INTRODUCTION
In Public Policy Foundations for Positive Behavior Interventions, Strategies, and Supports, Turnbull III, Wilcox, Stowe, Raper & Hedges, Fall 2000 make a persuasive case that Congress, in explicitly providing for the use of Positive Behavior Supports while reauthorizing the 1997 Individual with Disabilities Education Act [IDEA, 1999], has met strong constitutional requirements, not the least of which is a requirement that such intervention should lead to ‘benefit’. This implies, therefore, that the chosen intervention has some proven record in providing positive outcomes, e.g., changing the ‘impeding’ behaviors.
The need for enhancement is clearly indicated by the fact that Positive Behavior Supports, which “has been the subject of intense professional research for at least the last ten years and has a proven efficacy for changing the behavior of persons with developmental and other disabilities” [Turnbull III et al] is still met with the assertion that “It does not work as well for some students as its advocates assert or that it does not work at all for some students” [Mulick, 1994].
How is it that despite the use of positive behavior supports, with its proven efficacy, as the major behavioral intervention in public schools for the last ten years, we can still make the following statements:
“Serious antisocial behavior in children and adolescents constitutes a significant problem in children’s mental health services and may be one of the most serious public health challenges in American society” [Earls, 1989; Prinz & Miller, 1991]. In fact aggressive and violent behaviors, whether identified as mental health issues or not, are increasing among children in America. “Although many children and adolescents occasionally exhibit aggressive and sometimes antisocial behaviors in the course of development, an alarming increase is taking place in the significant number of youth who confront their parents, teachers, and schools with persistent threatening and destructive behaviors” [Rutherford, Jr. & Nelson, 1995].
Worse, perhaps is our society’s inability to address these issues. According to Koyanagi & Gaines, in All Systems Failure -1993, all of our systems have failed. “Over the past twenty years, numerous reports have chronicled the lack of appropriate services to meet the needs of children and adolescents with serious emotional disturbance. These previous studies report that children in need of mental health care often do not receive it or receive care that is inappropriate or inadequate [italics added].”
Is it that positive behavior supports are really not effective? We don’t think this is the answer to our question. Rather, we think that the answer is embodied in the citation: “has been the subject of intense professional research for at least the last ten years and has a proven efficacy for changing the behavior of persons with developmental and other disabilities [emphasis added].” If one reads the entire article, it becomes clear, starting on page 225, that the authors, as with most PBS specialists are focused on children with mental retardation or autism. This might be extended to a class of students for whom behavior is a manifestation of disability. When a child has a disability, a deficit in physical or cognitive abilities, inappropriate behavior is often manifested either because the disability has inhibited the learning of the proper behavior or because the disability has frustrated the ability to reach other goals.
However, there is a class of students for whom the behavior IS the disability. This group usually classified as ‘seriously emotionally disturbed’ in the special education system, as delinquents or worse in the regular education system, and often as ‘mentally ill’ by others, are usually unaffected by positive behavior supports as presently constituted. In hopes of better addressing this class of students in both regular and special education, this paper will address an expansion of positive behavior supports to include cognitive approaches. Both cognitive and behavioral approaches are based on social learning theory and operate with the same stringent models. None of the requirements of either IDEA or the specifics of the Turnbull III, et al paper are violated by this expansion.
Two points of clarification may be necessary. First, the word ‘cognition’ in its simplest form means the act or process of knowing or thinking. In most educational settings, it is generally used to indicate academic or intellectual abilities. That is not the focus for our concern. We are concerned with the student’s cognitive processes in regards to such areas as:
- appraisals: self/others, success/failure, expectations and experiences;
- constraints: ‘shoulds’, ‘musts’, ‘oughts’; and
- requirements: the student’s understanding of what s/he needs to be successful and how much s/he can cope with; his/her limitations.
It is this type of mental schema that makes ‘inappropriate’ behavior ‘appropriate’ in the mind of the student, and consequently somewhat immune to strictly behavioral approaches. The thinking is distorted, not deficient, and creates an inner logic which supports the emotions and behaviors which become manifest. Such distorted thinking may lead to deficiencies in behavioral skills. Problem solving, for example, is often a deficit of violent children who have no other disabilities. But it is not a cognitive deficiency, per se, that is the fundamental issue.
Second, while IDEA is specifically directed towards students who have been evaluated and found to be exceptional, we would direct the Positive Cognitive Behavior Supports [PCBS] to a broader range of students. Using the simple, although not necessarily easy, techniques with all children helps to satisfy the equal protection doctrine outlined by Turnbull III, et al. [similarly situated people may not be treated differently from other similarly situated individuals.] Thus, students whose behavior is disruptive or otherwise requiring of intervention, must be treated in the same manner. While many students with disruptive behavior are soon evaluated for special education, not all of this class are, at any one time, receiving special education. Additionally, the bane of a school district is to have a special education student and a regular education student participate together in the same incident. IDEA requires protections for the special education student – and particularly so for one who is developmentally delayed or mentally retarded, but not for the regular education student. The result is often a seemingly unfair and different response. The expansion of PBS into PCBS allows for a similar response for both.
It should also be noted that cognitive interventions are often helpful for students with developmental disabilities as well. Mryna Shure, [1981] has demonstrated the effectiveness of teaching four year olds Interpersonal Cognitive Problem Solving skills. If such skills can be taught to four years olds, many of the children with mental retardation have this capability. In fact, our recommendation is that all children with mental retardation who are able to operate at least at a four year old level, should receive such training.
Because of the ineffectiveness of strictly behavioral interventions with the class of children for whom behavior is the disability, the school is likely to either seek bio-medical intervention or suspend and expel to an extent which for all intent and purpose, keeps the student out of the school; the equivalent of ‘throwing them out’. The failure of the mental health services, either psychotherapy or biomedical [medication] to actually address the fundamental issues of disordered thinking merely adds to the frustration with this class of students.
