Teen Talk: Training Mental Health Counselors at a Disciplinary Alternative Education Program

1. Teen Talk: Training Mental Health Counselors at a Disciplinary Alternative Education Program Eunice Lerma, Ph.D, LPC, CSC Richard J. Ricard, Ph.D, LPC-Intern Courtney Heard, M.A., LPC-Intern Troy Tillmon, M.S

2. Teen Talk Program • Partnership between DAEP and Texas A&M University-Corpus Christi; Department of Counseling Education & Psychology; Counseling and Training Clinic. • Students meet twice a week in same gender, small group or individual counseling sessions to discuss topics relating to teenagers of today. • These counseling sessions are conducted by counseling interns and counselor education doctoral students from Texas A&M University-Corpus Christi.

3. Overall Program Objectives 1. Create a positive counselor/student relationship that emphasizes the role of the counselor as a helper interested in each student’s overall health and wellness. 2. Mental health counselors in training will have the opportunity to work with at-risk youth while building an understanding of the school system. 3. Students will receive appropriate responsive counseling services specifically based on their needs

4. Group and Individual Topics • Determined during the first initial meeting by the student and counselor. • Topics often include: • anger management • conflict resolution • coping skills • date violence • building healthy relationships • social skills • grief • team building • self-efficacy/self-esteem • enhancing intrinsic motivation

5. Dialectical Behavioral Therapy • A goal of DBT is to enhance client coping skills and facilitate an awareness and acceptance that change is constant. • DBT aims to replace maladjusted emotional and behavioral responses to change with behaviors that will reinforce non-emotionally and behaviorally charged adaptation. • DBT is shown to be effective in treating a variety of clinical diagnoses included eating disorders, substance abuse, and emotional and behavioral problems (Feigenbaum, 2007; Nelson-Gray et al., 2006; Rakfeldt, 2005).

6. Session 1:Group goals and guidelines; norms and individual goals; validation of members • Purpose • Group goals and guideline • Norms and ind. Goals • Validation of members • Activities • Confidentiality • Group norms • Establishing counseling relationship

7. Building Group Cohesiveness

8. Skittles Game • Red…What is your favorite color? • Orange…If you can travel anywhere where would you go? • Yellow…Name one thing people may not know about you? • Green…Who is your favorite artist? • Purple…Name two things that help you relax?

9. Validating Conversational Partners • Students practice listening and responding to conversational partners using appropriate • Paraphrasing • Clarifications and questions • Reflection of feelings • Students participate in structure role plays with counselor and group members act as coaches.

10. Session 2: Being Responsible; Knowing my thoughts, feeling my feelings and choosing my behaviors • Purpose • Acceptance of my thoughts, feelings and behaviors • Activities • Exercise in mindful focus of attention • Validation of student perceptions • Psychoeducation on the distinction of thoughts, feelings and behaviors • Practicing in choice of behavioral response • Radical Acceptance

11. Thoughts/Feelings/Behaviors/Events

12. Robot

13. Session 3: Describing how I feel • Purpose • Learning how to contact, describe, express emotions • Emotional regulation • Activities • Glossary of feeling words • Talking about our internal states • Awareness of body sensations

14. Mood Charades

15. Mood Jenga

16. Mind your own business… • Interpersonal sense? Individual Sense? • We have internal business.* • What we think • What we feel • What we believe • How we each make sense of the world

17. Session 4: Dealing with powerful feelings • Purpose • Learning to manage difficult emotional experiences ( distress Tolerance) • Activities • Mindful coping strategies • Riding the wave of emotional experiences

18. Riding the Emotional Waves • Tolerating difficult or overwhelming feelings involves accepting that Emotions Ebb and Flow • Ride out emotional highs like waves. Crashing waves are followed by flow of calm and recovery. • Resist the temptation to fight emotional experiences. Metaphors of Rip tide and negotiating currents at the beach are introduced.

