Presentation is loading. Please wait.

Presentation is loading. Please wait.

Diana Joyce, Ph.D. NCSP Douglas Jones, B.A. Angela Dobbins, M.Ed. University of Florida 1 All.

Similar presentations

Presentation on theme: "Diana Joyce, Ph.D. NCSP Douglas Jones, B.A. Angela Dobbins, M.Ed. University of Florida 1 All."— Presentation transcript:

1 Diana Joyce, Ph.D. NCSP Douglas Jones, B.A. Angela Dobbins, M.Ed. University of Florida 1 All Presentation Materials Including Sample Reports are Available at

2 Tier I Universal – All Students Tier II Supplemental, Targeted, Short- Term Tier III Intensive, Individual, Long- Term 2 Positive Behavioral Support: Frequent recognition for appropriate behaviors, proximity control, cueing, build-in appropriate movement opportunities (e.g., Kagan Brain Ex.), predictable structure, positively-phrased and highly visible behavioral expectations. Embedded Social Curriculum: Instruction in prosocial behavior/attitudes. Data Screening: School-wide climate survey, ISS/OSS data, incidence mapping, rating scales for emotional risk and social skills (SSIS, BESS, SOS) Observations, FBAs, Behavior Plans: Classroom observations to determine environmental contributors, antecedents, sustaining factors, frequency, patterns across subjects or time-of-day and task demands, self-monitoring or reinforcement plans, DRCs Counseling: Social Skills, Anger Mgmt, Test Anxiety, Friendship Groups Data Progress Monitoring: Tier II data Behavior Plans & Counseling Therapy: Individualized, greater frequency and intensity, often addressing multiple issues simultaneously Multi-agency Plans: Coordinate w/out-side agencies on counseling, behavioral plans, meds, family therapy, juvenile justice, etc. Data Progress Monitoring: Psychological assessment, Tier III data

3 DisorderEffective Interventions Internalizing AnxietyCBT, family anxiety management DepressionCBT, coping skills training, behavioral self-control therapy Fears/ PhobiasGraduated exposure, modeling, reinforced practice, In-vivo exposure, CBT, imaginal desensitization, self-calming techniques OCDCBT with exposure and response prevention, parent training Externalizing ADHDBehavior modification, reinforcement of other behaviors, organizers, parent training, medication ODD/CDBehavioral modification, anger management, CBT, REBT, time-out, problem-solving training, parent-child therapy, parent training 3 (Kendall & Hedtke, 2006)

4 Three Counseling Approaches Solution-Focused Conflicts, personal goals Psychoeducational E.g., Teach social skills, teach study skills Cognitive Behavioral Therapy Anxious behaviors, anger management, grief management 4

5 First Session Intro, Rapport-Building, Confidentiality, Rules Core Sessions Targeted Skills Curriculum Last Session, Closure Booster or Follow-up 5

6 Behavioral Observations FBA Data Knowledge Surveys Rating Scales BASC-2 Self-report BECK Youth Inventory RCMAS Outcome Rating Scales; Session Rating scales, etc. Discipline Referral Rates Work Completion Rates Improved Grades Absence/Tardy Rates Single Subject Design Daily Behavior Report Cards SUDS 6

7 Focus on what want to achieve (not past) Focus how to obtain goal Positive stated goals, measurable Case study Male, 6 th grade, good grades Prior counseling aggression, anxiety Weekly sessions, 1 month CBT, 5 month SFBT 7 (Sklare, 2005)

8 1. Miracle Question If you woke up & miracle happened, all of your problems were fixed… 2. What is 1 st sign miracle occurred? What would be different? 3. If we videotaped you after the miracle happened What would you be doing? 8 (Sklare, 2005)

9 1. Miracle = Areas needing remediating 2. First sign of miracle = guides goal development 3. Discussed when the miracle has occurred Builds positive thinking and reflection on when the student made behavioral changes 9 (Sklare, 2005)

10 Scaling Questions: Rate progress of goals on Likert scale Use scaling as discussion point When score high--What is preventing you from lower score? When score low– What need to do to allow that to happen? Coping Questions: Strengths - Actions - Goals Things must be difficult for you. How do you manage to do so well in school? 10 (Sklare, 2005)