DEFINITION:
In order to understand fully the implications of a cognitive enhancement of PBS, it is necessary to develop a basic understanding of cognitive theory. Whether we use the words “idea”, “concept”, or “thought”, it is proper to describe this mental activity as a basic element of consciousness. Ideas also include the symbolic mental representations of images, sensations and abstract notions such as conviction. It should be noted, though, that while everyone may think in terms of such mental representations, it is not necessarily true that the particular ideas that people hold onto about things are always the same. On the other hand, it seems that the thoughts of different people do tend to have something in common: regardless of what ideas they hold, a person’s thoughts are seldom random, disjointed entities. They tend to form coherent patterns [or schema] that stem from a few discrete fundamental principles and branch out in logical directions to encompass – to a greater or lesser degree – their whole universe of experienced phenomena. In other words, the conscious mind somehow organizes its mental product (whatever you might want to call it) into systematic frameworks of concepts, and these conceptual frameworks, contexts, schemas or systems of thought are of decisive importance in determining people’s basic ways of thinking – that is, their cognition – and serve as the foundations of their consciousness, bending the world into a shape that makes sense to them. [Russell, 1997]
It appears that there are some innate structures to the human mind which provide a basis for the development of a personal data base. Such a structure as, for example, the language grammar, provides the basis for learning language, any language, which is available. Any cursory examination of the nature of humanity will reveal the intimate association of words and symbols with most everything that people do.
The words and symbols that we employ have their counterparts within the mind. However imperfect, the correspondence between our own thoughts and the words we use to express them is of such a nature that we are able to surmise that a similar correspondence exists between the words and thoughts of others. HOW thoughts might be manifested as they are – in words and symbols – is still largely a mystery, but because they are, they can be used as a sort of window into the mind [Russell, 1997]. It certainly appears, however, that the strategy employed by the individual starts from a data based, ‘bottom up’ data collection system which uses the innate pattern identification system to group data in such a manner to create an explanation of the event or experience. These explanations also begin to form patterns and the individual begins to create hypothesis about why things happen in the way they do.
At some point these theoretical ideas become the force for interpretation, creating a ‘top down’, theory driven process. Once a theory is established, usually sometime around four years of age, all new experiences are framed from this summative attitude. Thus, if the person believes that the supernatural is ‘real’, an experience with an unidentified flying object could be believed to be an alien presence. On the other hand, if the theory does not accept the supernatural, the person may not be able to categorize the experience at all. Thus, a clash or conflict of mutually exclusive ideas allows little room for syncrenististic interaction. The word ‘syncretism’ is commonly defined as the combination of different forms of belief or practice. It is used to describe instances in which ideas belonging to different belief systems are fused or mixed together to form a new framework that contains elements of each [Russell, 1997]. Thus, a person may experience something that does not fit the theory, but is not mutually exclusive. S/he then may incorporate what is consistent and ignore the rest.
The particular ideas someone holds – and the ways those ideas are structured within the mind – become of decisive importance in determining the way of thinking and appraising new experiences of that particular individual; one’s internalized systems of thought serve as the foundations of one’s consciousness [inner logic] and bends reality into a shape that makes sense to them.
Concepts we hold to seem to be linked to each other in some fundamental way, in that they reinforce and complement rather than undermine or contradict each other, and that these groups of linked concepts exhibit some sort of internal synergy by virtue of their being organized in a systematic way by the processes of the mind. We can say that all the new ideas and connections may be interpreted as constituting an attitude – a framework of concepts that bends the experience (or some aspect of it) into something consistent and understandable.
Those aspects of human behavior governed by conscious choice can best be understood as correlates of the particular ways that people think, which are related in a fundamental way to the particular structures of thought that exist within their minds. In other words, we might say that people act the way they act because they think the way they think, and that the way they think can best be understood in terms of the frameworks of concepts they use to make sense of the world. These frameworks seem to have patterns themselves [Russell, 1997].
A specific focus occurs when individuals appraise themselves and others. Comparisons are made in which the individual not only decides on the performance of others, but metacognitively decides on how others judge their own performance. Such thoughts gradually shape themselves into a theory of self and others which affects the way in which we relate. In a similar way, we develop judgmental thoughts about success and failure. We determine the causes of our success or failure and attribute these causes to internal or external influences. These attributions affect our expectations of what will occur in other experiences. Thus, thoughts about appraisal is fundamentally linked across all of these factors. If I think that other people don’t like me, I may then consider my own worth as being less than satisfactory. If I am worthless, my success must be externally caused, while my failures are because of who I am. I certainly could not expect much in the future. This ‘attitude’ about self/others, success/failure, etc. creates a specific aspect of my personality. Perhaps, I walk around with a ‘chip on my shoulder’.
Likewise, people are concerned about freedom and constraints. We know that in order to improve our position in the self/other relationship appraisal, something needs to happen differently. We create shoulds, musts and oughts from previous experiences as a means of laying out the ground rules of relationships. Both we and other people must abide by these rules if our appraisals are to improve. Failure to do so adds to the problem. However, the constraints are not unrelated to the attitudes about self/other appraisals. We may assume that we ought to behave this way to get better, based on an assumption that we are worthless. If we were not worthless, but were in fact valuable, we might decide that we can act the way we please.
In similar manner, our thoughts about what we require to survive effectively is interactive as well. “I can’t possibly deal with that” is the statement of a person who is not powerful. Someone who is not valued. A self-valued person believes s/he can do almost anything.
