Cognitive behavior management operates form three major tenets:
Tenet 1: Response consequences (such as rewards or punishments) influence the likelihood that a person will perform a particular behavior again in a given situation. Note that this principle is also shared by classical behaviorists.
Tenet 2: Humans can learn by observing others, in addition to learning by participating in an act personally. Learning by observing others is called vicarious learning. The concept of vicarious learning is not one that would be subscribed to by classical behaviorists.
Tenet 3: Individuals are most likely to model behavior observed by others they identify with. Identification with others is a function of the degree to which a person is perceived to be similar to one’s self, in addition to the degree of emotional attachment that is felt toward an individual.
Accordingly, an individual’s behavior is uniquely determined by each of these three factors. While CBM upholds the behaviorist notion that response consequences mediate behavior, it contends that behavior is largely regulated antecedently through cognitive processes – the major of which are appraisal, attributions and expectations. The content used in these processes are the beliefs, schema and attitudes held in the cognitive structures – particularly beliefs about self, others and future prospects. Therefore, response consequences of a behavior are used to form expectations of behavioral outcomes. It is the ability to form these expectations that give humans the capability to predict the outcomes of their behavior, before the behavior is performed.
Based on this focus, it is incumbent upon the assessment specialist to provide in his/her evaluation report [ER] , the following aspects of the student:
Slow Triggers: these are the internal and external environmental conditions that predetermine potential behavior. For purposes of this material, we are interested in only the internal [cognitive], although a full assessment should provide the external [behavioral] context as well. The ER must include:
• specific information about the student’s beliefs about self, others and future prospects as related to educational competence [e.g., the student believes s/he is better, the same or worse than others in ability to achieve academically; sees others as supportive or distracting to his/her performance because ……….; see positive, neutral, negative future achievement].
• personal constructs [bi-polar language selected by the child to describe the similarities and differences between people in the environment as related to interpersonal relationship as related to the educational domain.
• personal constructs [bi-polar language selected by the child to describe the similarities and differences between people in the environment as related to interpersonal relationship as related to the home/family domain.
Fast Triggers: these are the operational process that shapes the thinking of the cognitive structures into the day-to-day performance. The ER must include:
• the child’s appraisal or comparison of self to others as related to academic and other school performance.
• explanation of cause [locus of control, controllability, and stability] for success/failure in the educational domain.
• expectation of success/failure on related educational performances [e.g., test taking, homework, oral presentation, etc.].
Selected Behavior Repertoire: this is the behavior that the child manifests in specific situations.
• what the child does when:
a) faced with a potential failure?
b) faced with potential embarrassment?
c) faced with potential success?
• what goal does the child state s/he expects to achieve with the behavior?
Social Status: this refers to the child social status in the educational domain.
• as perceived by the student
• as perceive by others
EVALUATION REPORT SAMPLE [Cognitive Data Only]
Summary of Findings/Interpretation of Assessment Results:
John says that he is a competent person who is able to compete with other students academically, but that he chooses not to do so. This proposition is not supported by others in the educational domain, nor by his own self talk in times of crisis. During observation, he was heard to indicate that he was not ‘smart enough to do the work’. Teachers and other students express the belief that John cannot compete. However, there is no evidence that he is deficient academically from the other testing. It is concluded therefore, that John does not believe that he is as capable as other, but believes that he can bluff others as long as he can avoid performing.
John uses constructs about both the educational domain and the family domain that seem to support that initial conclusion. People are either ‘nice’ or ‘mean’ depending upon whether they ask him to perform or not. Teachers and Parents who make excuses as to why he cannot take the math test are ‘nice’, those who insist that he take it are ‘mean’. Other constructs [supportive/interfering; caring/not caring] are used in the same manner. Thus John sees most of his teachers as ‘mean’, interfering and non caring and most of the counseling staff as ‘nice’, supportive and caring. In addition, his mother is ‘nice, supportive and caring, but his father is ‘mean’, nonsupportive and noncaring.
