The functional assessment requirements of the Individuals with Disabilities Education Act [IDEA ‘97] has provided an impetus for the consistent implementation and interpretation of the functional behavioral assessment or FBA. Unfortunately, it also ignored the history of children with emotional and behavioral problems who create the most difficult issues for education and clinical services. This omission occurs because of the unwillingness or inability of practitioners to identify the differences between children whose behaviors are predominantly the result of deficits and those whose difficulties are primarily the result of distortion. The failure to make these precise separations is manifest in the pseudoscience of the traditional system that insists that such behaviors are manifestations of a pathology over which the individual has no control. If this pathology theory were true, these individuals would naturally need to be controlled by rather expensive pharmaceuticals. The continued perseveration on this theme continues despite the fact that no scientific evidence exists which demonstrates the chemical imbalance or genetic source, nor the effectiveness of the medical responses. The whole facade would collapse leaving psychiatrists out of work and pharmaceutical companies with lost revenue, if this were to be discovered by the general public.
Mundus vult decipi: the world wants to be deceived. The truth is too complex and frightening; the taste for the truth is an acquired taste that few people acquire.
Not all deceptions are palatable. Untruths are too easy to come by, too quickly exploded, too cheap and ephemeral to give lasting comfort. Mundus vult decipi; but there is a hierarchy of deceptions.
On a higher level we find fictions that men eagerly believe, regardless of the evidence, because they gratify some wish.
Near the top of the ladder we encounter curious mixtures of untruth and truth that exert a lasting fascination on the intellectual community.
What cannot, on the face of it, be wholly true, although it is plain that there is some truth in it, evokes more discussion and dispute, divergent exegesis and attempts at emendations than what has been stated very carefully, without exaggeration or onesidedness.
Mundus vult decipi: The world winks at dishonesty. The world does not call it dishonesty.
Once a few respected men have fortified a brazen claim with their prestige, it becomes a cliché that gets repeated endlessly as if it were self-evident. Any protest is regarded as a heresy that shows how those who utter it do not belong: arguments are not met on their merits; instead one rehearses a few illustrious names and possible deigns to contrast them with some horrible examples.
I And You: A Prologue
Walter Kaufman
The functional difference between the deficit and distortion groups is most easily described through a contrast of a child who is autistic, retarded or neurologically impaired and one who is typical in every way except behavior. The former display certain difficulties caused by their disability which lead them to slower development of thinking, communicating or social (interpersonal) skills. Generally, the helping approach to such deficits is to ameliorate the failure of the individual to perform by diminishing the demands of the environment, while at the same time attempting to increase the skill through direct teaching.
Done properly, these positive behavioral approaches have demonstrated reasonable effectiveness with this population of children. However, the approaches have failed to impact in any significant way on those children who do not have such deficits, but display major distortions in the covert beliefs, attitudes and thoughts that mediate overt behaviors. This is a difference of order, not just of type. Yet despite this difference in order, educators continue their positive behavioral approaches, clinicians resort to chemical restraints and corrections officers add to this chaos with physical restraints (bars) when necessary,
The overriding reason for failure of all systems in serving the distortion group of children, usually labeled in schools as Severely Emotionally Disturbed [SED] and needing emotional support, in clinical services with diagnosis from the current Diagnostic and Statistical Manual, and in the community as juvenile delinquents, is partially the failure to recognize the differences between them and the first group, and partially a failure to address the actual issues involved. The fundamental issue that needs to be addressed is the distortion of reality created by the thoughts, beliefs and attitudes about self and others.
The positive behavioral approaches used with the developmentally delayed and disabled are woefully inadequate to the point of becoming destructive when applied to the group with distorted thinking. They are quickly identified by the second group as manipulative exercises and these thoughts are then used to justify the distortions already existent. When followed by chemical and/or physical restraints, the child’s theory of meaning or ‘inner logic’, which influences his/her anxiety, depression, anger or fear is solidified, rather than ameliorated. While restraints or the threat of restraints may diminish overt behavior they may make it more covert. In the mean time, these children are being taught lessons which will make their lives increasingly difficult. While each child appraises each experience uniquely, it is not hard to imaging the following scenarios.