Obviously, such areas of focus are affected by innate structures. If for some reason the basic perceptive or language structures are defective, we will at some time identify that our learning does not occur in the same way as most other people and we will tend to see ourselves as ‘different’ and often less able. Our disability is likely then to affect our appraisal, constraints and requirements. Our ‘theory’ of the world is likely to be a consistent one of defect, discrimination and defeat.
Strictly speaking, ideas which are held by different individuals do not influence each other directly – ideas influence minds of those that hold them, and people take action partly as a result of this influence; often this action (including the action of speaking or writing words) has an effect on the ideas held by others [Russell, 1997].
People act the way they act because they think the way they think. We are the sum total of what we think, and cannot act outside of this constraint [unless, of course, we are acting]; thus, our possibilities are constrained by what we believe to be true. Exactly what factors might be involved will have to be worked out, but there is enough positive correlation between the evidence we have about how people think, and about what they do, to surmise that the cognitive process is wrapped up in an integral way with conscious decision-making, and that the understanding of one is tantamount to the understanding of the other.
But another important factor must be understood. These mental structures, schema, contexts or frameworks are nonconscious. “The fact that people become unconscious of a repetitive or predictable stimulus does not mean that the stimulus has disappeared; on the contrary, it continues to be processed in the appropriate input system” [Baar, 1988]. Any highly practiced and automatic skill tends to become ‘modular’ — unconscious, separate from other skills, and free from voluntary control [La Berge, 1980, 1981; Posner & Snyder, 1975; Shiffrin & Schneider, 1977]. The decline in orienting to redundant stimuli is something very functional for the nervous system. One may say that the loss of consciousness of a predictable event ‘is’ the signal that the event has been learned completely [Baar, 1988].
Thus, the system of thought is profound and interactive. We act in certain ways or say certain things which affect those around us. “… you and I belong to a species with a remarkable ability: we can shape events in each other’s brains with exquisite precision. Simply by making noises with our mouths, we can reliably cause precise new combinations of ideas to arise in each other’s minds” [Pinker, 1994]. I can enhance your summative thought framework [attitudes/personality] or erode it by what I say. The impact of my vocalization increases with my significance to you as a person. If I am very important to you, my words may be profound.
Yet most communication is based on both shorthand and a basic trust. As reported by Tooby & Comides [1997], Grice has argued that interpreting the meaning of an utterance is only possible because listeners implicitly assume that speakers intend their utterances to be responsive to the surrounding discourse, relevant, and (for the most part) truthful. If this does not occur, communication breaks down. Ambiguity is additionally increased by the shorthand processes such as ‘Do you have the time?’. To most readers, it is clear that the person is not really asking if you have the time, but rather, if you have the time, will you tell me what time it is? In the process of pattern identification and theory building, children may be using blocks of communication in which information is ambiguous at best, and which may leave the listener free to interpret on many levels. Much contrary information therefore may be placed as theory supporting when no such thing was intended. In the case of our worthless individual, a statement such as ‘you’re a bad boy’ may be intended to mean, ‘you did a bad thing’, but by ignoring the other evidence, it can be used to support the theory of worthlessness.
Thus, through a process of ambiguous communication and personal experience, an individual builds a set of mental schema which constrain the possibilities of life. Addressing these issues through purely behavioral intervention are not sufficient to overcome such distortions. But through a process of helping the individual become aware of his/her thoughts, attending to those thoughts over time, analyzing those thoughts for validity, seeking alternative thoughts that may prove more helpful in reaching preferred goals, and finding ways to adapt to these new thoughts we can have a profound effect on the way this class of students behave.
Cognitive strategies thus, use techniques which lead the person through awareness, attention, analysis, alternatives and adaption. A question might be asked as to how we become aware of nonconscious thoughts. One of the most informative points of inference is the inner dialogue which is prevalent to all human beings. “Inner speech is one of the most important modes of experience. Most of us go around the world talking to ourselves, though we may be reluctant to do so out loud. We may be so accustomed to the inner voice that we are no longer aware of its existence ‘metacognitively’……the inner voice maintains a running commentary about our experiences, feelings and relationships with others; it comments on past events and helps to make plans for the future” [Klinger – 1971].
While we are not aware of the ‘automatic thoughts’ that we say to ourselves, these are like other reflexive behaviors such as breathing or blinking; we can become conscious of them if we are asked to attend to them. Parents, teachers and other significant people often hear ‘leakage’ of these automatic thoughts about appraisals, constraints and requirements articulated on a regular basis. “I can’t do that’, ‘I should do that’, or ‘Everybody hates me’. By becoming sensitized to what to listen for, and knowing when to ask, such natural support people can significantly help to reverse-engineer the ‘inner logic’ of the child. Specific cognitive interviews can add to the substantive knowledge.
THE PROCESS OF ENHANCEMENT
The purpose of assessment is to measure social competence. Competence can be defined as capacity equal to expectation. Almost everything we do involves either interacting with other persons or inhibiting interactions with other persons. If we fail to follow the often unspoken rules about these interactions, the consequences will be clear: others will judge us to be socially incompetent [Peter, etal 1998]. Thus, the requirement of assessment is to identify those areas of social learning limitation and to recommend social learning interventions.
