Richard Grizinski, PhD
School Psychologist - Emeritus
Trumbull County
For the past 25 years, in my role as a school psychologist, I have had a variety of positions in various school districts with exposure to multiple programs. In fact I had worked more than 20 years providing school psychological services to students in the Emotional Disturbance program. In addition, I have had the pleasure of working with School Psychology interns and practicum students as well.
One surprising aspect of working with school psychology interns and practicum students is discovering the lack of training in counseling theory and interventions. Interestingly, almost all of the interns I have encountered have earnestly expressed a desire to became knowledgeable of and proficient in the “what to do” aspects when working with students with emotional and/or behavioral problems.
I tend to believe in, utilize, and at times proselytize a cognitive therapy, more specifically drawing upon REBT, i.e., Rational Emotive Behavior Therapy, RBT (Rational Behavior Therapy), and some cognitive behavior therapy. I typically use these approaches when working with students and using with myself to shore up coping strategies, especially in situations that I find distressing or unpleasant. At times I have become my own best client. As a result, I would also like to be helpful in providing a brief understanding of the “Ways and Means of Change” from the philosophical assumptions, theory, and subsequent interventions. In other words, a “ways and means” of change by my definition would be good place to start for preparation prior to counseling students.
Philosophic influences
Most readers are aware of and somewhat knowledgeable about stoicism and humanistic orientations. General semantics theory is a little more esoteric and those aspiring school psychologist interns and practicum students have little understanding of it. Many of us have heard the phrase, “the map is not the territory.” In a nutshell, general semantics theory posits a number of premises. For example, our central nervous systems are stimuli organizing and stimuli omitting (reduction of incoming stimuli) organs, geared toward enhancing survival. In addition, the concepts or words we use are not the same as the “thing” being talked about (Korzybski, 1933).
Influences such as General Semantics Theory illustrate the importance of language and how it is used.
Are you familiar with the following?
“Is of predication….”
“Is of identity….” (Ellis, 1992).
If so, move on; however, it may be helpful or beneficial to know what this means and how it relates to cognitive therapy.
Examples of the “Is of predication or is of identity” come up often in the life of a school psychologist.
Take the following examples:
“He/she is depressed.”
“He/she is excessive or overly anxious.”
“He/she is emotionally disturbed or they have a Specific Learning Disability.”
Is it possible that “he/she” are normal human beings who exhibit certain behaviors or patterns of behavior that are associated with a DSM-5 (American Psychiatric Association, 2013) definition of depression or anxiety disorder, etc.?
Do they have a Specific Learning Disability or do they exhibit a pattern of behaviors that can be matched to IDEIA definitions of SLD and behaviors displayed academically that are a concern to an educator or parent?
Stoicism
Stoicism means something other than keeping a stiff upper lip. It is a philosophy that espouses the neutrality of “outside” or environmental events. In other words, human beings tend to affix meaning to events and with that in mind, “disturb ourselves”.
The environment or what happens in the environment influences us but does not “tell us what to feel, how intensely to feel about an event, or make us feel a certain way”. In other words, the stimulus is often the same, but the response can certainly be different. Constructivism can be another area of exploration for inquiring minds.
Humanism
Humanism would include philosophical and ethical codes of conducts valuing the whole individual. Vague as this sounds, this may help clarify this a bit more. As Ellis describes the construct, “Essence of humanism, both psychological and ethical areas, is that man (women too) is fully acknowledged to be human, that is, limited and fallible, and that in no way whatever is he (she) superhuman or subhuman” (Ellis, 1974). In other words, individuals make mistakes and that includes school psychologists; we too are fallible human beings. Sounds like a “no put-down” rule as well. No one is less than human or a thing. Incorporate this notion as a counselor then you facilitate or promote a self and other acceptance, reserving judgements and ratings for behaviors and/or performance, instead of the person. There is quite a difference between saying (and believing), “I did poorly on a test.” versus, “I’m a useless idiot.”
Other philosophical influences include empiricism, e.g. the scientific method or Scientific Positivism and Pragmatist Philosophy, stimulus-organism-response (SOR) theory, and existentialism, particularly ideas of Paul Tillich (Ellis, 1974).
Theory
On a theoretical level, both REBT and Rational Behavior Therapy espouse a fundamental premise that focuses on the influence or relationship between thinking and feeling. In other words, what happens at (A) or the activating event or what one is aware of at the time may influence reactions or feelings to an extent or degree. However, in a split second thoughts, beliefs, and/or evaluations are also occurring. Thoughts and beliefs (B) are viewed as the major influence, contributor, or producer of feelings or consequences (C) (Ellis, 1974).
It is that simple, i.e., (B) (thoughts and beliefs) produce feelings at (C). In our culture, we are trained so-to-speak that (A) the event we are aware produces the consequence or feeling at (C). For example, how many times have you heard someone say something to the effect of: “He (or she) made me mad;” “That song makes me feel sad;” or “It (the country side, ocean, mountain, weather, etc.) made me feel happy.”