- I am not in control of my own behavior. Therefore I am not responsible for my own behavior. Therefore, I have achieved a type of ‘diplomatic immunity’ for my misbehavior must be pardoned, as the behavior is not my fault. Furthermore, effort on my own behalf is useless.
- Problems in living are best solved by drugs. If this drug does not work, I will use another one. If new problems arise, these problems will need new drugs. The best advertising is by word of mouth; what drugs are most useful in the street? Perhaps we can trade drugs .
It is important to note that children with developmental delays or neurological impairments may also be prone to distorted thinking patterns. This is particularly true for those who are most capable of identifying the ‘difference that makes a difference’; the fact that they are not capable of achieving what they can conceive. Any cursory examination of the people with mental retardation who are involved with the ‘mental health’ system, for example, will show that it is those with the most capacity for identifying the difference that makes a difference, who are most likely to develop thought distortions and end up in the ‘mental health’ system.
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 [although an intervening medium such as print may be used]. 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. A parent does not encourage a child to think maladaptive thoughts; s/he conveys what s/he believes. If the parent’s thoughts are maladaptive, this is what is conveyed. S/he does not need to have maladaptive thoughts, however, to convey misinformation.
The NeuroLinguistic Program people have some interesting presuppositions that may be appropriate to consider.
The Meaning of Your Communication is the Response it Elicits.
If you compliment someone and they slap you, it is more intelligent to remember that’s the way to insult them, and try something else if you want to make them feel good. What this means of course, is that what you intend to say is not always what is received. Something gets lost in the translation. Parents and other child managers usually don’t intend to offend the sensibilities of children, but they often do. A second presupposition is that:
Resistance is a Comment about the Communicator
It’s up to the communicator to be flexible enough to get across the message that they want to send, and be sensitive enough in their observation to notice if their communication is having the desired response. Otherwise the child may begin to build a theory of meaning about self and others that is maladaptive. A child manager may want to urge a child to use his/her considerable potential to learn, but may convey a message that the child is a failure. As the child compares his/her own experiences [constant criticism] to the experience of others [praise for lesser work when the expectations are quite low], s/he may begin to believe that s/he is inadequate and that the child manager and others don’t like or appreciate him/her. This leads to disordered thought and cognitive errors.
Thus thought distortions occur when an interpretation of the world is made that is not utile [brings more pain than pleasure] or fit. Since these thoughts are generally habituated, they are not conscious and therefore are, in that nonconscious 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. Because 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. This is not blame, it is a fact; and a fact that can be remedied.
Distortion Paradigm Deficit Paradigm
Maladaptive beliefs, attitudes and Limitations in information
thoughts about self and others processing and reciprocal
leads to poor selections regarding communication skills lead to
interpersonal relations which poor social performance which
produce equally poor social reduces quality of life.
responses, causing reinforcement
of maladaptive thoughts and
deterioration in quality of life.
If the poor social responses can be changed to balanced and rational social responses, this can cause erosion of the maladaptive belief system and through the skills of cognitive process correction or cognitive restructuring, which are the same type of intervention with different degrees of intensity, the child can begin to relearn information about self and others which is more coherent to the reality of the world around them. In this manner they stop being an object of medication, scorn or bullying and become the subject of change and in control of setting new directions.
Since every individual behaves in ways that they believe are in their own best interest, it is important that both the individual child and the significant supervisors understand [become conscious of] their own thinking patterns so that they can examine its usefulness in light of their goals.
We believe that the traditional Functional Behavior Assessment [FBA] provides an important basic structure to address these issues. The FBA has several specific components, which lend themselves to developing plans to help the child/managers to correct the deficits, and/or distortions that are at the root of nonutile behavior:
- the collection of broad and specific information from key informants including the child and significant child managers provides us with clues to determine : 1) why the child engages in the impeding behavior, 2) when the child is most likely to engage in the behavior, and 3) under what conditions the child is less likely to engage in the behavior.
