Ivan Yau

1. Ivan Yau Cognitive Behavioral Parent Group - Practice Wisdom and Personal Reflection

2. 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.)

3. Theories Review • Reciprocal Inhibition (Wolpe, 1958, 1990) • Problem Solving – Social Problem Solving, Interpersonal Cognitive Problem Solving • Self-instructional Training(Meichenbaum, 1977, 1985)

4. 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?

5. Advantages on Use of Group • Improved Assessment • Frequent and varied opportunities for mutual reinforcement • Learn relationship skills effectively • Facilitate transfer of new behavior to real life

6. Some Orientations • Systematic Problem-solving Orientation • Goal Orientation • Empirical Orientation • Coping-Skill-Learning Orientation

7. Use of Group • Structure Vs Process • - serving the group goals, different from other theoretical orientations. • Cohesion, Norm Structure, Role Structure, Communication Structure, Leadership Structure, ……

8. General Process • Pre-group – orientation and assessment • Group building, developing common concerns • Learning of coping skills • Practice, transfer and maintenance of skill learning (Five Stage Model, Brock & Coufal,1985)

9. ParentingSkill 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

10. 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

11. 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

12. Assessing Target Problem in Group • Situational Analysis – very useful • Tools- structured group interviews, keeping a diary, case-study, role-playing • Developing a list of problem situation • Restricted use in time-limited group

13. 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

14. Coping Skill Training • Incremental, building on small success • Lots of small exercises for practice • Use of multi-modeling • Skill conceptualization matching with participant’s cognitive complexity • Behavioral Skills Vs Cognitive Skills

15. 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

16. 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

17. 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?

18. Coping Skill Training – on Anger • Perceptual shift • SIT – modified by Ivan and William • Cognitive 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。

19. 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.

20. 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)

21. Group Process • Reducing the structure • Increase in emotional sharing gradually • Prepare to handle new issues in group in later stage • Developing roles of group members and communication patterns gradually

22. 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.

23. 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)

24. My Web… • You may download this PowerPoint and Reference in my Web: http://myweb.polyu.edu.hk/~ssyty/ Thanks!!