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CLINICAL PROMPT – To be used AFTER the protocol is understood.

School-wide effective behavioral supports may require a restructuring of the beliefs to implement a process of changing messages in the culture.

  1. There must be psychoeducation, e.g., an explanation of the concepts required to make the change.
  2. There must be a growing awareness of what they now think.
  3. There must be an attendance to those thoughts.
  4. There must be an analysis that is formal and public.
  5. There must be an alternative meaning that is identified and promoted.
  6. There must be a process of adaptation and habituation.


This is a school-wide prevention protocol. It is designed to help schools provide consistent positive, balanced and rational messages to the children they serve. The cognitive aspect of behaviorism has its origins in the discipline of psychology, with its early foundation being laid by behavioral and social psychologists. The theory evolved under the umbrella of behaviorism, which is a cluster of psychological theories intended to explain why people and animals behave the way that they do. Behaviorism, introduced by John Watson in 1913, took an extremely pragmatic approach to understanding human behavior. According to Watson, behavior could be explained in terms of observable acts that could be described by stimulus-response sequences. Also central to behaviorist study was the notion that contiguity between stimulus and response determined the likelihood that learning would occur.

Since this time, the stimulus-response pathway has been a point of debate among behaviorists. This debate stems over whether there exists some mediating factor between stimulus and response that regulates behavior. Opinions on this have been divided over whether behavior is primarily governed consequently – by rewards or punishments, or antecedently – through feedback. Various mediating variables have been proposed leading to the present stimulus [thought:emotion] response perspective. This perspective, generically called Cognitive Behavior Management, suggests that while the behavioral aspects of reinforcement still exist, a major issue in the process of learning is the ‘inner logic’ or mental structure and processes of thought and emotion.

Continued research has indicated that the skills, protocols, techniques and procedures that are used in Cognitive Behavior Management can be used proactively to promote balanced and rational thinking in children and that a change in thinking will result in the prevention of problems in living. Greenberg, et al. have provided a report that identifies critical issues and themes in prevention research with school-age children and families through review and summary of the current state of knowledge on the effectiveness of preventive interventions intended to reduce the risk or effects of psychological disorders in school-age children. The beginning section of this document is a liberal adaptation of the initial section of that report.


“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].” The studies also cite a lack of coordination across agencies for meeting the needs of these children.

“The Joint Commission on the Mental Health of Children [1969], the President’s Commission on Mental health [1978], the Office of Technology Assessment [1986], the Institute of Medicine [1989] and the House Select Committee on Children, Youth and Families [1990] all concur that there are too few resources and that too many of the services which do exist are uncoordinated, inefficient and ultimately ineffective [italics added].

In 1989, the National Governor’s Association declared that what is needed is a commitment to translate existing knowledge ‘into an effective system to assist these children and their families in a comprehensive manner.”

Finally, the President’s Freedom Commission Report of 2003 has echoed the problems of all prior reports. Optimistically entitled Achieving the Promise: Transforming Mental Health Care in America – it reports:

… For too many Americans with mental illness, the mental health services and supports they need remain fragmented, disconnected and often inadequate, frustrating the opportunity for recovery. Today’s mental health care system is a patchwork relic – the result of disjointed reforms and policies.

And, we might add, the result of failed and destructive technology. In fact, the frequency of lying, cheating, stealing, fire setting, fighting, noncompliance and oppositional behaviors are growing at an exponential rate in our society. Models of such behavior without consequences abound in adult settings ranging from athletics to politics. Each child who reaches adulthood with cognitive processes and rationales that justify such behaviors, in turn models such behavior for their progeny and others. Even the professionals providing remedial services model punitive and coercive means through attempts to gain control. Thus, mental health professionals use coercive methods to gain compliance and schools seek punitive methods to “stay in control”.

Saving our children and our children’s children from such an antisocial culture will require more than a simple response; it will require a revolutionary transformation of the way adults present themselves to children; a systematic method to deal with prevention, development and remedial actions in a manner which alters adult behavior while consciously addressing the needs of the child.



In the last decade prevention has moved into the forefront and become a priority for many federal agencies in terms of policy, practice, and research. This shift began with a report by the National Advisory Mental Health Council (1990) and is reflected in the combined work of the National Institute of Mental Health (NIMH, 1993) and the Institute of Medicine (IOM, 1994). More recently, the National Advisory Mental Health Council Workgroup on Mental Disorders Prevention Research (NIMH, 1998) outlined a number of priorities and recommendations for research initiatives in prevention science.

The Need for a Preventive Focus in Child Psychological Development

Interest in prevention is also reflected in the goals that have been set for the nation’s health. One of the original objectives of Healthy People 2000 was to reduce the prevalence of psychological disorders in children and adolescents to less than 17%, from an estimated 20% among youth younger than 18 in 1992 (DHHS, 1991). As of 1997, the summary list of psychological objectives for Healthy People 2000 included reducing suicides to no more than 8.2 per 100,000 youth (aged 15-19) and reducing the incidence of injurious suicide attempts among adolescents to 1.8% and, more specifically, to 2.0% among female adolescents (DHHS, 1997). A number of other objectives were related to child and adolescent mental health. One of the risk reduction objectives in the Violent and Abusive Behavior category was to reduce the incidence of physical fighting among adolescents aged 14-17 from a baseline of 137 incidents per 100,000 high school students per month to 110 per 100,000 (DHHS, 1997). Two additional objectives in this category were to increase to at least 50% the proportion of elementary and secondary schools that include nonviolent conflict resolution skills and to extend violence prevention programs to at least 80% of local jurisdictions with populations over 100,000 (DHHS, 1997). Greenberg suggested that it was unlikely that these goals would be met by the year 2000. It is also unlikely that these goals have been met today.

There is growing concern in our country as increasing numbers of children and adolescents are having difficulty managing the challenges of development. Between 12% and 22% of America’s youth under age 18 are in need of psychological services (National Advisory Mental Health Council, 1990), and an estimated 7.5 million children and adolescents suffer from one or more mental disorders (OTA, 1986). In addition to the personal suffering experienced by children with emotional or behavioral problems and their families, mental health disorders also have a tremendous cost to society. According to the National Advisory Mental Health Council (1990), in 1990 psychological disorders cost the United States an estimated $74.9 billion.

While a number of reviews provide evidence that childhood disorders are amenable to intervention, the literature must be interpreted cautiously. There is still a great deal to be learned about specific types of interventions, their appropriateness for certain disorders, and the factors that contribute to outcome success and failure. We have not reached the point where we are able to serve all children effectively. As suggested by the Institute of Medicine in their report to Congress on the state of prevention research in psychological disorders, it is important not to overlook the significance of prevention even if intervention efforts have been unsuccessful; in fact, prevention may play a particularly important role for these types of disorders (IOM, 1994).

It is clear that to reduce levels of childhood psychological disorders, interventions need to begin earlier, or ideally, preventive interventions need to be provided prior to the development of significant symptomology. In addition, efforts need to be increased to reach the many children that do not have access to services. Many children and adolescents with clinical levels of problems receive inappropriate services. Another problem with service delivery is that some children only become eligible for clinical services after they have entered another system such as special education or juvenile court and this is usually after their problems have begun to escalate. This threshold issue may make sense financially, but does not benefit the successful outcome for the child.

On the other hand, there is clearly a suggestion that it is not only the accessibility of services that is questioned, but also the effectiveness of services that are offered. Some people are concerned that the ‘medical model’ paradigm is one that is destructive rather than helpful. There are many who find correlation between the rise of illicit drug use in this country and the use of drugs to alter the ‘feelings’ of people with severe and persistent psychological problems, particularly when used with children. Others have identified that the very language of the field becomes the method of identification for many people.

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 if one wishes to do the right thing, 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. And, 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. Elsewhere Gergen (1994) has called this a “cycle of progressive infirmity.” [Is Diagnosis a Disaster?: A Constructionist Trialogue Gergen, Hoffman, and Anderson.]

Perhaps a new approach is required. One that has its roots in the cognitive behavioral approaches and one that is related to a natural support for children, the school.

The Role of Developmental Theory in Prevention Research

Prevention science is highlighted by the integration of developmental theory with models from public health, epidemiology, and sociology in conceptualizing, designing, and implementing preventive interventions. As concepts in development have broadened to include ecological analysis and multivariate examination of causation and risk, developmental theory has provided a powerful framework for organizing and building the field.

Given the principle that the developing organism is strongly influenced by context, Bronfenbrenner’s model of the nature and levels of context has catalyzed the field. The ecological model posits four [04] levels for classifying context beginning with those ecologies in which the child directly interacts and proceeding to increasingly distant levels of the social world that affect child development.

  1. The first level, the microsystem, is composed of ecologies with which the child directly interacts such as the family, school, peer group, and neighborhood.
  2. The mesosystem encompasses the relationships between the various microsystems (e.g., the family-school connection or between the parents and the child’s peer group and peers’ families). The absence of mesosystem links may also be an important risk factor in development.

    Interactions within both the microsystem and mesosystem are often affected by circumstances that do not directly involve the child. For example, children and youth may be significantly affected by changes in marital circumstance, parental social support, changes in the legal system (e.g., changing definitions of neglect or abuse; regulation of firearms, tobacco, and illegal drugs), the social welfare system (e.g., welfare reforms, boundary changes for categorical services), the mass media (e.g., controls on children’s exposure to television violence, the widened horizons via the internet), or other social structures that set policies and practices that alter microsystem and mesosystem interactions.

  3. The exosystem is those contexts and actions that indirectly impact the child’s development. Many preventive interventions may be viewed as changes at the exosystem level that alter interactions among lower system levels.
  4. Finally, the macrosystem represents the widest level of systems influence, consisting of the broad ideological and institutional patterns and events that define a culture or subculture.

Developmental-ecological models can be used both to frame basic research attempts to understand layers of influence on behavior, and also to identify potential targets and mediators of intervention. It is important for researchers to specify, for example, whether their interventions focus primarily on: the microsystem – or a particular portion of it; multiple microsystems (e.g., interventions for both the home and school); the mesosystem (e.g., the family-school connection); informal networks that in turn affect the microsystem (e.g., the development of extended family or peer support to parents); or developing new models of service delivery or regulatory reform (e.g., formal services in the exosystem). Further, one might ask if these different levels of intervention emphasize changing the attitudes and behavior of individuals at these levels (i.e., person-centered), or changing the nature of the system’s operation itself (i.e., environment-focused).

The Role of Risk and Protective Factors in Preventive Interventions

Public health models have long based their interventions on reducing the risk factors for disease or disorder as well as promoting processes that buffer or protect against risk. Community-wide programs have focused on reducing both environmental and individual behavioral risks for both heart and lung disease and have demonstrated positive effects on health behaviors as well as reductions in smoking.

Risk factors and their operation

During the past decades, a number of risk factors have been identified that place children at increased risk for psychological disorders. Coie, et al., grouped empirically derived, generic risk factors into the following seven [07] individual and environmental domains:

  1. Constitutional handicaps: perinatal complications, neurochemical imbalance, organic handicaps, and sensory disabilities
  2. Skill development delays: low intelligence, social incompetence, attentional deficits, reading disabilities, and poor work skills and habits
  3. Emotional difficulties: apathy or emotional blunting, emotional immaturity, low self-esteem, and emotional disregulation
  4. Family circumstances: low social class, mental illness in the family, large family size, child abuse, stressful life events, family disorganization, communication deviance, family conflict, and poor bonding to parents
  5. Interpersonal problems: peer rejection, alienation, and isolation
  6. School problems: scholastic demoralization and school failure
  7. Ecological risks: neighborhood disorganization, extreme poverty, racial injustice, and unemployment.

Theory and research support a number of observations about the operation of these risk factors and the development of behavioral maladaptation.

  • First, development is complex and it is unlikely that there is a single cause of, or risk factor for, any disorder. It is doubtful that most childhood social and behavioral disorders can be eliminated by only intervening with causes that are purported to reside in the child alone.
  • Furthermore, there are multiple pathways to most psychological disorders. That is, different combinations of risk factors may lead to the same disorder and no single cause may be sufficient to produce a specific negative outcome.
  • In addition, risk factors occur not only at individual or family levels, but at all levels within the ecological model.

The complexity of developmental pathways is clear from research relating risk factors to disorders. ‘Equifinity’ is a systems concept growing from Chaos Theory that means “that a final state of any living system [psychological disorder] may be reached from different initial conditions. There appears to be a nonlinear relationship between risk factors and outcomes. Although one or two risk factors may show little prediction to poor outcomes, there are rapidly increasing rates of disorders with additional risk factors. However, not all children who experience such contexts develop adjustment problems and no one factor alone accounts for children’s adjustment problems. Just why this is true is not accounted for in the report, but can be found in the pattern formation and decision making of the individual child which is built over time from random data collection [i.e., not all stimuli are received equally by the individual in proximity nor are they necessarily interpreted the same]. Thus, as the child creates a theory of meaning about the world and his/her place in it, the patterns formed and the judgements made about those patterns differ and create either a balanced and rational or a distorted and irrational ‘inner logic’ which determines what the individual will even consider stressful, let alone how they will act in stressful situations.

Given the above findings, it is apparent that many developmental risk factors are not disorder-specific, but may relate instead to a variety of maladaptive thoughts that are supported or disputed by the ecosystem surrounding the child. The notion of generic and interrelated risk factors has led to a strategy of targeting multiple factors simultaneously with the hope that the potential payoff will be greater than a focused attack on controlling a single risk factor. Recent findings in behavioral epidemiology indicate that psychological problems, social problems, and health-risk behaviors often co-occur as an organized pattern of adolescent risk behaviors. Thus, because risk factors may predict multiple outcomes and there is great overlap among problem behaviors, prevention efforts that focus on reduction of interacting risk factors may have direct effects on diverse outcomes.