When John compares himself to other students he often refers to those who achieve good grades as ‘goody goodies’ and states that he doesn’t care about them at all. Those students who are also struggling with academics ‘keep it real’ and don’t ‘suck up’ to the teachers. Despite his contention that he is academically competent – he expects to fail because his teachers don’t like him and they don’t teach what is in the tests. The cause of this failure therefore is outside of himself and his own actions.
John says that when he is faced with failure and/or embarrassment, he chooses to not participate for the purpose of avoiding those outcomes. He notices that this adamancy often results in teachers ‘attacking’ him and causing ‘trouble’ [e.g., being sent to the principle]. When he expects to succeed, he has no problems.
John sees himself as popular with a set of peers, but not the ‘goody goodies’. Actually, he is wrong on both counts. Many of the academic achieving kids have a degree of positive feeling about John, while many of the other merely tolerate him.
RECOMMENDATIONS
• John needs to be helped to make a more balanced and rational self-appraisal. The first step in this process might be to work with the student to fill out the Self Concept Inventory – seeking always balanced and rational terms. Once this is completed, John may be more accepting of help on the other issues in his life.
• Help John to develop a Vision Statement that will articulate goals that he wants to achieve. The purpose of this technique is to assist John in obtaining absolute clarity on what he wants in every area of his/her life. If he is interested in improving the quality of day-to-day experiences, then he must define a richer, fuller, more satisfying life. He must face what he wants. This technique is designed to be a tool to determine and clarify all of the child’s personal desires, wants, and dreams; becoming aware of what they are, assessing them and making them real by acting on them.
• Seek to negotiate with John a cognitive behavior contract that states specifically what interventions will be provided to help John achieve his selected goals and John’s commitment to participate appropriately.
• follow the Self Affirmation Protocol [CMP#008]
1) begin with the child automatic thoughts and self talk as they occur in times of educational crisis:
a) note, record, rate, for degree of distress, etc.
b) analyze in ‘public’ – dispute, content
c) creative alternative meanings, identify consequences, prioritize
d) develop mantra to support new thoughts
2) introduce the concept of the pathological critic [See CBT#32]
a) personify the critic by naming to help John externalize the self-accusing voice
b) introduce John to his ‘healthy’ voice
c) identify the main functions of the critic
d) identify what reinforces the critic
3) identify distortions in thinking
4) start teaching the child to substitute accurate, realistic language for toxic beliefs [See CBT#02 &/or CBT#03]
a) ask questions that expose overgeneralization.
b) ask questions that expose faulty labeling
c) ask questions that expose lack of evidence.
5) refute the critic
6) thought stopping [See CBT#06]
7) identify strengths
a) create a list of genuine strengths and assets
b) identify the most troubling weaknesses
c) revise the weaknesses from pejorative language to accurate nonjudging descriptions
d) use affirmations taken from the strengths list to make affirmative signs for display
e) select two to four qualities that you genuinely appreciate in the child and work them into every session. The repetition of strengths is a must. It takes a great deal of repetition by an authority figure to undo the child’s negative programming.
8) use specific exercises to develop a forgiving, noncritical inner voice. Create a mantra of acceptance that is repeated over and over until a new attitude begins to sink in [See CBT#21 Self Verbalization Training].
9) There are four special problems that impact negatively on self-esteem:
a) inflexible rules and shoulds,
b) perfectionism,
c) extreme vulnerability to criticism, and
d) nonassertiveness [See CBT#23 Assertiveness Training].
10) there are several interventions you can use:
a) Teach coping statements. These can be in the form of affirmations or specific rebuttals to Critic attacks.
b) Visualization [See CBT#09 Coping Imagery]. These techniques will allow the John to begin seeing himself as confident, socially comfortable and competent. Visualization facilitates a more rapid shift in self concept because the client literally sees his body and behavior differently.
c) Anchoring [See CBT#30 Anchoring]. A technique for retrieving feelings of confidence from times in the past and bringing them into the present. An ability to access positive feelings at will has a significant strengthening effect on the healthy voice.