Our languages for describing and explaining the world (and ourselves) are not derived from or demanded by what exists. Rather, our languages of description and explanation are produced, sustained, and/or abandoned within processes of human interaction. Further, our languages are constituent features of a cultural pattern. They are embedded within relationships in such a way that to change the language would be to alter the relationship. As we generate new languages in our professions, and disseminate them within the culture, so do we insinuate ourselves into daily relations – for good or ill. [Gergen, Hoffman, & Anderson, 2000]
From this perspective, we should be increasingly alarmed by the expansion and intensification of diagnosis in this century. At the turn of the century our system for classifying mental disorders was quite rudimentary in terminology and not broadly accepted. As the century has unfolded, the terminology has expanded exponentially, and public consciousness of mental deficit terminology has grown acute. In the 1929 publication of Israel Wechsler’s The Neuroses, a group of approximately a dozen psychological disorders were identified. With the 1938 publication of the Manual of Psychiatry and Mental Hygiene (Rosanoff, 1938), some 40 psychogenic disturbances were recognized. (It is interesting to note that many of the terms included therein, such as paresthetic hysteria and autonomic hysteria, have since dropped from common usage, and some of them – such as moral deficiency, vagabondage, misanthropy, and masturbation – now seem quaint or obviously prejudicial. In 1952, with the American Psychiatric Association’s publication of the first Diagnostic and Statistical Manual of Mental Disorders (APA, 1952) some 50-60 different psychogenic disturbances were identified. By 1987 – only twenty years later – the manual had gone through three revisions. With the publication of DSM IIIR (APA, 1987) the number of recognized illnesses more than tripled (hovering between 180-200 depending on choice of definitional boundaries). DSM IV expands the list even further to perhaps over 300 diagnoses (APA, 1994). [Gergen, Hoffman, & Anderson, 2000]
At the present time, one may be classified as mentally ill by virtue of cocaine intoxication, caffeine intoxication, the use of hallucinogens, voyeurism, transvestism, sexual aversion, the inhibition of orgasm, gambling, academic problems, antisocial behavior, bereavement, and noncompliance with medical treatment. Numerous additions to the standardized nomenclature continuously appear in professional writings to the public. Consider, for example, seasonal affective disorder, stress, burnout, erotomania, the harlequin complex, and so on. What, we might ask, are the upper limits for classifying people in terms of deficits? [Gergen, Hoffman, & Anderson, 2000]
As these terminologies are disseminated to the public – through classrooms, popular magazines, television and film dramas, and the like – they become available for understanding ourselves and others. They are, after all, the “terms of the experts”, and they become languages of choice for understanding or labeling people (including the self) in daily life. Terms such as depression, paranoia, attention deficit disorder, sociopathic, and schizophrenia have become essential entries in the vocabulary of the educated person. [Gergen, Hoffman, & Anderson, 2000]
When the terms are applied in daily life they have substantial effects – in narrowing the explanation to the level of the individual, stigmatizing, and obscuring the contribution of other factors (including the demands of economic life, media images, and traditions of individual evaluation) to the actions in question. Further, when these terms are used to construct the self, they suggest that one should seek professional treatment. In this sense, the development and dissemination of the terminology by the profession acts to create a population of people who will seek professional help. And, as more professionals are required – as they have been in increasing numbers over the century – so is there pressure to increase the vocabulary in a “cycle of progressive infirmity”. [Gergen, Hoffman, & Anderson, 2000]
Diagnostic systems give a sense of legitimacy, confidence and predictability both to the professional and to the client. In both psychotherapy and the broader culture, a diagnosis implies that the object of inquiry and the method of inquiry are based on stable assumptions like those in the biomedical realm. It operates as a professional code which has the function of gathering, analyzing and ordering waiting-to-be-discovered data. As similarities and patterns are found, problems are then fitted into a deficit-based system of categories. In a larger sense, this framework is based on the assumption that language is representational and can accurately depict ‘reality’. When thinking of diagnosis, think of cybernetician, Heinz von Foerster’s remarks, “Believing is seeing”. If you believe in the representation symbolized by the word, you tend to see it. [Gergen, Hoffman, & Anderson, 2000] This is similar to the concept that ‘if your only tool is a hammer, every problem looks like a nail’.
Implicit in the DSM IV is the assumption that psychotherapy is a relationship between an expert who has knowledge and a non-expert who needs help. The public, the profession and the state have given authority to the therapist to collect information about the client and place it on a pre-determined therapist map from which the diagnosis is then derived and the treatment plan decided. This process reduces uncertainty by telling the therapist what the therapist ought to do and suggesting how the client ought to change in order to get well. [Gergen, Hoffman, & Anderson, 2000] It is also a process and a basic assumption which we ardently reject.
Because of these inherent predispositions manifested in ‘labeling’ process, we fully support the use of a functional behavior assessment process as promoted by IDEA, 1999. “The foundation for PBS-based interventions is a functional behavior assessment (FBA), defined as ‘a systematic process of identifying problem behaviors and events that (a) reliably predict occurrences and non-occurrence of those behaviors, and (b) maintain the behaviors across time’ [Turnbull et al, 2000]. PBCS interventions follow the same pattern. Both (a) and (b) can be ‘mental events’, and must be specifically sought through a functional cognitive behavior assessment (FCBA).
The FCBA procedures should lead to three results. The first is hypothesis statements that include three key features: (a) operational definitions of the problem thought(s) and subsequent feeling(s) and behavior(s), (b) descriptions of antecedent events [both mental and environmental] in which automatic thoughts occur that reliably predict occurrence and nonoccurrence of the problem behavior(s), and (c) descriptions of the consequence events [including thoughts and emotions] that maintain the problem behavior(s) [adapted from Sugai et al., 1999 as reported by Tunrbull et al., 2000].
The FBA is a process which seeks to identify the problem behavior a child or adolescent may exhibit, particularly in school, to determine the function or purpose of the behavior, and to develop interventions to teach acceptable alternatives to the behavior. Since this process is integral to school assessment and one which we desire to continue to use, albeit in an altered form, it is important that we delineate the differences between the traditional approach to this process and our expectations.
Traditionally the process starts with an identification of the behavior that needs to change and then proceeds with the following steps.
