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In reauthorizing the Individuals with Disabilities
Education Act, Congress has provided for the use of functional behavior
assessment and positive behavior supports. While the history of
such approaches have met with some success, they also have some
extraordinary failures. In an attempt to address these failures,
we enhance these processes with a cognitive flavor.
INTRODUCTION:
In Public Policy Foundations for Positive Behavior Interventions,
Strategies, and Supports, Turnbull III, Wilcox, Stowe, Raper
& Hedges, Fall 2000 make a persuasive case that Congress, in
explicitly providing for the use of Positive Behavior Supports while
reauthorizing the 1997 Individual with Disabilities Education Act
[IDEA, 1999], has met strong constitutional requirements, not the
least of which is a requirement that such intervention should lead
to benefit. This implies, therefore, that the chosen
intervention has some proven record in providing positive outcomes,
e.g., changing the impeding behaviors.
The need for enhancement is clearly indicated by the fact that
Positive Behavior Supports, which has been the subject of intense
professional research for at least the last ten years and has a
proven efficacy for changing the behavior of persons with developmental
and other disabilities [Turnbull III et al] is still met with the
assertion that It does not work as well for some students as its
advocates assert or that it does not work at all for some students
[Mulick, 1994].
How is it that despite the use of positive behavior supports, with
its proven efficacy, as the major behavioral intervention in public
schools for the last ten years, we can still make the following
statements:
"Serious antisocial behavior in children and adolescents
constitutes a significant problem in childrens mental health
services and may be one of the most serious public health challenges
in American society [Earls, 1989; Prinz & Miller, 1991]. In
fact aggressive and violent behaviors, whether identified as mental
health issues or not, are increasing among children in America.
Although many children and adolescents occasionally exhibit aggressive
and sometimes antisocial behaviors in the course of development,
an alarming increase is taking place in the significant number
of youth who confront their parents, teachers, and schools with
persistent threatening and destructive behaviors [Rutherford,
Jr & Nelson, 1995].
Worse, perhaps is our societys inability to address these
issues. According to Koyanagi & Gaines, in All Systems
Failure -1993, all of our systems have failed. Over the past
twenty years, numerous reports have chronicled the lack of appropriate
services to meet the needs of children and adolescents with serious
emotional disturbance. These previous studies report that children
in need of mental health care often do not receive it or receive
care that is inappropriate or inadequate."
Is it that positive behavior supports are really not effective?
We dont think this is the answer to our question. Rather,
we think that the answer is embodied in the citation: has been the
subject of intense professional research for at least the last ten
years and has a proven efficacy for changing the behavior of
persons with developmental and other disabilities. If one reads
the entire article, it becomes clear, starting on page 225, that
the authors, as with most PBS specialists are focused on children
with mental retardation or autism. This might be extended to a class
of students for whom behavior is a manifestation of disability.
When a child has a disability, a deficit in physical or cognitive
abilities, inappropriate behavior is often manifested either because
the disability has inhibited the learning of the proper behavior
or because the disability has frustrated the ability to reach other
goals.
However, there is a class of students for whom the behavior
IS the disability. This group usually classified as seriously
emotionally disturbed in the special education system, as
delinquents or worse in the regular education system, and often
as mentally ill by others, are usually unaffected by
positive behavior supports as presently constituted. In hopes of
better addressing this class of students in both regular and special
education, this paper will address an expansion of positive behavior
supports to include cognitive approaches. Both cognitive and behavioral
approaches are based on social learning theory and operate with
the same stringent models. None of the requirements of either IDEA
or the specifics of the Turnbull III, et al paper are violated
by this expansion.
Two points of clarification may be necessary. First, the word cognition
in its simplest form means the act or process of knowing or thinking.
In most educational settings, it is generally used to indicate academic
or intellectual abilities. That is not the focus for our concern.
We are concerned with the students cognitive processes in
regards to such areas as:
- appraisals: self/others, success/failure, expectations
and experiences;
- constraints: shoulds, musts,
oughts; and
- requirements: the students understanding of what
s/he needs to be successful and how much s/he can cope
with; his/her limitations.
It is this type of mental schema which makes inappropriate
behavior appropriate in the mind of the student, and
consequently somewhat immune to strictly behavioral approaches.
The thinking is distorted, not deficient, and creates
an inner logic which supports the emotions and behaviors
which become manifest. Such distorted thinking may lead to deficiencies
in behavioral skills. Problem solving, for example, is often a deficit
of violent children who have no other disabilities. But it is not
a cognitive deficiency, per se, that is the fundamental
issue.
Second, while IDEA is specifically directed towards students who
have been evaluated and found to be exceptional, we would direct
the Positive Cognitive Behavior Supports [PCBS] to a broader range
of students. Using the simple, although not necessarily easy, techniques
with all children helps to satisfy the equal protection
doctrine outlined by Turnbull III, et al. [similarly
situated people may not be treated differently from other similarly
situated individuals.] Thus, students whose behavior is disruptive
or otherwise requiring of intervention, must be treated in the same
manner. While many students with disruptive behavior are soon evaluated
for special education, not all of this class are, at any one time,
receiving special education. Additionally, the bane of a
school district is to have a special education student and a regular
education student participate together in the same incident. IDEA
requires protections for the special education student - and particularly
so for one who is developmentally delayed or mentally retarded,
but not for the regular education student. The result is often a
seemingly unfair and different response. The expansion of PBS into
PCBS allows for a similar response for both.
It should also be noted that cognitive interventions are often
helpful for students with developmental disabilities as well. Mryna
Shure, [1981] has demonstrated the effectiveness of teaching four
year olds Interpersonal Cognitive Problem Solving skills. If such
skills can be taught to four years olds, many of the children with
mental retardation have this capability. In fact, our recommendation
is that all children with mental retardation who are able to operate
at least at a four year old level, should receive such training.