19. Session 5: Interacting with others. Working for what you want • Purpose • Learning how to communicate effectively with others • Activities • Collect Social Interaction questionnaire

20. Social Interactive Questionnaire 1. Have you had conversations or contacts, more than a quick hello, with any of the following people that were encouraging or discouraging during the week? Bubble in one letter closest to your answer for each person or persons. Conversation with others: Family Members Best Friend (a) mostly encouraging (a) mostly encouraging (b) mostly discouraging (b) mostly discouraging (c) no contact or not much contact (c) no contact or not much contact Friends Teacher (a) mostly encouraging (a) mostly encouraging (b) mostly discouraging (b) mostly discouraging (c) no contact or not much contact (c) no contact or not much contact Staff/Counselor Girlfriend/Boyfriend (a) mostly encouraging (a) mostly encouraging (b) mostly discouraging (b) mostly discouraging (c) no contact or not much contact (c) no contact or not much contact (d) don’t have a boyfriend/girlfriend (d) don’t have a boyfriend/girlfriend

21. Social Interactive Questionnaire 2. Think about this week compared to last week. Bubble in one letter closest to how you feel. (a) this week is better than usual (b) this week is typical (c) this week is worse than usual 3. Happiness Rating: How happy have you been this past week? Select one. (a) very happy (b) mostly happy (c) mostly unhappy (d) very unhappy 4. Think about the most significant event that occurred to you this past week. Please write at least 2-3 sentences about it and how it affected you.

22. Role Playing • Parent/Child • Scenario • Your friend invited you to a party where there is going to be illegal activity. You have to report the next day to probation. What do you do? • Teacher/Student • Scenario The teacher tells you to sit down and do your work. Your friends turn around and say “She just punked you.” What do you do?

23. Session 6: Practicing Positive Interaction skills/conflict management • Purpose • Healthy interpersonal skills • Activities • DBT Dear Man practice • Song Lyrics

24. DEAR MAN • Describe • Express • Assert • Reinforce • Mindful • Appear Confident • Negotiable

25. Song Lyrics • “Never mind what haters say, ignore them 'til they fade away.” Live your life by TI • “My, shoulders are strong I prove 'em wrongI ain't doing nothing but moving on…”Tie my hands by Lil Wayne • “Don’t forget that impossible is nothin’, your environment is irrelevant. Just don’t let your emotions over power your intelligent. Refuse to give up, your mistakes will define you”TI featuring John Legend Slide Show

26. Session 7: Coping with difficulties • Purpose • Distress Tolerance • Activities • DBT Self-Soothing; Improve the moment

27. Session 8: Figuring out what I want and committing to SMART goals in life • Purpose • Behavioral Planning based on valued goals • Close Groups • Activities • Committed action worksheet • Sound Track of your life

28. Committed Action Worksheet(Olerud & Wilson, 2002) A part of my life that I value is ______________. My intention for this part is _________________. The committed actions that I’m willing to take include the following (be sure to note when you’ll begin these actions): ______________________________________

29. Soundtrack of your life • My life now • Kobe Bryant—Lil Wayne • Picture World Up—Lil Wayne • Heat—Lil Wayne • In the future • Who said I couldn’t make it—TI • Rolling in the Deep—Adele • I’m the boss—Rick Ross

30. SMART Goals • Specific—not too big or small • Measurable— “I know when I have met them.” • Agreed/Accountable/Attainable– “I will make myself accountable.” • Realistic– “Do I really have a chance to meet this?” • Timely– “Can I do this in the near future?”

31. Evaluation of Intervention Impact on Student Behavior • Number of participants: 63 • Total number of sessions: 340 (average 5 per group/individual) • Assessment: The Youth Outcome questionnaire (YOQ) (Burlingame, Wells, Lambert, 1996)—Pre and post test • Preliminary analysis (fall semester): Students participating in the counseling groups are benefiting from the intervention. • Students experienced statistically and clinically significant reductions in reported conduct problems (F(1,57)= 6.1, P<.017 and hyperactivity (F (1,57)= 5.6,p< .022). • Students benefit was directly related to the number of sessions they attended

32. While these results are preliminary, they suggest that our intervention is having the intended impact on student behavior. The lessons learned from our efforts to organize and conduct clinical groups on DAEP campuses seems easily generalizable to other DAEP settings and include: 1. Obtaining and maintaining administrative support for the intervention. 2. Securing a workforce that is manageable ( and no cost to campus) because of university collaboration. 3. Investment in a theoretical model that has empirical validation ( DBT) with typical presenting issues of students at DAEP campuses.

33. Questions? Contact Information Dr. Eunice Lerma eunice.lerma@ccisd.us Courtney Heard cheard0604@gmail.com Dr. Richard J. Ricard richard.ricard@tamucc.edu

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