11 11

12 Basic Components: Teach & Model Skill (Knowledge Deficit) Role Play w/Feedback (Performance Deficit) Practice-Practice (Fluency Deficit) Review Generalization (NASP, 2004) 12

13 Four skill areas: Survival Skills (respect, listening, following directions, boundaries) Interpersonal Skills (express feelings, manners, sharing, turn-taking, nonverbal cues) Problem-solving Skills (asking for help, apologizing, generate solutions) Conflict Resolution Skills (dealing with teasing, peer pressure, assertion) (NASP, 2004) 13

14 Unit I: Empathy Training Focus on building feeling vocabulary Identifying physical and situational cues Unit II: Emotion Management Focus on three strategies: 1.Self-coaching (Stay Calm) 2.Deep (Belly) Breathing, 3.Cognitive Distractions (Counting) 14

15 Unit III: Problem-Solving Step 1 - How do I feel? Step 2 - What is the problem? Step 3 – What can I do? Prosocial behaviors and assertive I statements reinforced 15

16 3 Kindergarten Males Identified Referral Concerns: Impulsive Inattentive Oppositional Pre-intervention Data BASC-2 Behavioral and Emotional Screening System (BESS) Parent Rating Scales Teacher Interviews 16

17 Group Focus: Empathy Training Impulse Control Problem-Solving Weekly, 30 Minute Sessions 17

18 18

19 Relaxation Training Diaphragmatic (deep) breathing Progressive muscle relaxation (PMR) Cognitive Strategies Reducing negative self-talk Challenging unrealistic and dysfunctional thoughts Considering different perspectives Behavior Strategies Behavioral exposures Successive approximation Problem-Solving Techniques 19

20 20

21 Marked by obsessive thoughts or impulses (i.e., intrusive thoughts, feelings that produce anxiety) and anxiety-reductive behaviors (compulsions). Negative reinforcement (i.e., the removal of something aversive) reinforces compulsive behaviors 21

22 Obsessions Compulsions Fear/Anxiety Reduction in Distress The Obsessive-Compulsive Cycle Negative Reinforcement (Piacentini et al, 2006) 22

23 Ritual Cycle SUDS = Subjective Units of Distress (0-100) SUDSSUDS Storch,

24 Psychoeducation Conceptualization of OCD Rationale for Treatment Creation of Symptom Hierarchy Exposure plus Response Prevention Addressing Obsessions Contingency Management (Piacentini et al, 2006) 24

25 Symptom Hierarchy StepSUDS 10. Bathing with toilet water Putting hand in public toilet w/o washing – 1 day 9 8. Flushing public toilet w/o washing – 12 hr 8 7. Flushing public toilet w/o washing – 30 min 7 6. Standing near urinal w/o washing 6 5. Flushing home toilet w/o washing 5 4. Touching public sink w/o washing 5 3. Touching sink in house w/o washing 4 2. Touching floor w/o washing 3 1. Touching doorknob w/o washing 2 Storch,

26 Make a OCD Thermometer (Subject Units of Distress Scale [SUDS]) Create a list of events that cause rituals (easiest to hardest) Be creative and intense Progress up that list slowly where the person does not engage in rituals. Tackle things one at a time. Dont leave the situation until anxiety drops. SUDS = Subjective Units of Distress (0-100 or 0-10) Storch, 2006 OCD Thermometer 26

27 Patients are gradually exposed to anxiety-provoking stimuli while refraining (or prevented) from engaging in anxiety-reductive compulsive behaviors. Avoid providing the child with reassurance (e.g., you wont get sick) or accommodating anxiety driven behaviors (e.g., Ill open the door for you). CBT with exposure and response prevention (ERP) is the best established psychological treatment for OCD (Abramowitz et al., 2005; Chambless et al., 1998) 27

28 Can collaborate with other mental health professionals to facilitate treatments Schools provide many opportunities to conduct exposures For more information see: Sloman, G. M., Gallant, J., & Storch, E. A. (2007). A School- Based Treatment Model for Pediatric Obsessive- Compulsive Disorder. Child Psychiatry and Human Development, 38,

29 10 yr-old male Learning Disorder ADHD Autism Spectrum Disorder OCD Referral concerns: Frustration Compulsive Behaviors Touching / Retouching Cloth Picking 29

30 Weekly CBT Sessions Coping Strategies Role Plays Frustration Exposures ERP for OCD symptoms Graduated Exposures Behavioral Management Compliance Training Contingency Reinforcement 30

31 31

32 32 ? ? ? ? ?