Protective factors and their operation

Protective factors are variables that reduce the likelihood of maladaptive outcomes under conditions of risk. Although less is known about protective factors and their operation, at least three [03] broad domains of protective factors have been identified.

  • The first domain includes characteristics of the individual such as cognitive skills, social-cognitive skills, temperamental characteristics, and social skills.
  • The second domain is comprised of the quality of the child’s interactions with the environment. These interactions include secure attachments to parents and attachments to peers or other adults who engage in positive health behaviors and have prosocial values.
  • A third protective domain involves aspects of the mesosystem and exosystem, such as school-home relations, quality schools, and regulatory activities. Similar to risk factors, some protective factors may be more malleable and, thus, more effective targets for prevention.

Coie, et al., suggested that protective factors may work in one or more of the following four [04] ways:

  • directly decrease dysfunction
  • interact with risk factors to buffer their effects
  • disrupt the mediational chain by which risk leads to disorder
  • prevent the initial occurrence of risk factors.

By specifying links between protective factors, positive outcomes, and reduced problem behaviors, prevention researchers may more successfully identify relevant targets for intervention. However, the development of rational and balanced thoughts concerning what is happening around you substantially buffers the potential for dysfunction as well as disrupting the mediational chain by which risk leads to disorder. By enhancing the balanced and rational thinking of the child managers, one reduces the negative messages and nonconscious reinforcements that may contribute to the disorder itself.

The specification of intervention goals is an important component of preventive-intervention research and practice. This requires both an understanding of risk and protective factors that contribute to outcomes, and also the identification of competencies that are presumed mediators or goals of the intervention. Although these goals may include the prevention of difficulties (e.g., absence of psychological distortion, abstention from substance use), they also involve the promotion of sound developmental outcomes. Further, the prevention of deleterious outcomes involves the enhancement of competency mediators (e.g., effective social problem-solving as a mediator of reductions in delinquency).

Preventive Intervention: Definition of Levels

The IOM Report (1994) clarified the placement of preventive intervention within the broader intervention framework by differentiating it from direct services (i.e., case identification; standard interventions for known disorders) and maintenance (i.e., acceptance of long-term clinical recommendation to reduce relapse; aftercare, including rehabilitation). Based, in part, on Gordon’s proposal to replace the terms primary, secondary, and tertiary prevention, the IOM Report defined three [03] forms of preventive intervention: universal, selective, and indicated.

  • Universal preventive interventions target the general public or a whole population group that has not been identified on the basis of individual risk. Exemplars include prenatal care, childhood immunization, and school-based competence enhancement programs. Because universal programs are positive, proactive, and provided independent of risk status, their potential for stigmatizing participants is minimized and they may be more readily accepted and adopted.
  • Selective interventions target individuals or subgroups (based on biological or social risk factors) whose risk of developing psychological disorders is significantly higher than average. Examples of selective intervention programs include: home visitation and infant day care for low-birth weight children, preschool programs for all children from poor neighborhoods, and support groups for children who have suffered losses/traumas.
  • Indicated preventive interventions target individuals who are identified as having prodromal signs or symptoms or biological markers related to psychological disorders, but who do not yet meet diagnostic criteria. Providing social skills or parent-child interaction training for children who have early behavioral problems are examples of indicated interventions.

II. Outcome Expectations for Social Competence

The goal of school-wide effective interventions is to help every child achieve social competence. Social competence is based on the following criteria.

Ability to understand and label emotions appropriately

Emotions are cognitions, not somatic reactions. Somatic sensations [messages from the senses] are the biological component that must be interpreted by the individual through a two step process: 1) a recognition thought [i.e., that is a snake], and 2) an emotional label [i.e., I am afraid]. Feelings then are biological, while emotions are biographical. Emotions are learned behaviors and the selection of an emotional label to fit a given stimulus is based on prior experience. If a child is to understand and identify emotions properly, s/he will need an appropriate vocabulary to define a range of emotions and the intensity of these emotions as well as prior experience in identifying emotional occurrences.

Ability to mediate emotions effectively

Mediation of emotions entails two constructs: first, that the child is able to identify the range of emotions and where the intensity of this emotion fits on that range, and second, that the child is able to handle the emotion: to keep their behavior under control, regardless of the emotional intensity. This might be referred to as ‘mental toughness’. A person with mental toughness is one who, although frightened to an extreme intensity, is able to continue to take actions for self preservation without panic.

Ability to express emotions effectively and appropriately

If one is to become ‘mentally tough’ this does not imply that one is not emotionally expressive. A child needs to be able to indicate to others that s/he is angry, anxious, sad or attached in a manner which does not project this emotion onto the other and allows the other to react. A father who is angry with his child, needs to be able to convey that anger without creating fear or anger in the child. Emotions are contagious, and anger is the most contagious emotion. If the child becomes angry and makes every one else angry, s/he reinforces his/her own anger, but does not necessarily resolve the trespass.

Ability to mediate behaviors effectively

Mediation of behaviors is connected to mediation of emotions. If the emotional content can be diminished, it is easier to control the actions the emotion demands. Thus, all three levels come into play: cognitively, the child must learn to recognize the things that ‘trigger’ emotions and determine whether they have a balanced and rational understanding of these triggers or whether they are triggers because of certain ‘cognitive errors’. Emotionally, the child needs to ensure that s/he has identified the proper emotion at the proper intensity for the situation at hand and to balance the emotional impact with the goals s/he hopes to reach. And behaviorally, s/he needs to understand that even legitimate actions may not be appropriate in all situations.

Ability to behave appropriately to expectations

This is the definition of social competence. Expectations vary in different settings and with different people. The child who is able to identify the expectations of the circumstances in which s/he finds him/herself and to adjust his/her behavior accordingly is socially competent.

Ability to understand and accept the emotions & behaviors of others

Epitomizing the ability to understand and accept the emotions of others is the situation where another person is intensely angry and projecting that anger on you – and you, seeing the other person is ‘out of control’ are able to back off and simply accept the fact that they are angry and out of control without making a response in kind. It is allowing another person who has been traumatized to express their horror without judgement. It is to avoid the contagion of the other’s emotions.

Ability to discriminate social cues

This component rests on the belief that behavior is determined not only by characteristics, traits or the personality of the individual, but also by the qualities of the situation or setting in which the behavior occurs. Competency requires not only that one have certain skills and abilities, but that one is able to use these skills and abilities at the appropriate time and place. This ability has a behavioral component [what did the person do?] and a situational component [where, when, and with whom was it done?]. Because both components contribute to success, either can be the cause of failure.

Ability to analyze thoughts & beliefs effectively

Most people have no idea what they believe and what they think in their ongoing thought stream. To be able to effectively identify that you have a thought stream [self talk] that is constantly operating and to know that these thoughts come from a basic belief structure is the first level of ‘mindfulness’ or the ability to observe yourself thinking and behaving. The opposite is ‘mindlessness’ in that you operate automatically without thought except for justification.

Ability to logically evaluate the effectiveness of thoughts & behavior

Once one is aware of his/her own thoughts, our confirmation bias reinforces whatever those thoughts are. In order to logically evaluate the effectiveness of our own thoughts and behaviors, we must find a way to overcome this bias. This can be done through a formal and public analytical process. This will usually require a trusted other who can act as a ‘psychological mirror’ helping us to see the outcomes from a different perspective. Does the child have a trusted other who can challenge his/her perspectives and is s/he able to nonemotionally examine a prior thought:emotion, behavior and outcome in a way that makes it a learning experience?

Ability to solve problems

Solving problems requires, first, understanding one’s own goals and second, understanding what are the barriers to reaching those goals. Solving the problem requires a way to continue to pursue one’s goals without the interference of the barrier. Part of this potential is concerned with what is required to meet the goal: what is a WANT and what is a MUST. One might need to give up some WANTS to achieve the goal, given the barrier. The child attitude of “I want what I want when I want it” does little to solve problems. All problems concerning other people should be approached from a ‘win – win’ perspective.

Ability to develop alternative solutions

Alternative thinking is a creative process requiring flexibility of mind. One must be able to think of the unthinkable in order to expand one’s alternatives. Rigid thinking, particularly as corralled by ‘shoulds’, is unlikely to be creative. Children must be able to provide from five to ten alternatives to every suggested social situation.

Ability to weigh consequences appropriately

This process requires both accuracy in prediction and an ability to accept the prediction. Thus, some children are able to predict that certain actions will get them into trouble and still decide to act in that manner – getting upset then when their prediction comes true. Accurate prediction is the key aspect, since if a child cannot accurately predict what consequences are likely to follow an action, they are unable to act according to sound judgement. However, children who are unwilling to accept their own predictions as sound judgement as to how to act are also in deficit. Both of these factors should be explored.

Ability to make appropriate decisions under stress

Appropriate does not, in this case, mean correct. One may make an error in decision at any time and it may be coincidental that the child makes a decision without positive outcome under stress. What is important is to determine the logic attributed to the decision. If the child’s logic is flawed, the decision, even if reaching good outcome, is flawed. If the child’s logic is sound, the decision, even if reaching the wrong outcome, is a good decision. You cannot assume that the logic of a decision is apparent. We all operate from an ‘inner logic’ which is idiosyncratic based on prior experiences. This inner logic may place the stress in a context that is distorted, thereby distorting the decision. Only by understanding the child’s inner logic in a time of stress can we determine whether the child’s decision was appropriate.

Ability to attribute outcomes to decision making and skills

Only as the child is able to see that his/her decisions and skills impact on the outcome, can s/he learn how to avoid future problems. The child who ‘externalizes’ the reasons for success and/or failure is doomed to a fatalistic process of continued problems in living. As the child is able to see that s/he is in control of these outcomes, the potential for growth and development becomes possible.

Ability to use failure as a learning experience

Combined with the acceptance that s/he can control his/her destiny, the child must learn that failure is not catastrophic, but is an opportunity to learn something new. It is impossible to learn something new from success, this only occurs from failure. Therefore, creativity and intelligence are built upon attempts that fail and are used productively. .”..I have not failed. I’ve just found 10,000 ways that won’t work.” Thomas Edison

Ability to communicate effectively & assertively

The meaning of a message is the response it engenders. Thus, if I compliment a person and s/he slaps me, the intent of my message was not clear. It is incumbent upon the sender to change the message. Effective communication implies responses that are expected by the sender. When the response is different than expected – there is a communication problem. One area where communication gets into trouble is when it is tied to emotional content such as anger. Aggressive and/or passive communication may be effective – but are not often productive. This child must learn to communicate assertively if s/he hopes to be accepted by others. The whole purpose of communication is to reach accord with others – to find an acceptance of others and they of you.

Ability to respond effectively and appropriately to other people’s behavior

The ability to avoid the contagion of another’s emotions is a highly valued skill. Too often, when a person attacks us in anger we are wont to respond in kind. The goal is ‘no points to defend’, if another person calls us a ‘jackass’ because they are angry, the appropriate response might be – “Well, I have been known to act like a jackass before, but I don’t see it here – what do you see?” or something of the kind. This is a very difficult competency that even some professionals do not carry off well. But this does not mean that we should not teach it to children; and if they are able to master this competency, they will be the better for it.

Ability to defer immediate gratification

A critical factor for any child to learn is to put off the need for immediate gratification. Longitudinal research in this area shows that four year olds who are able to defer gratification for even fifteen minutes have a much better prognosis for a quality life than those who cannot.

Ability to accurately attribute one’s own strengths & weaknesses

Self concept is one of the critical factors of psychological fitness which lead to competence. A child needs to learn to identify, in a balanced and rational manner, his or her own strengths and weaknesses.

Ability to accurately compare oneself to others

Once a child has developed a balanced and rational appraisal of him/herself, s/he must create a balanced and rational understanding of others and in comparison of self to others, s/he should be able to identify both strengths and weakness within a stable emotional context.

Ability to accept oneself

The ability to accept oneself concerns an understanding of one’s own strengths and weakness, affirming that which cannot be changed and making goals to change that which might be changed. The child does not affirm weaknesses that can and should be improved. Thus, it is one thing to accept that one cannot read and that this is not a good thing, but another entirely to believe that this will always be so. It is also balanced and rational to accept that one is not six feet tall, but to accept that this may always be so, and it is okay.

Ability to accept personal responsibility for one’s own actions

Personal responsibility is epitomized in the ability to accept the fact that you have made a mistake. First, one acknowledges that s/he made the mistake and that the mistake had consequences. Second, one attempts to correct the consequences if possible. Third, the person seeks to determine why the mistake occurred, and fourth, s/he makes every effort to avoid the same mistake in the future. A secondary, but less frequent occurrence of failure to take personal responsibility occurs when one is unable or unwilling to accept responsibility for a successful outcome. The “catch in praise’ is that it sets up an expectation that it will happen again. Some children may find such expectations onerous.

Ability to set effective and appropriate personal goals

The ability to set short and long term goals is an important factor in social competence. Most people have a difficult time identifying their goals, particularly long term goals, and do not hold these goals in mind during day to day operations. Often a person will indicate that they have a goal, which is defeated by their own actions on a daily basis. The ability to create a vision statement – or goals covering all major domains of life is an ongoing process. Thinking along these lines should be started in early education with a process of honing that goes on eternally. Children should be helped to understand that goals change as achievement and contexts change, but that goal setting remains important. The concept of creating your own future should be imbued in each child.

Ability to effectively implement strategies to achieve goals

The importance of goals is balanced by the power of achievement. Every goal needs an implementation strategy so that the child is able to see the development of mastery. Goals and implementation work better if they are contained within the context of what the child can control. Just as track performers do not set goals to win races, for they have no control over how other people will perform, but set goals to improve performance, so too the child’s goals should be framed.

Ability to act altruistically

Socially competent people are able to help other people. Each child must be able to see him/herself as able to help others and as willing to help. No matter what the child’s own level of achievement, there is something that they can do to contribute to the well being of others and they should be charged and allowed to do it.