- Collect data on the behavior,
- Develop a “hypothesis” (best guess) about the reason for the behavior,
- Develop an intervention to help change the behavior,
- Evaluate the effectiveness of the intervention, and
- Revise as needed.
CREATING A PROBLEM STATEMENT
The determination of what behaviors need to be changed are most often those that are identified by the surrounding participants, particularly those who have authority [supervising adults or ‘experts’]. These are most often the behaviors that impinge upon the adults authority or functioning. There are several difficulties with this beginning, not the least of which is the fact that the ‘problem’ behavior may be appropriate given the environmental context and/or the mental context [adults often provide environments which invite confrontation].
The first concern is the difficulty that FBA practitioners often have in moving beyond their own roots. Because the basic behavioral approach was developed in regard to a class of children who have developmental difficulties, it is generally seen as appropriate that society, as represented by those in authority, should shape the behavioral development. However, as the method is applied to this other class of children, those who have already learned behavior developmentally, this approach can easily lead to a coercive intervention process.
In order to explain this difference, we may define the first group of children, those with developmental delay, as having a deficit in their behavioral repertoire. Their delay has created a situation where they have been less able to learn from social modeling of peers and adults, either because of isolation from some of these influences, or because they were simply not ready when such an opportunity was available. Often, the solution to the initial delay [or even a simple protection of the child] creates the problem of delimiting social interaction in ways that contributes to a limited behavioral repertoire.
The second group of children can be defined as having a distortion in their way of perceiving their environment and, therefore, make decisions of when and where to use certain behaviors appropriately. This is a quite different circumstance and presentation. To respond as though there were a deficit often reinforces the distorted perspective.
For the first group, there may be validity in the traditional approach since the concept is that the children are trying to achieve some goal, but that the behavior they are using is not functionally valid. Having not learned appropriate behaviors through the normal social learning models, such children have used whatever works – even if it is not considered to be appropriate. They are not consciously rejecting other behavior sets – they simply don’t know what behaviors are appropriate or how to use them.
For the second group, however, they are in fact, rejecting other behavior sets which they are often quite capable of carrying out. They have selected the current behavior because, in their way of looking at the circumstance [their inner logic], they believe the behavior will achieve their personal goals. The fact that such behavior is reproached by adults may merely reinforce the distorted¬ thoughts. In fact, the interventions often escalate the crisis in interpersonal relationships because they so reinforce the distorted perceptions. This second group generally has no behavioral deficit [although some may be found as the intervention process continues], but rather has made a poor selection of behaviors based on what they believe and, consequently, perceive in the situation. The mental, or inner context, creates the reality in which the selection of response is made. The decision about why the child in this second group perceives the world the way s/he does is a decisive factor and this requires that we begin to gain some understanding of what is in, what the traditional behaviorists call, the ‘black box’.
We cannot truly know what goes on in another person’s mind, but through inquiry [elicitation] and the use of a beginner’s mind which is open to listening, we can begin to infer and verify the individual self. We have identified that people have a thought stream which comments on all events and experiences as they happen. Such inner speech is usually nonconscious and reflexive, meaning that, like other reflexive behaviors such as breathing and blinking, we rarely notice that these behaviors are happening unless, or until, there is reason to bring the experience into consciousness. It is important to note that once in consciousness, such reflexes can be controlled. We can breathe and blink, within physical limits, at a pace which we choose. This is also true of reflex thoughts; once in consciousness, such thoughts can be reconsidered and ‘debugged’.
Elicitation is the process of asking a person questions in order to understand their mental processes. If we really want to know what is in the ‘black box’ we must elicit nonconscious processes of which the person themselves are unaware. We must help them access consciously their own mental framework, schema or contexts. “Contexts are relatively enduring structures that are not conscious, but can evoke and be evoked by conscious events. Conscious contents and unconscious contents interweave to create a “stream of consciousness”. One plausible meaning of “self” is as the dominant enduring context of many conscious experiences, we may also say that conscious experience provides information to the self-as-context” [Baar, 1988].
But self is not an isolated construct. “The concepts of self and culture are interdependent: one cannot exist without the other. Thus, while it has become commonplace to regard the self as a cultural product, and enquire as to the ‘environmental’ (cultural) factors that lead to the expression or inhibition of this or that aspect of the self, we must not forget the reverse perspective; that culture itself is a product of the self. Selves are constituted within culture, and culture is maintained by the community of selves” [Lock, 2000].
This interactive quality of self and culture is difficult to measure. The cause and effect of such interactivity is not clear. At any given moment, the ‘self’ may make a decision about the culture that affects and changes the culture. In fact, ‘seeding the culture’ or ‘cultural restructuring’ is a specific cognitive intervention. The development and use of the diagnostic language mentioned above is a method of ‘seeding the environment’ in a manner which we believe has been quite destructive to the general population.
Dubin [1973] suggests that culture is best seen as a set of control mechanisms – plans, recipes, rules, instructions, which are the principal bases for the specificity of behavior and an essential condition for governing it. But the culture is also directed and evolved by memes. The molecular biologist, Jacques Monad, in his book “Chance and Necessity” wrote:
“…it is tempting to draw a parallel between the evolution of ideas and that of the biosphere. For … ideas have retained some of the properties of organisms. Like them, they tend to perpetuate their structure and to breed; they too can fuse, recombine, segregate their content; indeed they too can evolve,…” [1972].
Evolutionary biologist Richard Dawkins in “The Selfish Gene” developed this theme further by naming the unit of replication and selection in the ideosphere as the counterpart to the biosphere’s gene – a meme. He writes:
“examples of memes are tunes, ideas, catch-phrases, clothes fashions, ways of making pots or building arches. Just as genes propagate themselves in the gene pool by leaping from body to body via sperms or eggs, so memes propagate themselves in the meme pool by leaping from brain to brain via a process which, in the broad sense, can be called imitation” [1976].
