from the intervention.Students experienced statistically and clinically significant

reductions in reported conduct problems (F(1,57)= 6.1, P<.017 and hyperactivity (F (1,57)= 5.6,p< .022).

Students benefit was directly related to the number of sessions they attended

Page 32: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

While these results are preliminary, they suggest that our intervention is having the intended impact on student behavior. The lessons learned from our efforts to organize and conduct clinical groups on DAEP campuses seems easily generalizable to other DAEP settings and include:

 1. Obtaining and maintaining administrative support for the intervention.

2. Securing a workforce that is manageable ( and no cost to campus) because of university collaboration.

 3. Investment in a theoretical model that has empirical validation ( DBT) with typical presenting issues of students at DAEP campuses.

Page 33: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

Questions?

Contact InformationDr. Eunice [email protected]

Courtney [email protected]

Dr. Richard J. [email protected]

Page 34: Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S.

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