Collaborative Problem Solving (CPS) Summary

young-girl-in-classroom-schoolYOUTH WITH/WITHOUT DIFFICULT BEHAVIORS BENEFIT FROM CPS

DON’T SEEM TO LEARN FROM PLAN A

  • Expectations with use of predetermined punishments/rewards.
  • Poorly understood by child who doesn’t change. Some kids respond but don’t learn problem solving.
  • Severely resistant to the imposition of adult will and corresponding explosive outbursts causing upheaval, instability and frustration.
  • Incompatible match of child characteristics and the manner by which adult pursues expectations.
  • When a person’s threshold of adversity exceeds his skills, the likelihood of violence is heightened.

CPS MANTRAS

“Kids (and adults) do well if they can.”

  • Behind every challenging behavior is either an unsolved problem, or lagging skill, or both.
  • Your explanation of the behavior guide your intervention.
  • Reward and punishment do not teach skills of flexibility and frustration tolerance.

THREE PRIMARY DOMAINS

Frustration tolerance, problem solving and flexibility/adaptability.

 Pathways:

  • Deficits guide intervention options more specifically than knowing the kids diagnosis: ADHD, ODD, reactive attachment disorder, etc.
  • Executive, Language Processing, Emotional regulation, Cognitive flexibility, and Social skills.
  • Some kids simply aren’t available for academic learning until headway has been made on the challenges that may be impeding learning.
  • Factors other than lagging skills that contribute to explosive behavior: sleep issues, current trauma, seizure disorders, food and seasonal allergies, drug or alcohol use, and other complicating medical conditions or reactions to medicine.

Assessment and implementation issues:

  • Think Lagging Skills not bad behavior.
  • Shifting understanding of behavior away from motivational interpretations.
  • Attention, not motivated to do well, wants to be in control, wants things her way, avoid doing something, get something.
  • A story is just a story unless you use it to identify a pathway or a trigger.
  • Lagging skills explains why motivational strategies do not work.

Being in control (directive) of the case:

  • Focus on pathways, prioritizing lagging skills and triggers so that there is focus on one or two concerns at a time, anticipating brick walls or derailment.
  • Recognizing adult pathway deficits and responding to them
  • Individual training and support for participants before they work together
  • Use the ALSUP:  (Assessment of Lagging Skills and Unsolved Problems)

 Importance of Triggers or activating event:

  • Reacting to math assignment when math assignment is thought to be too hard.
  • Problems that have yet to be solved.
  • EG. Hypersensitivities can be homework, sharing, reading, writing, getting ready for school, focused learning, self-starting, sustained effort and getting along with others.

Plan A

Adult expectations pursued in a manner that greatly heighten the likelihood of explosive outbursts
Evidenced by increased insistence or pressure to meet adult expectations

Plan A approach:

  • List target behaviors needing compliance
  • Make list of incentives and punishments
  • Develop a currency system to track/monitor behavior and issue rewards/punishment
  • May be necessary behavior poses an immediate safety concern.

Plan B

Implementing CPS, things often get worse before they get better. Change in paradigm, frustration
tolerance, old plan A habits, maintenance needs. Involves willingness to repeat problem solving
sessions that replace blame with empathy and desire to find a plan that meets both adult and child.

Plan B approaches:

  • Essential information: Adult works to stay calm and not follow the escalation.
  • Dealing with Trigger: Best to focus on trigger solutions first.
  • Dealing with Pathways: Plan B helps with the pathways in general
  • Executive: dealing with past-future details
  • Language: self-expression skills when calm, teach vocabulary to connect feelings
    with concerns, develop tools, develop frustration list, phrases to ask for help:
    “Something is the matter.” “I can’t talk right now.” “In need help” “I don’t
    know what to do.” “I don’t feel right” “This isn’t going the way I thought it would.”
  • Emotion: empathy is calming, trust building, safety
  • Cognitive Flexibility: Anxiety from lack of frame of reference/mastery, having
    child’s knowledge/perspective validated, hearing another’s concerns.
    problem solving practice: ask for help, meet halfway/give a little, do it a
    different way.
  • Social Skills: working through something with someone, making plans for real
    social situations, acquiring new behavior options

Type 1: Proactive Plan B:

Key steps initiated by adult when all parties are calm. Need to build
trust that talking about problem to find mutually solution is not a Plan A
manipulation. Have a curious attitude. The aim is at trying to find what works. It’s
an experiment. We’ll learn as we go.

Start with Empathy/reassurance

  • Neutral observations: I notice homework has been a struggle lately, “What’s up…..”
  • What’s wrong with what others are doing?
  • For adolescents: “I hear ya” alternative to reflective listening
  • Don’t rush, make sure you understand kid’s concern or perspective
  • Better to believe the kids perspective than not believe it
  • Keep the kid talking.

Define the problem

  • Kid concern first, adult concern second
  • Requires mutual recognition of concern, not agreement
  • Child does not feel blamed – behaviors are not intentional
  • System/family problem not the child’s problem
  • Don’t mix in solutions with sharing concern
  • Invitation
  • “Let’s find a mutually satisfying and feasible solution for the problem/concern”

Type 2: Emergency Plan B

  • On the spot de-escalation but doesn’t set up a durable plan
  • Don’t rely on Emergency Plan B, it will wear you out

Plan C

  • Problems to solve another day.
  • Expectation deemed not realistic or necessary at a given time

Medication Issues:

  • Meds can help make the child/youth more available for problem solving
  • Inattention and distractibility: Stimulant meds: Ritalin, Dexedrine
  • Hyperactivity and impulse control: Stimulant Stratera
  • Atypical anti-depressants (Wellbutrin)
  • Antihypertensive (Clonidine, Tenex)
  • Trycyclic antidepressants (Pamelor, Tofranil, Anafranil)
  • Irritability and Obsessiveness
  • SSRI antidepressants (Zoloft, Paxil, Celexa, Luvox)
  • Extremely Short Fuse
  • Atypical antipsychotics (Risperdal, Zyprexa, Seroquil, Abilify)
  • Mood Stabilizers (Lithium, Tegretol, Depakote)

For More Information:

ThinkKids:

http://www.thinkkids.org/learn/our-collaborative-problemsolving-
approach/

OFSN Training Events:

http://www.ofsn.org/training/