Ability to take social responsibility

In a broader context, each child must learn that s/he has a responsibility to others as a group as well. The right to vote, for example, is also a responsibility to vote – for if no one votes the right will disappear. The responsibility to keep the roads, sidewalks and public buildings clean. Children should be able to articulate a social context of their own responsibilities.


The culture of the school needs to provide persistent and consistent messages to children in order to implement effective school-wide behavioral practices. To effectively provide the basis for children to become socially competent, we would, in the ideal, provide each of the prevention interventions across each of the four systems defined in the ecological model [microsystem, mesosystem, ecosystem and macrosystem]. This prospect is quite daunting, however, and our capacity to control the changes in these systems is erratic. What we have is a beginning technology for changing the culture in the microsystems of schools and perhaps families.

Reviewing the evidence

When we review the risk and protective factors, we find an element common to many messages. We posit the following:


A chain of messages is usually called a dialogue or a conversation.

MESSAGE – each signal that is perceived contains a conceptual/emotional content [C/EC]- if this content is novel, the message contains information [the difference that makes a difference] which will cause arousal and interpretation. If the message contains no information, it may not even be perceived, or if perceived, it may be ignored. Repetition of nonnovel messages often become habituated into the nonconscious and become our own thoughts – and perhaps part of our beliefs. Messages also gain in power if they come from significant people [usually parents, teachers, etc.].

Messages are conveyed through all of the senses – most often through the use of words, tone of voice, context and intangibles such as ‘body language’.

Context cannot be underestimated, for if you say something intending one context and it is taken in a different context, the message may be totally altered. This is similar to thinking you are sipping a cup of warm, black coffee and taking in cold cola. You are likely to spit it out before any recognition occurs since it is outside of the context expected. If the message seems to fit no context, it is likely the person will ask that it be repeated, for they cannot even ‘hear’ it. If it fits a context for them that is not the original context, their response may not be coherent to you. Meaning must have a context. Sometimes, just changing the context changes the whole meaning of the message. When done consciously, this is called reframing.

Interpretation of the C/EC is accomplished by comparing the information with all prior knowledge of the subject context and refined by your own nonconscious meaning system or beliefs. This usually effects a confirmation bias upon all messages – “Is there anything in this message that confirms my present belief system?” – If so, I will consider this message to be true [not necessarily acceptable or nondistressing]. If no confirmation exists, I will consider the information to be false UNLESS the C/EC is so powerful [salient, cogent] as to be irrefutable. If this is the case, I will need to a) assimilate this message by making slight alterations in its meaning so that it will fit into my belief system OR if too powerful, I will need to b) accommodate this message by altering my belief system so that this C/EC will fit.

If the C/EC is so powerful as to cause trauma to my meaning [belief] system – my usual coping mechanisms may prove no longer useful and I may find myself seeking peculiar ways to maintain some semblance of personal meaning [to maintain myself]. This is often interpreted by those around us as a ‘nervous breakdown’. It could also be viewed as an extraordinarily creative effort to maintain oneself in the face of obliteration – but that would be reframing the context from how these new behaviors affect me individually to how these new behavior affect the person’s own inner logic.


While we generally think of messages in the form of communication, it is important to understand that we produce and receive messages in all conscious states. We see something and interpret it through the lens of our own personal meaning system. If we believe that life is dangerous, we will see danger almost everywhere – thus confirming our belief. What this means is that our meaning system creates our reality – or at the very least, sets us up to expect the reality that we believe exists. Thus, our meaning system or inner logic suggests to us how we should relate to the world. The chain of messages -> interpretations -> responses becoming messages, sets in motion a chain of events that is very likely to be a self-fulfilling prophecy. Since the people around us interpret our response messages through their own internal logic, they may consider our response to their message to be bizarre or negative. How do you respond to a bizarre or negative message? The response usually confirms the message.

Emotional shock can be evoked by providing a response that is not coherent to the expectations of the message sender. Yeshoua ben Yosip suggested this when he instructed his followers to “Turn the other cheek”. Usually when you hit someone, you expect some sort of retaliation. To simply have the person turn the other cheek to be struck again can be disconcerting. You can test out this construct reasonably safely by responding to someone in a car politely asking you whether they can move into your lane in front of your car, by saying NO! The response is usually not one of anger, but of disbelief. They are not even sure that they perceived your message correctly. Even more disconcerting if you say NO with a smile on your face. It is a good idea, however, not to persist, since as they figure it out, they are likely to become angry.

Often, children with problems in living get into ‘intimate dances’ with adults where neither communicator even listens to the response messages of the other because they ‘know’ what the other is going to say. Imagine changing the response message to an adolescent who calls you a ‘jackass’ or worse, when you respond “Well, I have been known to be a jackass on occasion, but I am not sure I see it here – how do you see it?”

Such reframing of the message is a powerful tool in helping the other person to reconsider their meaning system. However, you do not need to wait for a negative message in order to respond, you can send out new, novel messages on a regular basis. These memes, or communication units, can be thought out and even scripted to provide a different meaning to things that occur on a regular basis. As an example, all human beings seek to answer the question ‘why?’ – when something occurs. Why did I pass/fail? Why did s/he not call? Why? Why? Why? Human beings are not so much a rational animal as a rationalizing animal. ‘That’ happened because of ‘this’. Where did the ‘this’ come from – the inner logic. “Why was I not invited to the party?” – 1) they forgot me, 2) they don’t like me, 3) they did not have enough room, 4) they knew I couldn’t afford to go and did not want to hurt my feelings, and on and on. How many reasons can you think of? Interestingly enough, the more you can think of the more likely you are going to be able to come up with a reason that is balanced and rational or not distressing. People with problems in living are often caught in a ‘one pony show’ – “they don’t like me” – that’s it.

By ‘seeding’ the environment with balanced and rational memes that explain the reasons differently you can prime the person to come up with more appropriate reasons. Memes such as “this room is so clean – you are very responsible kids”, or “people like you because you are so easy to talk to”, give both a situation and a possible reason for why that situation occurs. In all cases, the possible reason must be an internal attribution that is balanced and rational. Think of how often we give such memes with an opposing spin – “this room is a mess, I don’t understand how you can be so lazy”. “You failed again, you dummy!” Unfortunately, these memes, while effective, are negative and defeating. Yet we tend to use this kind of meme quite often.

In order to change the memes in a culture, we are required to first, examine consciously what messages we are now sending and make a determined effort to eliminate those that are destructive. This may not be as easy as it seems, since even in our helping processes, we often send negative messages:

  • you have a brain disease, learning disability – whatever other label you use
  • its not your fault, you have no control over your behavior
  • you must take this medication to control your behavior – it will make you feel better
  • feeling good is important
  • you will never be able to control yourself

Compare these messages with messages such as:

  • well it is true you have a learning disability, but that might be a good thing, it causes you to seek creative ideas and you are quite a creative kid
  • yes, you had a very serious breakdown in coping skills because of this trauma; but you are capable of taking control again
  • suicide is a choice to end your suffering, but it is not your only choice – you have options
  • not everyone has the same skills, but you can learn to use the skills you have more effectively

These balanced and rational statements about problems in living, even serious and persistent problems in living, emphasize the capabilities of the person to choose other, more positive options.

What we must remember is that it is not what happens, it is our interpretation – how we give meaning to – what happens, that is important. There are two factors that contribute to the meaning we give. First, there are the beliefs that affect the situation. If I see, hear or otherwise perceive something strange in the sky, I might decide that it is a ‘flying saucer’ OR that it was simply something I could not identify. The choice is somewhat contingent upon whether I believe that there are flying saucers. On the other hand, I am influenced by the messages sent to me by other people – if everyone agrees that it was a ‘flying saucer’, I am more likely to believe that as well.

The force of each of these contributors depends on the power of the belief and/or the significance of the ‘others’. If I am ambivalent about ‘flying saucers’ I am more likely to agree if others say that is what is being perceived. On the other hand, if the person telling me that it is a flying saucer is significant – parent, teacher – I am more likely to absorb their beliefs and accept what they say.

When we discuss messages that have to do with the ‘pillars’ of cognitive structure – mental schema about self and others – it is easy to see how parents and teachers can substantively influence the way in which the child thinks. If a parent keeps telling a child that s/he is ‘stupid’ – it is highly probable that the child will begin to believe that this is true, even when his/her belief system does not start from that position and there is evidence to the contrary. Repetition and significance form a powerful vector that can be used for good or evil. If a parent, teacher or other significant adult continuously sends messages to a child distort thinking about self and others, that adult is guilty of psychological abuse. The messages may not be intentional nor necessarily malicious. However, the abuse nonetheless exists since the outcome could result in serious and persistent problems in living based on a personal meaning system that is maladaptive. The pain and suffering caused by such maladaptions can be as, or more, damaging than that caused by sexual or physical abuse.

Conversing with a child, either verbally or nonverbally, is therefore not a trivial task. The messages we send are often ambiguous and the child must ‘fill in the gaps’ in the same way the brain fills in the gap to cover the ‘blind spot’ in sight. How the child fills in the gaps can be powerfully influenced by the balanced and rational messages sent by significant adults. How to make the adults mindful of what messages they are sending and to alter any messages that might be disorienting, distorted or distressing, is the essence of universal prevention for a whole series of social problems, which include psychological problems, delinquency, and substance abuse.

Children are natural mimics–they act like their parents in spite of every effort to teach them good manners. –Unknown

Adults socialize children through the way they communicate to them. As a child attempts to learn to predict and control the world, s/he is required to find patterns and make analogies about those patterns [‘this’ is like ‘that’], and finally to generalize the patterns into a broad theory or perspective of the world and his/her place in it. This theory is a huge network of defined pattern comparison over the first four to seven years of life, with emphasis on beliefs about self, others and future prospects. Since adults are primarily responsible for the first four years of input, the messages they send are magnified in importance. Once the theory coalesces, the ‘bottom up’ data collection, becomes a ‘top down’ process that filters all new information through the theory and tends to ignore contrary data with a confirmation bias.

Child Management Strategies Concept Type Concept Impact Emotional Spin Emotional Impact
Authoritarian Power assertions, commands, demands Disrespect, demeaning Bullying, shaming, belittling Fear, anger
Authoritarian Balanced and rational direction, instruction, requests Acceptance, value Respect, courtesy Caring
Laissez-Faire Easy going, ignoring, rejection Loss, worthlessness Flippant, seems not to care Sadness, anger

Psychologists have identified these three basic modes or strategies for communicating to children; but to suggest that these are carried out in ‘pure’ form would be unwise. For the most part, adults trend toward one or the other, but often mix modes of communication to the detriment of the child. The more variation in modal theme an adult has, the more confusing it is to the child – and since confusion results in uncertainty, the child’s personal style becomes uncertain. Depending on the temperament of the child, which we will discuss in some detail later, the child is likely to become anxious and fearful, angry and/or sad. While this may be the worst of all worlds, two of the three child management strategies, even in a ‘pure’ state, are very problematic. While the child may feel more clear on the pattern that s/he is experiencing, s/he may still have difficulty with the message.

Temperament is that aspect of our personalities that is presumed to be genetically based, inborn, there from birth or even before. According to C. George Boeree, the issue of personality types, including temperament, is as old as the ancient Greeks, who came up with two dimensions of temperament, leading to four ‘types’, based on what kind of fluids (called humors) of which they had too much or too little.

The sanguine type is cheerful and optimistic, pleasant to be with, comfortable with his or her work.

The choleric type is characterized by a quick, hot temper, often an aggressive nature.

Next, the phlegmatic temperament characterized by slowness, laziness, and dullness.

Finally, people with a melancholy temperament tend to be sad, even depressed, and take a pessimistic view of the world.

These four types are actually the corners of two dissecting lines: temperature and humidity.

Boeree goes on to tell us how Ivan Pavlov, of classical conditioning fame, used the humors to describe his dogs’ personalities.

One of the things Pavlov tried with his dogs was conflicting conditioning — ringing a bell that signaled food at the same time as another bell that signaled the end of the meal. Some dogs took it well, and maintained their cheerfulness. Some got angry and barked like crazy. Some just laid down and fell asleep. And some whimpered and whined and seemed to have a nervous breakdown.

Pavlov believed that he could account for these personality types with two dimensions: On the one hand there is the overall level of arousal (called excitation) that the dogs’ brains had available. On the other, there was the ability the dogs’ brains had of changing their level of arousal — i.e. the level of inhibition that their brains had available. Lots of arousal, but good inhibition: sanguine. Lots of arousal, but poor inhibition: choleric. Not much arousal, plus good inhibition: phlegmatic. Not much arousal, plus poor inhibition: melancholy. Arousal would be analogous to warmth, inhibition analogous to moisture!

However, the question of temperament is a difficult one to assess. How much is innate and how much is learned. It is still the message that counts.

When speaking of the ‘message’, we must be aware that we are talking about several different levels of perception. First, there is the intent of the sender. This intent may be clear to the sender, but not to the receiver. However, the intent is often conveyed, not by the ‘message’ itself, but by the demeanor of the sender. Demeanor (bearing, deportment, mein) is conveyed by many nonverbal actions and by some of the verbal actions such as tone and emphasis. The quote above indicates that often the child takes an intent that is not ever expressed in words and runs with it. The intent being expressed is manifested more by the way the adult behaves than what the adult says. The intent also conveys one of the modes to the child. But be aware, although the child perceives and interprets the demeanor, the child may or may not be right. So a child manager may be laissez-faire about managing the child and the child may interpret this as a wonderful present of the authority to do what s/he wants – a reinforcement of the adult’s trust in the wisdom of the child OR s/he may interpret this as an adult ignoring him/her, an adult wishing the child did not exist or would go away – a sense of nonpersonhood and ultimately worthlessness. So it is not just the concept type or content that is important, but the emotional spin that goes with it. And often the emotional spin can be perceived through the demeanor of the sender – even though the words contradict. A parent who conveys love, even with a very authoritarian strategy may end with a child with a positive connotation for commands.

