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PRACTICE components PRACTICE components

P P sychoeducationsychoeducation and parenting skillsand parenting skillsyy p gp g R elaxationR elaxation A ffective expression and regulationA ffective expression and regulation C ognitive copingC ognitive coping T T rauma narrative development & processingrauma narrative development & processing I I n vivo gradual exposuren vivo gradual exposure C C onjoint parent child sessionsonjoint parent child sessions E E nhancing safety and future developmentnhancing safety and future development

Cognitive CopingCognitive Coping

Learn the relations between thoughts, feelings, Learn the relations between thoughts, feelings, and behaviorsand behaviorsand behaviorsand behaviors

Practice the skill of focusing on the positive Practice the skill of focusing on the positive instead of the negative aspects of any given instead of the negative aspects of any given situationsituation Teach cognitive triangle Teach cognitive triangle Recognize thoughts that are too Personalized, Permanent, Recognize thoughts that are too Personalized, Permanent,

and Pervasiveand Pervasiveand Pervasiveand Pervasive Challenging negative thoughtsChallenging negative thoughts Learned optimismLearned optimism Positive self talkPositive self talk Recognizing how one is coping well Recognizing how one is coping well

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Cognitive Triangle: Thoughts, Cognitive Triangle: Thoughts, Feelings, and BehaviorsFeelings, and Behaviors

T iT iTriggerTrigger

Consequences

Cognitive Work w/ KidsCognitive Work w/ Kids--Identifying thoughtsIdentifying thoughts

How do I get kids to talk about their thoughts?How do I get kids to talk about their thoughts? Use KID LANGUAGE! Use KID LANGUAGE! NN ADJUST TO THEIR DEVELOPMENTAL LEVEL, ADJUST TO THEIR DEVELOPMENTAL LEVEL, BE BE

CREATIVE!CREATIVE! What do you think about when you’re ______(insert What do you think about when you’re ______(insert

feeling)? feeling)? Are there any thoughts or pictures that go through your Are there any thoughts or pictures that go through your

mind?mind? What popped into your head? What did you say to What popped into your head? What did you say to

yourself?yourself? What went through your head? What went through your head? What is your brain saying? What is your brain saying?

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Cognitive Work w/ KidsCognitive Work w/ Kids--Identifying thoughtsIdentifying thoughts

We talk to ourselves in private all the We talk to ourselves in private all the time. What were you saying to yourself time. What were you saying to yourself when X happened?when X happened?

If I were to play a CD back of what you If I were to play a CD back of what you were telling yourself, what would I hear?were telling yourself, what would I hear?

T.V. (feeling, thinking, doing channels)T.V. (feeling, thinking, doing channels)

Making it Child FriendlyMaking it Child Friendly

Use Thought Bubbles over character's Use Thought Bubbles over character's headsheadsheadsheads

Use gamesUse games

Dr. Dr. PlaywellPlaywell

Triangle beanbag toss Triangle beanbag toss

Triangle baseball Triangle baseball

Turtle Technique (see handout)Turtle Technique (see handout)

Parent as Coping CoachParent as Coping Coach

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Differentiating Thoughts and Differentiating Thoughts and Feelings: Feelings: Preschoolers/Younger KidsPreschoolers/Younger Kids

Sort themSort them

Feelings Thoughts

Make it funMake it fun

Warm Fuzzy Thoughts

(or Feelings)

Cold Prickly Thoughts

(or Feelings)

Sorting Types of Thoughts and Feelings: Preschoolers/ Younger Kids

( g )

warm coldwarm

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$50 each book

Thought Tracker, Feeling Finder, Go Getter

Dr. Playwell GamesDr. Playwell Games

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Childswork/Childsplay Early Prevention Series

The Horse Who Lost Her HerdThe Horse Who Lost Her Herd

The Koala Who Wouldn't Cooperate

The Cheetah Who Lost Her Speed

The Bear Who Lost His Sleep

The Chimp Who Lost Her ChatterThe Chimp Who Lost Her Chatter

The Hyena Who Lost Her Laugh

The Lion Who Lost His Roar

The Penguin Who Lost Her Cool

The Rabbit Who Lost His Hop

Cognitive Distortions: Cognitive Distortions: Making it Child FriendlyMaking it Child Friendly

The DownersThe Downers Negative glassesNegative glasses

Predicting FailurePredicting Failure The mindThe mind readerreader Negative glassesNegative glasses

Positive doesn’t countPositive doesn’t count Blowing Things UpBlowing Things Up

AllAll--oror--nothing nothing thinkingthinking

Magnifying the Magnifying the

The mindThe mind--readerreader The fortuneThe fortune--tellerteller

Feeling ThoughtsFeeling Thoughts Emotional reasoningEmotional reasoning Dustbin labelsDustbin labels

Setting Yourself UpSetting Yourself Upg y gg y gnegativenegative

SnowballingSnowballing

Setting Yourself Up Setting Yourself Up To FailTo Fail

Blame Me!Blame Me!

Stallard, P. (2002). Think Good-Feel Good. West Sussex, England: John Wiley & Sons Ltd.

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Examples to Illustrate Cognitive TriadExamples to Illustrate Cognitive Triad

A child did poorly on an exam at schoolA child did poorly on an exam at schoolWhat are some reasons for this?What are some reasons for this?What are some reasons for this?What are some reasons for this?“I’m stupid”“I’m stupid” (thought) (thought) –– how does how does this make you feel? What do you do?this make you feel? What do you do?The test was unfairThe test was unfair (thought) (thought) –– how how

does this make you feel? What do you does this make you feel? What do you do?do?do?do?I didn’t study hard enoughI didn’t study hard enough

(thought) (thought) –– how does this make you how does this make you feel? What do you do?feel? What do you do?

