Ivan Yau

Cognitive Behavioral Parent Group- Practice Wisdom and Personal Reflection

Theories Review

Behavior Learning Theories – Classical Conditioning, Operant Conditioning, Social Learning

Social Cognitive Theory (Bandura, 1986, 1997) – Reciprocal Determinism, Self-efficacy, Vicarious Learning,…

Cognitive Therapy – (Beck, A. 1989, also REBT of Ellis, A.)

Theories Review

Reciprocal Inhibition (Wolpe, 1958, 1990)

Problem Solving – Social Problem Solving, Interpersonal Cognitive Problem Solving

Self-instructional Training (Meichenbaum, 1977, 1985)

Concepts Highlighted

Schedules of reinforcement – five schedules and how to mix these well together?

Reinforcement – Direct Reinforcement, Vicarious Reinforcement, Self Reinforcement… and its implications for practice?

Merging of Social Problem Solving into Guidance and Conflict Resolution – how?

Advantages on Use of Group

Improved Assessment Frequent and varied opportunities for

mutual reinforcementLearn relationship skills effectivelyFacilitate transfer of new behavior to real

life

Some Orientations

Systematic Problem-solving OrientationGoal OrientationEmpirical OrientationCoping-Skill-Learning Orientation

Use of Group

Structure Vs Process- serving the group goals, different from

other theoretical orientations.Cohesion, Norm Structure, Role Structure,

Communication Structure, Leadership Structure, ……

General Process

Pre-group – orientation and assessmentGroup building, developing common

concernsLearning of coping skills Practice, transfer and maintenance of skill

learning (Five Stage Model, Brock & Coufal,1985)

Parenting Skill Training Group: Pre-group

Pre-group interview with guide and assessment tool – pay attention to flow of interactive pattern

Orientation – skill learning, group process, expected outcome, expectation members’ role,……

Assessing applicant’s concern – behavioral interviewing, commitment, previous group experience, ……

Further clarification – matching of expectations

Assessment – Further Tips

Severity of the problem – critical issues: adolescent’s out of control behavior, parent’s self emotional outburst

Homogenous Vs Heterogeneous considerations – Class? Educational background? Problem Nature?

Interactive Pattern – following the flow of discussion / over-ventilation

Group Building

Even and broad participations, particularly in early stage – control on agenda for small sharing in turn

Sharing similar background and positive experience / feelings first, not limited to problems to be dealt with

Matching of individual / common concerns and group goals, adjusting session plan if necessary – issues of study, anger control

Assessing Target Problem in Group

Situational Analysis – very usefulTools- structured group interviews,

keeping a diary, case-study, role-playing Developing a list of problem situationRestricted use in time-limited group

Situational Analysis

The interaction pattern is explored.Target behaviors are identified in

interpersonal context.The consequences are assessed to see if

the behavior is effective in achieving its intended goals.

Critical Moment is the point at which group member can do (think / feel) differently to handle the situation significantly better

Coping Skill Training

Incremental, building on small successLots of small exercises for practiceUse of multi-modelingSkill conceptualization matching with

participant’s cognitive complexityBehavioral Skills Vs Cognitive Skills

Defining Anger Scenario – an example

Use three sentences to describe the background of the situation

Describe the relationship of the situation to the general problem

Describe a recent event, your response and perceived consequences to yourself and others.

Degree to which you were satisfied with your response and how important to you

Modified from Sheldon Rose

Coping Skill Training

Skill application, instead of dealing with specific target behavior

Positive skill first – to reinforce desirable behaviors

Skill – rationale, applicability and conceptualization

Exaggerated demonstration of problematic interaction

Fine-tuning skills

Coping Skill Training – Cognitive work

Cognitive Restructuring – a powerful but very intensive intervention strategy

Worker should be very familiar with cognitive errors / dysfunctional thoughts

Exercises are very helpful for getting familiar with these concepts

Use of praise and attention is very effective in intervening in perception bias for many parents

Which one should come first? Cognitive Vs. behavioral skill training?

Coping Skill Training – on Anger

Perceptual shiftSIT – modified by Ivan and WilliamCognitive work Re-directing strategies一分鐘斥責法 ( 游達裕、黎頴之 , based on

Reciprocal Inhibition): 1. 指出不當行為 , 2. 表達感受 , 3. 沉默片刻 , 4. 重申對孩子的信任 , 5. 展示其他可接受的行為。

Coping Skill Training – on Conflict

Before outburst of emotion: Time-out – particularly useful for parenting on adolescents

Articulation of children’s needs first (mastery of active listening) and then own concerns

Negotiation on alternatives based on common concerns, use of problem-solving process.

Consolidation and Transfer

Home work design – guaranteed success, progressive, flexible

Close monitoring for home practice – particularly for early stage

Home work review – further consolidation, use of idea of BSFT, drawing common points for review

After group period, further design of home work assignment (1:1.5 principle)

Group Process

Reducing the structureIncrease in emotional sharing graduallyPrepare to handle new issues in group in

later stageDeveloping roles of group members and

communication patterns gradually

Personal Reflections I

Very practical, useful and powerful.Useful for developing group work practice

of other orientations.Much depends on ability to conceptualize

the target problem in CBT framework (also help participants to do so!)

Motivational work and orientation contribute a lot to its success, but these are usually ignored / overlooked.

Personal Reflections II

Reinforcing desirable behaviors, and what are desirable? issues of ‘value’ clarification. e.g. 你主動打電話給嫲嫲 , 去關心她 , 我很開心。 (Behavior + Value + Praise and Attention)

Cognitive restructuring – Perspective taking is the core foundation for relationship building.

Communication skill is usually neglected, but is used for different purposes in other approaches (e.g. PET)

My Web…

You may download this PowerPoint and Reference in my Web:

http://myweb.polyu.edu.hk/~ssyty/

Thanks!!