Because of the ineffectiveness of strictly behavioral interventions
with the class of children for whom behavior is the disability,
the school is likely to either seek bio-medical intervention or
suspend and expell to an extent which for all intent and purpose,
keeps the student out of the school; the equivalent of throwing
them out. The failure of the mental health services, either
psychotherapy or biomedical [medication] to actually address the
fundamental issues of disordered thinking merely adds to the frustration
with this class of students.
DEFINITION:
In order to understand fully the implications of a cognitive enhancement
of PBS, it is necessary to develop a basic understanding of cognitive
theory. Whether we use the words "idea", "concept",
or "thought", it is proper to describe this mental activity
as a basic element of consciousness. Ideas also include the symbolic
mental representations of images, sensations and abstract notions
such as conviction. It should be noted, though, that while everyone
may think in terms of such mental representations, it is not necessarily
true that the particular ideas that people hold onto about things
are always the same. On the other hand, it seems that the thoughts
of different people do tend to have something in common: regardless
of what ideas they hold, a person's thoughts are seldom random,
disjointed entities. They tend to form coherent patterns [or schema]
that stem from a few discrete fundamental principles and branch
out in logical directions to encompass - to a greater or lesser
degree - their whole universe of experienced phenomena. In other
words, the conscious mind somehow organizes its mental product (whatever
you might want to call it) into systematic frameworks of concepts,
and these conceptual frameworks, contexts, schemas or systems of
thought are of decisive importance in determining people's basic
ways of thinking - that is, their cognition - and serve as the foundations
of their consciousness, bending the world into a shape that makes
sense to them. [Russell, 1997]
It appears that there are some innate structures to the human mind
which provide a basis for the development of a personal data base.
Such a structure as, for example, the language grammar, provides
the basis for learning language, any language, which is available.
Any cursory examination of the nature of humanity will reveal the
intimate association of words and symbols with most everything that
people do.
The words and symbols that we employ have their counterparts within
the mind. However imperfect, the correspondence between our own
thoughts and the words we use to express them is of such a nature
that we are able to surmise that a similar correspondence exists
between the words and thoughts of others. HOW thoughts might be
manifested as they are - in words and symbols - is still largely
a mystery, but because they are, they can be used as a sort of window
into the mind [Russell, 1997]. It certainly appears, however, that
the strategy employed by the individual starts from a data based,
bottom up data collection system which uses the innate
pattern identification system to group data in such a manner to
create an explanation of the event or experience. These explanations
also begin to form patterns and the individual begins to create
hypothesis about why things happen in the way they do.
At some point these theoretical ideas become the force for interpretation,
creating a top down, theory driven process. Once a theory
is established, usually sometime around four years of age, all new
experiences are framed from this summative attitude. Thus, if the
person believes that the supernatural is real, an experience
with an unidentified flying object could be believed to be an alien
presence. On the other hand, if the theory does not accept the supernatural,
the person may not be able to categorize the experience at all.
Thus, a clash or conflict of mutually exclusive ideas allows little
room for syncrenististic interaction. The word syncretism
is commonly defined as the combination of different forms of belief
or practice. It is used to describe instances in which ideas belonging
to different belief systems are fused or mixed together to form
a new framework that contains elements of each [Russell, 1997].
Thus, a person may experience something that does not fit the theory,
but is not mutually exclusive. S/he then may incorporate what is
consistent and ignore the rest.
The particular ideas someone holds - and the ways those ideas are
structured within the mind - become of decisive importance in determining
the way of thinking and appraising new experiences of that particular
individual; one's internalized systems of thought serve as the foundations
of one's consciousness [inner logic] and bends reality into a shape
that makes sense to them.
Concepts we hold to seem to be linked to each other in some fundamental
way, in that they reinforce and complement rather than undermine
or contradict each other, and that these groups of linked concepts
exhibit some sort of internal synergy by virtue of their being organized
in a systematic way by the processes of the mind. We can say that
all the new ideas and connections may be interpreted as constituting
an attitude - a framework of concepts that bends the experience
(or some aspect of it) into something consistent and understandable.
Those aspects of human behavior governed by conscious choice can
best be understood as correlates of the particular ways that people
think, which are related in a fundamental way to the particular
structures of thought that exist within their minds. In other words,
we might say that people act the way they act because they think
the way they think, and that the way they think can best be
understood in terms of the frameworks of concepts they use to make
sense of the world. These frameworks seem to have patterns themselves
[Russell, 1997].
A specific focus occurs when individuals appraise themselves
and others. Comparisons are made in which the individual not only
decides on the performance of others, but metacognitively decides
on how others judge their own performance. Such thoughts gradually
shape themselves into a theory of self and others which affects
the way in which we relate. In a similar way, we develop judgmental
thoughts about success and failure. We determine the causes of our
success or failure and attribute these causes to internal or external
influences. These attributions affect our expectations of what will
occur in other experiences. Thus, thoughts about appraisal is fundamentally
linked across all of these factors. If I think that other people
dont like me, I may then consider my own worth as being less
than satisfactory. If I am worthless, my success must be externally
caused, while my failures are because of who I am. I certainly could
not expect much in the future. This attitude about self/others,
success/failure, etc. creates a specific aspect of my personality.
Perhaps, I walk around with a chip on my shoulder.
Likewise, people are concerned about freedom and constraints. We
know that in order to improve our position in the self/other relationship
appraisal, something needs to happen differently. We create shoulds,
musts and oughts from previous experiences as a means
of laying out the ground rules of relationships. Both we and other
people must abide by these rules if our appraisals are to improve.
Failure to do so adds to the problem. However, the constraints are
not unrelated to the attitudes about self/other appraisals. We may
assume that we ought to behave this way to get better, based on
an assumption that we are worthless. If we were not worthless, but
were in fact valuable, we might decide that we can act the way we
please.
In similar manner, our thoughts about what we require to
survive effectively is interactive as well. I cant possibly
deal with that is the statement of a person who is not powerful.