Quite a few logical problems follow if (A) causes (C). For example, for (A)to cause (C) wouldn’t we have to say that everyone or statistical majority would have to react or feel the same way when an event happened? It sounds absurd, but think about a major event, like the Super Bowl, for example. Did everyone feel the same way about the half-time show? What about the outcome of the game or about Peyton Manning’s performance? If (A) causes (C), pretty much we are all in trouble logically and experientially and perhaps reacting like robots.
Finding a place to begin
Once the initial phases of therapy or counseling have been started and an alliance begun, the ABC theory is explained. In other words, a psychoeducational process that can be replete with drawings or ready-made pictures are used to explain, “the link between thoughts/beliefs and feelings” is begun.
For some individuals the mere mention and argument (Socratic one that is) that (C) (feelings) is a byproduct of (B) (thoughts and beliefs), rather than (A) (activating event of what one is aware of at the time) may be easy to acknowledge but difficult to believe (Digiuseppe, et al, 2014). Repetition or several examples may be crucial to drive this point home.
During this process it is sometimes helpful to begin a distinction process to ‘fine tune,’ so to speak, the types of beliefs that are examined in counseling. For example, one’s beliefs about global warming, capital punishment, the Browns draft choices, etc. can be discussed; however, the thoughts and beliefs leading to unpleasant emotional reactions such as anger, anxiety, depression, and upsettedness are zeroed in on in session. In other words, “what is the goal” or the “aim” or “what brought you here” is the crux of counseling.
Techniques or interventions
What I call the “ways and means of change” incorporates but is not limited to the following:
Thought management exercises can be very helpful. How can you stop thoughts if your mind seems to function automatically? That is, we typically don’t tell our minds to start thinking, so how do we command or get them to stop? Well you can’t, except for momentary instances. Asking a student to ask themselves a question like, “What thought will pop up next?” is an example. Another technique would entail teaching a student meditation methods (Creed, Reisweber, & Beck, 2011) or use of koans.
Thought distraction methods are very useful. Palliative methods include such time-honored interventions such as diaphragmatic breathing (deep breathing), progressive muscle relaxation, and guided imagery, to name a few. Counting to 10 or backward from 50 by threes would be another example of a distraction method (Creed, et al, 2011).
Changing non-factual, unproven or false beliefs, and/or mental mistakes is a central technique in cognitive behavior therapy. Disputation, deconstruction of, or challenging irrational beliefs is somewhat trickier business. In other words, some explanation or operational definitions of irrational as a opposed to rational thoughts or beliefs is critical.
Ellis delineated four major types of irrational beliefs: demandingness (mustabatory); awfulizing; low frustration tolerance (I can’t stand-it-itess); and condemnation (about self or others) (Ellis & Velten, 1992). The aim is to find, identify, or catch then modify or deconstruct the irrational belief (leading to emotional problem). The school psychologist helps (ideally collaborates with) the client to replace irrational or distorted beliefs with an alternative belief, based on the definition of a rational belief (Maultsby, 1990). Of course practice and reinforcement of in-session work is important. Once practiced or mastered in-session, generalizing to other settings or during interactions with others can follow next.
With adolescents in particular, confusing needs and wants seems to be area of belief or pattern of thinking that crops up on a regular basis. Needs are what you must have in order to survive, like air, water, nourishment (food), shelter, a dialysis machine, etc. Just about everything else are wants. There are conditional needs, but I’ll let you explore this on your own (Pucci, 2008).
Camera check of perceptions (sticking to the facts). This technique was made well known by Dr. Maxwell Maultsby (Rational Behavior Therapy). In other words, what would you see if you took a movie or snapshot of the event that you reacted negatively towards (Maultsby, 1996)?
Rational emotive imagery (Maultsby, 1990), is another method that can be utilized with students and taps into our ability to use non-verbal abilities or visualization prowess. Evoking an image (scenario or interchange with another) where an emotional overreaction occurred and then reducing the intensity of the reaction, for example, from anger to annoyance, can be a step in the right direction to promote better self-control. On a side note, Maultsby’s writings in particular are easy to follow and understand then apply to clients.
Practice or use of “I statements”. In other words modeling and teaching assertive communication that involves identifying feelings and assertively expressing them is a very useful in-session technique.
One aspect I like about REBT is the use of in-session time to verify what is discussed. In other words, in-session activities, interventions, or experiments are typically discussed, tried, and practiced. In other words, a behavior rehearsal that is modeled and experiential, so the student can learn what to do help themselves (Ellis & Lange, 2003).
Other aspects about Cognitive therapy that I like (and perhaps you will as well) include the following:
The basic premise that thoughts and beliefs influence or produce feelings is relatively easy to teach in a short period of time.
