Collaborative Problem SolvingAn Approach to Helping Explosive Students with Challenging Behaviour
By Ron Teffaine, M.Ed., CSC
Agenda for Today• 9:00 am - 10:15 am CPS (theory, research, tools) • 10:15 am - 10:20 am Nutrition Break• 10:20 am - 11:30 am CPS (Plan A, C, B)• 11:30 am - 1:15 pm Lunch & HTA AGM• 1:15 pm - 2:30 pm CPS (videos & practicing the
Plan B steps in groups)• 2:30 pm – 2:50 pm Nutrition Break• 2:50 pm – 3:45 pm CPS (group practice,
questions, fill out evaluation form)
• What do I want from this workshop today? Jot down an idea, and be prepared to share it.
What Would You Do?
• Read over the two scenarios in your handout.
• Briefly write down what you would do if you were the teachers of those students.
• Be prepared to share an idea or two with the rest of the class.
Ross W. Greene, Ph.D.• Director of the Collaborative Problem Solving
Institute at Massachusetts General Hospital,• Associate professor of Psychiatry at Harvard
Medical School.
Originator of the Collaborative Problem Solving Approach
Wrote two popular books about CPS
CPS for parents CPS for teachers
Who was CPS Designed for?
Explosive children and adolescents:• Severely resistant to adults • Have explosive outbursts• A heterogeneous group, with a
variety of diagnoses:
e.g., ADHD, ODD, CD, IED, Dysthymia, Bipolar Disorder, Temper Dysregulation Disorder, Asperger’s Disorder, FASD, etc.
Why A New Model? The Coercion Model dominated the conceptualization &
treatment of explosive behaviour for 45 years prior to CPS. It says that 4 patterns of discipline contribute to coercive adult-
child interactions: (1) Inconsistent (2) Irritable explosive(3) Low supervision/involvement(4) Inflexible or rigid
Children learn that arguing and tantrums coerce adults to give in to their wishes.
The solution has been Parent Training (PT).
PT has limitations:• Many parents give up or drop out• 30-40% of parents report behaviour problems at follow-up• 50% of treated children never reach normal
Parent Training books based on Coercion Model
Two popular books for teachers based on the coercion model:
William Jensen & Ginger Rhode
Coercion Model in School
Ignoring
Arguing
Verbal &/or PhysicalAggression
Asking
Begging
Threatening
Wins
AggressiveDemanding
Loses
Gives in
Stalling
Three Conceptual Models:(1) Main Effect
• Child’s outcome is product of either adult or child characteristics
Child
Adult
ExplosiveOutcomeor
A or C = Outcome
Poor parenting
skills
Has a disorder, (e.g., ADHD)
The solution is Parent Training!
The solution is Medication!
Three Conceptual Models:(2) Interactional
• Child’s outcome depends on the combination of adult & child characteristics
Adult Child Outcome+
A + C = Outcome
(A-1) + (C-1) = (O-2)
(A-1) + (C0) = (O-1)
Severe
Moderate
Three Conceptual Models:(3) Transactional
• Child’s outcome depends on degree of “fit” or “compatibility” between adult & child characteristics
Unique Fit
CPS is based on this model
Goal of treatment
Is not to fix the adult or the child, it is to improve the
“compatibility” between adult
and child.
How well does CPS work?
Subjects - 50 children (ages 4-12) with ODD
Journal of Consulting and Clinical Psychology 2004, Vol. 72., No. 6, 1157-1164
Conclusion: CPS resulted in better outcomes than PT.
CPS Philosophy:
“Children do well if they can.”
VS.
“Children do well if they want to.”
Suggests explosive kids are
attention-seeking, manipulative, limit-testing, or poorly
motivated
Suggests kids would do well if they had the right
skills to appropriately adapt to the
environmental demands
Explosive kids have a Learning Disability in three global domains:
(1) Flexibility / adaptability
(2) Frustration tolerance
(3) Problem solving
These disabilities hinder a child’s ability to adapt to changes or demands, and internalize standards of conduct.
As a result, explosive children find it difficult to comply with adults’ imposed goals and standards.
Different parts of the brain contribute to the LD in flexibility/adaptability, frustration tolerance, & problem solving:
Prefrontal Cortex – executive functioning
Limbic System – emotions
Right Brain –novel,
holistic, analogical,
spatial processing
Left Brain –routine,
sequential, analytical, linguistic
processing
Problems in Five Cognitive Pathways contribute to the LD in the 3 domains1. Executive skills:
• Impulsivity, perseveration, trouble remembering things, enmeshed thoughts & feelings, weak forethought, and disorganization
2. Language-processing skills:• Trouble comprehending, weak grammatical expression, slow
verbal fluency, difficulty labeling feelings, poor pragmatics 3. Emotion regulation skills:
• Chronic irritability, depression, and/or anxiety4. Cognitive flexibility skills:
• Concrete, literal, black-and-white thinkers, who are rigid and detail-oriented
5. Social skills:• Cognitive distortions, inaccurate interpretations, lacks empathy,
poor self-monitoring, lacks interpersonal skills
Exploring the Cognitive Pathways
The Pathways Inventory
is an excellent toolfor exploringskill deficits among the 5
pathways
• As you observe a student’s explosive behaviour over time, think about which pathways are needed to meet the demands of the problem situations.
