1. Community Support Services Training Direct Care Series – Session 7
Zakia Clay, MSW, LCSW
Ann Reilly, MA, LSW, CPRP
Anthony Zazzarino, MA, LPC, CPRP

2. Review from Session 6

3. Learning Objectives Identify reasons for skills deficits
Describe a method for skills training
Understand techniques for reinforcing skill attainment
Develop a skills training lesson plan
Practice skills training in a group format

4. DMHAS Expectations
The aim of skill development is to promote community integration and restore the individuals to the maximum possible functioning level by improving social, interpersonal, problem-solving, coping and communication skills
Reimbursable activities are those that involve teaching the consumer various physical, cognitive/intellectual and behavioral skills related to identified goals. This leads to increased competence and proficiency in living independently in the community
(Larosiliere, 2011)

5. Skills Training at a Minimum…
Discussions with the consumer about the skill to be learned
Benefits of learning the skill
Breaking the skill down into its component parts
Showing examples of how the skill is correctly used or performed
Arranging opportunities to practice skill use in the community setting
Providing evaluation and feedback
(Larosiliere, 2011)

6. Why So Much Focus on Skills Training?
Many people living with chronic mental illness lack critical skills
Skill deficits interfere with successful community integration
Skill deficits create barriers to achievement of rehabilitation goals
Skill deficits may result in ongoing dependency on staff
(Bellack, 2004)

7. Sources of Skill Deficits
Lack of acquisition in childhood, adolescence, early adulthood
Lack of practice in “normal” settings
Positive and negatives symptoms of schizophrenia
Affective states (e.g. social anxiety)
Neurobiological factors (attention, memory, problem solving)
Motivational factors (avoidance due to previous failure and/or stress associated with social demands)
Learned dependency
Environmental factors (lack of opportunities)
Poor self esteem
(Bellack, 2004)

8. Small Group Discussion
What skills have been important to you in your life?
What skills do you still need to learn to enhance your community integration?
Of those, which skills do you still need to work on?
What help do you need to learn the skills?

9. What Types of Skills do Many Consumers Need to Learn?
Social
ADL/Independent Living
Illness Management
Vocational
Academics
Other?

10. Bellack’s social skill categories
Basic Social Skills
Conversational Skills
Assertiveness Skills
Conflict Management Skills
Communal Living Skills
Friendship and Dating Skills
Health Maintenance Skills
Vocational/Work Skills
Coping Skills for Drug & Alcohol Use

11. Research Supports This…
5 of Bandura’s principles are incorporated into social skills training:
Modeling, Reinforcement, Shaping, Overlearning, and Generalization
Social behaviors are acquired through both observing others’ actions & the consequences of one’s own actions
Chronic mental illness can interfere with natural development and maintenance of these skills
(Bellack, 2004)

12. Process of Skills Teaching (Tell, Show, Do)
Establish a rationale for learning the skill
Discuss the steps of the skill
Model the skill
Ask a person to try out the skill
Provide positive feedback
Provide corrective feedback
If needed, ask the person to try using the skill again
Provide additional feedback (positive & corrective)
If training in a group have other members do steps 4-8
Encourage practice of the skill in natural environments (homework)
(Bellack, 2004)

13. Activity Example – How to Do Laundry
Break down the steps on to do laundry

14. Techniques for Reinforcing Skills
Always start with a review of homework
Provide positive reinforcement for efforts to practice the skill after learning
Engage each member in role plays based on homework or other real life situations
Collaborate on additional, individually tailored, homework assignments
(Bellack, 2004)

15. Additional Techniques & Considerations
Pacing to determining optimal number of sessions for a specific skill
Prompting
Supplementary modeling
Discrimination modeling
Role playing
Coaching
(Bellack, 2004)

16. Things to remember…
Once you gain expertise in teaching skills to individuals or small groups you can teach most any skill, as long as you can:
Identify the behavioral steps of the skill
Model the skill
If you can’t teach the skill, can you find someone that can?

17. Skills Training Activity –
Trainers will count the room off into 4 groups and assign the skill that will be taught.
Identify a recorder and as a group complete a lesson plan for teaching the skill group
One from each group will teach another group their skill
One member of the group will be the observer
Come together to process and wrap up

18. Process of Skill Teaching (Tell, Show, Do)
Establish a rationale for learning the skill
Discuss the steps of the skill
Model the skill
Ask a person to try out the skill
Provide positive feedback
Provide corrective feedback
If needed, ask the person to try using the skill again
Provide additional feedback (positive & corrective)
If training in a group have other members do steps 4-8
Encourage practice of the skill in natural environments (homework)
(Bellack, 2004)

19. References
Bandura, A. (1977). Social learning theory. Englewood Cliffs, N.J.: Prentice-Hall. Bellack, A.S., Mueser, K.T., Gingerich, S. & Agresta, J. (2004). Social Skills Training for Schizophrenia, 2nd Edition. New York: Guildford Press. Larosiliere, V (2011). Community Support Services [memo]. Retrieved from o_providers.pdf.