Someone who is not valued. A self-valued person believes s/he can
do almost anything.
Obviously, such areas of focus are affected by innate structures.
If for some reason the basic perceptive or language structures are
defective, we will at some time identify that our learning does
not occur in the same way as most other people and we will tend
to see ourselves as different and often less able. Our
disability is likely then to affect our appraisal, constraints and
requirements. Our theory of the world is likely to be
a consistent one of defect, discrimination and defeat.
Strictly speaking, ideas which are held by different individuals
do not influence each other directly - ideas influence minds of
those that hold them, and people take action partly as a result
of this influence; often this action (including the action of speaking
or writing words) has an effect on the ideas held by others [Russell,
1997].
People act the way they act because they think the way they think.
We are the sum total of what we think, and cannot act outside of
this constraint [unless, of course, we are acting]; thus, our possibilities
are constrained by what we believe to be true. Exactly what factors
might be involved will have to be worked out, but there is enough
positive correlation between the evidence we have about how people
think, and about what they do, to surmise that the cognitive process
is wrapped up in an integral way with conscious decision-making,
and that the understanding of one is tantamount to the understanding
of the other.
But another important factor must be understood. These mental structures,
schema, contexts or frameworks are nonconscious. The fact that people
become unconscious of a repetitive or predictable stimulus does
not mean that the stimulus has disappeared; on the contrary, it
continues to be processed in the appropriate input system [Baar,
1988]. Any highly practiced and automatic skill tends to become
modular --- unconscious, separate from other skills,
and free from voluntary control [La Berge, 1980, 1981; Posner &
Snyder, 1975; Shiffrin & Schneider, 1977]. The decline in orienting
to redundant stimuli is something very functional for the nervous
system. One may say that the loss of consciousness of a predictable
event is the signal that the event has been learned
completely [Baar, 1988].
Thus, the system of thought is profound and interactive. We act
in certain ways or say certain things which affect those around
us. ... you and I belong to a species with a remarkable ability:
we can shape events in each others brains with exquisite precision.
Simply by making noises with our mouths, we can reliably cause precise
new combinations of ideas to arise in each others minds [Pinker,
1994]. I can enhance your summative thought framework [attitudes/personality]
or erode it by what I say. The impact of my vocalization increases
with my significance to you as a person. If I am very important
to you, my words may be profound.
Yet most communication is based on both shorthand and a basic trust.
As reported by Tooby & Comides [1997], Grice has argued that
interpreting the meaning of an utterance is only possible because
listeners implicitly assume that speakers intend their utterances
to be responsive to the surrounding discourse, relevant, and (for
the most part) truthful. If this does not occur, communication breaks
down. Ambiguity is additionally increased by the shorthand processes
such as Do you have the time?. To most readers, it is
clear that the person is not really asking if you have the time,
but rather, if you have the time, will you tell me what time it
is? In the process of pattern identification and theory building,
children may be using blocks of communication in which information
is ambiguous at best, and which may leave the listener free to interpret
on many levels. Much contrary information therefore may be placed
as theory supporting when no such thing was intended. In the case
of our worthless individual, a statement such as youre
a bad boy may be intended to mean, you did a bad thing,
but by ignoring the other evidence, it can be used to support the
theory of worthlessness.
Thus, through a process of ambiguous communication and personal
experience, an individual builds a set of mental schema which constrain
the possibilities of life. Addressing these issues through
purely behavioral intervention are not sufficient to overcome such
distortions. But through a process of helping the individual become
aware of his/her thoughts, attending to those thoughts
over time, analyzing those thoughts for validity, seeking
alternative thoughts that may prove more helpful in reaching
preferred goals, and finding ways to adapt to these new thoughts
we can have a profound effect on the way this class of students
behave.
Cognitive strategies thus, use techniques which lead the person
through awareness, attention, analysis, alternatives and adaption.
A question might be asked as to how we become aware of nonconscious
thoughts. One of the most informative points of inference is the
inner dialogue which is prevalent to all human beings. Inner speech
is one of the most important modes of experience. Most of us go
around the world talking to ourselves, though we may be reluctant
to do so out loud. We may be so accustomed to the inner voice that
we are no longer aware of its existence metacognitively......the
inner voice maintains a running commentary about our experiences,
feelings and relationships with others; it comments on past events
and helps to make plans for the future [Klinger - 1971].
While we are not aware of the automatic thoughts that
we say to ourselves, these are like other reflexive behaviors such
as breathing or blinking; we can become conscious of them if we
are asked to attend to them. Parents, teachers and other significant
people often hear leakage of these automatic thoughts
about appraisals, constraints and requirements articulated on a
regular basis. I cant do that, I should do that,
or Everybody hates me. By becoming sensitized to what
to listen for, and knowing when to ask, such natural support people
can significantly help to reverse-engineer the inner logic
of the child. Specific cognitive interviews can add to the substantive
knowledge.
THE PROCESS OF ENHANCEMENT
The purpose of assessment is to measure social competence.
Competence can be defined as capacity equal to expectation.
Almost everything we do involves either interacting with other persons
or inhibiting interactions with other persons. If we fail to follow
the often unspoken rules about these interactions, the consequences
will be clear: others will judge us to be socially incompetent [Peter,
etal 1998]. Thus, the requirement of assessment is to identify those
areas of social learning limitation and to recommend social learning
interventions.
Our languages for describing and explaining the world (and ourselves)
are not derived from or demanded by what exists. Rather, our languages
of description and explanation are produced, sustained, and/or abandoned
within processes of human interaction. Further, our languages are
constituent features of a cultural pattern. They are embedded within
relationships in such a way that to change the language would
be to alter the relationship. As we generate new languages in
our professions, and disseminate them within the culture, so do
we insinuate ourselves into daily relations - for good or ill. [Gergen,
Hoffman, & Anderson, 2000]
From this perspective, we should be increasingly alarmed by the
expansion and intensification of diagnosis in this century. At the
turn of the century our system for classifying mental disorders
was quite rudimentary in terminology and not broadly accepted. As
the century has unfolded, the terminology has expanded exponentially,
and public consciousness of mental deficit terminology has grown
acute. In the 1929 publication of Israel Wechsler's The Neuroses,
a group of approximately a dozen psychological disorders were identified.