• e.g., If John gets upset every time you tell him to get a partner or join a group, he may lack the necessary social skills.
• e.g., If John gets nervous and upset just before show-and-tell time, he may have language processing deficits and/or excessive anxiety because of poor emotional regulation.
Exploring “Pathway” skill deficits
Exploring “Triggers” – Unsolved Problems• Triggers – are “problems that have yet to be solved.”
These are situations that precipitate or increase the likelihood of explosive episodes.• e.g., telling a student to do some written work,
telling a student to put materials away, when a student loses a game, when criticized for being late, when accidentally bumped, asking for homework, etc.
• By identifying triggers and pathway deficits, explosive episodes become more predictable. can help with generating possible solutions, can anticipate what adaptations can be used to
prevent and reduce explosive episodes.
High Probability Triggers
Exploring Triggers & PathwaysTwo other tools can be used to explore common triggers and lagging skills among the 5 pathways:
The ALSUP Checklist The ALSUP Rating Scale
Exploring Triggers & PathwaysThe ALSUP Rating Scale
Use one ALSUP Rating Scale for each student scenario presented at the beginning of the workshop to identify the “Triggers” & “Pathways” likely involved.
Individual Exercise
Prioritize Triggers & Pathways Examine the collected data using the Pathways
Inventory, ALSUP Checklist or Rating Scale. Transfer the problems to the Prioritizing Triggers
& Cognitive Pathways form. Determine which Triggers are the most frequent or
interfere the most. Observe which Pathway lagging skills are affected
most often. Rank order the problems in order of priority, so
that each can be worked through.
Prioritize Triggers & Pathways cont’d…
Impacton
Cognitive Pathways Affected(from the ALSUP)
Triggers(Unsolved Problems)
FreqPerDay
OtherKids
TheTeacher
ExecutiveSkills
LanguageSkills
Emotion-Regulation
Skills
CognitiveFlexibility
Skills
SocialSkills
RANK
When other kids push ahead of him
6Often
3 3 1
Asked to correct his written work
4Some-times
2 3 2
Asked to work with a new partner
1Some-times
2 2 3
• Use the CPS PLAN form to categorize items into High Priority unsolved problems and lagging skills, as well as Low Priority unsolved problems/accommodations.
Prioritize Triggers & Pathways cont’d…
Document Plan B Sessions
Three plans for handling problems
1. Plan A – imposition of adult will. Insisting that expectations be met. Adult assumes motivation is the problem, so may offer incentives or threaten punishment.• Entry phrases: “No,” “You must..,” “You have
to…” “You can’t..,” etc.• Escalating insistence:
“Look, if you __, I’ll give you ___.” REWARD
“If you don’t __, you’ll miss __!” PUNISHMENT
Three plans for handling problems
2. Plan C – involves reducing or removing expectations, at least temporarily. • Adults signal this when they say nothing, or do
not object to a student’s request or behaviour.• When Plan C follows Plan A, it could be
interpreted as “giving in” to a child’s explosive behaviour. This may increase it.
• However; starting with Plan C simply means you’re choosing not to impose an expectation just yet.
Three plans for handling problems
3. Plan B – engaging the student in a collaborative attempt at problem solving to achieve a mutually satisfying (win-win) resolution of whatever concerns or factors are interfering with expectations being met. • Although Plan A seems quicker, it can
precipitate explosive episodes, which are more time consuming than solving the problems durably with Plan B.
Criteria for an Effective Intervention
1. Create a helping relationship2. Solve the problems (triggers)
precipitating explosive episodes3. Teach lagging skills within the 5
cognitive pathways4. Reduce the frequency, intensity, and
duration of challenging behaviour5. Help pursue adult expectations
How well does each plan achieve the goals of an effective intervention?
Goals Achieved by Each Plan
Create Helping
Relationship
TeachSkills
SolveProblems(triggers)
ReduceOutbursts
PursueExpecta-
tions
Plan A With FBA
With FBA
?temporarily
Plan C Plan B
How Does Plan B Teach Skills? Executive skills:
• Organized, planful (nonimpulsive) thinking develops as adults guide students’ thinking with Plan B.
