Transcript isart

isART
luke moynahan & Geir Sollid
nordART
2004
it takes a whole village
to raise a child
English saying
the challenges
• children and youth’s access to media violence is
increasing (APA 1997; Bushman & Anderson, 2002)
• displacement of persons is increasing, worldwide
• appropriate models for coping with stressors are
lacking or not provided
• anti-social behaviour among youth is increasing,
worldwide (World report on violence and health: WHO, 2002)
• parents are spending less time with their young
social competence
• persons demonstrate social competence when
they…
– initiate and sustain reciprocal interpersonal
relationships with members of their intimate,
effective and available social networks
– attain personal goals with high probability and
contribute effectively to attaining collective goals
– satisfy culturally determined explicit rules and
implicit norms for conduct in accordance with
established fundamental human rights and cultural
practices,
– which result in positive evaluation by others
Gundersen & moynahan, 2003.
social competence
• social competence is a behavioural competence
that cannot be understood independent of
contextual demands
• can not be defined solely with respect to the
capacity or behavioural dexteritey of the
individual
• from a teaching perspective it is necessary to
take account of both contextual and
developmental factors in providing training…
– social arenas
• family, school, community, work
• dyads, groups and larger systems
– age: developmental transitions, increasing demands
• skill complexity
• subtlety of contextual stimuli
positive consequences
• research within developmental social
psychology (int.al. Durkin, 1995), social and
clinical psychology (Seligman, 2002; Barlow &
Durand, 1996)
• reveals that children who demonstrate high
levels of social competence … also show
– improved physical health, higher school
achievement, larger social networks and higher
degree of perceived social support, higher
probability of employment
costs of non-competence
• children who demonstrate low social competence
reveal increased vulnerability to …
– poor physical health
– educational under achievement
– family dysfunction including high levels of family stress
factors,
– social isolation and weak social networks,
– increased risk of conduct disorders, aggressive and antisocial behaviour
– increased risk of susbtance abuse
– underemployment and unemployment
• (Andrews; Dodge; Farrington; Loeber; Patterson; Ogden;
Svedhem)
heuristic model
• SE
MOm
SDm
Rm
SR m
Pm
Setting event
motivational operation (multiple)
diskriminative stimuli (multiple)
multiple responses
reinforcing stimuli (multiple)
prompts
Tertiary
treatment
prevention
individual
Secondary
group focus
prevention
Primary
prevention
population focus
high
cost
structured
educational
information
low
cost
Goldstein
the Prepare Curriculum
• Arnold P. Goldstein (1934 - 2002)
• originally trained as a psychoanalytic
psychologist
• came quickly under the influence of Bandura
• (1973) Aggression : A social learning analysis
• developed a skills based programme for use
with juvenile delinqents
• (1974) Structured Larning Therapy
• fully developed a multi-component programme
in the late 1980’s
• (1988) The Prepare Curriculum
Prepare Curriculum
(Goldstein, 1988, 1999)
• consists of 10 component programmes
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skillstreaming (interpersonal skills)
situational perception training
problem solving training
stress management training
anger control training
cooperation training
understanding and using groups
empathy training
moral reasoning training
recruiting pro-social support
PEACE
• developed from the Prepare Curriculum
and Aggression Replacement Training
programme by Dr. Sara Salmon (2003)
• Parental empowerment
• Empathy
• Aggression management
• Character education
• Essental social skills
Aggression Replacement Training
• developed with multi- problem, delinquent youth in
youth correctional facilities in north eastern USA by
Arnold Goldstein and Barry Glick (1988) - later,
collaboration with John Gibbs (1998)
• based on social learning analysis of aggression
(Bandura, 1973), stress inoculation training
(Meichenbaum, Novaco & Feindler) and the epigenetic
Moral Development paradigm of Kohlberg (1968).