- the analysis of this information about the external context [what physical and verbal communication is occurring] and the internal context [what the child managers believe and what the child believes are occurring] allows for the creation of an hypothesis statement which can 1) summarize assessment results, 2) offer explanations for the child’s behavior, and 3) to guide the development of a plan of change,
- the testing of the hypothesis and through feedback, the revision of the hypothesis as necessary.
A variety of service providers may be familiar with functional behavior assessments and may, in fact, have conducted such assessments. Such assessments have, in the past, been designed to assess the behaviors of children with disabilities that cause deficits in the behavior repertoire, rather then to identify distortions that cause behavior decisions that ultimately prove detrimental.
This presentation attempts to combine what is known about thought and behavior, with the highly effective process of functional assessments. It does not change the process and/or the components of the traditional functional assessment, but adds a mental or internal component to the environmental and external exploration. The one additional factor is that it will emphasize using the opportunity to assess the mental context, not only of the child, but of the child managers as well. It is a major tenet of this discussion that it is the relationship between the child and those around him/her that is not working. Teaching a child to adapt to a maladaptive ecosystem is hardly an appropriate goal.
A second focus of the presentation is to provide a consistent pattern for the interpretation and implementation of the Functional Cognitive Behavior Assessment [FCBA].
Since the process of the FBA are reasonably well known or can be attained with reasonable rigor through a search of the literature, this presentation will focus on the additional responsibilities of the assessment process added by the cognitive factors. First, is to identify the areas of cognitive errors that are of major concern. These would include the major schema concerning self, others and future prospects as well as the attributions of success and failure. This set of beliefs, attitudes and thoughts provide a significant backdrop for overall performance.
We must search the cognitive domain for evidence of explanatory constructs in much the same way that we describe sequences of overt behaviors, look for evidence of fixed-action patterns, releasing stimuli and so forth. Such tasks require the development of techniques [interviews, questionnaires, think-aloud protocols, videotape reconstruction, thought sampling, etc.] to assess more adequately the individual’s cognitive processes. Social competence must be broadened to consider the important impact of the individual’s internal dialogue on his/her social behavior.
THE FACILITATOR
A FCBA is a vital part of any educational or clinical evaluation. The process not only provides the clinical team with considerable information about the nature of the child’s interactions with peers and child managers, but it begins to develop insight into the ‘inner logic’ of the child and the people in the child’s ecosystem.
The facilitator of this process should have some basic skills and knowledge, which include, but are not limited to:
- Group facilitation skills
- Basic understanding of the Antecedent-Behavior-Consequence [ABC] structure
- Basic understanding of the Thinking-Feeling-Acting structure
- Additional interest and concern with attribution and expectancy theory with special focus on expectancies and appraisals
- Ability to use Creative Thinking skills to reframe perspectives
- Understanding of sociometry
- Awareness of the types of cognitive errors that usually occur.
THE PROCESS
The process of FCBA includes essentially five [5] steps, which include:
1. Data Collection
• Initial Line of Inquiry
• Observation of the child
• Observation of the Child Managers
• Sociometric measurements
• Individual Surveys [Core Beliefs Inventory, Perceptions, Locus of Control, etc. (See Attached)]
2. Reformulation of hypotheses about the child’s ‘inner logic’ or cognitive thought processes which includes cognitive errors and core beliefs about self, others and future prospects [including attributions of success/failure].
3. Design of intervention protocols
4. Implementation of intervention protocols
5. Evaluation of impact of intervention
We will concentrate on data collection. As preparation for that exploration, we will first identify a list of cognitive errors and their definitions. Such lists vary in detail, but generally contain the same types of information.
- Filtering: The person 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 person has to be perfect or s/he’s a failure. There’s no middle ground, no room for mistakes.