So the receiver (child) must judge the meaning of the demeanor and the concepts of the message. Thus, a group of words such as – “Will you please stop doing that” – might convey a mild request for the child to alter his/her behaviors (including a polite respect) or if said harshly, with an emphasis on STOP and a reddening of the face – might be perceived as a threat to bodily harm if s/he does not stop. How does the child determine which interpretation is the ‘truth’? It may be based on the emotional spin and partially it may be based upon the prior experiences. What patterns have been perceived in the past in relationship with this individual or with other adults that can be brought to bear on the judgement? If the child has experienced harsh commands and demands combined with bullying and belittling most often in the past, s/he may respond with fear or anger at a command that is not disrespectful or demeaning as though it was. “Stop that” may be a simple directive, but perceived as a bullying command. If given by a peer, it may open an opportunity for a response that leads to an opportunity to operationalize the anger as aggression, which might not be possible with the adult who set the pattern. By why aggression? Isn’t that a learned pattern as well?

From the chart we can see that the Authoritative mode is the best for gaining a positive impact. It is most likely that the child will develop positive beliefs about him/herself and others if s/he experiences a caring authoritative adult. However, even this mode can run into trouble with a child who already has identified patterns of adult communication that makes him/her anxious, fearful, sad and/or angry. For giving directions and instructions can be interpreted as commanding and demanding. And some children, because of their prior pattern of experiences, are sensitive to such interpretations. On the other hand, direction and instruction may be seen as impinging on the child’s autonomy if the child has been pleasantly ignored and sees him/herself as setting his/her own directions. It is important to note that communication is a feedback system, in which the receiver receives feedback from his/her own prior experiences and then gives feedback to the original sender.

An additional difficulty with communication is that we don’t just send one message to one receiver. We send multiple messages – often contradictory – at the same time AND we get a response, which we interpret in the same manner as the child and to which we then respond. Each response also is embedded in a demeanor that either correlates with or doesn’t correlate with the conceptual content [words].

Thus, communication [multiple messages in multiple verbal and nonverbal, concept and emotional modes] leads us to believe that something is happening that is consistent with our experiences of the past. A well intended adult sending messages with a kind and caring intent can get a rebuff. What is a person to think? Is this child ungrateful, ignorant or incorrigible? And if so, how do I respond?

We use the term transactional communication to convey the use of the notions articulated in the theory of Transactional Analysis. There is the Child Schema – “I want what I want when I want it”. There is the Parent Schema – “You will do it because I told you to do it”. Note that both of these are power assertions. Power assertions almost always result in a push back, unless the person is so worn down by power assertions that are supported by punishment that they have learned helplessness. Power assertions are not recommended. What is the recommended response to a power assertion – a balanced and rational statement. The use of balanced and rational statements demands patience, persistence and probably a positive self image. The reason for patience and persistence is that people using power assertions are unlikely to immediately accede to balanced and rational discussion. The reason for the positive self-image is that one is required to ignore what can appear to be a threat to one’s person and territory.

Thus, a child who has learned to mimic a profane adult may suggest that you – the person who sent with kind intent the message that was rebuffed – are a ‘jackass’. Now generally, this will tend to get you irritated and when irritated the response is likely to be one of defensiveness. This is not helpful. What we need to find out is what the child is thinking and defensiveness is not likely to achieve this purpose. Therefore, a more appropriate response might be inquiry. “Gee, I have acted like a jackass on occasion [notice we change the metaphor “you are a jackass” to an analogy, “like a jackass”], but I don’t see it here, “what do you think I am doing that makes me like a jackass”? That seems to be balanced and rational. And what is the response likely to be. One might at first expect the child to be confused – s/he made an irrational statement in anger – meant more to convey the anger than a concept – and received an acceptance rather than a rebuff. More than likely, s/he really hadn’t thought about what s/he meant. The response is likely to continue to convey the anger without making any more sense. Possibly, “You know what I mean” [anger combined with some feeling of confusion that you are somehow manipulating].

Since the child’s meaning theory is oriented around beliefs about self, others and future prospects, s/he may perseverate in trying to get an appropriate response from you [anger, authoritarian statements] for some time. This is what s/he has predicted and s/he believes that s/he can control in some fashion. For these kids, the balanced and rational response results in confusion and uncertainty. You are challenging the basic beliefs about self and others – a profound experience. Depending on the strength of the child’s theory, you may dent the surface causing him/her to put your response into some kind of acceptable format so that it can be assimilated into the theory -”this is just a ploy to get me off guard – go along, but stay alert”. Or, you may actually puncture a child’s mildly held theory and require a change – “this adult does not fit the pattern -s/he is the exception to the rule – meaning that there are exceptions and perhaps I should reconsider my beliefs” – before s/he can accommodate the idea – meaning to modify the belief itself so that the response makes sense within it.

We are always fine-tuning our theory of meaning through assimilation and accommodation. However, people with severe and persistent problems in living often have very rigid beliefs and, therefore, make it difficult for such fine-tuning to occur. For some situations, you may actually communicate something that shatters the belief system – leaving the person with no way to cope – and providing an opportunity for real change to occur.

You will note that this process is the equivalent of the authoritative child management strategy. Thus, the strategy can be used developmentally or remedially. In other words, when the child is first collecting data on patterns, analogies, generalizations and other higher level abstractions, this process can be used to provide the most fertile soil for the development of positive [balanced and rational] beliefs about self, others and future prospects. And as we have indicated, this strategy has specific remedial merit for the child whose theory of meaning is distorted. This is not to imply that balanced and rational conversations are not also powerful tools to communicating with adults. It merely contends that use of such communication strategies reinforces positive emotional spin and impact, thereby enhancing the child’s potential to develop a positive pattern of identification and ultimately to create a theory of meaning that has balanced and rational beliefs about self, others and future prospects.

After the primary caretaker and other adults in the child’s community of interest have provided a pattern of messages that have been used to create a workable theory of meaning, the child’s socialization process is taken over by peers. The unfortunate part is that once the child has created a distorted theory of meaning, his/her communications are likely to reap the most negative of responses, thus reinforcing the negative beliefs already abounding in his/her belief system. Thus, if the child does not trust other people because s/he believes that s/he is worthless and therefore unlikable, s/he will tend to convey a morose, negative attitude to those around. Most of us respond negatively to these kinds of attitudes, thus reinforcing the person’s assumptions that s/he is worthless and unlikable.

Peer rejection is the single most vital indicator of future problems in living. A pattern of negative relationships is set very early, and without someone to create a crack in the theory, it is likely to continue with self-fulfilling confirmations. The one area of possible interpersonal relations is to align oneself with other people with the same belief system. Thus, children with negative theories often become members of a ‘victims’ group where all of the members agree with the negative values – thus reinforcing each other with the rightness of their anger, fear and sadness – although mostly it will be the anger – the emotion of justification – that is the one that provides the ‘glue’ that holds the group together. All the members believe that they have been violated and, therefore, have the right to strike back. They are all justifiably angry at a world that has rejected them.

This, of course, makes change even more difficult as it would require a repudiation of the only sources of solace that the child has. Even if s/he were to suddenly believe that all of the theory of meaning was wrong, s/he would need to abandon his/her friends or try, perhaps, to change them. Such an attempt might be the way the break is finally made, since others with the old theories are likely to turn on the newly ordained ‘do gooder’.

What we are trying to articulate is that children create their own personalities out of organizing the pattern of their experiences and trying to make sense out of them. If the communication patterns of significant adults are negative or do not make sense – the resulting theories are likely to be unable to provide good skills in predicting and controlling the world. The ‘inner logic’ is then reinforced by the way people react to the child’s own communication patterns and a cycle of ‘bad vibes’ and reinforcement continues.

We can label such behaviors anything we want – conduct disorder, oppositional defiant disorder, etc., but we miss the point in doing so. These are the golems or Frankensteins of our own making. Certainly the child has participated in this process, interpreting messages in his or her own unique way, and possibly with many errors. However, it is hard to believe that a child who has arrived at the conclusion that s/he is worthless and unlikable, that others are not to be trusted and that the future holds no hope, has purely invented these notions.

The most unfortunate aspect of this whole process is that many of these kids become parents and need to manage the development of their own child’s theory of meaning. What strategies might they choose?

“The apple does not fall far from the tree.”

The Risk And Protective Factors

When we look at the following risk factors articulated by Greenberg, et al, we discover that other than the first, the potential message inherent in the factor is the issue and even the first has a message component

  1. Constitutional handicaps: perinatal complications, neurochemical imbalance, organic handicaps, and sensory disabilities.

    A child born with such disabilities is prone to a negative comparison with others in the process of developing his/her theory of meaning. How do people ‘look’ at the child, what do they say? Unless the child has parents who are able to convey love, caring and affection regardless of the disability AND overcome the sympathetic, victim aspects of the circumstances, it is quite difficult for the child to conclude that s/he is okay and that other people are just like him/her and accept him/her in an amiable manner.

  2. Skill development delays: low intelligence, social incompetence, attentional deficits, reading disabilities, and poor work skills and habits.

    Imagine the difficulty you might have with these competence issues. Perhaps you are slow in processing information, but bright enough to know that you are slow – how do you deal with this? It is not insignificant that the majority of people with mental retardation who end up in the mental health system are at the upper end of the intelligence scale. It must be intolerable to see yourself as grouped with severely retarded people rather than ‘normal’ people when you are so close.

  3. Emotional difficulties: apathy or emotional blunting, emotional immaturity, low self-esteem, and emotional disregulation.

    Emotional literacy is built on proper messages and emotional difficulty is the result of distorted beliefs because of maladaptive messages or misinterpretation of the messages.

  4. Family circumstances: low social class, mental illness in the family, large family size, child abuse, stressful life events, family disorganization, communication deviance, family conflict, and poor bonding to parents.

    In and of itself, social class has no impact upon a person’s social competence and performance. The belief that somehow in this society it does, sends a very clear message of inferiority. Parents with psychological problems have those problems because of the messages they received as children and, therefore, are likely to provide distorted messages. Family conflict certainly provides grist for ambivalent interpretations that can be destructive to a child. Poor bonding is almost in a class by itself for how can one even define oneself if there is no other.

  5. Interpersonal problems: peer rejection, alienation, and isolation.

    Interpersonal problems with peers is a message exchange that is powerful and negative. In all probability, unless there is a constitutional handicap, the problems stem from the child’s own beliefs which caused behaviors that were atypical. Even a child with a constitutional handicap is likely to be accepted if there are appropriate messages. Unfortunately, child managers often send messages to other children to reject a child.

  6. School problems: scholastic demoralization and school failure.

    Failure of any kind can be reframed as a learning experience. However, often the messages sent in one failure set up the expectation of other failures. If such expectations exist, the messages of the child manager can support this belief or challenge it.

  7. Ecological risks: neighborhood disorganization, extreme poverty, racial injustice, and unemployment.

Again, these factors in and of themselves are either not significant except for the messages they send or are the result of negative messages.

Now that we understand the power of messages, we need to find the mechanisms to change the messages that presently exist in a maladaptive environment. This does not necessarily mean that the environment is invalidating or psychotraumatizing, but it would include such environments.

A similar situation exists, when we look at the protective factors.

  • First, development is complex and it is unlikely that there is a single cause of, or risk factor for, any disorder. It is doubtful that most childhood social and behavioral disorders can be eliminated by only intervening with causes that are purported to reside in the child alone.The mental development, we would suggest, is contingent upon the child creating his/her own reality through identification of patterns and interpretations of meanings. These beliefs, attitudes and values are, as we have already seen, initiated and maintained by the child’s managers. Thus, a child management strategy that is balanced and rational as well as directive and instructional is a protective environment.
  • Furthermore, there are multiple pathways to most psychological disorders. That is, different combinations of risk factors may lead to the same disorder and no single cause may be sufficient to produce a specific negative outcome.We have already discussed this in terms of random access to stimuli and interpretative genius of the child.
  • In addition, risk factors occur not only at individual or family levels, but at all levels within the ecological model.While we agree that the power of the informational age provides messages from all places, we would argue that if unable to change these, it is desirable to provide the child with a balanced and rational perspective from which to perceive these messages. You may hear someone say you are inferior, but you don’t need to accept it. Further, we have indicated that the most powerful messages come from those who are most significant, and at least for the young child, these are people in the microsystem.

A Word About Culture

In contrast with some earlier anthropological approaches to culture, cultures are no longer regarded as material phenomena, but rather as cognitive organizations of material phenomena. Cognitive anthropologists study how people understand and organize the material objects, events, and experiences that make up their world as the people they study perceive it. It is an approach that stresses how people make sense of reality according to their own indigenous cognitive categories, not those of the anthropologist. Cognitive anthropology posits that each culture orders events, material life and ideas, to its own criteria. The fundamental aim of cognitive anthropology is to reliably represent the logical systems of thought of other people according to criteria, which can be discovered and replicated through analysis.

By the early 1980s, schema theory had become the primary means of understanding the psychological aspect of culture. Schemas are entirely abstract entities and unconsciously enacted by individuals. They are models of the world that organize experience and the understandings shared by members of a group or society. Schemata, in conjunction with connectionist networks, provided even more abstract psychological theory about the nature of mental representations. Schema theory created a new class of mental entities. Prior to schema theory, the major pieces of culture were thought to be either material or symbolic in nature. Culture, as conceptualized by anthropologists, started to become thought of in terms of parts instead of wholes. The concept of parts, however, was not used in the sense of static entities constituting an integrated whole, but was used in the sense that the nature of the parts changed. Through the use of schemata, culture could be placed in the mind, and the parts became cognitively formed units: features, prototypes, schemas, propositions, and cognitive categories. Culture could be explained by analyzing these units, or pieces of culture.

