Clinical Prompt
Language & Concepts/Word Games
- is/is not
- and/or
- some/all
- before/after
- now/later
- same/different
Formal Problem Solving Dialogue
ICPS Dialogue Ladder
Means-ends Thinking
- means-ends story
- creative thinking
Consequential Thinking
- before/after
- What if…
- chain reaction consequences
- I’m stuck
- I don’t care
Evaluating Solutions
- feelings
- goal setting
- Problem Solving Tree
Forms & Charts
Problem Solving Tree CBT#20-001
Download Available | Worksheet
Introduction
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!”], parent 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.”
Symptom Effectiveness
Although educators and clinicians have historically asserted that relief of emotional tension can help one think straight, ICPS supports the reverse idea – the ability to think straight can help relieve emotional tension. ICPS will help children:
- 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.
For twenty-five years, ICPS has demonstrated successful outcomes through careful evaluation of thousands of ICPS trained youngsters from ages four to twelve with varied IQ levels from urban and suburban schools nationwide. This approach has been documented in three books for professional audiences, in educational training manuals, and in numerous articles in professional journals and has received several national awards. To cite just a few: In 1982 ICPS was chosen by the National Mental Health Association to receive the prestigious Lela Rowland Prevention Award, and in 1987 ICPS was selected as a model mental health prevention program by the Task Force on Promotion, Prevention and Intervention Alternatives, sponsored by the American Psychological Association. In 1992 the National Mental Health Association selected ICPS as one of its recommended programs. The Substance Abuse and Mental Health Services Administration recently recognized the intervention as an evidence-based exemplary violence prevention program. The most recent acknowledgments include kudos from Strengthening America’s Families Project and the Office of Juvenile Justice and Delinquency prevention as a model violence prevention program.
The teaching of these social competencies has been demonstrated to prevent behaviors – social withdrawal and conduct problems – that are associated with later problems in living such as depression, substance abuse, delinquency and suicide and also with other serious problem behaviors such as early and unsafe sexual activity, school dropout and violence.
Time for Mastery
Younger children up to about age eight, can benefit from ICPS by learning interpersonal problem solving skills that can reduce and prevent high risk behaviors in only three months time with three one half hour sessions per week or about thirteen and one half hours. Older children can also benefit, though it may take two three month programs or about twenty six hours of exposure to ICPS. Older children may already know the language and concepts, but find it difficult to overcome preconcieved reflex or automatic thoughts about problem areas.
Instructions
To the extent that interpersonal cognitive processes precede action, and that good problem solvers are better adjusted and more socially competent than poor ones, we can begin to envision social competence as a problem solving skill, not just in adults, but, as far as we can measure it in children as young as four [04] years of age.
An individual who can plan his or her actions, weigh the pros and cons, and consider the effects of interpersonal acts upon others is less likely to fail and make impulsive mistakes, and thereby suffers less frustration. If problem after problem should remain unresolved, and interpersonal needs remain consistently unsatisfied, maladaptive behavior and other social difficulties often ensue.
One process of thought, that of means-ends thinking, includes the ability to plan, step by step, ways to reach an interpersonal goal. As part of this process, one considers potential obstacles that could interfere with reaching that goal, and also recognizes that problem resolution does not always occur immediately.
Another process involves the spontaneous tendency to weigh pros and cons of transgression, a form of consequential thinking.
Means-ends thinking skills significantly distinguish typical children from the diagnostically disturbed or behaviorally troubled – beginning at about nine [09] years of age, while a spontaneous tendency to weigh pros and cons of an act emerges as a significant behavior during the adolescent years.
Language & Concepts
ICPS has a particular concern not only with being assured that the child is clear in understanding concepts, but in the way you and other adults talk to the child. Talking in ways that help children think about their problems is what ICPS is all about.
Shure tells us that four [04] year olds can not plan sequential means to reach a goal, but they can conceive of alternative ways to solve problems by naming different types of categories of solutions. Spontaneous weighing of pros and cons to an act is beyond their developmental level, but if specifically asked, they can describe what might happen next or what another person might do or say if an act were carried out.
Given these conceptual gifts, the first responsibility is to teach a consistent language that can be used to promote problem solving and to test the concepts engendered by this language. For young children, this is done by playing with words. Play is the work of children, and through play, children absorb and test themselves against the world. By incorporating word games with significant words and concepts into a play arena, the adult can capture both the learning and valuing aspect of such development. After the child is familiar with the words and concepts, the helper can provide a formal dialogue at the time when problems occur to help the child think through the problem and make the appropriate decisions.