- Overgeneralization: The person reaches a general conclusion based on a single incident or piece of evidence. S/he exaggerates the frequency of problems and uses negative global labels.
- Mind Reading: Without them saying, the person knows 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 him/her.
- Catastrophizing: The person expects, even visualizes disaster. S/he notices or hears about a problem and start asking, “What if?” What if tragedy strikes? What if it happens to me?
- Magnifying: The person 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 person assumes that everything people do or say is some kind of reaction to them. S/he also compares him/herself to others, trying to determine who is smarter, more competent, better looking, and so on.
- Shoulds: The person 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.
- Externalizing: The person explains the cause of success and/or failure as external forces such as task difficulty or luck over which s/he has no control, instead of to his/her own effort. “It’s his fault! She doesn’t like me!”
- Prophesizing: The person has negative and relatively stable expectatancy or generalized beliefs about a lack of self competence in achievement situations. “I’m going to fail this test. Nobody is going to talk to me.” Prophesizes negative outcomes.
One other error is sometimes included and that is canceling the positive. Canceling the positive usually occurs when someone gives a compliment: e.g., “I should have done better. This wasn’t my best work.”
Data Collection
Initial Line of Inquiry
This is the fundamental data collection process and should be done with a group of people who are invested in and charged with managing the child – referred to as the child’s ‘community of interest’. This would include, of course, educators and parents, but also should include the child, perhaps some peers, siblings, favorite uncles and anyone else who knows the child well and has some influence with the child.
It should be acknowledged to all concerned at the beginning that the assessment is of the total community, not just of the child. The facilitator would do well to help the group understand the nature of the thought – feeling – behavior sequence and discuss how both deliberate and inadvertent commentary can cause the child to be assured that his/her maladaptive thoughts are adaptive and that continued behavior is necessary for self protection.
What is being sought through this Inquiry is ‘leakage’ of the core beliefs of the child and child managers. Such leakage occurs in self-talk. Self-talk is the constant inner dialogue that occurs about each event and experience we have. We see someone fall and we comment ‘Oh, isn’t that a shame’; ‘Look at that idiot!’ or in some other manner indicate the way we appraise or judge the situation. Such appraisals and judgements occur all the time though we rarely ever stop to think about them. They are called automatic or reflex thoughts and occur like other reflex behaviors such a blinking or breathing. We rarely notice them. Once we do notice them, however, we have some ability to control them. We can choose not to blink for a period of time or blink rapidly in a deliberate fashion.
Both the child and the child managers may be surprised at what they are thinking when the crisis of behavior occurs. This is not, however, the time to explore these thoughts, the facilitator will merely want to collect them as they are volunteered [I was thinking about how …] or as they came out in self talk [He said, “You don’t ever listen to me”.]. As these ‘memes’ [rhymes with genes and is a phrase or fragment of wording which carries an idea] are gathered, we will begin to look for patterns of thought which fit the categories of cognitive errors. We can generally expect that one or two of these errors will occur regularly within an individual. They may also suggest something about the core beliefs [self, others & future prospects] of the individual, but they do not need to at this point. If we can identify these errors, they can be addressed directly or they can be used by the clinician to delve further into the core beliefs.
The following are some of the kinds of questions that may be asked:
COGNITIVE ERROR CHECKLIST GUIDING THOUGHTS
Ask: what of the following characterize the adolescent’s thinking traits: Remember that all of us will have occasion to make these errors. What we are looking for is habitual patterns.
- Filtering: Does [name] tend to focus on the negative details while ignoring positive aspects of a situation? When [name] takes this negative position, what does s/he say if you recall a positive experience? Note whether the response to a positive is accepted even grudgingly, or whether it is attributed to circumstances or luck.
- Polar Thinking: Does [name] tend to see things as black or white, good or bad with no middle ground. All or nothing thinking refers to the tendency to evaluate personal qualities in extreme categories. Such things as “now that I failed that test, I will never pass” is an example.