• Concurrent to the cognitive approaches or at a scheduled time, John should be addressing the issues identified in CBT#12 – Getting Mobilized. Although this technique is written from a focus on depression as the focus, the same process, in modified form, can be helpful to the child whose self-appraisal needs to be addressed. Using this technique for self-affirmation requires a focus on performance mastery more than pleasure. We tend to enjoy succeeding and, therefore, the achievement of mastery is self-fulfilling.
• Motivation relates to the sustained interest or involvement in a goal oriented task. It is important that the child define goals, and the use of CBT#27 – Motivation and Goal Setting can be considered before, after or as an integrated feature with Getting Mobilized.
1) create the future [self-fulfilling prophecies] – A Self Fulfilling Prophecy is said to occur when one’s belief concerning the occurrence of some future event…makes one behave in a manner…that increases the likelihood that the expected event will occur….
2) reframing [negative to positive] – The goal should not be related to ‘I’m too fat and must lose weight’, but rather to ‘I am thin’.
3) present time perspective – The present tense time technique assists in visualizing a goal as if it already exists. A goal stated in future time is likely to always remain in the future.
4) cognitive errors [shoulds] – When you have a list of ironclad rules about how you and other people “should” act, this generally means that the goals operate within the “shoulds”.
5) visualization [attainment] – You can learn new behavior sequences by imagining yourself performing the desired behavior successfully. Called covert modeling, it enables a person to identify, refine, and practice in his/her mind the necessary steps for completing a desired behavior.
6) intentionality – It is expectancy in the sense of that which the expecter believes is likely to occur, rather than that which a person believes ought to occur, that leads to the behavior that fulfills the prophecy.
The Process
- Monitoring and Recording Weekly Activities [See Weekly Activity Schedule [CBT#12-001]. Each box on the schedule represents an hour of time. Throughout the next week have the child record his/her main activity or activities during each hour. Whatever s/he is doing, just have him/her write it down. The reason you’re having the child keep detailed accounts of activities is to establish an activity baseline that will help you and the child recognize progress in the weeks ahead. One of the things you are looking for in this baseline is ‘what does the child avoid doing because s/he has an expectation of failure, but may, in fact, want to do.
- Identifying and Rating Mastery Activities. While John is recording the first week’s activities, he will need to pay attention to mastery. Mastery has a slightly different meaning in the context of this technique, but this can be adjusted and used effectively in the context identified here. What will be required in this shift is that the change worker identify specific performance activities that the child must do [schoolwork] or would like to do, but is afraid of failure. These activities must be defined in a way that performance can be measured and tracked. Picture, for example, a child who wants to learn to play basketball. S/he will identify the baseline number of foul shots s/he can make out of ten. S/he may record this over five sets of ten shots each. S/he, with your encouragement and support, will then set a mastery task of increasing the average number of shots made in five sets over time. This process should be done in very limited increments. If John started with only one of ten, the immediate goal is to make two of ten. It does not matter if other children are making eight or nine of ten. The sense of progress, which is being tracked, should also increase the sense of pleasure in the activity.
- Scheduling Activities. If John’s expectation was of failure, he may have been avoiding shooting foul shots, even though there is a desire to do so. No one wants to look foolish. It’s time to encourage the child to increase performance mastery activities during the week. Have him identify at least ten hours on the activity schedule when he is engaged in an activity that provides neither pleasure nor a sense of mastery. See if he can find one or two of these hours each day. These are two or three hours committed to personal continuous quality improvement in a specific area of interest. This can be in any area of the John’s choice.
You can also try to have him/her add mastery activities. Often these are efforts the child may be avoiding. The Mastery Activities List [CBT#12-003] may or may not be appropriate for consideration. The list indicates some activities that John might schedule into his week, but the choices are really personal.