Cognitive anthropology trends now appear to be leaning toward the study of how cultural schemas are related to action. This brings up issues of emotion, motivation, and how individuals during socialization internalize culture.

‘Cultural model’ is not a precisely articulated concept but rather it “serves as a catchall phrase for many different kinds of cultural knowledge”. Cultural models generally refer to the unconscious set of assumptions and understandings members of a society or group share. They greatly affect people’s understanding of the world and of human behavior. Cultural models can be thought of as loose, interpretative frameworks. They are both overtly and unconsciously taught and are rooted in knowledge learned from others as well as from accumulated personal experience. Cultural models are not fixed entities but are malleable structures by nature. As experience is ascribed meaning, it can reinforce models. However, specific experiences can also challenge and change models if experiences are considered distinct. Models, nevertheless, can be consciously altered. Most often, cultural models are connected to the emotional responses of particular experiences so that people regard their assumptions about the world and the things in it as ‘natural’. If an emotion evokes a response of disgust or frustration, for example, a person can deliberately take action to change the model. And that is exactly what Culture Restructuring is about.

Managing Change

Managing people in an organization has certain congruence with managing people with problems in living. In both cases, there is a requirement to get the personal preferences of the individuals involved compatible with a specific, defined set of assumptions which the manager believes will be beneficial to both the individual and the organization or society. And in both cases, the critical assumption underlying the need for change is that the learning environment [culture] has somehow created and maintained thoughts that are now considered to be incompatible with the desired culture. Osborne & Plastrik [1997] have done a wonderful job in Banishing Bureaucracy of outlining culture change that we have accessed here for our own purposes. We have intertwined Baar’s Cognitive Theory of Consciousness as well.

Osborne & Plastrik start off by telling us that changing an organization’s culture is not a science. This is not because there are not structures from cognitive and behavioral science that can be utilized, but rather because culture is so pervasive and complex. Further, cultures are based on nonconscious mental contexts that are held by a group at varying levels of coherence. Within every culture there are established presuppositions that tend to become unconscious. Whatever we believe with absolute certainty we tend to take for granted. We lose sight of the fact that alternatives to our stable presuppositions can even be entertained.

Thus, a culture is a many faceted perspective, perhaps best seen as a set of cognitive control mechanisms – plans, recipes, rules, instructions, which are the principal bases for the specificity of behavior and an essential condition for governing it. Since these variables have generally become repetitious and habitual, they have become nonconscious mental contexts, that, for people who are committed to them, there becomes an inability to consciously think consistently of the alternatives to their own, stable presuppositions. It is important to note that the culture in an organization is not necessarily the organization’s plans, recipes, rules and instructions, but those informal plans, recipes, rules and instructions that form in response to the organizational system.

The traditional means for structuring experience was the myth, a term deriving from the Greek mythos, meaning ‘word’ in the sense that it is a definitive statement on the subject. To give someone the ‘word’, even today is to ‘show them the ropes’ or tell them how events and incidents occur within the context of this environment. A myth, then was an authoritative account of the facts that were not to be questioned, no matter how strange they may seem. Myths need be neither true nor false, just useful constructs for explaining the nature of an experience. Such myths were the ‘common knowledge’ of various cultures and helped naive people understand the nature of the world. One of the main uses of myths was to provide an explanation of how real world events work. People using myths made no pretensions to truth, rather they were stating – “this is the way we do things around here”. It is somehow comforting at times of crisis to have a belief system that provides some explanation for what would otherwise seem a capricious event. In this same sense, ‘the way we do things around here’, the mythos culture if you will, may be quite different from the logos culture [logical or formal culture] of the organization.

A paradigm is a set of assumptions about the nature of reality. Thomas Kuhn introduced the notion in 1962, with the publication of his book the Structure of Scientific Revolutions. The scientific paradigms he described were highly rational: they had explicit rules, recorded in scientific literature. Cultural paradigms are different: they are often unwritten, unspoken, even unconscious. A cultural paradigm is like an identity: it is so much a part of each of us that we are not even aware of it. If someone asked us to write down the basic assumptions of our cultural paradigms, few of us could do it. And yet we could not operate without them. Kuhn argued that “something like a paradigm is prerequisite to perception itself. What a man sees depends both upon what he looks at and also what his previous visual-conceptual experience has taught him to see.”

Thus, the cognitive mental contexts described by Baar are the parcels or quanta that support the cultural paradigm and the quanta, in various combinations, predispose us to acting in certain ways. In conceptual contexts, we can at times make a quanta consciously accessible, and change it. The new conceptual context then begins to shape the interpretation of observations. Since new paradigms, which are made up of many quanta are born from old ones, they ordinarily incorporate much of the vocabulary and apparatus, both conceptual and manipulative, that the traditional paradigm had previously employed. But they seldom employ these borrowed elements in quite the traditional way. Within the new paradigm, old terms, concepts and experiments fall into new relationships with the other.

Communication across the revolutionary divide is inevitably partial. Both parties are looking at the world, and what they look at has not changed. But in some areas they see different things, and they see them in different relations one to the other. Kuhn calls this phenomenon ‘the incommensurability of competing paradigms’. Just because it is a transition between incommensurables, the transition between competing paradigms cannot be made a step at a time, forced by logic and natural experience.

Paradigms are conceptual contexts. If one tried to make a paradigm conscious, one could only make one aspect of it conscious at any one time because of the limited capacity of consciousness. But typically paradigm differences between two groups of scientists involves not just one, but many different aspects of the mental framework simultaneously. The variety of aspects would be both greater in culture and less knowable.

For persons within a culture change in understanding either occurs as an epiphany [a spiritual experience], or becomes quite difficult to understand causing anxiety and uncertainty. Further increase of exposure results in still more hesitation and confusion until finally, and sometimes quite suddenly, many begin to produce some of the correct identifications without hesitation. This is because new quanta have now become, through repetition and habituation, no longer novel, but a nonconscious context. A few people, however, will never be able to make the requisite adjustments of their contexts and the people who then failed often experienced acute personal distress.

To change a culture, you have to change paradigms.

According to Osborne and Plastrik, the first thing you have to do is get people to let go of their old assumptions. In science, the key is what Kuhn calls “anomalies” – problems the old paradigm cannot solve, realities it cannot explain, facts it cannot admit to be true. As these anomalies pile up, people begin to lose faith in the old paradigm. Thus, the manager needs to develop a change strategy that will:

  • introduce anomalies and help people to perceive them
  • provide a clearly defined new paradigm
  • build faith in the new paradigm
  • help people let go of the old paradigm
  • give people time in the neutral zone
  • give people touchstones
  • provide a safety net

This requires that a whole plan be implemented at once. People begin to let go of their old paradigms when they run into experiences, facts, and feelings that cannot be explained by the old set of assumptions. These anomalies provoke ‘dissonance’ – conflicts between what one has experienced and what one knows to be possible. Often people cope by refusing to see the anomalies. When anomalies appear, they immediately define them as something else. If they are able to retreat to another part of the organization and find support for their resistance, it is unlikely that the culture will ever change in the direction that management has chosen. [Though it will change in response to the new order.]

To break through this paradigm blindness, you must not only introduce anomalies into the culture, you must actively help people perceive them for what they are. As they begin to experience the resulting dissonance, they will be uncomfortable. Asking people to give up their most basic assumptions about life is like asking them to play a new game without knowing the rules – a game that will determine whether they have a job, how much they earn, and what their colleagues think of them.

Hence, you must give them a new set of rules. You must provide a new way of understanding the anomalies – they can embrace. They will not be able to tolerate the ambiguity for very long: they will either make the leap or retreat into their old paradigm.

Osborne and Plastrik liken it to the trapeze artist, there must be no ambiguity about there being a specific time and place to land when s/he lets go of the bar. Every paradigm shift is ultimately a leap of faith and for those who have faith only in the old culture, there is likely to be a great deal of anxiety about who to trust and where they will land. To build people’s faith in a new culture, you must first earn their trust. None of us put our faith in people we don’t trust. You must then prove to them that others who have made the leap before them have flourished, and to assure them that they too will flourish in the new culture. A paradigm shift begins with an ending. It begins when people let go of their former worldview – a frightening process that creates much of the resistance to change.

You must accept the fact that it will take time before people fully internalize the new paradigm of consistent balanced and rational messages. It’s the limbo between the old sense of identify and the new. It is a time when the old way is gone and the new doesn’t feel comfortable yet. People make the new beginning only if they have first made an ending and spent some time in the neutral zone. And yet, in some apparent disagreement with Osborne and Plastrik, you must also make it untenable to continue holding onto the old bar. The trapeze artist of our analogy is likely to take a greater risk to leap to the new bar, if s/he is aware that the old bar is disappearing. But being aware that the old culture [bar] is gone and not being able to see the new culture [bar] is ‘being between a rock and a hard place’. It is a dilemma without any apparent answer. Managers who seek to change cultures want the new place to be very apparent. And so Osborne and Plastrik suggest that you give them touchstones – guidelines and reference points they can hold onto as anchors as they struggle.

What this means is that in a transformation of culture, the management must be prepared to articulate the new culture completely and to change the world abruptly. This is not a transition. A transition would change pieces and not the whole. An abrupt change requires that their be plans, recipes, rules, instructions, which are the principal bases for the specificity of behavior and an essential condition for governing it. Change is a time of uncertainty. Uncertainty causes anxiety. Managers limit uncertainty not by ‘easing into a new program’, but by being explicit about expectations. Like them or not, knowing the new expectations and how they will be measured relieves uncertainty, and for most diminishes anxiety.

Osborne and Plastrik have more to say on cultural change which should be explored not only by public, but private managers as well. Additionally, the understanding of the workings of thought on emotion and behavior is important knowledge for all managers and articles such as Reconstructing Judgement will help you understand how to better manage people in all types of organizational situations.


Cognitive Restructuring is a process of changing the messages that are exchanged in the culture – and changing the messages requires some degree of change in the beliefs that people hold. In order to provide school-wide effective behavioral supports in a universal way in the district, it stands to reason, that there must be a ‘buy in’ at some level by the people involved whether it be the administration and faculty of the school or the child managers in a family.

Persuading someone to change the way they think, requires a process.

  1. There must be psychoeducation, e.g., an explanation of the concepts required to make the change.
  2. There must be a growing awareness of what they now think.
  3. There must be an attendance to those thoughts.
  4. There must be an analysis that is formal and public.
  5. There must be an alternative meaning that is identified and promoted.
  6. There must be a process of adaptation and habituation.

This is the same process used in Cognitive Process Correction, except that the selection of the thoughts that are distressful and the thoughts that are balanced and rational are made by management in the case of the school – and to some extent by the counselor in the case of the family.

Because it is a group of people, the control over the process by the client is somewhat diminished, although any individual in the group has the power to decide not to believe any of the changed thoughts.

Since the primary change is in the messages – one can identify the memes [communication units] which are presently in use that are causing distress. For example, school personnel traditionally use discipline as a verb, rather than as a noun: “I need to discipline this student” as opposed to “I need to teach this child discipline”. If this is identified as an unacceptable message and everyone is asked to identify when others make the error, there is a process of change. One could increase the power of the cognitive reinforcement by having each person receive a token [worth one dollar] whenever they are cited as having used the word correctly.

Changing the words we use is a difficult task. We select our words nonconsciously, and unless we are made aware and find some way to attend to our language we will fall into the old habits.

We can also create scripts for specific students and/or situations [See CBT#24 Attribution Training or CBT#34 Reframing]. Use of cognitive qualifiers and interruption of deletions in speech could be targeted. Each of the Cognitive Behavior Techniques has the potential to be used in the change process. Do we, for example, teach the concepts of Assertiveness whenever we see a person in the culture being nonassertive?

In the final analysis, however, cognitive change is self change. In an institution such as a school, there is a certain level of coercive power that can be used – if the leader of the organization requires the change – there will be a change. However, remember the formal and informal cultures of organizations. If we want the change to meet certain standards, we will need measures of those standards and take remedial action on all who do not meet them.

For the family, the issue is somewhat different. A family is usually a small enough unit that the decisions of changing can be more or less conscious and consensus oriented. The family can decide, with the help of a counselor, if the present culture is working for them or not. If it is not, they can, with the help of the counselor, work on identifying the stressful elements and going through the process of changing them.

It is simple, but not easy. Change of any kind requires trust and that is in small quantities in the helping systems these days. Nonetheless, we can take action to address the needs of our children and change the process of acculturation that has been damaging. To develop an effective school-wide behavioral support system requires more than simply implementing a set of techniques in response to children whose behavior has become problematic. It requires a commitment of administration and a culture of balanced and rational messages.



This is a noninclusive list of strategies and interventions that can be built into a school-wide program. Individual districts or principals can decide on these or other optional programs which have an evidence based history.

The CCIU department Assessment & Clinical Services, directed by Cris Chambers, Psy.D., can provide additional options as well as training to Districts upon request. To request a consult or for further information, call 484-237-5273.

Universal Prevention Strategies

These strategies target the general population group that has not been identified on the basis of individual risk. Thus, these programs would be made available to ALL children in the school. Because universal programs are positive, proactive, and provided independent of risk status, their potential for stigmatizing participants is minimized and they may be more readily accepted and adopted.

1. Seeding:

This involves describing a particular state to the children in order to evoke that state (and, additionally, that once evoked, it can be ‘anchored’, linked, directed, intensified, combined with embedded commands, etc.). Preconscious processing can influence the ease with which certain ideas are brought to mind, and the manner in which objects and events are perceived and interpreted. Finally, in order for preconscious processing to affect action it is necessary that relevant goal structures be activated in procedural memory.