• Comprises three components …
• skillstreaming
• anger control training
• moral reasoning training
Aggression Replacement Training
• skillstreaming – behavioural component
– interpersonal skills training
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40 skills for preschool and elementary school children
60 skills for late elementary and middle school children
50 skills for adolescents
teaches pupils what to do
• anger control training – emotional component
– affective skills training
• coaches pupils in identifying the causes, cues and consequences of
anger and aggressive responding
• teaches pupils to use pro-social alternatives
• moral reasoning training – cognitive component
– values based training
• through the discussion/debate of relevant moral dilemmas children are
guided to adopt more mature and pro-social moral judgements
• immature moral reasoning is subjected to challenges by trainers and
group members
skillstreaming
skillstreaming with groups
basic training method
• 2 trainers demonstrate the chosen skill twice
• the group is asked to describe what they saw in
sequence*
• group members discuss the relevance of the skill to
their own lives, similar experiences are evoked
• all members of the group role play the skill
– step by step replay of the modelled skill, trainers provide and
rapidly fade specific prompts in order for the students to
attain fluent use of the skill
• feedback round after each role play
– response specific feedback to the main actor is provided by
the co-actor and the group. Video recording is used as
feedback and basis for self-feedback
• homework and transfer training tasks are planned
refinements
• in working with pupils with autism spectrum
disorder (ASD) and especially with children
and youth with Asperger syndrome
refinements have been necessary in order to
improve efficacy…
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observation + description during demonstration
”Arne Scheie & Steven Spielberg” method
task analyses of skills to yield critical components
fluency training of component skill elements
behaviour specific feedback routines
skillstreaming
• adjustments to skillstreaming
– selection of skills based upon functional behavioural
assessment by child, parents and teachers
– simultaneous and delayed imitation training
– microtraining – fluency training of microskill elements
with rapid, response specific feedback
– correspondce training – say/do and do/say
– use of video in training of self-evaluation of
performance (reflexive feedback)
– skills virus/general case programming
– commentator (simultaneous descriptor) and director
(functional instruction) training
“transfer training"
• laminated skill cards highlight the major steps
and rules for use of skills, trainers may use
fotoflows* (self-modelling) as well as booster
training in natural settings
• overlearning – the group design ensures
several repititions of the skill (multiple
exemplar training) homework tasks also
ensure further trials
• identical elements – role plays are made as
lifelike as possible
“transfer training"
• stimulus variation – invite other trainers,
students to session, train in several locations
at different times, creative use of homework
• use of reinforcement contingencies – students
are trained in
– self-reinforcement *
– external reinforcement contingencies may be
planned with parents other teachers etc (contrived
reinforcement s\can be used)
– group contingencies and group token economies
may be established to ensure vicarious
reinforcement
ART with ASD populations
• necessary enhancements to skillstreaming
– refinements of interpersonal skills
• microtraining of skill elements
• family skills training
– increased opportunities for rehearsal:
• fluency training of component skills
– extended modelling procedures
• simultaneous – delayed imitation
• fotoflow and self-modelling (Dowrick, 1977; moynahan, 1979)
– selection of skills based upon interventive assessment
& joint functional analysis (moynahan, 2001)
anger control training
anger and aggression
• anger – physiology
– detrimental physical effects including decreased cortisol
modulation of testosterone, increased blood levels of
catecholamines, depletion of frontal cortical serotonin,
corticolimbic GABA dysregulation, insuline resistence,
increased FFA blood levels, circulatory problems etc
• arousal – detrimental psychological effects
– aversive state, uncontrollable, stimulus over selectivity,
disposes towards violence
• verbal behaviour
– ”aggressive inners” (Cooper, Kostewicz) pervade thinking and
disturb social functioning
• imaginary behaviour
– catastrophic imagery, violent imagery, disturbed sleep and
increased hostile attributions
• facilitation of aggression
– aggression as addiction, stimulus overselectivity
what is anger control training?
• training consists of the gradual, week by week
build up of an alternative chain of anger
replacement skills
• training involves exposure to anger provoking
events combined with use of alternative skills
• in working with children and youth with autism
we have included techniques based upon
relational frame theory (Hayes, BarnesHolmes & Roche, 2002)
anger control training
1.
2.