Word pairs such as is/is not, and/or, some/all, before/after, now/later, same/different are important for framing the problem solving environment. Although the child may already be familiar with all or most of these words, they are used in a special way in the formal dialogue. These words are used in play because when children learn to associate particular words with play, they are more likely to use them when it’s time to settle disputes.
Young children will laugh when you first say, ‘Mommy is a lady, but she is not a kitten.’ Or, ‘Our feet look the same, but your feet are a different size.’ Or, ‘Do you think I should eat this banana before or after I peel it?’
These word pairs help children think if an idea is or is not a good one, and to think about what happened before a fight began, and whether ‘he hit you before or after you hit him’. Children enjoy thinking about different ways to solve their problem when they associate the word different with fun. And the are more willing to wait until later when they recognize the word later from their play games.
This does not mean that adolescents can not benefit from the use of such words, although it is likely that you will need to find an artful way to present them. They are not words that are unused in an adolescent vocabulary, but developing a formal dialogue in which you address in vivo problem experiences and help the adolescent ‘walk though’ the process after the fact, is in itself, a teaching process. For older children, the process is one of bringing the process into conscious consideration and overcoming ‘automatic thinking’.
Formal Problem Solving Dialogue
Poor problem solvers are likely to display behavior characteristics of impulsivity or inhibition, to show little concern for or even awareness of others in distress and are less liked by their peers.
The use of the formal dialogue changes the usual context for such an child or adolescents. Common themes of antisocial thinking include the belief and mind-set that they are being victimized. Many children and adolescents are accustomed to feeling unfairly treated and have learned a defiant, hostile attitude as part of their basic orientation toward life and other people. From the cognitive perspective, both their perception of being victimized and their hostile response to it are learned cognitive behaviors. These are learned ways of thinking that are reinforced by experiences of success and self gratification. For instance, the sense of victim outrage is itself a feeling of strength and righteousness, much preferable (in their mind) to feelings of weakness and vulnerability.
Unfortunately, such beliefs are all to often supported by the ‘power assertion’ approach to child management, which is focused on punishment, rather than resolution of the problem.
The use of the formal dialogue of ICPS specifically redirects the disruptive person to focus on the facts of the situation, including his/her own thoughts in regard to the means-ends and consequences of their actions. The language and concepts need to be consistent, although the process of dialogue will follow a natural course.
The ICPS Dialogue Ladder
Shure suggests that there is a dialogue ladder with rungs indicating the approach to the child/adolescent in relationship to problems. At the bottom of that ladder is a command and control process which demands, belittles and punishes. This is easily identified by such power assertions statements such as ‘Go to your room!”, “That’s stupid!’, for ‘Get out of the way!’; which may be followed by yanking the child and/or slapping.
One of the Mentor’s responsibilities is to collect data on in vivo events, and you should identify when and how often and by whom, the child is confronted with such power assertions and other lower rung approaches, and report this information to the Clinical Supervisor. In this way, the Clinical Supervisor may be able to teach the adult responsible a better method of child management.
Rung 2 is identified by Shure as Suggestion Without Explanation – such as ‘Please move over to one side of the TV.’ While this is less confrontational, the locus of control is still with the adult and for children with whom control is an issue, this may still lead to confrontation and ultimately Command and Control responses.
Rung 3 is only slightly better in that it provides Suggestion with Explanation, Including Feelings. “If you stand in front of the TV, we can not see.’ or ‘I feel angry when you block our view.’ While this may be helpful to many children, it is unlikely to appease the need for control of the disruptive child.
Rung 4 is the Formal ICPS Dialogue which focuses the whole decision process on the child and provides a clear process of consideration of word concepts, feelings, solutions and consequences and allows the child/adolescent to make the choice. This process does not preclude the implementation of strong consequences for continued poor choices, but it helps to make explicit to the child and adolescent what those choices are and that they are responsible for their choices [giving the child a sense of power].
The responsibility of the Mentor is to always stay on the Formal ICPS Dialogue rung of the ladder regardless of what other authoritative people may be doing. The process is one of training the child/adolescent how to think, not what to think.