  • Attribution Training: The theory about how people explain things is called Attribution Theory. The concept of attributions can be understood as a variety of theories which are interwoven to create a body of knowledge about people and the way in which they make decisions. Human beings have a strong need to understand and explain what is going on in the world; to answer the question ‘why’? Attribution relates to the placement of a cause to explain the effects of events and experiences. As with all other cognitive activities, the information which affects the causes are not simply from the environment, but also from the person’s own mental contexts and theories. Thus, such attributions are subject to the same types of errors. Predictably, the errors vary when the causes are placed on the effects of events and experiences of someone else and when they are placed on the effects of events and experiences of yourself. Because people must explain the world, it opens up some interesting influence possibilities. If you can affect how the child understands and explains what is going on, you might be able to influence how they behave and, therefore, potentially change the outcomes and consequences. Changing personal attributions can occur either through individual self-examination or external manipulation. Internal self-examination can be focused either on the attributions or on the total cognitive set. External manipulation can occur either within the total culture or with a single significant individual. The seeding of balanced and rational antecedent internal attributions can have a positive effect on the individual child’s concepts of personal responsibility. Marshall’s Discipline Without Reward Or Punishment is one way of seeding the culture.
  • Affirmative Mantras: The best affirmation mantras are based on a recollection of positive resources and successes in the past [See Anchoring to the Good Times]. Otherwise, a general statement of ‘I’m doing the best that I can!’ or “I can do this!’ seems to make the best supportive mantras. When affirmative mantras are effective, children will begin to be able to diminish the voice of their internal critic for longer periods of time, and when it does say something, it will be at a much lower volume.
  • Anchors: If someone is in a certain state, you can set up an anchor, that means you can trigger this state by associating it with an external stimulus. Anchors can be a specific hand gesture or a picture (visual), a word, sound or voice tone (auditory), a touch or a movement (kinesthetic), a smell (olfactory) or a taste (gustatory). With anchors you can easily change and control your/someone’s emotional state. When anchoring, you have to follow these conditions:
    • Uniqueness of stimulus: The anchor should be something that children don’t do in other situations. So don’t anchor something like clapping the hands (Only if you want to go into a specific state when you are at the theater and have to clap your hands).
    • Intensity of experience: You have to be associated into the experience. It should be strong.
    • Purity of experience: Your experience should be without contamination.
    • Timing of anchor: The experience should be at its peak. You have to wait for the right moment to set up the anchor.
    • Accuracy of replication of anchor: Different kind of touches are different anchors. You have to do the same thing when you set up and fire off the anchor.
  • Anchoring to the Good Times: Facing psychological pain is a skill. If you know how pain works and how to cope with it, the actual encounters will be less overwhelming. At these times, all you want to do is escape. When you find yourself feeling this way, it can help to remind yourself that you have endured this feeling before and it will eventually pass. An anchor is a stimulus that evokes feelings from specific events in the past. For instance, if you think of your grandmother’s love and protection whenever you eat freshly made oatmeal cookies, then oatmeal cookies are an anchor for you. The cookies are the stimulus and the feelings of love and safety are your consistent response. Of course, many of your anchors are involuntary, but you can help children form voluntary ones to use to their advantage by giving the following directions.
    • have the children sit in a comfortable position in a place where they won’t be disturbed. Have them close their eyes and relax, breathing deeply.
    • have them go back in time, picturing a moment when s/he felt successful and confident.
    • have the children notice everything about the time: sights, sounds, tastes, smells and feelings. See how you looked, how others looked. Hear the confidence in your voice; hear the praise from others. “Let yourself feel the confidence and praise from others. Let yourself feel the confidence and self acceptance”.
    • “When your images are clear enough to make you feel confident, touch your left wrist with your right hand. Touch it firmly, in a particular spot that you can easily remember. You are anchoring the feelings to this touch on the wrist, and you will want to exactly duplicate that touch later on.”

Have the children repeat this sequence with four other memories or fantasy scenes that are connected to feelings of worth and self-confidence. Now each child can combat negative feelings and images with a touch that anchors him or her to some very fine moments in his/her life.

2. Assertive Discipline:

This is a systematic behavior management protocol designed by Lee Canter to put elementary and secondary classroom teachers in charge of their classes. Combining tenets from assertiveness training and behavior modification, Canter (1979) believes that he has identified four discipline competencies that all teachers need to master to handle problem behaviors successfully. The competencies include 1) identifying appropriate behaviors that form the basis for classroom rules, 2) systematically setting limits for inappropriate behavior, 3) consistently reinforcing appropriate behavior, and 4) working cooperatively with parents and principals. In this cookbook approach to discipline, the steps for acquiring these competencies are detailed, even to the extent of specifying the number of rules and the number of negative consequences.

  • In this approach, it is recommended that the school district identify basic classroom rules, limit setting and reinforcement procedures and allow changes by individual teachers only after review.
  • The cooperation with parents should be formatted into specific patterns and include the potential for social learning family interventions.

3. Life Space Crisis Intervention

This is a process that can be used in almost any situation or location because it requires no props or equipment, only an understanding adult, skilled in verbal strategies that are essential requirements for helping roles. Every crisis requires talk! An adult’s skills in using verbal strategies will directly influence both the immediate solution to a crisis and the long-term effect of the crisis on a student. Crisis handled well can lead to positive, long lasting changes; crisis handled ineptly will contribute to a devastating cycle of alienation, hostility and aggression. The six steps of LSCI can be divided into

Diagnostic Stages
1) Drain Off – staff de-escalation and focusing skills to drain off the child’s intense feelings while controlling one’s counter aggressive reactions and focusing on the crisis;
2) Timeline – staff relationship skills to obtain and validate the child’s perception of the crisis;
3) Central Issue – staff diagnosis skills to determine if the crisis represents one of six patterns of self-defeating behavior; and

Reclaiming Stages:
4) Insight – staff clinical skills to pursue the child’s specific pattern of self-defeating behavior for personal insight and accountability;
5) New Skills – staff empowering skills to teach the child new social skills to overcome his/her pattern of self defeating behavior; and
6) Transfer of Learning – staff consultation and contracting skills to help the child reenter the social arena and to reinforce and generalize new social skills.

4. Psychological First Aid:

This is a crisis intervention technique aimed at assisting a person to move past an unsettling event so that the probability of debilitating effects [e.g., emotional scars, physical harm] is minimized and the probability of growth [e.g., new skills, new outlook on life, more options] is maximized. Reorganization after crisis may be toward growth or psychological impairment, depending upon a host of variables in each case – not the least of which is the kind of help available during the critical time. The question of whether teachers, aides, friends and other natural support people will be able to mobilize themselves to provide effective help is a critical one. Psychological first aid provides a five step process [1) empathetic listening, 2) question about immediate past, present and immediate future, 3) explore possibilities, 4) assist in taking the next step, and 5) follow up], with which a lay person can help shape a crisis into an opportunity. All district staff and many students can be trained to provide this assistance to the person in crisis.

5. Assertiveness Training

The technique emphasizes the building of assertiveness skills, using model presentation, rehearsal, positive feedback, prompting, covert modeling, and homework assignments. Basic assumptions regarding one’s assertive rights are made explicit, traditional assumptions and fears that inhibit assertive behavior are challenged, and the pros and cons of assertive and nonassertive behavior are explored. The technique can be provided in all classrooms.

6. Emotional Literacy

An effective social – emotional – cognitive program is important because children frequently have difficulties with self control, self affirmation, understanding of emotions and social problem solving. The Promoting Alternative THinking Strategies [PATHS] Curriculum provides school personnel with a systematic developmental procedure for enhancing social competence in children. Experience has shown that PATHS has demonstrated its effectiveness as a prevention program. It has been implemented in entire schools of elementary aged children [Kindergarten through Grade 6]. It is structured as a generic model for the elementary school years and not written by specific grade levels, which allows for multiple methods of use.

7. Interpersonal Cognitive Problem Solving

Although very different from other popular methods of child management, the Interpersonal Cognitive Problem Solving [ICPS] approach, now called I Can Problem Solve, [also ICPS], developed by Myrna Shure continues the movement toward positive childrearing. As Shure states “In 1965 Haim Ginott sparked interest in positive parenting by suggesting in his book, Between Parent and Child, that instead of telling a child what not to do [“Don’t run!”], parents should emphasize the positive by telling them what to do [“Walk!”]. Then, in 1970, Thomas Gordon wrote the acclaimed book Parent Effectiveness Training [PET], which opened the door to the idea that active listening and using ‘I’ messages [“I feel angry when your room is messy”] instead of ‘you’ messages [“You are too messy”] are learned parenting skills.” These two landmark books paved the way for Shure’s book Raising a Thinking Child to take parents a step further. “ICPS moves from a primary focus on skills of the parent to focus on skills of the child as well. The thinking child does not have to be told how people feel or what to do; the thinking child can appreciate how people feel, decide what to do, and evaluate whether the idea is, or is not, a good one.” The historical assertion that relief of emotional tension can help one think straight is reversed – the ability to think straight can help relieve emotional tension. Children learn to:

  • think about what to do when they face a problem with another person;
  • think about different ways to solve the same problem;
  • think about the consequences of what they do; and
  • realize that other people have feelings and think about their own feelings too.

ICPS has been taught to children as young a four years of age and should be taught to every child in the district before the age of eight years.

8. Problem Management & Decision Analysis

A five-step problem-solving strategy for generating novel solutions to any kind of problem, combined with a decision analysis of ‘MUSTS’ and ‘WANTS’. A convenient acronym is SOLVE, which stands for:

State the problem.
Outline your goals.
List your alternatives.
View the consequences.
Evaluate your results.

9. Relaxation Training

Relaxation training refers to the regular practice of one or more of a group of specific relaxation exercises. These exercises most often involve a combination of deep breathing, muscle relaxation, and visualization techniques which have been proven to release the muscular tension that the body stores during times of stress.

During relaxation training sessions the children will discover that racing thoughts will start to slow, and that feelings of fear and anxiety will ease considerably. In fact, when the body is completely relaxed, it’s impossible to feel fear or anxiety. In 1975, Herbert Benson studied how the body changes when a person is deeply relaxed. During the state that Benson termed the “relaxation response”, he observed that the heart rate, breath rate, blood pressure, skeletal muscle tension, metabolic rate, oxygen consumption, and skin electrical conductivity all decreased. On the other hand, alpha brain wave frequency—associated with a state of calm well-being—increased. Every one of these physical conditions is exactly opposite to reactions that anxiety and fear produce in the body. Children can be taught these techniques and practice them in class in specific parts of the day.

10. Social Skill Training:

This is a direct approach to improving a person’s interpersonal relationships. Critical elements in their approach are:

  • definition of the problem or target behavior for improvement
  • assessment of the extent to which the problem or behavior occurs, and
  • development and implementation of systematic intervention plan.

Goals associated with general affective growth, such as enhancement of self concept or the development of a personal set of values, are NOT a primary focus. Instead, friendship skills, such as greeting, asking for and returning information, inviting participation in activities and leave taking are taught. Other programs target social maintenance skills [such as giving positive attention, helping or cooperating], or conflict resolution skills [such as nonaggressive, compromising or persuasive behaviors]. Any behaviors believed to contribute to successful interpersonal functioning may be the focus.

11. Thinking, Feeling, Behaving

The purpose of this program is to provide educators with a comprehensive curriculum to help youngsters learn positive psychological concepts. Each volume [Grades 1 – 6 & Grades 7 – 12] contains a total of ninety [90] activities, field tested, arranged by grade level and grouped into the following topic areas: Self Acceptance, Feelings, Beliefs and Behavior, Problem Solving/ Decision Making, and Interpersonal Relationships. The lessons are sequential in nature and developmentally appropriate for the grade specified. The two volumes used together thus provide an integrated program for students through their educational career. Each activity seeks to achieve a specific objectives.

12. Individual Behavior Learning Packets

The goal and activities of the Individual Behavior Learning Packets are focused on a proactive instructional approach to behavior management as proposed by Colvin, Kameenui and Sugai. This focus conceptualizes the management of social behavior problems in much the same way as the management of instructional problems. Most often, educators approach social behavior problems differently than instructional problems. For example, when a student makes an error in academic subjects (e.g., decoding, math computation, concept application), a correction procedure is implemented and the student is provided with more practice and review. If the errors become persistent or chronic, teachers diagnose the problem (i.e., identify the misrule), rearrange the presentation, and provide more practice and review. Clearly, such a proactive emphasis enhances the student’s opportunities to make the correct academic response. The Individual Behavior Learning System is a formal method to implement the remedial process for social behavior in learning situations. It provides constructive, positive learning experiences for students serving consequences for violating a school standard for behavior. The System consists of three notebooks, each with twelve [12] packets keyed to thirty-six [36] different school or attitude problems.

Minor Packets target particular forms of unacceptable behavior that usually occur within the classroom and are typically annoying and non-threatening. Students demonstrating these behaviors often serve classroom detention or are held out of class for a day or two.

Major Packets target those behaviors that are more serious in nature and may be of a threatening nature. These behaviors may extend to situations outside of the classroom and perhaps even outside the school itself. Students committing such infractions often are assigned an in-school or out-of-school suspensions. Some of these violations may also involve the police (for offenses involving drugs, gang behavior, alcohol, etc.).

Attitude Packets focus on the student’s state of mind when s/he made the decision to break a school rule. These packets are much more general in scope and can easily be used in conjunction with either Minor or Major Packets to complement the remediation process. For example, a student who is caught smoking might be given both the Smoking Packet from the Major series and the Making Changes Packet from the Attitude series. Attitude packets can also be assigned to students who commit the same offense more than twice. For example, a student late to class will be given the Late to Class Packet twice and if he is disciplined a third time for being late to class you may want to give him the attitude packet on Learning From Mistakes or Being Responsible.