With the 1938 publication of the Manual of Psychiatry and Mental
Hygiene (Rosanoff, 1938), some 40 psychogenic disturbances were
recognized. (It is interesting to note that many of the terms included
therein, such as paresthetic hysteria and autonomic hysteria, have
since dropped from common usage, and some of them - such as moral
deficiency, vagabondage, misanthropy, and masturbation - now seem
quaint or obviously prejudicial. In 1952, with the American Psychiatric
Association's publication of the first Diagnostic and Statistical
Manual of Mental Disorders (APA, 1952) some 50-60 different psychogenic
disturbances were identified. By 1987 - only twenty years later
- the manual had gone through three revisions. With the publication
of DSM IIIR (APA, 1987) the number of recognized illnesses more
than tripled (hovering between 180-200 depending on choice of definitional
boundaries). DSM IV expands the list even further to perhaps over
300 diagnoses (APA, 1994). [Gergen, Hoffman, & Anderson, 2000]
At the present time, one may be classified as mentally ill by virtue
of cocaine intoxication, caffeine intoxication, the use of hallucinogens,
voyeurism, transvestism, sexual aversion, the inhibition of orgasm,
gambling, academic problems, antisocial behavior, bereavement, and
noncompliance with medical treatment. Numerous additions to the
standardized nomenclature continuously appear in professional writings
to the public. Consider, for example, seasonal affective disorder,
stress, burnout, erotomania, the harlequin complex, and so on. What,
we might ask, are the upper limits for classifying people in terms
of deficits? [Gergen, Hoffman, & Anderson, 2000]
As these terminologies are disseminated to the public - through
classrooms, popular magazines, television and film dramas, and the
like - they become available for understanding ourselves and others.
They are, after all, the "terms of the experts", and they
become languages of choice for understanding or labeling people
(including the self) in daily life. Terms such as depression, paranoia,
attention deficit disorder, sociopathic, and schizophrenia have
become essential entries in the vocabulary of the educated person.
[Gergen, Hoffman, & Anderson, 2000]
When the terms are applied in daily life they have substantial
effects - in narrowing the explanation to the level of the individual,
stigmatizing, and obscuring the contribution of other factors (including
the demands of economic life, media images, and traditions of individual
evaluation) to the actions in question. Further, when these terms
are used to construct the self, they suggest that one should seek
professional treatment. In this sense, the development and dissemination
of the terminology by the profession acts to create a population
of people who will seek professional help. And, as more professionals
are required - as they have been in increasing numbers over the
century - so is there pressure to increase the vocabulary in a "cycle
of progressive infirmity". [Gergen, Hoffman, & Anderson,
2000]
Diagnostic systems give a sense of legitimacy, confidence and predictability
both to the professional and to the client. In both psychotherapy
and the broader culture, a diagnosis implies that the object of
inquiry and the method of inquiry are based on stable assumptions
like those in the biomedical realm. It operates as a professional
code which has the function of gathering, analyzing and ordering
waiting-to-be-discovered data. As similarities and patterns are
found, problems are then fitted into a deficit-based system of categories.
In a larger sense, this framework is based on the assumption
that language is representational and can accurately depict reality.
When thinking of diagnosis, think of cybernetician, Heinz von Foerster's
remarks, "Believing is seeing". If you believe in the
representation symbolized by the word, you tend to see it. [Gergen,
Hoffman, & Anderson, 2000] This is similar to the concept that
if your only tool is a hammer, every problem looks like a
nail.
Implicit in the DSM IV is the assumption that psychotherapy is
a relationship between an expert who has knowledge and a non-expert
who needs help. The public, the profession and the state have given
authority to the therapist to collect information about the client
and place it on a pre-determined therapist map from which the diagnosis
is then derived and the treatment plan decided. This process reduces
uncertainty by telling the therapist what the therapist ought to
do and suggesting how the client ought to change in order to get
well. [Gergen, Hoffman, & Anderson, 2000] It is also a process
and a basic assumption which we ardently reject.
Because of these inherent predispositions manifested in labeling
process, we fully support the use of a functional behavior assessment
process as promoted by IDEA, 1999. The foundation for PBS-based
interventions is a functional behavior assessment (FBA), defined
as a systematic process of identifying problem behaviors and
events that (a) reliably predict occurrences and non-occurrence
of those behaviors, and (b) maintain the behaviors across time
[Turnbull et al, 2000]. PBCS interventions follow the same
pattern. Both (a) and (b) can be mental events, and
must be specifically sought through a functional cognitive behavior
assessment (FCBA).
The FCBA procedures should lead to three results. The first is
hypothesis statements that include three key features: (a) operational
definitions of the problem thought(s) and subsequent feeling(s)
and behavior(s), (b) descriptions of antecedent events [both mental
and environmental] in which automatic thoughts occur that reliably
predict occurrence and nonoccurrence of the problem behavior(s),
and (c) descriptions of the consequence events [including thoughts
and emotions] that maintain the problem behavior(s) [adapted from
Sugai et al., 1999 as reported by Tunrbull et al., 2000].
The FBA is a process which seeks to identify the problem behavior
a child or adolescent may exhibit, particularly in school, to determine
the function or purpose of the behavior, and to develop interventions
to teach acceptable alternatives to the behavior. Since this process
is integral to school assessment and one which we desire to continue
to use, albeit in an altered form, it is important that we delineate
the differences between the traditional approach to this process
and our expectations.
Traditionally the process starts with an identification of the
behavior that needs to change and then proceeds with the following
steps.