1.
2.
3.
4.
anger triggers
external triggers
internal triggers
+
anger cues
+
anger reducers
breathing techniques
counting backwards
pleasant imagery
thinking ahead (consequences)
+
positive reminders
+
self evaluation
+
use of skillstreaming alternatives
anger control training
1.
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INTRODUCTION, the ABC’s of anger
antecedents, behaviours and consequences of anger
anger as a natural response to aversive events
preparing for flight or fight
2. TRIGGERS; external triggers (people, events)
internal triggers (thoughts, emotions, selfdialogues) of anger* (fuse metaphor)
3. ANGER CUES (signals); muscle tightening,
clenched fists, pounding heart; internal
changes – ”stomach dread”, ”boiling” etc
ANGER REDUCERS; deep breathing,
backwards counting, pleasant imagery*
STEPS WEEK BY WEEK
4. POSITIVE REMINDERS; self-instructional
coping statements*
5. SELF-EVALUATION; self-rewarding
statements based on coping performance *
6. THINKING AHEAD, rehearsing the
consequences of actions*
7. ANGRY BEHAVIOR CYCLE; what do YOU do
to make others angry*
steps week by week
8. REHEARSAL OF FULL SEQUENCE;
steps 1-7 + social skill
9. REHEARSAL OF FULL SEQUENCE;
hassle log review
10. OVERALL REVIEW; full sequence
“angerometer”
what angers you?
very angry
angry
irritated
how do you react?
refinements
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use of mindfulness strategies*
use of acceptance strategies*
transformation of response functions*
alternative coping strategies such as …
walk and talk with yourself,
self questioning: ”what does s/he really want?”
standing at an angle,
hands in pockets,
scaling the stressor (KKK),
refinements
– fluency training in identification of anger
signals, interne and externe triggers
– regaining composure (self control)
– helium balloons
– turning point and bubble talk techniques
– magic remote control
– response specific feedback from the group
– reflexive (self) observation with use of
video – ”how provoking am I?”
ART with ASD populations
• school based ART – occurrence of ASD required
us to train with mixed groups of pupils (AD/HD,
CD)
• ASD requires us to focus on interdependent
operants and contingencies operating in the
pupils intimate and effective social networks
– intimate: families and near friends
– effective: schoolmates, neighbours, teachers
• social competence as a subject in its own right
provides a forum and a curriculum for nonsegregated school based training
transformation of response
functions
• from anger cues to ART reminders
– RFT reformulation of verbal behaviour (Hayes,
Barnes-Holmes & Roche, 2002)
– prior training in regaining of composure
– training in reflective and reflexive observation of
anger cues
– thanking the anger cues – Vygotsky-Luria sequence
– performance of anger reducers physical and verbal
– performance of alternative interpersonal skill
– completion of the alternative to anger cycle
training transformation of response functions
750
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Frekvensregistreringer av målatferd.
August.2002 - Juli.2003
1000
950
900
850
800
Etter ART
700
650
Vold.
T
R
F
Etter ART
Trusler
T
R
F
Etter ART
Uaksept. Sosial atferd
T
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Etter ART
T
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F
600
550
500
450
400
350
300
250
200
150
100
50
0
Uhensiktsmessig sosial atferd
Frekvensregistrering av målatferder
August 2003 - 2004
130
120
110
100
90
Slag
slag m/ gjenstand
Spark
Dytting/skubbing
Kasting av
gjenstander
Truer m/ gjenstand
Direkte verbal trussel
Indirekte verbal trussel
Skinnangrep
80
70
Spytter på nær.p
Spytter på fremmede
Smeller i dører
Banning
Høylytt nekting
Knuser/ødelegger
gjennstander
Brøler/roper
Overdreven klemming
Ikke ønsket berøring
oppsøker nabo ubedt
Tar kontakt med fremmede
60
50
40
30
20
10
aug.03
sep.03
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0
Vold.
Trusler
Uaksept. Sosial atferd
Uhensiktsmessig sosial atferd
22
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30 200
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Reg. Positivt samspill, 15 min. intervall.