33 Christner, R. W., Forrest, E., Morley, J., & Weinstein, E. (2007). Taking cognitive- behavior therapy to school: a school-based mental health approach. Journal of Contemporary Psychotherapy, 37, Kendall, E C., Choudhury, M. A., Hudson,J, & Pc'ebb, A. (2002). The C.A.T. Project Manual Ardmore, PA: Workbook Publishing. Kendall, P. & Hedtke, K. (2006). Cognitive-Behavioral Therapy for Anxious Children: Therapist Manual (3 rd ed). Ardmore, PA: Workbook Publishing. Nelson III, M. W., Finch, A. J., & Ghee, C. (2006). Anger management with children and adolescents. In P. Kendall (Ed.). Child and adolescent therapy: cognitive-behavioral procedures. New York, NY: Guilford. Stallard, P. (2002). Think good- Feel good: A cognitive behavioral therapy workbook for children and young people. Hoboken, NJ: John Wiley & Sons. 33

34 ACHIEVE: A Collaborative School-based Reform Process, Howard Knoff, Social Skills, Conflict Resolution, Self Regulation, Positive School Climate, Aggression Replacement Training, Mark Amendola, Anger Control, Aggression, Moral Reasoning Training I Can Problem Solve, Myrna Shure, Aggression, Emotionality, Withdrawal, Rejected Intervention Central, Jim Wright, ADHD, Bullying, Defiance Life Skills Training, Gilbert Botvin, Self-esteem, Social Skills, Substance Abuse, Social Anxiety, Peer Pressure, On-Line Graphing Resources PeaceBuilders, Michael Krupnick, Positive School Climate, Prosocial Behaviors, Conflict, Sibling Fighting, School Attachment, Peer Rejection Peace Education Foundation, Conflict Resolution Programs, Peer Mediation, Crisis Management, Primary Mental Health Project, Deborah Johnson, Mild Aggression, Withdrawal, Shyness, Anxious, Poor Classroom Adjustment, Second Step Prevention Curriculum, Committee for Children Skill Streaming, A. Goldstein & E. McGinnis, Prosocial Skills, Stress Coping, Friendship Building, Sharing 34

35 Abramowitz, J. S., Whiteside, S. P., and Deacon, B. J. (2005). The effectiveness of treatment for pediatric obsessive-compulsive disorder: A meta-analysis. Behavior Therapy, 36, Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits- Christoph, P., et al. (1998). Update on empirically validated therapies, II. Clinical Psychologist, 51, Kendall, P. C. (Ed.). (2006). Child and adolescent therapy: Cognitive–behavioral procedures (3rd ed.). New York: Guilford Press. National Association of School Psychologists. (2004). Social skills: Building skills for success in school and life. Bethesda, MD: Author. Piacentini, J., March, J., & Franklin, M. (2006). Cognitive–behavioral therapy for youth with obsessivecompulsive disorder. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive–behavioral procedures (3rd ed., (pp. 297–321). New York: Guilford Press. Sklare, G. B. (2005). Brief counseling that works: A solution-focused approach for school counselors and administrators. Thousand Oaks, CA: Corwin Press. Sloman, G. M., Gallant, J., & Storch, E. A. (2007). A School-Based Treatment Model for Pediatric Obsessive-Compulsive Disorder. Child Psychiatry and Human Development, 38, Storch, E. A.(2006). Treatment of a patient with Obsessive-Compulsive Disorder. Journal of Family Practice, 55,

Download ppt "Diana Joyce, Ph.D. NCSP Douglas Jones, B.A. Angela Dobbins, M.Ed. University of Florida 1 All."

Similar presentations

Ads by Google