- Collect data on the behavior,
- Develop a "hypothesis" (best guess) about the reason
for the behavior,
- Develop an intervention to help change the behavior,
- Evaluate the effectiveness of the intervention, and
- Revise as needed.
CREATING A PROBLEM STATEMENT
The determination of what behaviors need to be changed are most
often those that are identified by the surrounding participants,
particularly those who have authority [supervising adults or experts].
These are most often the behaviors that impinge upon the
adults authority or functioning. There are several difficulties
with this beginning, not the least of which is the fact that the
problem behavior may be appropriate given the environmental
context and/or the mental context [adults often provide environments
which invite confrontation].
The first concern is the difficulty that FBA practitioners often
have in moving beyond their own roots. Because the basic behavioral
approach was developed in regard to a class of children who
have developmental difficulties, it is generally seen as appropriate
that society, as represented by those in authority, should shape
the behavioral development. However, as the method is applied to
this other class of children, those who have already learned behavior
developmentally, this approach can easily lead to a coercive intervention
process.
In order to explain this difference, we may define the first group
of children, those with developmental delay, as having a deficit
in their behavioral repertoire. Their delay has created a
situation where they have been less able to learn from social modeling
of peers and adults, either because of isolation from some of these
influences, or because they were simply not ready when such an opportunity
was available. Often, the solution to the initial delay [or even
a simple protection of the child] creates the problem of delimiting
social interaction in ways that contributes to a limited behavioral
repertoire.
The second group of children can be defined as having a distortion
in their way of perceiving their environment and, therefore, make
decisions of when and where to use certain behaviors appropriately.
This is a quite different circumstance and presentation. To respond
as though there were a deficit often reinforces the distorted
perspective.
For the first group, there may be validity in the traditional approach
since the concept is that the children are trying to achieve some
goal, but that the behavior they are using is not functionally valid.
Having not learned appropriate behaviors through the normal social
learning models, such children have used whatever works -
even if it is not considered to be appropriate. They are not consciously
rejecting other behavior sets - they simply dont know what
behaviors are appropriate or how to use them.
For the second group, however, they are in fact, rejecting other
behavior sets which they are often quite capable of carrying out.
They have selected the current behavior because, in their way of
looking at the circumstance [their inner logic], they believe the
behavior will achieve their personal goals. The fact that such behavior
is reproached by adults may merely reinforce the distorted
thoughts. In fact, the interventions often escalate the crisis in
interpersonal relationships because they so reinforce the distorted
perceptions. This second group generally has no behavioral deficit
[although some may be found as the intervention process continues],
but rather has made a poor selection of behaviors based on what
they believe and, consequently, perceive in the situation. The mental,
or inner context, creates the reality in which the selection of
response is made. The decision about why the child in this
second group perceives the world the way s/he does is a decisive
factor and this requires that we begin to gain some understanding
of what is in, what the traditional behaviorists call, the black
box.
We cannot truly know what goes on in another persons mind,
but through inquiry [elicitation] and the use of a beginners
mind which is open to listening, we can begin to infer and verify
the individual self. We have identified that people have a thought
stream which comments on all events and experiences as they happen.
Such inner speech is usually nonconscious and reflexive, meaning
that, like other reflexive behaviors such as breathing and blinking,
we rarely notice that these behaviors are happening unless, or until,
there is reason to bring the experience into consciousness. It is
important to note that once in consciousness, such reflexes can
be controlled. We can breathe and blink, within physical limits,
at a pace which we choose. This is also true of reflex thoughts;
once in consciousness, such thoughts can be reconsidered and debugged.
Elicitation is the process of asking a person questions
in order to understand their mental processes. If we really want
to know what is in the black box we must elicit nonconscious
processes of which the person themselves are unaware. We must help
them access consciously their own mental framework, schema or contexts.
Contexts are relatively enduring structures that are not conscious,
but can evoke and be evoked by conscious events. Conscious contents
and unconscious contents interweave to create a stream of consciousness.
One plausible meaning of self is as the dominant enduring context
of many conscious experiences, we may also say that conscious
experience provides information to the self-as-context [Baar, 1988].
But self is not an isolated construct. The concepts of self and
culture are interdependent: one cannot exist without the other.
Thus, while it has become commonplace to regard the self as a cultural
product, and enquire as to the 'environmental' (cultural) factors
that lead to the expression or inhibition of this or that aspect
of the self, we must not forget the reverse perspective; that culture
itself is a product of the self. Selves are constituted within culture,
and culture is maintained by the community of selves [Lock, 2000].
This interactive quality of self and culture is difficult to measure.
The cause and effect of such interactivity is not clear. At any
given moment, the self may make a decision about the
culture which affects and changes the culture. In fact, seeding
the culture or cultural restructuring is a specific
cognitive intervention. The development and use of the diagnostic
language mentioned above is a method of seeding the environment
in a manner which we believe has been quite destructive to the general
population.
Dubin [1973] suggests that culture is best seen as a set of control
mechanisms - plans, recipes, rules, instructions, which are the
principal bases for the specificity of behavior and an essential
condition for governing it. But the culture is also directed and
evolved by memes. The molecular biologist, Jacques Monad, in his
book Chance and Necessity wrote:
"...it is tempting to draw a parallel between the evolution
of ideas and that of the biosphere. For ... ideas have retained
some of the properties of organisms. Like them, they tend to perpetuate
their structure and to breed; they too can fuse, recombine, segregate
their content; indeed they too can evolve,... " [1972].
