Cognitive Behavioral Interventions

SOCIAL SKILLS TRAINING:TWO TYPES OF INTERPERSONAL COMPETENCE

Cognitive Competence

Knowledge about relationships (what they are, why they are important, how they develop, social norms)

Perceptual skills (how the client interprets the social world)

Decision-making skills (when and how to approach others)

Assessment skills (how to consider a variety of possible explanations for the behavior of others in social situations)

Social Skills Training:Two Types of Interpersonal Competence (cont.)

Behavioral Competence

Self presentation (to enhance likelihood of positive responses)

Social initiatives (includes how to start conversations)

Conversational (talking, listening, turn-taking)

Maintenance (of relationships over time)

Conflict resolution (handling disagreements, disappointments)

Steps in Social Skill Building

•Through assessment, determine what skill the client wants or

needs

•Describe the skill and its utility

•Outline all parts of the skill separately (there are probably

more than you first think)

•Model the skill for the client

•Role play each part of the skill

•Evaluate the role-plays

•Combine the parts of the role-plays into a full rehearsal

•Encourage the client to apply the skill in real-life formats

•Evaluate and refine the skill

Critical Social Skills

• Assertiveness • Listening• Interpreting others’ reactions • Giving and receiving positive comments • Basic self-presentation and etiquette• Emotions management • Starting conversations • Being active in conversations • Reciprocity and balance • Initiating contacts, making suggestions

Critical Social Skills (cont.)

• Identifying social support resources• Interpreting others’ reactions and comments • The ability to talk about a number of topics• Knowing whom to approach, when, and how• Being open to differences• Problem solving capacity• Having positive self-regard• The ability to organize time

SELF-INSTRUCTION TRAINING:A FORM OF COGNITIVE RESTRUCTURING

Goal• To increase the client’s control over his or her behavior by

improving the quality of internal, self-directed speech

Assumptions• Behavior is mediated by internal, self-directed speech

• Self-dialogue may be dominated by negative cues

• People may have a lack of positive cues in their self-dialogue

• Intervention must also incorporate skill development activities

Steps in Self-Instruction Training

Assess behavior and its relationship to deficits in “sub-vocal” dialogue

Demonstrate how overt self-directed speech can be used to guide behavior

Help the client rehearse new self-talk (and related behaviors)

Help the client make plans to risk more adaptive behavior while using covert self directed speech

Follow up on the client’s experiences: Revise target behaviors, self-dialogue Add new target behaviors or end the intervention

THE SOCIAL WORKER’S PRESENTATION IN COGNITIVE-BEHAVIORAL INTERVENTION

»Avoid complicated explanations

»Compare verbal and nonverbal communication

»Ask clients for concrete examples of their issues of concern

»Use deductive questioning

»Regularly elicit client’s reactions to the social worker’s statements

»Ask clients for concrete examples of how they can apply the material

THE SOCIAL WORKER’S PRESENTATION IN COGNITIVE-BEHAVIORAL INTERVENTION

(cont.)» Offer options for clients

» Employ frequent modeling and behavioral rehearsal

» Use displacement stories

» Use appropriate self-disclosure

» Encourage client use of prompts in the home environment

» Validate frustrations

» Compliment extensively

COGNITIVE-BEHAVIORAL INTERVENTION WITH CHILDREN AND ADOLESCENTS

•Children and adolescents often experience cognitive deficits rather than

cognitive distortions

•Cognitive procedures can be effective for adolescents but not children

–Verbal interventions are generally limited in effectiveness prior to

adolescence

•Modeling is An effective means of teaching youth new experiences

•Behavioral interventions are effective with children lacking in language

ability

COGNITIVE-BEHAVIORAL INTERVENTION WITH CHILDREN AND ADOLESCENTS (cont.)

• In adolescence there is a sharp decline in

the value of adult-mediated reinforcers …

• Limited life experience makes

generalization difficult for children

– … but they do respond positively to

warmth, non-judgmental attitudes

COGNITIVE-BEHAVIORAL GROUP INTERVENTIONWITH ADOLESCENT SEX OFEFNDERS

Denial or Minimization – Each offender is required to give full disclosure of his offenses, including thoughts and feelings when offending

The other group members challenge the person’s minimization practices.

Distorted Perceptions – Group members challenge a person’s self-serving perceptions of his behavior and the feelings of the victim at the time of the offense

Victim Empathy – This is a lengthy process, facilitated by role plays, of becoming able to recognize emotions in others, adopt the other person’s perspective during an offense, replicate the victim’s emotion, and take action to reduce their distress..

COGNITIVE-BEHAVIORAL GROUP INTERVENTIONWITH ADOLESCENT SEX OFFENDERS (cont.)

• Pro-offending Attitudes include a client’s negative views of women and children, and pro-crime beliefs. These are challenged as they arise in any group discussion

C/B Group Intervention with Adolescent Sex Offenders (continued)

Attachment Style – The offender describes his two most recent relationships, so that his “attachment style” can be inferred.

The group points out the disadvantages of those ways of relating to othersThe benefits of appropriate intimacy (sexual and otherwise) are reviewed. The nature of jealousy and how it can be acted out is also reviewed. The client is helped to develop social skills to promote his potential for intimacy.

C/B Group Intervention with Adolescent Sex Offenders (continued)

• Deviant Fantasies – Offenders are required to list their fantasies and monitor their frequency and strength. – They must indicate whether and how they attempt to

resist the fantasies. – Group discussion follows around the meaning of the

person’s fantasies and the role they play in the offending behavior.

C/B Group Intervention with Adolescent Sex Offenders (continued)

Relapse Prevention – This includes an identification of the typical offense cycle Specifying the factors that increase risk Acquiring coping skills that may reduce risk Establishing plans to avoid risk.

Each offender lists two warning signs One that only he can observe (such as fantasies) Another that his parole supervisor or family and

friends can observe.