What this looks like with kids What this looks like with kids

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Cognitive CopingCognitive Coping

Connecting feelings with thoughts & behaviors

What you felt, what you thought,

And what you did!

Thought

Making the Connections related to traumatic event

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Worry Brain: 6 ½ year old male Worry Brain: 6 ½ year old male

Methods of Challenging Methods of Challenging Dysfunctional ThoughtsDysfunctional Thoughts

Clarifying differences between accurate vs. Clarifying differences between accurate vs. inaccurate thoughts or helpful vs. hurtful inaccurate thoughts or helpful vs. hurtful thoughtsthoughts

Thought InterruptionThought Interruption

Socratic method (Colombo approach)Socratic method (Colombo approach)

Best Friend/Little Sister Role PlayBest Friend/Little Sister Role Play

Responsibility PieResponsibility Pie

Gaining Another PerspectiveGaining Another Perspective

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Cognitive Coping: Thought Cognitive Coping: Thought InterruptionInterruption

Use when overwhelmed w/ trauma remindersUse when overwhelmed w/ trauma reminders Temporary measures early in treatmentTemporary measures early in treatment Teaches children control over their thoughtsTeaches children control over their thoughts

Changing the channelChanging the channel Saying “go away” or “snap out of it”Saying “go away” or “snap out of it” Imagining a stop signImagining a stop sign

Replace unwanted thought with a positive oneReplace unwanted thought with a positive one Replace unwanted thought with a positive oneReplace unwanted thought with a positive oneTry pairing the interruption technique with a Try pairing the interruption technique with a

“perfect image” that the youngster has drawn out. “perfect image” that the youngster has drawn out. Have kids talk in detail about the image.Have kids talk in detail about the image.

Distraction Techniques (e.g., count backwards, list your Distraction Techniques (e.g., count backwards, list your favorite…)favorite…)

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Coping with the thoughtsCoping with the thoughts

Translation Questions- Identify the meaning attributed to eventsTranslation Questions- Identify the meaning attributed to events

Memory Questions- Develop a shared factual understandingMemory Questions- Develop a shared factual understanding

Socratic Method (Guided Discovery)Socratic Method (Guided Discovery)

Analysis Questions- Promote logical evaluationAnalysis Questions- Promote logical evaluation

Application Questions- Identify helpful knowledge of experiencesApplication Questions- Identify helpful knowledge of experiences

Interpretation Questions- Explore the relationship between eventsInterpretation Questions- Explore the relationship between events

Evaluation Questions- Promote re-evaluation and reflectionEvaluation Questions- Promote re-evaluation and reflection

Synthesis Questions- Encourage creative/alternative thinkingSynthesis Questions- Encourage creative/alternative thinking

Stallard, P. (2005). A Clinician’s Guide to Think Good-Feel Good. West Sussex, England: John Wiley & Sons Ltd.

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Best Friend Role PlayBest Friend Role Play

Activity: Role Play this ExampleActivity: Role Play this Example

You’re in the lunchroom and are walking You’re in the lunchroom and are walking t t bl h l tt t bl h l tover to a table where your classmates are over to a table where your classmates are

sitting. They start laughing sitting. They start laughing What are some reasons for this? What goes What are some reasons for this? What goes

through your head when they start laughing?through your head when they start laughing?How does that make you feel? What do you How does that make you feel? What do you

do?do?

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Responsibility PieResponsibility Pie

Before Cognitive Processing

Responsibility PieResponsibility Pie

After Cognitive Processing

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Gaining Another PerGaining Another Per--SPECSPEC--tivetive

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Parallel Work With CaregiversParallel Work With Caregivers

How caregivers talk to and behave toward How caregivers talk to and behave toward children can greatly influence developing beliefschildren can greatly influence developing beliefschildren can greatly influence developing beliefs children can greatly influence developing beliefs about self, others, and the worldabout self, others, and the world

Parents’ feelings and thoughts about the trauma Parents’ feelings and thoughts about the trauma impact on their children’s behaviors and impact on their children’s behaviors and developing beliefsdeveloping beliefsP id i h f h h iP id i h f h h i Provide parents with a forum to share their Provide parents with a forum to share their feelings and thoughts related to the trauma feelings and thoughts related to the trauma (even the socially undesirable thoughts)(even the socially undesirable thoughts)

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Cognitive and Affective Processing Cognitive and Affective Processing for Caregivers:for Caregivers:

Examine thoughts which are Examine thoughts which are permanentpermanent, , pervasivepervasive, , oror too personalizedtoo personalizedor or too personalizedtoo personalized Permanent: “ My child will Permanent: “ My child will nevernever be happy again.”be happy again.” Pervasive: “I can’t trust Pervasive: “I can’t trust anyoneanyone with my child.”with my child.” Personalized: “I am a terrible parent because my Personalized: “I am a terrible parent because my

child was sexually abused.” “I child was sexually abused.” “I shouldshould have known have known that man was a sex offender.”that man was a sex offender.”

"If my best friend had a child who experienced a similar "If my best friend had a child who experienced a similar traumatic experience, would I say to him or her what I am traumatic experience, would I say to him or her what I am saying to myself?"saying to myself?"

"Would I want my child to overhear me making this statement "Would I want my child to overhear me making this statement out loud?" out loud?"

Self statements Self statements can become self fulfilling prophecies…..can become self fulfilling prophecies…..

can become self fulfilling prophecies…..can become self fulfilling prophecies…..

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