These Learning Packets can serve several purposes:

  • Give misbehaving students a better understanding of why they misbehave
  • Prompt students to set goals that help them improve their behavior
  • Serve as a meaningful consequence for misbehaving students.

Each Learning Packet consists of the following:

Narrative text: which identifies the type of misbehavior, tells why such actions are wrong, outlines the consequences of such behavior, and makes suggestions for alternative ways of dealing with problems.

Two illustrative stories: in which fictional characters illustrate various forms of unacceptable behavior.

Two Response Forms: one for the first offense and one for the second. Students are required to complete the forms and answer questions related to the Packet text and to their particular behavioral problems. In some cases, students may need extra paper to complete their answers.

In each instance, the purpose of the packet is to improve the student’s behavior in the future. Themes of respecting the rights and feelings of others, discovering the causes of misbehavior, understanding the short and long-term implications of such behavior, taking responsibility for our actions, and developing goals will enable the student to change for the better.

Selective Prevention interventions

These interventions target individuals or a subgroup (based on biological or social risk factors) whose risk of developing psychological disorders is significantly higher than average. Examples of selective intervention programs might include children from single parent families, children who have had traumatic experiences, or children with exceptionalities. These are not children who are necessarily manifesting problematic behaviors, but those who are in a risk group.

A sampling of techniques might include:

1. Accurate Self Appraisal

This technique starts with a self-concept inventory. The child is asked to write down [or record on tape] as many words or phrases as s/he can to describe him/her self in the following areas:

  • physical appearance: Include descriptions of height, weight, facial appearance, quality of skin, hair, style of dress, as well as specific body areas such as neck, chest, waist and legs.
  • how you relate to others: Include description of strengths and weaknesses in intimate relations and in relationships to friends, family and co-students/workers, as well as how you relate to strangers.
  • Personality: Describe positive and negative personality traits.
  • How other people see you: Describe the strengths and weaknesses that your friends and family see.
  • Performance at school or on the job: Include descriptions of the way you handle the major tasks of work &/or school.
  • Performance of the daily tasks of life: Should include such areas as hygiene, health, maintenance of your living environment, food preparations, chores and any other ways that you take care of personal or family needs.
  • Mental functioning: Include an assessment of how well you reason and solve problems, your capacity for learning and creativity, your general fund of knowledge, your areas of special knowledge, wisdom you have acquired, insight, etc..
  • Sexuality: How you see and feel about yourself in relation to the opposite sex.

After finishing the inventory, go back and put a plus by items that represent a strength and a minus by items you consider a weakness or would like to change about yourself. Don’t mark items that are neutral, factual observations.

Divide a sheet of paper into two columns. On the left write down each item marked with a minus, leaving three lines between each to write on. Revise the language of these concerns following these rules:

  • Use non-pejorative language: Such as stupid, fat, ugly, etc.
  • Use accurate language: Don’t exaggerate and don’t embellish. Make the items purely descriptive. Confine to the facts.
  • Use language that is specific rather than general: Eliminate words like everything, always, never, completely, etc.
  • Find exceptions or corresponding strengths: An essential step for those items that the child really feels bad about.

Each weakness should be revised.

The next step is to acknowledge strengths. As a result of cultural and parental conditioning, the child may find it anxiety provoking to give him/herself credit. Be audacious. On a fresh sheet – write down all of the pluses. Seek corresponding strengths on the revised weakness page. Try to add other special qualities not remembered.

Exercise: for a few moments think about the people you most admire or care for. What qualities make this so? Jot them down. It is now time to meld your strengths and weakness into a self-description that is accurate, fair and supportive. It must be the truth, acknowledging weaknesses that you might like to change, but it will also include personal assets. The new description should cover all eight areas of the Self Concept Inventory.

Celebrate Strengths: Remember strengths in times of distress. Remind yourself verbally. Three methods to help develop a system to remind about affirmation:

  • Daily affirmations: This is a one sentence positive statement, which typically begins with ‘I’, and is repeated at intervals throughout the day
  • Reminder signs: Write a brief affirmation in large letters on a three by five card. Place this on your mirror, by the refrigerator or on your night stand, where you will see it.
  • Active ingredients: Recall specific examples and times when you clearly demonstrated your strengths. Each day, select three strengths and look into the past for situations that show those qualities.
2. Cognitive Process Correction

This is a five step process which includes 1) awareness of automatic thoughts, 2) attendance to those thoughts, 3) formal and public analysis of those thoughts, 4) seeking alternative thoughts, and 4) adaptation through habituation and reinforcement, as described in the following techniques.

  • Perceiving Reflex [Automatic] Thoughts: a process of teaching a person to become aware of their automatic thoughts through ‘leakage’ of self verbalization and exploration.
  • Altering Limited Thinking Patterns: A process of helping people, through thought journals, attend to their automatic thoughts and identify cognitive errors.
  • Changing Distressing Thoughts: incorporates a process of analyzing thoughts for veracity and utility [pleasure/pain] finding alternative thoughts and replacing disturbing thoughts
3. Anger Control

There are six constructs to emotional control over anger:

  • Learning the language and concepts. There are thoughts, emotions and actions and these can be separated.
  • Understanding that situations and events do not make us angry.
  • Different people respond differently to events – it is our thoughts about the event that make us angry.
  • There is a difference between emotions and ‘behaviors’. Emotions are always OK, although they can be either comfortable or uncomfortable, but behaviors can be either OK or Not OK.
  • We must learn to recognize both the internal and external signs of anger.
  • We must understand the degree of intensity of feeling and be able to identify the signals about our own behavior.
4. Anger Inoculation

Provocations don’t make you angry; hurtful, attacking statements don’t make you angry; stressful and overwhelming situations do not make you angry. What turns painful and stressful situations into anger are trigger thoughts. Trigger thoughts:

  • blame others for deliberately, needlessly causing you pain, and
  • see others as breaking rules of appropriate or reasonable behavior.

A person is not helpless when provocations occur. Anger is not automatic. Stress inoculation teaches you how to relax away your physical tension while developing effective coping thoughts to replace the old anger triggers. There are five steps in stress inoculation for anger control:

  1. mastering relaxation skills,
  2. developing an anger hierarchy,
  3. developing coping thoughts for items in your hierarchy,
  4. applying anger-coping skills during visualized hierarchy scenes, and
  5. practicing anger-coping skills in real life.
5. Assertiveness Training

In the same manner as used for the Universal Prevention Strategies, the technique emphasizes the building of assertiveness skills, using model presentation, rehearsal, positive feedback, prompting, covert modeling, and homework assignments. Basic assumptions regarding one’s assertive rights are made explicit, traditional assumptions and fears that inhibit assertive behavior are challenged, and the pros and cons of assertive and nonassertive behavior are explored.

6. Belief Change Cycle

You need six different ground anchors. Write the stations on different pieces of paper and arrange them in a circle. The six stations or ground anchors are:

  • Wanting to believe (something new)
  • Being open to believe (something new)
  • Current beliefs
  • Being open to doubt
  • Beliefs that you used to believe but don’t believe anymore (Museum of old beliefs)
  • Deep Trust
  1. Stand in the “Wanting to believe” space, think of a new belief that you want to have.
  2. Move to the “Being open to believe” space, be or feel as if you were more open to the new belief.
  3. In the “Current beliefs” space, concentrate on the new belief. Try to find limiting or conflicting beliefs.
  4. In the “Being open to doubt” space, concentrate on these conflicting or limiting beliefs. Go to the “Deep Trust” space and find out whether you want to make some changes to your old beliefs or to the new belief.
  5. Take your insights with you and move them to the “Museum of old beliefs”.
  6. Go to the “Deep Trust” space and look at the changes you have made.
7. Changing Core Beliefs with Visualization

This metaperceptive technique works because the unconscious mind doesn’t believe in time. To the unconscious mind, things that happened when you were six months old can be just as important and immediate as things that happened yesterday. If this technique is to be used with a child, it will be important that s/he understand the context of the visualization. The technique is a process of revisiting yourself in the past from a first position and second position and visualizing an interaction between the two.

8. Change Personal History

If you have memories that are unpleasant and that still have a negative impact, you can transform them into positive memories. You can do this by recalling the memory and add some resources. To do this, go back to the memory you want to change. If there are more than one memory of this kind, try to detect the first memory and go back to it. Now, dissociate from it. Identify the resources that you would have needed in that situation to change it to a positive memory. Anchor these resources and see the memory as if you already had the resources you needed to make it a positive memory (while still being dissociated from it). Add the resources until the memory is positive. Travel back into the present and change all the memories that happened as a result of the first memory. And then, future pace so that it will never happen again.

9. Circle of Excellence

Uses a kinesthetic anchor to activate a Moment of Excellence, e.g, a moment in which you are at the top, in which you feel like superman. Imagine a circle on the floor. In this circle there is a picture of you, being in a specific state. This picture of you behaves the way you want to behave when you are in this state. When you walk into this circle, you will be in the specific state. Another possibility of using the Circle of Excellence is by imagining another person, your idol or a character in a movie, and placing this picture into the circle. You can be like them if you want.

10. Cognitive Modeling:

This is one of the techniques based on cognitive behavior modification, which involves the manipulation of antecedents (before response of the student) and consequences (after response of the student) to change both overt (external) and covert (internal) behavior. Cognitive modeling incorporates modeling plus some form of verbal rehearsal such as verbal mediation, self instruction, or problem-solving procedures. Students are active participants in the program and imitate as the model uses various types of verbal mediation. The students then rehearse the behaviors aloud, in a whisper, and silently. Cognitive modeling is often used to develop self-control in students.

11. Goal Development

This is a cognitive process that is built upon the following principles:

  • create the future [self-fulfilling prophecies] – A Self Fulfilling Prophecy is said to occur when one’s belief concerning the occurrence of some future event…makes one behave in a manner…that increases the likelihood that the expected event will occur.
  • reframing [negative to positive] – The goal should not be related to ‘I’m too fat and must lose weight’, but rather to ‘I am thin’.
  • present time perspective – The present tense time technique assists in visualizing a goal as if it already exists. A goal stated in future time is likely to always remain in the future.
  • cognitive errors [shoulds] – When you have a list of ironclad rules about how you and other people “should” act, this generally means that the goals operate within the “shoulds”.
  • visualization [attainment] – You can learn new behavior sequences by imagining yourself performing the desired behavior successfully. Called covert modeling, it enables a person to identify, refine, and practice in his/her mind the necessary steps for completing a desired behavior
  • intentionality – It is expectancy in the sense of that which the expecter believes is likely to occur, rather than that which a person believes ought to occur, that leads to the behavior that fulfills the prophecy.
12. Self Management

This technique involves teaching students how to manage their own behaviors. Students actively participate in the selection of the target behavior for improvement and the behavioral goals, in the antecedent and consequent events, and in the recording and evaluation of the behavioral changes. External, or teacher/Mentor control, is minimal.

13. Self Representation

Self-schemas are defined as domains of knowledge about the self that are derived from past interpersonal experiences which organize the processing of self-related information contained in one’s social experiences and include the idea of ‘possible selves’; that is, what the individual might become, would like to become and is afraid of becoming. Researchers have used self-scenarios, some constructed by an observer according to a standardized procedures and clinically relevant, and other self-scenarios which are not relevant, which are used to help individuals identify and deal with cognitive errors. The use of these self-representations serves to prime the person’s recognition of schematic material making them aware of their view of themselves within certain contexts that are contained in schematic memory. Considering that each person holds multiple self-representations or experiences multiple states of mind, this exercise gives the ability to track changes in self-schemas, which is a vital component of any intervention that proclaims itself capable of altering not only how subjects behave, but what they think of themselves. The method also could aid efforts in formulating tailor-made, individualized plans for each level of affective, motor and cognitive responses for each concerning stimuli situation. Such plans can include using self-schemas in which one feels confident and secure, as a bridge to feeling confident and secure in more demanding situations.

Each scenario consists of four [04] components and is structured by the observer according to the format of 1) stimulus situation, 2) affective response, 3) motor response and, 4) cognitive response. Stimulus situations included representations of emotionally evocative circumstances or conditions such as “When I am in a social situation…” Affective responses involve statements that reflect the person’s affective lexicon and statements such as “I become very anxious and nervous”. Motor responses included descriptions of instrumental predispositions that typically reflect security operations, such as “I tend to act in a quiet and inhibited manner”. Cognitive responses consisted of statement regarding automatic thinking, such as “I’m always wondering what people think of me”, and a conditional statement of self-worth or self-protection, such as “I need the approval of others in order to be worthwhile” or “I must take great precautions in order to feel safe and secure”.

14. Self Verbalization

This technique is about improving the human thought stream through self instruction to alter that constant monologue that goes on mentally as we name events, judge experiences, compare ourselves with others, and comment on just about everything.

Indicated preventive interventions

These interventions target individuals who are identified as having prodromal signs or symptoms or biological markers related to psychological disorders, but who do not yet meet diagnostic criteria. Providing social skills or parent-child interaction training for children who have early behavioral problems are examples of indicated interventions. Children with exceptionalities are likely to fall into this category and require special prevention measures.

Some sample interventions might include:

1. Structured Teaching:

A technique that, along with limited numbers of students, usually eight [08] to fifteen [15], uses:

  • physical space organization of the classroom
    • consistent, visually clear boundaries for activities
    • transition area [check schedules]
  • scheduling to help anticipate and predict events
    • reduces problems with time and organization
    • minimizes strain on attention and memory; anxiety
    • compensates for language impairment
    • fosters independence
    • increases motivation to complete work before play
  • • individual work stations
    • informs students about what to do while in independent work time
    • informs students of amount of work to be done
    • helps students see when almost finished
  • learning task organization
    • individualized ‘jigs’ or templates to demonstrate how task is to be completed
  • work systems sequencing
  • prompts and reinforcement
2. Systematic Desensitization:

This is a process primarily used to treat phobias and specific anxieties. The phobic person is first given training in deep muscle relaxation and then is progressively exposed to increasing anxiety evoking situations [real or imagined]. Because relaxation and fear are mutually exclusive, stimuli that formerly induced panic are now greatly calmed.