One can actually find empirical studies showing efficacy of cognitive behavioral therapy. See for yourself on this one.
There is what I call expansive and contractive properties with a “ways and means of change”. In other words the school psychologist can employ a 45 minute session or 15 minute session. For example, strategies like reviewing the ABC model, reviewing homework, and/or identifying and challenging an irrational belief can be done in one session or broken down in mini-sessions. Language used by the school psychologist can be more technical or less technical, depending upon the student’s age, grade in school, etc. Irrational belief can be changed to false belief, opinion based, faulty thinking, unproven thinking, etc. Another example would be the use of homework. Almost all students are acquainted with the term homework. However, one does not have to call in-between sessions work homework. The school psychologist can call in-between session work helpful ideas, moving in the right direction, mental exercises, or homework.
Self-care
Application to you – how do you want to self-counsel? In other words, what behaviors would you like to change, i.e., your anger (stewing about, brooding over or mentally or verbally rehashing in your mind) or excessive or elevated anxiety (fretting about, needless worry, or self-defeating nervousness)? Has excessive alcohol usage, street drugs, or high-risk behaviors solved your life problems? I doubt it and alcohol, illicit drugs, etc. have probably only temporarily helped you feel better, not get better.
Have you tried diaphragmatic breathing, use of koans, or other meditation techniques? If you answered yes, how do those methods work for you? If you answered no, then what’s stopping you? If you have difficulty with your self-work, finding a mentor may be helpful. Also, getting involved in therapy with someone trained in REBT, Rational Behavior Therapy, or Cognitive Behavior Therapy would be very useful and experiential (you’ve done what you’re doing) as well.
The following includes resources (some of which leads to other resources) to obtain information about training programs, CDs, books, videos, etc..
- www.albertellis.org Many books, CDs, training programs, live seminars, etc.
- www.beckinstitute.org Many books, CDs, training programs, live seminars, etc.
- www.behavioralhealthassoc.com I completed their program – many books, training, therapy, etc.
- www.academcyct.org Academy of cognitive therapy. Many resources such as training programs, books, etc.
- www.apa.org American Psychological Association. Many books, research articles, CEU training, etc.
- www.rational-living-therapy.org Dr. Aldo Pucci founder/developer. Many books, CDs, training, etc.
- www.behavioraltech.org Information about Dr. Marsha Linehan’s dialectical behavior therapy. Books, training, etc.
- www.schematherapy.com Dr. Jeffrey Young’s approach to treatment
- www.nasponline.org National Association of School Psychologists. Lots of information, e.g., books, research, articles, etc.
- www.nami.org National Alliance on Mental Illness. Lots of information including articles, research, books, etc.
- www.nimh.nih.gov National Institute of Mental Health. The TADS study, i.e., treatment for adolescents with depression study – see for yourself. Many articles, research, books, treatment, etc.
- www.crosscountryeducation.com Many live seminars and other resources as well. Dr. Aldo Pucci continues to provide training – not sure what he does in terms of programs in Weirton, WV.
- ww.PESI.com Provides continuing education for professionals such as live seminars, books, etc.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Bernard, M.E. & Joyce, M.R. (1984). Rational-emotive therapy with children and adolescents. New York: John Wiley & Sons.
Creed, T.A., Reisweber, J., Beck, A.T. (2011). Cognitive therapy for adolescents in school settings. New York: Guilford Press.
Digiuseppe, R.A., Doyle, K.A., Dryden, W. & Backx, W. (2014). A practitioner’s guide to rational emotive behavior therapy. Oxford, U.K.: Oxford University Press.
Ellis, A. (1992). Alfred Korzybski memorial lecture 1991: General semantics and rational-emotive therapy. General Semantics Bulletin, 56, 12-49.
Ellis, A. (1974). Humanistic psychotherapy. New York: McGraw-Hill.
Ellis, A. (1988). How to stubbornly refuse to make yourself miserable about anything – yes anything. Secaucas, N.J: Lyle Stuart.
Ellis, A., & Lange, A. (2003). How to keep people from pushing your buttons. Citadel: Reprint edition.
Ellis, A., & Bernard, M.E. (2006). Rational emotive behavioral approaches to childhood disorders: Theory, practice, and research. New York: Springer.
Ellis, A. & Velten, E. (1992). When AA doesn’t work for you: Rational steps to quitting alcohol. NJ: Barricade Books Inc.
Korzybski, A. (1933). Science and sanity. Reprint, Concord, CA: International Society for General Semantics, 1990.
Maultsby, Maxie. (1990). Rational behavior therapy. WI: Rational self-help aids/I’ACT.
Maultsby, Maxie. Coping better: Anytime anywhere. (1986). VA: RBT Center LLC.
Pucci, A. Feel the way you want to feel…no matter what. (2008). IN: iUniverse.