• Separation of affect develops as kids learn that solutions to problems take their concerns into account.
• Shifting cognitive set develops as students learn to anticipate triggers and agree to solutions (e.g., teacher reminders, visual schedules, social stories, etc.).
Language-Processing skills: • Expressing frustration in a socially acceptable manner
(e.g., “I’m frustrated” vs. “Screw you!”) can develop based on teacher suggestions during brainstorming.
How Does Plan B Teach Skills? Emotion Regulation skills:
• Reduction of anxiety & irritability occurs as chronic problems associated with these feelings are resolved using Plan B.
• Dispelling cognitive distortions (e.g., labeling, overgeneralizing, catastrophizing, etc.) associated with anxiety & depression can occur as Plan B identifies them and provides disconfirming evidence for them.
Cognitive Flexibility skills: • Thinking becomes more flexible as anxiety is
decreased through the “Empathy” step & reassurance.• Considering another’s perspective develops through
the “Defining the Problem” step.
How Does Plan B Teach Skills? Social Skills:
• Some skills are trained simply by using Plan B:e.g., Assertiveness, cooperation, problem solving, etc.
• Other skills may need to be trained directly using strategies similar to published social skills training programs:
e.g., Skillstreaming – Dr. Arnold Goldstein & Dr. Ellen McGinnis
• Social skills are taught in a collaborative fashion, so there’s a better chance the info. will be heard.
• Plan B often teaches social skills in the natural environment, therefore, there’s better generalization.
1. Proactive Plan B – this is preferred!• This is a proactive procedure, done at a time
when each person is calm and able to think well (e.g., before/after school, lunchtime, recess, etc.)
2. Emergency Plan B• This is done at the start of challenging behaviour
or after an explosive episode.• If done too often, this is called “Perpetual Plan B”
and signals the urgency for Proactive Plan B.
Plan B Two main types:
What if student starts to Escalate?
• Use the student’s interests or passions• Ask student to deliver a message• Send to designated “comfort zone”• Go for a walk with the student & allow venting
(From “No More Meltdowns”- Jed Baker, Ph.D).
• Use Non-violent Crisis Intervention
Anxious Student:• Noticeable change from usual behaviour (e.g.,
quieter, louder, fidgety, etc.); student has a problem Offer assistance; be nonjudgmental, caring,
empathic, and supportive
• Try Distraction
What if student continues to Escalate?Use Non-violent Crisis Intervention
Defensive Student:• Agitated – now we have the problem• Starting to lose rationality; challenging
1. Questioning Give info., redirect2. Refusal Set limits (+ then -)3. Release Allow venting4. Intimidation Get help, keep hands off5. Tension Reduction Therapeutic rapport
Emergency Plan B C.O.P.I.N.G. or
Proactive Plan BThree steps or ingredients:
1. Empathy• Gather information about and achieve a clear
understanding of the student’s concern or perspective on the unsolved problem.
2. Define the problem• Enter the adult’s concern for consideration.
3. Invitation• Brainstorm ideas that are realistic and mutually
satisfactory (i.e., win-win solutions).
B
Proactive Plan B in Action
Proactive Plan B
STEP 1 – Empathy
Words to use: Initial inquiry
• “I’ve noticed that …(insert unsolved problem) … what’s up?”
Drilling for Information• Ask W4 (who, what, where, when) & How
questions about the unsolved problem.• Explore facts, thoughts, beliefs, feelings,
physical reactions, relationships, choices, etc.• Investigate the conditions under which it
occurs, & those under which it doesn’t. What’s the difference to the student?
• Use active listening, reflect & summarize ideas.• Take your time; don’t rush this step.
Step 1. EmpathyPlan B
You tend to ___ when…___ occurs when you…
Step 1. EmpathyMore Help: If you’re not sure what to say next, say:
• “How so?” “I’m confused.” “I don’t quite understand.” “Can you tell me about that?” “Let me think about that for a second.”
If the student doesn’t talk or says, “I don’t know,” try to figure out why. Maybe…• your observation wasn’t very neutral• the problem was too vague• you’re using Plan A• he/she really doesn’t know – give time, break down
problem
Plan B
Step 1. Empathy
What You’re Thinking: Am I using a concerned, caring, and
respectful tone of voice? What don’t I yet understand about the kid’s
concern or perspective? What doesn’t make sense to me yet? What do I need to ask to understand it
better?
?