3. Testing Core Beliefs

This technique identifies, tests and modifies these beliefs based on work by Aaron Beck and Arthur Freeman (1990), Donald Meichenbaum (1988), Jeffrey Young (1990), and Matthew McKay and Patrick Fanning (1991). Core beliefs and rules are so habitual that they have become nonconscious and go into action in nonconscious ways. They are so fundamental to a person’s personality that few people are aware of them. Yet every part of life is dictated by these beliefs and rules. They have enormous influence on automatic or reflex thoughts. In summary, core beliefs are the foundation of the individual’s personality. They largely dictate what you can and cannot do (rules), and how you interpret events in your world (automatic thoughts).

4. Theme Analysis

A way of analyzing the Basic Thought Journal or Monologue Diary to uncover core beliefs. Instead of Laddering the automatic thoughts, you analyze the situations, looking for common themes to connect them. When listed all together, comparisons can be made as to whether there are certain situations that repeat themselves in terms of type. This is probably not a task that a child can do alone, but with the help of a changeworker, s/he may be able to recognize themes when pointed out. Theme Analysis can also be done with the self-statements.

5. Traumatic Incident Reduction

When accessed with the specific cognitive imagery procedure of Traumatic Incident Reduction, a primary traumatic incident can be stripped of its emotional charge permitting its embedded cognitive components to be revealed and restructured. With its emotional impact depleted and its irrational ideation revised, the memory of a traumatic incident becomes innocuous and thereafter remains permanently incapable of restimulation and intrusion into present time.

When clients have more than one trauma in their history, the only completely effective procedure is one that traces each symptom of the composite post traumatic reaction back through sequence(s) of related earlier incidents to each of the contributing primaries. The simple fact is that in order to deal effectively with past trauma, we must guide the client through to its resolution in metaperceptive imagery. The imagery process itself, however, is just the means by which we help post traumatic stress disorder [PTSD] clients get through their residual primary pain. It is by revising the errant cognitions associated with that pain that they are freed from the grip of their PTSD.

6. Worry Control

This technique will teach your clients to control worry in four ways.

  • practice regularly the relaxation techniques.
  • conduct, accurate risk assessments to counter any tendency to overestimate future danger.
  • practice worry exposure by scheduling a thirty-minute period each day for full-scale, concentrated, organized worrying.
  • use worry behavior prevention, for controlling the ineffective strategies used now.
7. Phobia Techniques
  • One dissociation: Imagine that you are sitting in a cinema. Look at the movie screen. See yourself on this screen in a black and white picture. In this picture you are looking at the you that you see in a time just before experiencing the phobia. Now start the black and white movie. See a copy of yourself in this phobic situation. When the movie finishes, associate into the final picture. Add color to the picture. Rewind the movie. The movie should rewind in one or two seconds. Now you should be cured.
  • Double dissociation: Instead of just sitting in the cinema and seeing yourself on the screen, you float out of your body, go to the projection booth and watch yourself watch a movie about yourself. The rest is the same.
  • You can add resources to the movie. For example, add objects or symbols that are useful for the you on the screen to defend himself against the phobia. Or you can anchor the resources and fire them off at the beginning of the movie. Or you can watch the movie while hearing circus music.
8. Opening a Closed Object System

First determine the kind of object with which the child is preoccupied [long-slender, round-soft or round-hard, etc.], then collect about a dozen of the favored kind of object. With your collection of child-preferred objects close at hand, approach the child. While the child is ‘working’ with his/her object, quickly and firmly remove it from the child, then immediately replace it with one of the objects in your collection. Repeat this procedure 3-4 times the first day, 5-6 the second day, 7-8 the third day. As the child becomes accustomed to the interruptions and replacements, you can begin to delay returning the object for a second or two until s/he can tolerate delays of up to 5-6 seconds. The delay provides you with opportunity to place the object in front of your face so that the child continues to look at both you and the object. At this point, you might begin to offer objects that are slightly different to the child. For example, if s/he has been preferring round-soft offer round-hard, etc.

9. Intensive Behavior Analysis

This technique with an optimal age for effectiveness before five [05] focuses on teaching in small, measurable units of behavior systematically every skill that the child does not demonstrate – from relatively simple responses to complex acts. Each step is taught [often in one to one teaching situations] by presenting a specific cue or instruction. Sometimes a prompt is added [such as gentle physical guidance to get the child started]. Prompts should be used sparingly and faded quickly. Appropriate responses are followed by consequences that have been found to function effectively as reinforcers. A high priority goal is to make the learning fun for the child. Another is to teach the child how to discriminate among many different stimuli. Problematic responses [such as tantrums, stereotypes, self-injury, withdrawal] are explicitly not reinforced. Teaching trials are repeated many times, initially in rapid succession, until the child performs a response readily. The child’s responses are recorded and evaluated according to specific, objective definitions and criteria. Graphs provide a picture of progress. The timing and pacing of teaching sessions, practice opportunities and consequences are determined precisely for each child and each skill.

10. Fast Phobia

This metaperceptive technique can desensitize the client from the distressing memory by:

  • Identify what internal representation (internal picture, word, feeling) triggers the traumatic or phobic response.
  • Then isolate what has to happen in the environment or in the person’s mind to produce that particular internal representation.
  • This for the purpose of getting the client to have a different internal representation in response to the stimulus so he or she has a choice of ways to respond.
  • The new representation might be of the same category (visualization to visualization), or it might be one of a different category (visualization to auditory).
  • In either case, if the old trauma, or phobic response-producing representation, is obliterated by another representation of comparable intensity, the trauma, or phobic response, will not be activated (i.e., desensitization).
  • The cure of the trauma or phobia demonstrates that the tiniest change on the level of internal representation can often change an entire frame of reference.
11. Eye Movement Desensitization and Reprocessing

This is a controversial neurological approach which is combined with cognitive processes and consists of eight essential phases. Generally we take the point of view that what we call ‘mind’ is simply the functioning of the central nervous system. And the images, words, sounds, and feelings that make up subjective experience are simply the traces the processes of this nervous system leave in our awareness. Neurological approaches go about changing the mind’s programming by confusing the nervous system in ways that the subject doesn’t directly connect to the subjective phenomena he wants changed. EMDR and some other approaches access the nervous system through the subject’s eye movements and also by presenting the subject with tactile sensations (on the face) or audio switching from ear to ear. The empirical evidence confirming the effectiveness of EMDR does so very convincingly. In the process of empirical validation it is of great clinical significance to determine which portion(s) of the treatment package are responsible for which treatment effect. The empirical evidence supporting EMDR has yet to systematically apply the contents of the treatment, making it impossible to isolate the general effects of EMDR from the alleged effects of eye movements or any other stimulation of the sort (Lohr, Kleinknecht, Tolin, & Barrett, 1995). The systematic application of treatment components, as well as the assessment of emotional processing (which some EMDR studies have neglected) is extremely necessary in not only the investigation of treatment efficacy, but also in the validation of the theory that justifies the treatment’s clinical application (Lohr, Tolin, & Lilienfeld, 1998). Based on the empirical evidence, the question still remains regarding exactly how EMDR works.

The number of sessions devoted to each phase and the number of phases included in each session vary from client to client. The first phase involves taking a client history to evaluate the suitability for intervention. The client’s ability to deal with high levels of disturbance, the amount of external stress in his or her life, and medical conditions are all considered. The intervention plan is then designed. Phase two is the preparation phase, in which the clinician introduces the client to EMDR procedures, explains EMDR theory, establishes expectations about outcome effects, and prepares the client for possible between-session disturbance. At this point, clinicians often give the client an audiotape of relaxation exercises so that s/he can use it before beginning the EMDR sessions and between sessions. Guided imagery and relaxation are occasionally used during the sessions to facilitate the client’s ability to deal with the recalled memories. Phase three is assessment, which includes identifying the memory and an image that best represents that memory. Then the client chooses a negative cognition that s/he has in relation to the event, such as “I am useless/bad/unlovable”. The client then identifies a positive cognition to replace the negative one, such as “I am worthwhile/a good person/lovable” and rates how much he or she believes this positive statement using the 7-point Validity of Positive Cognition (VOC) scale. Then, the image and the negative cognition are combined, and the client rates his/her level of disturbance on the 10-point Subjective Units of Disturbance Scale (SUDS). The fourth phase involves desensitization. The client focuses on the negative affect and follows the clinician’s rapidly moving fingers, sweeping back and forth approximately 12 to 14 inches. The procedure is repeated in sets ranging from 10 seconds to longer than a minute, until the SUDS level is reduced to 0 or 1. Recently, it has been noted that eye movement is not necessarily needed, because similar results have been found by tapping alternate hands on a chair rest or broadcasting alternating tones in a client’s ear. Any of these strategies can be implemented at this point. It is also emphasized that these initial sets are often not sufficient for complete processing and that other strategies and advanced EMDR procedures may be needed to restimulate processing. Phase five is the installation phase, which focuses on cognitive restructuring. Here, the positive cognition is strengthened in order to replace the negative belief. The client holds the positive belief with the image in his or her mind and the eye movement sets are continued until the client rates the positive cognition at a 6 or 7 on the VOC scale. After linking the positive cognition with the target memory, an associative bond is created. Thus, the client believes the positive cognition when remembering the previously disturbing image. In phase six, the client holds the image and the positive cognition in his/her mind and scans the body in order to identify any tension. These body sensations are then targeted during the following sets of eye movements or alternative desensitization techniques. Phase seven is closure, which includes a debriefing reminding the client that s/he may experience disturbing images, thoughts, or emotions between sessions. The client is told that this is a positive sign and is often asked to keep a log or journal about negative thoughts, situations, dreams, and memories that may occur. If the client is not debriefed, there is a danger of decompensation or, in an extreme case, suicide. Phase eight is reevaluation, which is implemented at the beginning of each new session. Previously accessed targets are brought back and the client’s responses are reviewed to assess if the treatment effects have been maintained. New images or memories are then targeted following the eight-step procedure.

After the client has gone through these steps, the previously disturbing memories should be altered. The image may change in content or appearance, the sounds or voices recalled often become quieter or disappear, the client’s cognitions may become more therapeutically adaptive, and emotions and physical sensations often lessen in intensity. After treatment, many people feel as though a slate has been wiped clean and a space created where new learning can take place. They feel as if the memory is now a part of the past. Other positive effects are also common, such as improved competence, mood, attitude, or self-appraisal. Processing may continue on a sporadic basis for days or weeks following the sessions, including increased dream activity, mood changes, additional memory recall and new insights.

12. Establishing and Expanding a ‘Give’ System

First, get a variety of similar objects such as blocks of different shapes and a large container into which those objects can be thrown. Select a container that makes a satisfying, resounding sound when the object lands in it. Then set up a contagious system where you begin to rapidly throw the blocks one at a time into the container as you say “in!’ each time. If the child has not joined you, take his/her hand and help him/her [hand over hand] pick up and drop the objects one at a time into the container. As the child gets into this contagious system [evident as the child throws 4-5 blocks without support], introduce your extended palm right in front of where s/he throws the block and tap your palm urgently as you say ‘give!’. If s/he places the block in your hand, immediately drop it into the box. If not, keep trying this procedure until the child puts the block in your hand. Once s/he tolerates giving you the block while your hand hovers over the container, gradually move your hand to the left or right of the container and continue tapping your hand while saying, ‘give!’ as you did before. Again, remember to immediately drop the block into the box as soon as you receive it. Once the child can expand his/her response to your hand and spoken signal even when it is quite remote from the box, the same ‘give!’ sign can easily be extended to elicit his/her handing you other objects in other contexts.

13. Cross-mapping Submodalities

Visualize two situations, maybe one that you want to behave different in and one in which you behaved how you want to behave. Compare the differences between the submodalities of the pictures. You can change the negative picture into a positive one by changing the submodalities so that they match the submodalities of the positive picture. For example, the negative picture could be dim and the positive picture could be bright. In this case, make the negative picture brighter to change it to a positive one.

14. Coping Imagery

This is a process that can be mastered with regular practice in six simple steps:

  • Learning to relax.
  • Writing the sequence of events that make up a problematic situation.
  • Identifying the stress points in the sequence.
  • Planning specific coping strategies for each stress point.
  • Rehearsing the sequence in your mind using newly developed coping strategies.
  • Applying coping imagery to real-life events.
15. Coping in Vivo

Provides a coping script that can be used while learning to face feared situations. The client will need to develop specific self-instructions to:

  • Help physically relax.
  • Remind themselves of the action plan should they encounter problems during exposure.
  • Cope with anxious arousal and fight-or-flight symptoms.
  • Cope with catastrophic thoughts.
  • Accept anxious feelings as temporary and learn to float past them.
  • Distract themselves, if necessary, from frightening thoughts.

There are two options for how to use a coping script. The first is to memorize key elements of the script and use them as needed during exposure. The second is to record the script on tape and then listen to it on a portable cassette player while entering a feared situation. The one advantage of a portable cassette player is that it will remind the child of coping strategies even if anxiety is making it hard to think and remember what s/he wanted to do.

16. Coping with Panic

This is a clinical technique that includes four main components:

  • Education about the nature of panic – what causes it and how it can be controlled.
  • Breath control training – a simple technique to simultaneously relax your diaphragm and slow down your breath rate.
  • Cognitive restructuring to help you reinterpret frightening physical symptoms while learning to control catastrophic thinking.
  • Interoceptive desensitization – a technique that exposes you to your most feared physical sensations in a safe, controlled way, while teaching you how to cope.