Such memes can be perceived as the carriers of culture and it is important for us to identify memes in order to see how all of us are influenced by this process. As the meme [e.g., diagnostic label] propagates itself from brain to brain through imitation, from supervisor to subordinate, worker to client, client to family, it provides much of the destructive thinking which generates the presumed coherence upon which a coercive system is based. Such diagnostic labels create the ‘possibility’ to act for the person’s own good – an anathema to the helping process.
The plans, recipes, rules, instructions, etc. and the memes which convey them and which make up a larger culture, however, may be modified by the individual selves in the smaller segments. It can be argued that any defined segment of culture has a smaller component which may have variance down to the ‘culture’, or if you prefer, ‘personality ’ of the individual person. What are the memes that shape this individual child? How many children define themselves with diagnostic memes?
CREATING AN HYPOTHESIS
In this construction, the ‘personality’ is composed of the plans, recipes, rules and instructions of the individual person. The question is, what plans, recipes, rules and constructions has a child learned from his/her local and immediate culture: the family, the school, the community. As Lock indicates, both the messenger and the receiver are responsible for the learned outcome. Subjective experience is not an environmental variable despite the fact that many people think of their feelings and the pictures that flash through their minds and the words that go through their heads as being things that just happen, or perhaps are caused by externals: “She makes me mad” or “It makes me happy when X happens”. [Lady, 2000]
It is these cultural or personality components and their individual nuances that we seek to elicit. In the process of doing so, we are aware that there are certain errors or distortions that are relatively common in human thought processing, and we should be concerned with listening for indications of them in both outer and inner speech. Although there are other groupings, they are often listed in these eight categories [McKay, Fanning & Davis, 1997].
- Filtering: The child focuses on the negative details while ignoring all the positive aspects of a situation.
- Polarized Thinking: Things are black or white, good or bad. The child has to be perfect or considers him/herself a failure. There’s no middle ground, no room for mistakes.
- Overgeneralization: The child reaches a general conclusion based on a single incident or piece of evidence. S/he exaggerates the frequency of problems and use negative global labels.
- Mind Reading: The child claims to know what people are feeling and why they act the way they do. In particular, s/he has certain knowledge of how people think and feel about them.
- Catastrophizing: The child expects, even visualizes disaster. S/he notices or hears about a problem and starts asking, “What if?” What if tragedy strikes? What if it happens to me?
- Magnifying: The child exaggerates the degree or intensity of a problem. S/he turns up the volume on anything bad, making it loud, large, and overwhelming.
- Personalization: The child assumes that everything people do or say is some kind of reaction to him/her. S/he also compares him/herself to others, trying to determine who is smarter, more competent, better looking, and so on.
- Shoulds: The child has a list of ironclad rules about how s/he and other people should act. People who break the rules anger him/her, and s/he feels guilty when s/he violates the rules.
These cognitive errors can provide a significant perspective to the mental context which provides the data to the individual upon which a behavior is selected, whether there is a behavior deficit or a cognitive disorder, and how you can effectively create an intervention plan to address the problems in living that are caused. If you believe that the people around you should behave in certain ways and they don’t behave in that way, it is likely that you will be offended and act in a complementary fashion. However, if no one else believes as you do, the offense is incomprehensible. Thus, until the helper and the child examine the ‘inner logic’ of the beliefs that are held nonconsciously, it will be unlikely that an hypothesis can be adequately created.
While the traditional, behavioral, use of FBA seeks to define the environmental context, the FCBA, seeks to add, and even make predominant, the inner or mental context that ultimately determines the behavior selected. As a matter of course, because of a need to assure that we do not merely seek external contexts, we would insist that the assessment seek the mental context even for those children who would be defined in group one, the developmentally delayed. To ignore that a mental context is operating with a child who is delayed can be a grave error. Even seriously delayed children, who communicate inefficiently, form mental contexts that contributes to the outcome behavior.
Thus, the data collection process, starting with the initial inquiry, entails eliciting information about the situation in which the child is experiencing difficulty and should be specifically focused on what s/he says as reported by those around him/her and confirmed by the student. Along with searching for cognitive errors, a deeper search for images, sounds, smells, and other sensory representations can help to define the mental context of the behavior and the recommendations for resolution. The core beliefs about self, others and future prospects, combined with the attributions for success and failure are highly pertinent to helping the child identify what s/he wants to change so s/he can begin to shape a perspective of a quality life. The term quality life is specifically personal. Quality is defined by the client.¬
Developing an ‘hypothesis’ or best guess about the reason for the behavior cannot occur in isolation of the child. One cannot presume to know what the child’s motivation is. Until the child has defined a quality life, there is no context to understand whether our intervention is helpful. To create an intervention to help change the behavior without understanding what the individual child wants to achieve is like building a road to somewhere without first determining where you want to go. And if the child chooses, for whatever reason, that s/he does not want to change the behavior, you are faced with resistance. Such resistance does not occur in changework. This is because changework starts with a basic assumption that the assessment process has helped the child/family decide what they want to change and the experts help to define the steps necessary to make such a change.
Evaluating the effectiveness of the intervention is not an external professional process. Since the child/family have defined quality, they have certain criterion that they have used to define an outcome expectation. This outcome expectation may or may not agree with the outcome expectation of the school or community. If it does not, the child is likely to continue to have problems in living. However, this is a choice, and choices have consequences. Part of the responsibility of the helper is to make sure that the child understands social consequences so that they may make an informed choice.