- Overgeneralization: Does [name] reach conclusions on a single incident or piece of evidence. This is usually expressed as this always [or conversely never] happens to me.
- Mind Reading: Does [name] tend to state that s/he knows what people are feeling or thinking and why they act the way they do. In particular about how people think and feel about you. Prediction, as a fact, that something bad is going to happen – a self-fulfilling prophecy perhaps? Ask the adolescent why s/he thinks the adult did what s/he did, and the client demonstrates complete understanding of the other person’s inner thoughts – s/he doesn’t like me; s/he thinks all adolescent’s are bad, etc. Did the client ever ask the adult?
- Catastrophizing: Does [name] always seem to expect disaster The prediction of disaster as a regular part of viewing the future.
- Magnifying &/or Minimizing: Does [name] often exaggerate or underestimate the degree or intensity of a problem. “So what” statements are almost as important as “end of the world” interpretations.
- Personalization: Does [name] assume that everything people do or say is a reaction to him/her. The mother of guilt, this distortion assumes personal responsibility for negative events when there is no basis for doing so.
- Shoulds: Does [name] have a list of ironclad rules about how s/he and other people ‘should’, ‘must’, ‘ought to’ or ‘have to’ act. Along with musts and oughts, such statements cause emotional consequence of guilt, when you cannot live up to expectations; and anger, frustration and resentment when others don’t.
Ask the group to make a statement of the child/adolescent’s usual cognitive errors. Always check validity with the child/adolescent.
Restate The cognitive error list at the end.
Identifying the types of cognitive errors made by individual children/adolescents can help to identify areas for addressing cognitive issues. Of particular interests, although not directly asked in the interview process is to identify automatic thoughts, or those thoughts that the child/adolescent says to him/herself as they go through experiencing the day. By identifying the usual cognitive errors, we can usually define the kind of inner dialogue that occurs when something goes wrong. Automatic thoughts needn’t be expressed in words at all, but can be a brief visual image or any physical sensation. However, such thoughts are almost always believed no matter how illogical they may appear upon analysis. Automatic thoughts are reflexive and experienced as spontaneous, persistent and self-perpetuating. They are hard to turn off or change because they are unattended and plausible. Automatic thoughts often differ from public statements, since most people talk very differently to others than they do to themselves. But since automatic thoughts repeat habitual themes such as chronic anger, anxiety or depression to the exclusion of all contrary thoughts, these themes will often appear in other areas. Preoccupation with habitual themes creates a kind of tunnel vision in which the person thinks only one kind of thought and notices only one aspect of the environment. Aaron Beck uses the term selective abstraction.
Since automatic thoughts are learned and have become habitual. The process of identifying how a person thinks and how the salient people in the environment respond to that thinking are important points in considering how to address the distortions. The decision ranges from addressing the issues professionally in formal settings or in situ, or to simply seed the culture with new responses.
Whatever the choice, the child/adolescent will need to follow a process of becoming aware of his/her internal dialogue, attending to it [often through recorded documentation], analyzing it, and ultimately learning when and how to dispute the automatic thought as a means of changing perspective, emotions and ultimately behavior.
EXPECTATION INQUIRY GUIDING THOUGHTS
Ask: under what conditions would (child’s name) be expected to approximate expected motivational behavior? Individuals are most attentive to behavior-outcome contingencies in learning new tasks. Otherwise, they may model the behavior of salient others or operate out of habit.
• When faced by a new task, is the child usually motivated to try her best?
• If not, are there new tasks that s/he is more likely to try hard on than others? When other salient peers try hard? When the rewards are increased in quantity or quality? When the odds of success are in their favor?
• If so, are these differences likely to be attributable to the type of task or the type of reward. While individuals may be extensively shaped by the reward/punishment contingencies around him, s/he also is more likely to analyze her behavior in rationalistic terms only when facing important decisions.
• Does s/he strive to increase the probability of receiving positive outcomes and reducing negative outcomes? For example: does s/he attempt to negotiate scoring on a curve for an unannounced test?