22.11.02 - 31.05.03
100 %
90 %
80 %
70 %
50 %
10 %
NAFO
60 %
Juleferie
30 %
sum i prosent,P
20 %
sum i prosent,H
Poly. (sum i prosent,P)
Vinterferie
Påskeferie
40 %
Poly. (sum i prosent,H)
0%
01
.0
6.
20
06
03
.0
6.
20
11
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16
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Positivt samspill med 30 min. intervall
01.06.2003 til 30.09.2003
100 %
90 %
80 %
60 %
50 %
40 %
hjemme hos
Mor&Far
ferie med
personal
70 %
Reg.ark
Mistet?
Sommerferie med Mor og Far
reg. helg
Mor&Far
Reg.P
Reg.H
Poly. (Reg.H)
30 %
Poly. (Reg.P)
20 %
10 %
0%
25.02.2004
18.02.2004
11.02.2004
04.02.2004
28.01.2004
21.01.2004
14.01.2004
07.01.2004
31.12.2003
24.12.2003
17.12.2003
10.12.2003
Poly. (Sum.reg.P.)
03.12.2003
10 %
26.11.2003
Poly. (Sum reg H.)
19.11.2003
20 %
12.11.2003
05.11.2003
29.10.2003
22.10.2003
15.10.2003
08.10.2003
01.10.2003
Positivt samspill med 30 min. intervall.
01.10.2003 - 28.02.2004
100 %
90 %
80 %
70 %
60 %
50 %
40 %
30 %
Sum.reg.P.
Sum reg H.
0%
moral reasoning training
moral reasoning training
• adaptations and enhancements
– role play based presentation of dilemmas
– role play as contrived exposure to
provocations
– turning point and four step techniques
– ”bubble talk” techniques
– commentator and director techniques
moral reasoning training
dilemma discussion methods
dilemma discussion –method 1
• the goal is to create conflict (cognitive
dissonance) – perturb students immature or
dogmatic moral stance
• group composition and dynamics are vital –
trainers must ensure that the group comprises
both stage 1 & 2 reasoners
• rules must ensure active participation, respect
for each others opinions and the right to
disagree
• discussion starts with the trainer who presents
the dilemma, copies are given to each student
• trainer asks for opinions from each member and
leads discussion.
dilemma discussion –method 1
• trainers encourage differences of opinion
• when level 1 reasoners are confronted by level 2
reasoners whom they like and respect the level 1
reasoners experience a dilemma that is
uncomfortable (dissonance)
• trainers adjourn discussion until the next meeting
• level 1 reasoners often seek out level 2 reasoners and
seek further clarification (why did you say that? why
do you mean that? – between session change
dilemma discussion – method 2
• the goal is to help the group arrive at a more
mature moral reasoning level
• 1 – a written dilemma is provided to each member
and is read out loud by the trainer or group
members
• 2 – trainers lead a summary of the dilemma (with
use of flipover)
• 3 – trainers then elicit opinions, suggestions and
solutions form each member
• 4 – trainers then conduct a polling of support for
each suggestion etc
moral reasoning training
• adaptations and enhancements
– role play based presentation of dilemmas
– role play as contrived exposure to
provocations
– turning point and four step techniques
– ”bubble talk” techniques
– commentator and director techniques
dilemma discussion – method 2
• 5 – group is divided into two smaller groups
• 6 – each trainer helps her/his smaller group refine
their arguments
• 7 – a spokesperson is chosen to present the
opinions and arguments of the smalle group
• 8 – the larger group reconvenes – arguments from
both smaller groups are written up on the flipover
• 9 – the group debates the newer arguments
• 10- debate continues until consensus is obtained or
that members agree that they are satisfied with
own presentation
PEACE CURRICULUM
• Cuuriculum developed by Sara Salmon
and colleagues as ”extended ART” at
peace4allkids, Center for Safe Schools
and Communities
• P – Parental empowerment
• E – Empathy training
• A – Aggression management
• C – Character education
• E – Essential social skills