CREATING A PLAN FOR CHANGE
The outcome of any assessment process is to create a plan for change. The ability to metaperceive ourselves as well as altering the reality of the experience allows us to ‘debug’ our present mental contexts and create new ones. It is this process which allows us to change. But change is not always easy. Just because a person wants to change doesn’t mean that s/he is willing to do it. Human beings are coherency-seeking systems. Our personalities are a coherent set of mental contexts, we are the sum of our thoughts. We are set up at every level to try and maintain coherency, that is, to maintain ourselves as we are. And that’s a good thing. We are operating out of a set of mental contexts that include all of our beliefs and our strategies, etc. That’s what keeps you you and me me; everything that comes into a person’s world goes through their own particular filters and gets distorted, generalized, and deleted. If it weren’t for that, you would not be you, but simply a reflection of whatever environment you are in at the time [Lady, 2000].
The clinical challenge that this presents is: How do I get through these schemas or contexts and make it possible for this child to reorganize his/her attitudes – in a way that supports the outcome that s/he wants? Developing a cognitive behavior plan or protocol requires that the child first become aware of his/her own thoughts. This is usually done through a process of capturing ‘automatic’ thoughts that occur at times of stress or exposure. Once the child begins to become aware of these thoughts, the protocol usually uses a tool such as a journal so that the child’s attention is kept focused. While the child’s focus is kept, the next step is to analyze the validity of the thought either through dispute, or though rational analytic skills – checking whether the thought helps or hinders the person’s ability to meet their personal goals.
Next, the child is helped to look for [create] other alternatives for those thoughts that s/he finds to be invalid. Children with problems in living often have rigid thoughts and little imagination. Creating alternative thoughts is a creative process and requires thinking skills that consequently may need to be taught. Each new alternative is also analyzed [or disputed] and a decision is made by the child as to what option holds the best potential for success.
Finally, the plan seeks to supply methods to adapt to the newly selected, alternative thought. This is done through one of two processes. Redundancy effects show that we generally lose consciousness of repeated and predictable events. Using this fact, self-verbalization of a mantra to replace the automatic thought is often a good choice for replacing the old thoughts. If the child learns to repeat [speak/think] a specific self-verbalization each time the target situation appears, this does two things: first, it blocks the old self talk which contain the negative thoughts, and second, it begins a process of inculcating a new automatic thought which produces better results.
We can also address adaptive potentials by setting up a ritual context through metaperception. By having the child change the experiential context in his/her imaginative visualization, using a reproduction of every sensory potential in an imaginary scene, it becomes possible to open up their set of attitudes and to allow a new experience to come in long enough for them to have that experience and then re-form their attitudes around it. The imaginary experience has the same impact psychologically as a real experience, and as the child imagines him/her self-succeeding in a difficult situation using different thoughts and behaviors to achieve this success, a new attitude [way of thinking] can occur. The child experiences what it would be like to be someone else without having to commit to such a person [Lady 2000].
Again, the redundancy effects can be utilized. As the child practices this visualization more and more, the experience becomes habitual and the process nonconscious. The helper can assist this imaginary process. If the resource needed to deal with a particular situation was “to feel like I’m in control”, for instance, the helper would first elicit that feeling of being in control This process might start by asking: “Is there some sort of situation you deal with now where you really feel in control? … Can you remember at this moment what that feels like, to really be in control?”. Once such a situation or memory is established, the helper can then instruct the client to move that resource into the problem context: “Now I want you to keep remembering what it feels like to really be in control, and while you still have that feeling I want you to imagine dealing with that teacher directly and assertively” [Lady 2000].
Several processes are occurring here:
• The child is anticipating and creating a plan for dealing with a difficult situation, not simply impulsively responding to that situation when it occurs,
• The creation of a plan provides the opportunity for the child to think about different ways that s/he might respond, creating flexibility of thinking,
• There is the opportunity for the child to examine how the other person might respond to various kinds of behaviors that s/he offers,
• The child experiences the feelings of successful outcome, and
• The child is rehearsing a new repertoire of behaviors.
The important thing is to actually take the child through the experience in his/her imagination using all of the metaperceptions. What usually doesn’t work is simply giving the child instructions on what to do in the future. Counseling is often telling people what to do, while changework is teaching them to actually do it without even having to think about it.
Identifying the resource someone needs in a particular context, finding out where that person already had that resource in their life, and then moving the resource into the problem area – is a process of self-help. At one time or another in his/her life, the child has probably experienced all the emotional states that exist. S/he knows what they are like, s/he can remember what it was like to be in that state, and s/he can put him/herself in that state simply by remembering the time when s/he had that emotion and by “moving back into” that emotion. S/he can, at least sometimes, choose an emotional state instead of accepting that the world causes his/her emotions.
If we add to that a positive internal attribution for success as a self instruction mantra, the child is reinforcing that s/he has some control over such situations. After experiencing such feelings if the child decides that s/he likes this new person and that s/he can still be him/herself even though s/he re-forms his/her attitudes around this new experience, that’s when change occurs.
ELICITING
Eliciting is the process of asking a person questions in order to understand their mental processes. There are two rules: go very, very slowly; and know the right things to look for.
Going very, very slowly is quite difficult to learn. Part of the art of eliciting is being alert to those moments where the subject says “That’s no problem” or “I just know” or “I just do it”. The key to good eliciting is being able to get information about precisely those things that the subject does so well that s/he doesn’t even think about them and doesn’t know how to explain them.
Another key point in eliciting is that you can’t learn much by listening to a subject talk about what s/he does in the abstract. You need to watch the subject actually do it – or at least pretend to do it. Have the child pick up the phone to deal with a call. (“Don’t assume the caller is already on the line. Start when the phone rings.”) And the child has to be willing to put up with the fact that you are going to constantly interrupt with questions.