• Does s/he attempt to control the reinforcement contingencies leading to both desirable and undesirable outcomes? For example: does s/he try to create a negotiated role with the teacher or parent about the limitation or maximization of consequences? E.g., “I will do this if you will….”
• If direct control of the reinforcement contingencies is impossible; does s/he attempt to personally influence the allocater of resources so as to improve personal outcomes? For example: does s/he attempt to develop a personal role with teacher, which will allow for “special” treatment?
• If both direct and indirect control of the reinforcement contingencies through personal influence is impossible; does s/he attempt to make the contingencies more predictable? For example: does s/he attempt to get a clarification of what will happen if?
• Does s/he strive to reduce the possibility of negative outcomes before attempting to control or make predictable positive outcomes? For example: instead of I will do this if you will – is there an attempt to negotiate the maximum negative consequences?
Restate the child’s model of expectation motivation: for example: s/he tends to try to control the outcomes of attempting new tasks by a) trying very hard; b) controlling contingencies; c) negotiating a special role; or d) simply not doing anything. Individuals may tend to strive to reduce sources of uncertainty, but they do not strive for high probabilities of receiving low reward. Therefore, we would expect that the child will do everything short of accepting negative consequences automatically.
• ASK: is this a child with high or low skill?
Role conflict [conflicting information] and ambiguity [absence of information] reduce the ability to predict behavior outcome contingencies.
ATTRIBUTIONS GUIDING THOUGHTS
ASK: People ‘make sense’ of events by setting them in a causal framework. They may attribute outcomes of their activities to one of two tendencies: personal forces [ability and effort] or to impersonal forces over which they have little control [situation and bad luck].
• When successful in an activity; how does s/he usually attribute this success? Attribution of success to self and their own skill and effort, even if this is not totally true, is likely to be a sign of reasonably good self appraisal.
• If success is generally attributed to self, is this realistic? Even though such behavior is generally positive, overdoing it may indicate a fragile personality.
• When unsuccessful in an activity; how does s/he usually attribute this failure? Attributions of failure to other circumstances, even if not totally true, is likely to be a good strategy to protect self appraisal.
• If failure attributed to self; is this realistic? While some failure attribution to self is reasonable, frequent or continuous attribution is probably not.
• If such failure attribution to self is realistic; what attitude prevails? Is the child seeing this as a temporary setback which can be overcome with hard work or is s/he seeing it as a stable consistent failure for which nothing can be done since it is uncontrollable?
• If such failure attribution to self is not realistic, is it disputed, by adults? If so, what is the child’s response? We are looking for admission that such attributions might be unstable and controllable through increased skill or effort. If s/he has succeeded before and believes s/he can succeed again by trying harder or improving skills, a failure attribution can be a positive motivation for improvement.
• If the child consistently attributes both success and failure outcome through realistic rationales, is s/he also able to recognize failure as non-catastrophic? Usually this will be the case if s/he sees the failures as being unstable and controllable through increased skill and effort. On the other hand, if s/he sees the attributions of failure as stable and uncontrollable, this may lead to anxiety and panic.
• If the child consistently attributes both success and failure outcome to external causes – is it realistic or not? If it is realistic the child needs to learn skills.
• If the child consistently attributes failure to external forces, but success to self – is this realistic? If not, the child may be using an external orientation as a defensive function to preserve self-esteem. Ask if this seems to fit?
Restate the child’s attribution style.
• Is this statement accurate? Across all domains? Retool the statement until you get consensus.