Means-ends Thinking
Give the child/adolescent a means-ends story depicting hypothetical problems between an adult and a child/adolescent, or between two children/adolescents. Then ask the child/adolescent to make up a story connecting the beginning and the end. Score the number of means provided to reach the stated goal; and the number of obstacles conceptualized which might impede reaching the goal. Many children with problems in living will have a higher degree of capacity to identify the problems than the solutions.
Increasing the number of alternative means or solutions requires two components:
- to focus the child on the solution rather than the problem, and
- to help the child think creatively about solutions.
To be creative requires, that the habitual be made conscious. We must focus our attention. Wonder & Donovan [1984] propose that we construct a mental, slow motion movie of a situation looking for aspects that we have previously overlooked.
We tend to formulate our point of view to protect our preconceived attitudes. It makes us distort, rationalize or forget things. In order to be creative, we must abandon or at least constrain our attitudes. One way to do this is to deliberately look at the issue from different perspectives.
Certain basics can be extrapolated.
- We can look at the process – which deals with change in time and space [growth, transformation, development, evolution, sequence, stage and cycle]. By concentrating on the details of order we ask about phases and steps, expansion/diminishment, etc.
- We can look at differences [contrasts, distinctions] or similarities [connections, affiliations]. These help us to define allegories – “This is like that” – or metaphors – “this is that”.
- We can view the problem on a different order or level. What does society look like from a molecular level or an astrophysical level. Social problems of individuals look differently from higher or lower orders.
All of these changes of perspectives are important, but perspective is not limited to these constructs. We can change our perspective by becoming someone or something else. One effective method is to prohibit your present thinking. If they passed a law prohibiting what you think should be done; what would you do?
As a quick review the table below captures the three basic principles of creative thinking techniques:
Attention: to what?
- elements in the current reality
- features, attributes, and categories
- assumptions, patterns and perspectives
- metaphors and analogies
- what works and what doesn’t
- anything you don’t normally pay attention to
Escape from what?
- current mental patterns
- time and place
- early judgment
- barriers and rules
- past experience
Movement in what sense?
- in time or place
- to another point of view
- free association
- building on ideas
With these factors in mind, many of the creative thinking gurus can offer specific techniques for consideration. However, if we look closely at the Formal ICPS Dialogue, we see the principles of creative thinking captured within the process. We gain attention through shaping the criteria to is/is not, before/after, etc. Moving to the mental processes that make up problem solving, we escape through probing for sameness & differences from our past experiences and hierarchy of ideas, while moving into a differing point of view through the exploratory concepts of and/or. Thus, the Formal ICPS Dialogue is a process of stimulating creative thinking.
You may not need more than the Formal ICPS Dialogue, but if you believe that you or the child need additional creative thinking support.. For older children lateral thinking or thinking hats may have some appeal.
Consequential Thinking
The people in society who repeatedly respond to their problems with others in insensitive, cruel or destructive ways haven’t grown up in the habit of thinking about the consequences of their solutions before they act. It is difficult for some children to think about what they could do and what might happen if they carry out an action.
The goal of consequential thinking is to help the child think about what might happen next if a particular solution is carried out. Therefore, consequences make sense only when children know that events follow one another in a certain order.
Sequential thinking can be reviewed by looking back at the word games for before and after. You can practice this concept with the child while you are doing any two step process. ‘I put the toothpaste on my brush before I brush my teeth.’
Story building is another sequential game. Make up a story about anything at all and then let the child finish it. Or stop and allow the child to add an event. ‘Mother mixed all the ingredients for a cake and then she…..’ After the child interjects a step, you can continue the story to the next stop. Or you can gather a group of children and have them take turns interjecting or finishing.
You can also review the idea of sequence with a game called ‘What might happen IF…’ This can be shaped for older adolescents by the way you develop the circumstances. You give the child the circumstances and let them fill in the consequences. You can try the following for starters:
‘What might happen IF…..
- you stayed up all night
- you didn’t do your homework
- you smiled and said hello to everyone
- you weren’t afraid of anything
- you stole a car
The advantage of this game is that it provides not only the opportunity to practice the concept of consequences, but offers some inferences about the child’s values and belief systems.
As with alternative thinking, the word might is emphasized because no one can predict what will happen next – consequences when other people are involved are never a certainty.