In many cases, eye-accessing cues are very helpful. It’s not so much a matter of putting an interpretation on the eye movements (“Up and to the subject’s right means he’s constructing an image, up and to the left means he’s recalling a stored image”). It’s that the moment the eyes move lets you know that it’s time to interrupt with a question. (“What happened just now? What did you just do? Are you seeing a picture of something?”)
Other non-verbal cues can also be important. (“What does that mean – that gesture you just made? What was going on in your mind when you made that gesture?”) (“I noticed that when you first started, your leg kept jerking up and down fairly rapidly. And then at a certain point the leg stopped moving. Go back to the point when the leg stopped moving and tell me what was going on in your mind.”)
A lot of the most important stuff is below the threshold of consciousness, so you really have to slow the subject down so s/he can become aware of what s/he’s doing. It is this art of asking a person questions about their subjective experience that is the most difficult of all aspects to learn. The average person has no competence at all in eliciting. But for the person who wants to scientifically study the structure of subjective experience, eliciting is where the real information is.
We use the term eliciting in two distinctly different forms in this paper. The first form is eliciting information as part of the process of determining the subject’s desires and intentions. This is a very important usage. The other form is that of eliciting the actual mental state through metaperception. This form of eliciting is more oriented to the actual change process than merely the gathering of information necessary to design the change process. However, both of these forms of eliciting are important to the staff, since the first is required in order to place the services and supports in the proper power arrangement – it is the client who is the agent of change and who decides what quality is; and the second, may be a process of determining which metaperceptions are the most fluid and useful for enhancing change.
There seems to be no need for balancing the process. If the assessment process happens to be helpful in creating opportunities for change, so what? Present method also create this potential with the memes that are conveyed through expert language. However, professional people traditionally take no responsibility for this impact. It is most important that there is development of a process that will make assessors aware of this linguistic impact of their involvement and to use this impact effectively. As we change our language, we change the relationship. We want to enlarge the explanation level of the individual child/family so that whey can see themselves as having problems in living that are within their own capacity to address with our help. We want to choose the ‘reality’ that we depict with our language. We wish to position ourselves in such a manner that we are helping the child/family achieve their own goals. This cannot happen if we continue to operate in traditional modes.
EVALUATION & REVISION
Since the use of a cognitive behavior plan requires that the child make a clear choice about which thoughts s/he will continue to use to seek goal achievement, the evaluation is entirely based upon seeking variable techniques that provide the child with the opportunity to experience and understand the world differently. While there are many techniques available, some of which are oriented towards specific characteristics, a trained practitioner will be able to ‘invent’ techniques that are suitable to the individual child. Keeping a log, for example, requires that the child be able to write. Substitution of a tape recorder may alter the technique sufficiently to make it usable for the child, while maintaining the purpose of the log. In the final analysis, however, the child will choose or not choose to think differently. There is no coercive capacity in the intervention process. If the child continues to think in ways that cause him/her to act in a manner that is intrusive or destructive, the consequences are available in society. We may not like this fact, but this is reality, not a mental context.
EXCHANGE RELATIONSHIPS
A final comment needs to be made about the plan of change. It must be noted here that not all children who are capable of processing information effectively develop distorted thinking. Thinking distortions occur with the exchange of information [the difference that makes a difference (Bateson)], and such an exchange requires a relationship between two people at minimum. Because the exchange of information requires a sender and a receiver, and because each conveys only his/her mental representation of reality, and because language is so ambiguous and affect is so contagious, the distortions of thinking are a product of relationships, not individual pathologies.
Thus thought distortions occur when an interpretation of the world is made that is not utile [brings more pain than pleasure]. Since these thoughts are generally habituated, they are not conscious and therefore are, in that state, uncorrectable. There is reason to believe that ‘debugging’ of the system can happen only in the conscious realm, and thus it is important that the players become aware of these thoughts and attend to them. Note that it is not just the child who must be aware of his/her distorted thoughts, but the significant child managers as well. Since they a) miscommunicated the exchange of information, b) communicated distorted information, and/or c) responded poorly to the response – these significant adults either helped create and/or maintain the distorted thoughts.
Since every individual behaves in ways that thy believe are in their own best interest, it is important that both the individual child and the significant supervisors understand [become conscious of] their thinking patterns so that they can examine its usefulness in light of their goals and change the information exchange in ways that support the changes desired by the child.
References
Baar, B.J., A Cognitive Theory of Consciousness, 1988.
Klinger, 1971 as reported in Baar, A Cognitive Theory of Consciousness, 1988
La Berge, 1980, 1981; Posner & Snyder, 1975; Shiffrin & Schneider, 1977 as reported in Baar, A Cognitive Theory of Consciousness, 1988
Lady, Lee, <CG0DF8.654@news.Hawaii.Edu> lady@Hawaii.Edu This site has provided much of the material and language for eliciting and changework.
Lock, A., Against Cognitivism: the discursive construction of cognitive mechanism, 2000
McKay, M., Davis, M., & Fanning, P., Thoughts & Feelings: Taking Control of Your Moods and Your Life, New Harbinger Publication, Inc., 1997
Russell, P., Foundations Of Consciousness: How Ideas Bend the World into Shape, 1997
Shure, M., Social Competence as a Problem Solving Skill, Chapter 6 in Social Competence, Wine & Smye [Eds], The Guilford Press, 1981.
Tooby, J. & Cosmides, L. In a Letter to the Editor of The New York Review of Books on Stephen Jay Gould’s “Darwinian Fundamentalism”, (June 12, 1997) and “Evolution: The Pleasures of Pluralism” (June 26, 1997)
Turnbull III, Wilcox, Stowe, Raper & Hedges, Public Policy Foundations for Positive Behavior Interventions, Strategies, and Supports, Journal of Positive Behavior Interventions, Volume 2, No. 4. Fall 2000