Plan B
Step 1. Empathy
Don’t…• Skip the Empathy step• Assume you already know the student’s
concern• Rush through the step without sufficient drilling
– “Perfunctory Empathy”• Leave the Empathy step before you completely
understand the kid’s concern or perspective• Talk about solutions yet
Plan B
Plan B - Empathy Step – Drilling for Information
Group Work Time
Observer
Teacher
Student
Step 1
Plan B exercise: Step 1 - Empathy• Break up into groups of 3.• One person will be the student (1), one the teacher
(2), and one the observer (3).• Each group member will get a “Role-Play Sheet” that
lists two unsolved problems.• The teacher (2) will try out Step 1 of Plan B with one
problem.• The teacher and observer use the “Cheat Sheet.”• The teacher may also use the
CPS “Deciding on Solutions” form if desired.• The observer will use the “Feedback Form” to record
what went well under step 1 of Plan B, and a helpful comment or two under the suggestions column.
• Once step 1 is completed, rotate so that each group member has a turn.
Proactive Plan B
STEP 2 – Define The Problem
Step 2. Define The ProblemWords:
“The thing is (insert adult concern)…” “My concern is (insert adult concern)…”
More Help: Most adult concerns fall into 2 categories:
• How the problem is affecting the student• How the problem is affecting others
What You’re Thinking: Have I been clear about my concern? Does the student understand what I said?
Well,…
Adult’sConcern
Step 2. Define The Problem
Don’t…• Start talking about solutions yet• Sermonize• Judge• Lecture• Use sarcasm
Group Work Time
Observer
Teacher
Student
Step 2
Plan B exercise: Step 2 – Define the Problem• Stay in your groups.• Decide who will be the student (1), teacher (2), and the
observer (3).• Continue using the “Role-Play Sheet” that lists two
unsolved problems.• The teacher (2) will try out Step 2 of Plan B with one
problem.• The teacher and observer use the “Cheat Sheet.”• The observer will use the “Feedback Form” to record
what went well under Step 2 of Plan B, and a helpful comment or two under the suggestions column.
• Once step 2 is completed, rotate so that each group member has a turn.
Proactive Plan B
STEP 3 – Invitation
Step 3. Invitation
Words to use: Restate the concerns, usually beginning with:
• “I wonder if there is a way we can…”• “Let’s see if we can figure that out”• “Let’s see what we can do about that”• “Do you have any ideas?” (Let the student go first!)• “Well, I have a few ideas… would you like to hear
them?”
Plan B
Step 3. Invitation
More Help: Stick closely to the identified concerns Let the student go first, but remember it’s a team
effort Consider the odds of a solution actually working:
• If they’re below 60-70%, talk about what is making you skeptical
Try the CPS “Deciding on Solutions” form At the end, agree to return to Plan B again if the
first solution doesn’t work
Plan B
Brainstorming
Step 3. Invitation
What You’re Thinking: Have I summarized both concerns accurately?
Have we truly considered whether both of us can do what we’ve agreed upon?
Does the solution address both of our concerns?
What are the odds of this solution working?
?
Plan B
Step 3. Invitation
Don’t… Rush through this step Enter this step with pre-ordained,
“ingenious” solutions Agree to solutions that both you and the
student can’t actually perform Agree to solutions that don’t truly address
both your concerns
Plan B
Plan B - Invitation Step – “Ingenious Solutions”
Group Work Time
Observer
Teacher
Student
Step 3
Plan B exercise: Step 3 – Invitation• Stay in your groups.• Decide who will be the student (1), teacher (2), and the
observer (3).• Continue using the “Role-Play Sheet” that lists two
unsolved problems.• The teacher (2) will try out Step 3 of Plan B with one
problem.• The teacher and observer use the “Cheat Sheet.”• The observer will use the “Feedback Form” to record
what went well under Step 3 of Plan B, and a helpful comment or two under the suggestions column.
• Once step 3 is completed, rotate so that each group member has a turn.
Plan B in Groups
Plan B in Groups• The teacher acts as the group facilitator.• Establish expectations for communicating (e.g.,
respectful I-messages), listening, and taking turns (e.g., use a foam talking ball).
• Record expectations on chart paper for all to see.• Remind the group of the expectations if they
aren’t being met.• Display a Plan B Outline on the wall.• Be neutral – there are no good or bad concerns,
only ones that need to be addressed.• Help the students prioritize problems to address.
Plan B in Groups• Empathy Step - all students take turns offering
their perspective on a problem that affects the class or individuals within the class.
• Define the Problem - the adult offers his/her concerns and perceptions after the kids are done.
• Invitation Step - have kids brainstorm solutions based on at least 2 criteria: (1) ideas are realistic, (2) ideas are mutually satisfactory. The teacher joins in after letting students try first.
• Recording - When “drilling” or “brainstorming,” record the information on a whiteboard, flip chart, overhead, or Mimio display so all can see.
Questions or
Final Comments?
For more information about CPS, visit the
“Lives In the Balance” website at:
http://www.livesinthebalance.org
Please fill out the Workshop Evaluation form
Thank You