All of us need a way to understand and explain our experiences. Such explanations normally vary widely based on the uniqueness of the experiences we have and the way each of us chooses to interpret them. However, human beings tend towards habitual thinking. Therefore, as we experience apparently congruent events over time, we may develop an explanatory style that becomes almost a reflexive thought:
Some explanatory styles are so salient they define the person’s maladjustment: depression, anger, paranoia, etc. The purpose of the inquiry is to help the team understand the traits within the explanatory style of the child/adolescent, and in the process to also gather some sense of how adults in his/her environment respond. There are three dimensions to the attributional problem:
locus: The attribution for success/failure outcome is usually seen as internal or external. Personal forces such as ability and effort or impersonal forces such as circumstances and bad luck are the likely categories.
stability: The attribution may be seen as stable or unchangeable such as the degree of difficulty or as unstable such as the degree of effort. While some people see the four characteristics differently [e.g., some see bad luck as changeable] there is some consistency in seeing ability and effort as changeable and circumstance and bad luck as unchangeable.
controllability: If something is changeable, it is potentially controllable.
However, things like luck change, but are not controllable
It is quickly apparent that the most optimistic attributions are those that can be controlled and changed. The most significant of the four categories is effort. If the child is willing to make a commitment to try harder, this is the most significant variable in changing outcomes and ultimately the explanatory style. Often, however, salient adults suggest through their own belief, or the language they use, that there is no validity in the child trying harder, because the child is not capable of improvement. The effort in the inquiry, therefore, is two sided: 1) how does the child/adolescent attribute causality; and 2) how do the salient adults respond to such explanations?
Habitual thoughts become reflexive behaviors, like breathing or blinking. The first step in changing reflexive behaviors is awareness, followed by appraisal. When adults challenge or dispute such reflexive thoughts the process causes the individual to stop and think; just as saying to a child “don’t blink your eyes” is likely to bring an awareness and control of blinking at least for a short period of time.
Thus, from the collection of such data from the child him/herself and from people who know the child/adolescent best, we can develop an assessment based plan of intervention which might include both a direct professional intervention &/or an indirect secondary intervention from natural supports.
Once this information is collected, along with the behavioral information about external contexts, you are able to begin the process of developing a hypothesis about why the child behaves the way s/he does. We will leave the rest of the process and seek other areas of data collection.
Observation of the Child
The child should be observed in various life domains with a focus not only on a counting of specific behaviors and the external context of the behavior, but on what is said, both by the child and the people in his/her ecosystem. We must search the cognitive domain for evidence of explanatory constructs as the outcome of the observation is to identify what antecedent stimuli [mental and environmental] precede the target behaviors; what mental interpretations [child and ecosystem] accompany the target behaviors; and finally, what series of consequences [mental and external] follow. One should remember that in the mental context an appraisal thought could become cause [event] that triggers another thought.
In much the same way that we describe sequences of over behaviors, look for evidence of patterns of thought – feelings – behavior that are fixed and recurrent. Another NLP presuppositions of considerable merit is that Every Behavior has a Positive Intent. No matter how seemingly odd, or mean, or outright wrong, to the person engaging in that behavior, it makes sense, and they perceive it as a way of getting some outcome they want. People make the best choices they can with the information they have in consciousness. People would obviously not choose to do something self-defeating or foolish if they knew the consequences in advance, or had a better choice.
Based on this assumption and the explanatory context of the self-talk ‘leakage’, we can begin to understand the ‘inner logic’ that is being used to select behavioral responses. This sense of ‘inner logic; includes psychotic states as well. Denial that voices exist is simply to debate between a rational and an irrational person; and in such debates the irrational person always wins. To accept that the voices exist provides an opportunity for the clinician to enter into the ‘inner logic’ and debate from the same basis. The behavior has a positive intent – but based on what context? Tell me about the voices. What do they say? Who are they? Are you sure? How can you be sure?
Observation of the Child Managers
The observation of the child manager could be done in exactly the same manner as that of the child. However, that would be to lose focus. The child manager may be instigating and/or maintaining the distorted thinking of the child, but unless or until a decision is made that the child manager is the prime client; the focus in on the points of contact, not on his/her maladaptations. It is sometimes necessary to directly serve a child manager to address his/her personal problems in order to change the relationship to the child. Depressed mothers and alcoholic fathers present a distinct challenge to their children. But that decision is outside the realm of this paper.