Evolutionary biologist Richard Dawkins in The Selfish Gene developed
this theme further by naming the unit of replication and selection
in the ideosphere as the counterpart to the biospheres gene
- a meme. He writes:
"examples of memes are tunes, ideas, catch-phrases, clothes
fashions, ways of making pots or building arches. Just as genes
propagate themselves in the gene pool by leaping from body to
body via sperms or eggs, so memes propagate themselves in the
meme pool by leaping from brain to brain via a process which,
in the broad sense, can be called imitation." [1976]
Such memes can be perceived as the carriers of culture and it is
important for us to identify memes in order to see how all of us
are influenced by this process. As the meme [e.g., diagnostic label]
propagates itself from brain to brain through imitation, from supervisor
to subordinate, worker to client, client to family, it provides
much of the destructive thinking which generates the presumed coherence
upon which a coercive system is based. Such diagnostic labels create
the possibility to act for the persons own good
- an anathema to the helping process.
The plans, recipes, rules, instructions, etc. and the memes which
convey them and which make up a larger culture, however, may be
modified by the individual selves in the smaller segments. It can
be argued that any defined segment of culture has a smaller component
which may have variance down to the culture, or if you
prefer, personality1 of the individual person. What
are the memes which shape this individual child? How many children
define themselves with diagnostic memes?
CREATING AN HYPOTHESIS
In this construction, the personality is composed of
the plans, recipes, rules and instructions of the individual person.
The question is, what plans, recipes, rules and constructions has
a child learned from his/her local and immediate culture: the family,
the school, the community. As Lock indicates, both the messenger
and the receiver are responsible for the learned outcome. Subjective
experience is not an environmental variable despite the fact that
many people think of their feelings and the pictures that flash
through their minds and the words that go through their heads as
being things that just happen, or perhaps are caused by externals:
She makes me mad or It makes me happy when X happens. [Lady, 2000]
It is these cultural or personality components and their individual
nuances that we seek to elicit. In the process of doing so, we are
aware that there are certain errors or distortions which are relatively
common in human thought processing, and we should be concerned with
listening for indications of them in both outer and inner speech.
Although there are other groupings, they are often listed in these
eight categories [McKay, Fanning & Davis, 1997].
- Filtering: The child focuses on the negative details
while ignoring all the positive aspects of a situation.
- Polarized Thinking: Things are black or white, good or
bad. The child has to be perfect or considers him/herself a failure.
There's no middle ground, no room for mistakes.
- Overgeneralization: The child reaches a general conclusion
based on a single incident or piece of evidence. S/he exaggerates
the frequency of problems and use negative global labels.
- Mind Reading: The child claims to know what people are
feeling and why they act the way they do. In particular, s/he
has certain knowledge of how people think and feel about them.
- Catastrophizing: The child expects, even visualizes disaster.
S/he notices or hears about a problem and starts asking, "What
if?" What if tragedy strikes? What if it happens to me?
- Magnifying: The child exaggerates the degree or intensity
of a problem. S/he turns up the volume on anything bad, making
it loud, large, and overwhelming.
- Personalization: The child assumes that everything people
do or say is some kind of reaction to him/her. S/he also compares
him/herself to others, trying to determine who is smarter, more
competent, better looking, and so on.
- Shoulds: The child has a list of ironclad rules about
how s/he and other people should act. People who break the rules
anger him/her, and s/he feels guilty when s/he violates the rules.
These cognitive errors can provide a significant perspective to
the mental context which provides the data to the individual upon
which a behavior is selected, whether there is a behavior deficit
or a cognitive disorder, and how you can effectively create an intervention
plan to address the problems in living that are caused. If you believe
that the people around you should behave in certain
ways and they dont behave in that way, it is likely that you
will be offended and act in a complementary fashion. However, if
no one else believes as you do, the offense is incomprehensible.
Thus, until the helper and the child examine the inner logic
of the beliefs which are held nonconsciously, it will be unlikely
that an hypothesis can be adequately created.
While the traditional, behavioral, use of FBA seeks to define the
environmental context, the FCBA, seeks to add, and even make predominant,
the inner or mental context which ultimately determines the behavior
selected. As a matter of course, because of a need to assure that
we do not merely seek external contexts, we would insist that the
assessment seek the mental context even for those children who would
be defined in group one, the developmentally delayed. To ignore
that a mental context is operating with a child who is delayed can
be a grave error. Even seriously delayed children, who communicate
inefficiently, form mental contexts which contributes to the outcome
behavior.
Thus, the data collection process, starting with the initial
inquiry, entails eliciting information about the situation in
which the child is experiencing difficulty and should be specifically
focused on what s/he says as reported by those around him/her and
confirmed by the student. Along with searching for cognitive errors,
a deeper search for images, sounds, smells, and other sensory representations
can help to define the mental context of the behavior and the recommendations
for resolution. The core beliefs about self, others and future prospects,
combined with the attributions for success and failure are highly
pertinent to helping the child identify what s/he wants to
change so s/he can begin to shape a perspective of a quality
life. The term quality life is specifically personal. Quality
is defined by the client.
Developing an hypothesis or best guess about the reason
for the behavior cannot occur in isolation of the child. One cannot
presume to know what the childs motivation is. Until the child
has defined a quality life, there is no context to understand whether
our intervention is helpful. To create an intervention to help change
the behavior without understanding what the individual child wants
to achieve is like building a road to somewhere without first determining
where you want to go. And if the child chooses, for whatever reason,
that s/he does not want to change the behavior, you are faced with
resistance. Such resistance does not occur in changework.
This is because changework starts with a basic assumption
that the assessment process has helped the child/family decide what
they want to change and the experts help to define the steps necessary
to make such a change.
Evaluating the effectiveness of the intervention is not an external
professional process. Since the child/family have defined quality,
they have certain criterion that they have used to define
an outcome expectation. This outcome expectation may or may
not agree with the outcome expectation of the school or community.
If it does not, the child is likely to continue to have problems
in living. However, this is a choice, and choices have consequences.
Part of the responsibility of the helper is to make sure that the
child understands social consequences so that they may make an informed
choice.
CREATING A PLAN FOR CHANGE
The outcome of any assessment process is to create a plan for change.