You are attempting to get John to make the connection between internal forces [persistence, practice] and the outcome [mastery, a higher average of shots made]. This is a conscious process and the praise is for the persistence and practice, not for the outcome. This is based upon the assumption that the outcome performance will improve if the internal force is exercised.Note that some mastery activities may be too involved to accomplish in an hour, or simply too overwhelming when tackled all at once. It may help to break a mastery activity into smaller steps that can be accomplished in no more than five to fifteen minutes.
- Prediction Ratings. A very important part of planning activities is trying to anticipate how they will make John feel. Most self-rejecting people make very negative predictions about the amount of achievement they will have. They do not believe that this is in their control. It’s OK for the child not to feel hopeful . He may anticipate very little in the way of successful outcome from the planned activities. But he should do them anyway and evaluate what happens.
Have John use a modified Weekly Activity Schedule to plan the mastery activities for the coming week. He should use the 1-10 scale to predict how much achievement he will make, and circle that number on the schedule. For example, the child may predict that s/he will fail a test with a 50% or an F [check with teacher to make sure that you are using the proper measurement technique].
As the performance activities occur, John should write the actual mastery rating for each new activity. This can be placed right next to the circled prediction. One of the things John is likely to notice is that actual achievement experiences often are better than expected. The fact that the new activities may feel better than anticipated could help John resist the discouraging inner voice that says, “Don’t bother with anything new; it’s a lot of work and you’ll never succeed.”
SPECIAL CONSIDERATIONS
We do not mean to suggest by the focus of the protocol that confirmation is not important. Generally, an increase in performance mastery will produce social reinforcement or confirmation from others. However, we must consider the power of John’s family on the self-affirmation process. The salience of the family culture and its reinforcement or erosion potential cannot be overestimated. Families often initiate and help to maintain the thoughts that their children carry. In the mind of this assessor, the family is maintaining negative self-affirmation and therefore we recommend the addition of Social Learning Family Intervention to the protocol.
Social Learning Family Intervention is a comprehensive approach that combines training with clinical intervention and enhancement of natural supports.
Child Management Training: the parents will be offered a step-by-step approach where each newly learned skill forms the foundation for the next skill to be learned. Nine child management practices form the core content components of the program. Parents will be:
- taught how to pinpoint problem behaviors of concern and to track them at home [e.g., negative expectancies, avoidance behavior];
- taught social and tangible reinforcement techniques [e.g., praise, point systems, privileges, treats]. Over time, the tangible reinforcers are replaced by the parents’ social reinforcement;
- they are taught discipline procedures, focusing on discipline as a noun instead of as a verb. Discipline is seen as a method of teaching John how to discipline himself and take responsibility. When parents see John behave inappropriately, they learn to apply a mild consequence such as a five-minute time out combined with a learning experience [either written (Individual Behavior Learning Packet), or have a discussion about what constitutes appropriate behavior]. Response costs and work chores are advocated;
- taught to ‘monitor’ their John, even when he is away from home. This involves parents knowing where John is at all times, what he are doing, and who he are with and when he will be home;
- taught how to set up a time and area for homework and the best methods to help their John finish homework assignments.
- taught how to contract with the school to receive daily notes regarding assignments and completion;
- taught problem solving and negotiation strategies and become increasingly responsible for designing their own programs;
- taught how to reward children’s prosocial behaviors through praise and attention. The objective is for parents to learn to break the cycle by increasing social rewards and attention for positive effort and persistence and reducing their commands, questions and criticisms;
- taught how to communicate transactionally, adult to adult; and
- taught ways to communicate direct, concise and effective directions for mastery.
Training methods include role-playing, modeling and coaching. Homework can be assigned in the form of daily ten-minute practice sessions with the child using the strategies learned. After each session, the trainer leads a family discussion of the relevant interactions and encourages parent ideas.
The process takes a minimum of thirty hours with additional time for follow-up and reinforcement.