ivan yau cognitive behavioral parent group - practice wisdom and personal reflection
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Ivan Yau
Cognitive Behavioral Parent Group- Practice Wisdom and Personal Reflection
Theories Review
Behavior Learning Theories – Classical Conditioning, Operant Conditioning, Social Learning
Social Cognitive Theory (Bandura, 1986, 1997) – Reciprocal Determinism, Self-efficacy, Vicarious Learning,…
Cognitive Therapy – (Beck, A. 1989, also REBT of Ellis, A.)
Theories Review
Reciprocal Inhibition (Wolpe, 1958, 1990)
Problem Solving – Social Problem Solving, Interpersonal Cognitive Problem Solving
Self-instructional Training (Meichenbaum, 1977, 1985)
Concepts Highlighted
Schedules of reinforcement – five schedules and how to mix these well together?
Reinforcement – Direct Reinforcement, Vicarious Reinforcement, Self Reinforcement… and its implications for practice?
Merging of Social Problem Solving into Guidance and Conflict Resolution – how?
Advantages on Use of Group
Improved Assessment Frequent and varied opportunities for
mutual reinforcementLearn relationship skills effectivelyFacilitate transfer of new behavior to real
life
Some Orientations
Systematic Problem-solving OrientationGoal OrientationEmpirical OrientationCoping-Skill-Learning Orientation
Use of Group
Structure Vs Process- serving the group goals, different from
other theoretical orientations.Cohesion, Norm Structure, Role Structure,
Communication Structure, Leadership Structure, ……
General Process
Pre-group – orientation and assessmentGroup building, developing common
concernsLearning of coping skills Practice, transfer and maintenance of skill
learning (Five Stage Model, Brock & Coufal,1985)
Parenting Skill Training Group: Pre-group
Pre-group interview with guide and assessment tool – pay attention to flow of interactive pattern
Orientation – skill learning, group process, expected outcome, expectation members’ role,……
Assessing applicant’s concern – behavioral interviewing, commitment, previous group experience, ……
Further clarification – matching of expectations
Assessment – Further Tips
Severity of the problem – critical issues: adolescent’s out of control behavior, parent’s self emotional outburst
Homogenous Vs Heterogeneous considerations – Class? Educational background? Problem Nature?
Interactive Pattern – following the flow of discussion / over-ventilation
Group Building
Even and broad participations, particularly in early stage – control on agenda for small sharing in turn
Sharing similar background and positive experience / feelings first, not limited to problems to be dealt with
Matching of individual / common concerns and group goals, adjusting session plan if necessary – issues of study, anger control
Assessing Target Problem in Group
Situational Analysis – very usefulTools- structured group interviews,
keeping a diary, case-study, role-playing Developing a list of problem situationRestricted use in time-limited group
Situational Analysis
The interaction pattern is explored.Target behaviors are identified in
interpersonal context.The consequences are assessed to see if
the behavior is effective in achieving its intended goals.
Critical Moment is the point at which group member can do (think / feel) differently to handle the situation significantly better
Coping Skill Training
Incremental, building on small successLots of small exercises for practiceUse of multi-modelingSkill conceptualization matching with
participant’s cognitive complexityBehavioral Skills Vs Cognitive Skills
Defining Anger Scenario – an example
Use three sentences to describe the background of the situation
Describe the relationship of the situation to the general problem
Describe a recent event, your response and perceived consequences to yourself and others.
Degree to which you were satisfied with your response and how important to you
Modified from Sheldon Rose
Coping Skill Training
Skill application, instead of dealing with specific target behavior
Positive skill first – to reinforce desirable behaviors
Skill – rationale, applicability and conceptualization
Exaggerated demonstration of problematic interaction
Fine-tuning skills
Coping Skill Training – Cognitive work
Cognitive Restructuring – a powerful but very intensive intervention strategy
Worker should be very familiar with cognitive errors / dysfunctional thoughts
Exercises are very helpful for getting familiar with these concepts
Use of praise and attention is very effective in intervening in perception bias for many parents
Which one should come first? Cognitive Vs. behavioral skill training?
Coping Skill Training – on Anger
Perceptual shiftSIT – modified by Ivan and WilliamCognitive work Re-directing strategies一分鐘斥責法 ( 游達裕、黎頴之 , based on
Reciprocal Inhibition): 1. 指出不當行為 , 2. 表達感受 , 3. 沉默片刻 , 4. 重申對孩子的信任 , 5. 展示其他可接受的行為。
Coping Skill Training – on Conflict
Before outburst of emotion: Time-out – particularly useful for parenting on adolescents
Articulation of children’s needs first (mastery of active listening) and then own concerns
Negotiation on alternatives based on common concerns, use of problem-solving process.
Consolidation and Transfer
Home work design – guaranteed success, progressive, flexible
Close monitoring for home practice – particularly for early stage
Home work review – further consolidation, use of idea of BSFT, drawing common points for review
After group period, further design of home work assignment (1:1.5 principle)
Group Process
Reducing the structureIncrease in emotional sharing graduallyPrepare to handle new issues in group in
later stageDeveloping roles of group members and
communication patterns gradually
Personal Reflections I
Very practical, useful and powerful.Useful for developing group work practice
of other orientations.Much depends on ability to conceptualize
the target problem in CBT framework (also help participants to do so!)
Motivational work and orientation contribute a lot to its success, but these are usually ignored / overlooked.
Personal Reflections II
Reinforcing desirable behaviors, and what are desirable? issues of ‘value’ clarification. e.g. 你主動打電話給嫲嫲 , 去關心她 , 我很開心。 (Behavior + Value + Praise and Attention)
Cognitive restructuring – Perspective taking is the core foundation for relationship building.
Communication skill is usually neglected, but is used for different purposes in other approaches (e.g. PET)
My Web…
You may download this PowerPoint and Reference in my Web:
http://myweb.polyu.edu.hk/~ssyty/
Thanks!!
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