The ability to metaperceive ourselves as well as altering the reality
of the experience allows us to debug our present mental
contexts and create new ones. It is this process which allows us
to change. But change is not always easy. Just because a person
wants to change doesn't mean that s/he is willing to do it. Human
beings are coherency-seeking systems. Our personalities are a coherent
set of mental contexts, we are the sum of our thoughts. We are set
up at every level to try and maintain coherency, that is, to maintain
ourselves as we are. And that's a good thing. We are operating out
of a set of mental contexts which include all of our beliefs and
our strategies, etc. That's what keeps you you and me me; everything
that comes into a persons world goes through their own particular
filters and gets distorted, generalized, and deleted. If it weren't
for that, you would not be you, but simply a reflection of whatever
environment you are in at the time [Lady, 2000].
The clinical challenge that this presents is: How do I get through
these schemas or contexts and make it possible for this child to
reorganize his/her attitudes - in a way that supports the outcome
that s/he wants? Developing a cognitive behavior plan or protocol
requires that the child first become aware of his/her own thoughts.
This is usually done through a process of capturing automatic
thoughts that occur at times of stress or exposure. Once the child
begins to become aware of these thoughts, the protocol usually uses
a tool such as a journal so that the childs attention is kept
focused. While the childs focus is kept, the next step is
to analyze the validity of the thought either through dispute, or
though rational analytic skills - checking whether the thought helps
or hinders the persons ability to meet their personal goals.
Next, the child is helped to look for [create] other alternatives
for those thoughts which s/he finds to be invalid. Children with
problems in living often have rigid thoughts and little imagination.
Creating alternative thoughts is a creative process and requires
thinking skills which consequently may need to be taught. Each new
alternative is also analyzed [or disputed] and a decision is made
by the child as to what option holds the best potential for success.
Finally, the plan seeks to supply methods to adapt to the newly
selected, alternative thought. This is done through one of two processes.
Redundancy effects show that we generally lose consciousness of
repeated and predictable events. Using this fact, self-verbalization
of a mantra to replace the automatic thought is often a good choice
for replacing the old thoughts. If the child learns to repeat [speak/think]
a specific self-verbalization each time the target situation appears,
this does two things: first, it blocks the old self talk which contain
the negative thoughts, and second, it begins a process of inculcating
a new automatic thought which produces better results.
We can also address adaptive potentials by setting up a ritual
context through metaperception. By having the child change the
experiential context in his/her imaginative visualization,
using a reproduction of every sensory potential in an imaginary
scene, it becomes possible to open up their set of attitudes and
to allow a new experience to come in long enough for them to have
that experience and then re-form their attitudes around it. The
imaginary experience has the same impact psychologically as a real
experience, and as the child imagines him/her self succeeding in
a difficult situation using different thoughts and behaviors to
achieve this success, a new attitude [way of thinking] can occur.
The child experiences what it would be like to be someone else without
having to commit to such a person [Lady 2000].
Again, the redundancy effects can be utilized. As the child practices
this visualization more and more, the experience becomes habitual
and the process nonconscious. The helper can assist this imaginary
process. If the resource needed to deal with a particular situation
was to feel like I'm in control, for instance, the helper would
first elicit that feeling of being in control This process might
start by asking :Is there some sort of situation you deal with now
where you really feel in control? ... Can you remember at this moment
what that feels like, to really be in control?. Once such a situation
or memory is established, the helper can then instruct the client
to move that resource into the problem context: Now I want you to
keep remembering what it feels like to really be in control, and
while you still have that feeling I want you to imagine dealing
with that teacher directly and assertively [Lady 2000].
Several processes are occurring here:
- the child is anticipating and creating a plan for dealing with
a difficult situation, not simply impulsively responding to that
situation when it occurs,
- the creation of a plan provides the opportunity for the child
to think about different ways that s/he might respond, creating
flexibility of thinking,
- there is the opportunity for the child to examine how the other
person might respond to various kinds of behaviors that s/he offers,
- the child experiences the feelings of successful outcome, and
- the child is rehearsing a new repertoire of behaviors.
The important thing is to actually take the child through the experience
in his/her imagination using all of the metaperceptions. What usually
doesn't work is simply giving the child instructions on what to
do in the future. Counseling is often telling people what to do,
while changework is teaching them to actually do it without even
having to think about it.
Identifying the resource someone needs in a particular context,
finding out where that person already had that resource in their
life, and then moving the resource into the problem area - is a
process of self-help. At one time or another in his/her life, the
child has probably experienced all the emotional states that exist.
S/he knows what they are like, s/he can remember what it was like
to be in that state, and s/he can put him/herself in that state
simply by remembering the time when s/he had that emotion and by
moving back into that emotion. S/he can, at least sometimes, choose
an emotional state instead of accepting that the world causes his/her
emotions.
If we add to that a positive internal attribution for success as
a self instruction mantra, the child is reinforcing that s/he has
some control over such situations. After experiencing such feelings
if the child decides that s/he likes this new person and that s/he
can still be him/herself even though s/he re-forms his/her
attitudes around this new experience, that's when change occurs.
ELICITING2
Eliciting is the process of asking a person questions in order
to understand their mental processes. There are two rules: go very,
very slowly; and know the right things to look for.
Going very, very slowly is quite difficult to learn. Part of the
art of eliciting is being alert to those moments where the subject
says That's no problem or I just know or I just do it. The key to
good eliciting is being able to get information about precisely
those things that the subject does so well that s/he doesn't even
think about them and doesn't know how to explain them.
Another key point in eliciting is that you can't learn much by
listening to a subject talk about what s/he does in the abstract.
You need to watch the subject actually do it - or at least pretend
to do it. Have the child pick up the phone to deal with a call.
(Don't assume the caller is already on the line. Start when the
phone rings.) And the child has to be willing to put up with the
fact that you are going to constantly interrupt with questions.