For younger child you can consider consequences by following this procedure:
- state the problem or have the child state the problem
- elicit alternative solutions in the usual way
- stop at a solution that is conducive to asking for consequences [usually ‘hit’, ‘grab’ or ‘tell someone’ are good to start with]
- write the solution on the left side of the paper
- announce that you are going to make up a different kind of story about what might happen next. Ask for lots of different responses,
- list each response on the right side of the paper, drawing a line from the solution to each response.
If the child offers a chain reaction consequence, point it out to the child and then get back on the right track. If the consequence is unclear or seemingly irrelevant, probe the child to find out what s/he had in mind. It is especially important to question the child as to who is doing the action. An answer of ‘nothing’ or ‘I don’t know’ may be a genuine response that shows that the child is stuck and can’t think of anything, but may also mean that they don’t care or don’t want to think about it.
It is important to figure out if it is an ‘I’m stuck’ or ‘I don’t care’ response. If a child’s answer is ‘nothing’, you can respond by saying Maybe nothing will happen, but let’s just make up something that might happen. Encourage the child to ‘pretend’ a consequence. If a child’s answer is ‘I don’t know’, you can agree with them that no one can be sure what will happen, but then encourage them to pretend and make up something that might happen.
If a child gets stuck on variations of the same theme, you can point out that those things are ‘kind of alike because they all __________________[tell someone].
Evaluating Solutions
When you give children the freedom to think of ways to solve their own problems they will occasionally come up with solutions you may not like. Research shows that when they learn to think the ICPS way they are, in time, less likely to act on the kinds of solutions that really don’t solve problems.
If the child offers solutions that seem inappropriate or undesirable, you can help them reevaluate their ideas by asking such questions as:
‘How would (the other person) feel if you did that?
‘What else might happen if you do that?’
‘What is something different you can do so that won’t happen’
In continuing to seek alternatives, there is the implication that the solution is not the ideal one, without the criticism. Children, even very young children or children with severe problems in living, know good solutions when they consider them. The problem is to get them to consider them. For older, confrontational children, the problem is one of power. They need to have the power to decide – sometimes even to do what they know is not an adequate solution to reach their goals, but to do it without your authority.
What is needed is a different experience; a new and fortifying relationship. One which will engage the individual’s positive will and affirm his/her right to be different from others. Having had this difference accepted by others, the individual can now accept him/herself. Self acceptance becomes possible through the love experience [Rank] of being accepted by another person. The valid love relationship requires acceptance of the self-willing in another, bestowing worthiness in preparation for choosing meaning. Thus worthiness is not in ourselves and our behavior, but in the acceptance of that behavior by someone significant to us.
This does not imply, that there are not necessary consequences to such self-willed behavior. But those consequences are not personal, they are formal. And the more the consequences are oriented towards training the child to make better choices rather than punishing the child for transgression; the more they transfer discipline to the child as self-discipline. In order to gain the trust and assistance of the child, you will need to understand that better is defined by the child. The art of the approach is to help the child reach his/her goals regarding problem solutions, not reach goals that you or other authorities sanction. This may require work on the development of other goals than simply avoiding what adult authorities believe is in his/her best interest [See Technique #27 – Motivation &Goal Setting].
Depending on the age of the child, you can use the Problem Solving Tree [CBT#20-001] to have the child work out the problem solving situation on paper and determine how well such solutions meet his/her goals. And in the process, determine the need for training the child in goal setting.
Have the child list in the left hand column an event that seems to have been a problem in the past. Discuss with the child the type of event and ask the child to state what they would identify as the best possible outcome of the event. Have the child write this as a goal statement.
In the next column, have the child list as many solutions as s/he can think of [leave space between the solutions]. After all the solutions have been listed, ask the child to list what might happen if s/he were to implement the solution. Probe until the child has listed all of the possible consequences s/he can think of for each possible solution. Have the child draw arrows from the appropriate solution to the consequences that are connected.
After the consequences are listed, have the child prioritize the consequence with #1 being the consequence that is closest to the goal statement.
The child can develop a different problem solving tree for each problem situation identified.
Summary
As the process of the formal dialogue become habitual, the child will be able to use these skills without formal prodding or with minor ‘cues’. The skill is one that, once mastered, tends to improve over time. While we could hope that all four year olds are taught the skill, it is never too late.
Download Available | Worksheet