Wednesday, May 16, 2012

Week 3 Group Topics and Review


         Week 3 of 8

Week three of the Collaborative Problem Solving Parent Group offers parents a detailed description of Plan B.

If you are reading this as a therapist, teacher, or other professional working with a child or family, background knowledge of the model is recommended.

Week 3 Practice:
The group practiced identifying potential triggers based on specific lagging skill constellations and started creating a list of their child's unsolved problems.

Week 3 Information:
Problems to be solved, Escalation Cycle with and without skills, considering the brain you are trying to connect with, Teens, Trauma and life-long brain plasticity.

Problems to be solved:

Antecedents or triggers are the unsolved problems. These are usually quite predictable situations which require specific thinking skills to handle in an adaptive fashion. Unsolved Problems are the situations which outstrip the child’s capacity to cope. When a person is unable to cope adaptively with a situation, maladaptive behavior tends to surface. A problem tends to contain two unmet concerns: the concern of the child and the concern of the parent/adult.

Escalation Cycle:
A trigger that is met with the thinking skills to handle that trigger, may produce a slight escalation off baseline as the child becomes a little uncomfortable. A trigger that a child does not have the thinking skills to handle in an adaptive way, is likely to set in motion a more intense escalation featuring higher levels of emotion and less access to the frontal lobes of the brain. When this happens, IQ drops fast, and the escalated person becomes less and less able to reason, plan, understand language, and control their behavior. The peak of each person's escalation is different. For one child, the "peak" may be hiding quietly in a closet refusing to come out. For another, it may be hitting, head banging, cutting, throwing, and other aggressive or destructive behaviors. 

Managing escalations is rough, exhausting, thankless, and, sometimes, dangerous work! There are not good or magic solutions to apply once someone is fully escalated and out of control. If you experience such escalations, you know that you have to do your best to keep yourself, your children, and your family as safe as possible; and get through it yet again. 

What you are learning will help! You will gain the skills to:
Decrease escalations by using Plan C
Decrease escalations by solving the problems that trigger the escalations by using Plan B
Help your child calm and become re-regulated early in an escalation by using Emergency B
Keep in mind that, "Kids do well if they can," and that "Doing well is preferable."
Decrease escalations over time by strengthening their thinking skills. Higher skills=better coping 

Predictability vs. Unpredictability
Certain situations require certain thinking skills to handle. It can be predicted that a child lacking certain skills will have difficulty in certain situations requiring those skills. Right? Often, parents, discouraged and overwhelmed by a long history of negative behaviors and a lack of effective strategies to deal with those behaviors, come into group, or therapy, with the idea that, ”The explosions happen all the time, over anything, and are totally unpredictable,” or some variation of this sentiment. Use of the “Making Meltdowns Predictable Trigger Worksheet” should help make the meltdowns more predictable and add some sense of reason to why they happen.

Plan B Prep and Adult Concerns
Prior to heading into a proactive Plan B conversation, it is best to think through or write down guesses about the child’s possible concerns and the adult concern. What is the adult concern about brushing teeth in the evening? Concerns for adults usually boil down into health issues, safety issues, and future well-being. The brushing of teeth usually brings out the concerns for future tooth health and the financial burden of dental work.

Before starting Plan B put aside your preconceptions and predictions about what the concerns of the child are. You may have to help the child identify their concerns through educated guessing, but it is up to the child to say, “Yeah, that’s it!”

Forget your solutions and remember your concerns. “You are going to brush your teeth” is a solution whereas “I’m concerned that you might get cavities and you’ll end up at the dentist a lot. That would be painful for your mouth and the family bank account” is a concern. “I am not going to brush my teeth” is a solution addressing the concern of “The toothpaste burns my mouth.” The final solution agreed upon must meet the concerns of both parties and may not be what you originally wanted.

Why Plan B? Plan B Teaches Skills (a very incomplete list)
Empathy
            Language processing
            Emotional regulation (especially in emergency Plan B)
            Social skills
Define the Problem
            Perspective taking
            Empathy
            Executive skills, short term memory, organizing thoughts
            Cognitive flexibility
Invitation
            Cognitive flexibility
            Social skills
            Language processing
            Executive skills, anticipating consequences

Extra credit: If you really want to get in to this…go through the lagging skills one by one and think through which steps practice which skills in one or more of the participants of the Plan B conversation. This was a group exercise in the last Teir 2 training by Stuart Ablon I attended. The general consensus in the room was that most skills are touched on in each step of Plan B.  

Things to Remember:
Kids do well if they can
Doing well is preferable
Know your concern before you start
How you explain the problem leads to how you solve it
Remember your child's pathways
Remember your child's triggers and Unsolved Problems
Drill down to find the concern (when, where, with)
Empathy, Empathy, Empathy

Plan B in a Nutshell
Step 1.  Empathy/ Reassurance
-Drilling down to find the concerns.
“What's Up” + Empathy Statements
Step 2.  Define the Problem
-Putting both concerns on the table
“I hear you are upset about____ and
I am concerned that______.”
Step 3.  Invitation
-Child generates solutions, becomes part of process.
“Let's work on this.” / “Do you have any ideas?”
-“That's an idea.”
-Is it doable? Does it meet both our concerns?
-”Let's give this a try!”

Week 3 Homework:
Try pro-active Plan B with your child
Read chapters 8 and 9
Do something fun and unexpected with your child!

What the Kids Did This Week: (If we are running a youth group above and beyond childcare)
•  Kids in our childcare listened to a short story about a boy named Raymond. Raymond has new friends down the street and has been staying there until dark, when his parents expect him home. His parents are concerned that this summer, Raymond has been staying out later and later, possibly wearing out his welcome and just getting home too late. Small groups talked about the situation and each participant drew or wrote down ideas and solutions to the problem.
• The small groups also thought through the problem of room-cleaning. Kids wrote or drew ideas about why it is important to the grownups to do it and, from their own perspective, what bugs them or is hard when it is time to put away the mess.
• The kids also had dinner with their parents!

Week 3 Handouts:

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