In many cases, eye accessing cues are very helpful. It's not so
much a matter of putting an interpretation on the eye movements
(Up and to the subject's right means he's constructing an image,
up and to the left means he's recalling a stored image). It's that
the moment the eyes move lets you know that it's time to interrupt
with a question. (What happened just now? What did you just do?
Are you seeing a picture of something?)
Other non-verbal cues can also be important. (What does that mean
- that gesture you just made? What was going on in your mind when
you made that gesture?) (I noticed that when you first started,
your leg kept jerking up and down fairly rapidly. And then at a
certain point the leg stopped moving. Go back to the point when
the leg stopped moving and tell me what was going on in your mind.)
A lot of the most important stuff is below the threshold of consciousness,
so you really have to slow the subject down so s/he can become aware
of what s/he's doing. It is this art of asking a person questions
about their subjective experience that is the most difficult of
all aspects to learn. The average person has no competence at all
in eliciting. But for the person who wants to scientifically study
the structure of subjective experience, eliciting is where the real
information is.
We use the term eliciting in two distinctly different forms
in this paper. The first form is eliciting information as part of
the process of determining the subjects desires and intentions.
This is a very important usage. The other form is that of eliciting
the actual mental state through metaperception. This form of eliciting
is more oriented to the actual change process than merely the gathering
of information necessary to design the change process. However,
both of these forms of eliciting are important to the staff, since
the first is required in order to place the services and supports
in the proper power arrangement - it is the client who is the agent
of change and who decides what quality is; and the second, may be
a process of determining which metaperceptions are the most fluid
and useful for enhancing change.
There seems to be no need for balancing the process. If the assessment
process happens to be helpful in creating opportunities for change,
so what? Present method also create this potential with the memes
that are conveyed through expert language. However, professional
people traditionally take no responsibility for this impact. It
is most important that there is development of a process which will
make assessors aware of this linguistic impact of their involvement
and to use this impact effectively. As we change our language, we
change the relationship. We want to enlarge the explanation level
of the individual child/family so that whey can see themselves as
having problems in living that are within their own capacity to
address with our help. We want to choose the reality
that we depict with our language. We wish to position ourselves
in such a manner that we are helping the child/family achieve their
own goals. This cannot happen if we continue to operate in traditional
modes.
EVALUATION & REVISION
Since the use of a cognitive behavior plan requires that the child
make a clear choice about which thoughts s/he will continue to use
to seek goal achievement, the evaluation is entirely based upon
seeking variable techniques which provide the child with the opportunity
to experience and understand the world differently. While there
are many techniques available, some of which are oriented towards
specific characteristics, a trained practitioner will be able to
invent techniques which are suitable to the individual
child. Keeping a log, for example, requires that the child be able
to write. Substitution of a tape recorder may alter the technique
sufficiently to make it usable for the child, while maintaining
the purpose of the log. In the final analysis, however, the child
will choose or not choose to think differently. There is no coercive
capacity in the intervention process. If the child continues to
think in ways that cause him/her to act in a manner which is intrusive
or destructive, the consequences are available in society. We may
not like this fact, but this is reality, not a mental context.
EXCHANGE RELATIONSHIPS
Thus thought distortions occur when an interpretation of the world
is made that is not utile [brings more pain than pleasure]. Since
these thoughts are generally habituated, they are not conscious
and therefore are, in that state, uncorrectable. There is reason
to believe that debugging of the system can happen only
in the conscious realm, and thus it is important that the players
become aware of these thoughts and attend to them. Note that it
is not just the child who must be aware of his/her distorted thoughts,
but the significant child managers as well. Since they a) miscommunicated
the exchange of information, b) communicated distorted information,
and/or c) responded poorly to the response - these significant adults
either helped create and/or maintain the distorted thoughts.
Since every individual behaves in ways that thy believe are in
their own best interest, it is important that both the individual
child and the significant supervisors understand [become conscious
of] their thinking patterns so that they can examine its usefulness
in light of thier goals and change the information exchange in ways
that support the changes desired by the child.
References:
Baar, B.J., A Cognitive Theory of Consciousness, 1988.
Klinger, 1971 as reported in Baar, A Cognitive Theory of Consciousness,
1988
La Berge, 1980, 1981; Posner & Snyder, 1975; Shiffrin &
Schneider, 1977 as reported in Baar, A Cognitive Theory of Consciousness,
1988
Lady, Lee, <CG0DF8.654@news.Hawaii.Edu> lady@Hawaii.Edu This
site has provided much of the material and language for eliciting
and changework.
Lock, A., Against Cognitivism: the discursive construction of cognitive
mechanism, 2000
McKay, M., Davis, M., & Fanning, P., Thoughts & Feelings:
Taking Control of Your Moods and Your Life, New Harbinger Publication,
Inc., 1997
Russell, P., Foundations Of Consciousness: How Ideas Bend the World
into Shape, 1997
Shure, M., Social Competence as a Problem Solving Skill, Chapter
6 in Social Competence, Wine & Smye [Eds], The Guilford Press,
1981.
Tooby, J. & Cosmides, L. In a Letter to the Editor of The New
York Review of Books on Stephen Jay Gould's "Darwinian Fundamentalism,
(June 12,1997) and "Evolution: The Pleasures of Pluralism"
(June 26, 1997)
Turnbull III, Wilcox, Stowe, Raper & Hedges, Public Policy
Foundations for Positive Behavior Interventions, Strategies, and
Supports, Journal of Positive Behavior Interventions, Volume 2,
No. 4. Fall 2000
Footnotes:
1. Each individual self, creates plans, recipes, rules, instructions,
which are the principal basis for the specificity of behavior and
an essential condition for governing that behavior within the context
of ones personal theory of the world.
2. The language of this section is adapted almost entirely from:
lady@Hawaii.Edu (Lee Lady) Newsgroups: sci.psychology Summary: NLP
arises from 'modeling', Sun, 19 Dec 1993 20:46:49 GMT
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