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Archive for August, 2012

Although it often seems like unneccessary extra work (an sometimes it is), preparation can be an absolute life saver for a parent of a child on the spectrum. Recently I used the a preparation cartoon to help a young client, Stan,  plan a trip to Kohl’s.  In this scenario, Stan entered the office with great excitement. He stated, “I found my wallet with $10 in it…Now I can buy the Imaginext Pirate Lego Set (I’ve been wanting for months) at Kohls”. Before meeting with Stan, his mother pulled me aside to let me know that the anticipation (getting the lego set) had been building up over several days and that she was now concerned with the what ifs – What if it costs more than $10? What if it’s no longer being sold in the store?.

We both decided that preparing Stan for these potential outcomes would be best practice. I began by getting a clear idea from Stan of his expectations (walk into the store, get the toy, pay the cashier $10, walk out a happy guy). Then I created three possible outcomes: Walk in and it’s priced higher than $10(you can’t afford it), Walk in an it’s no longer there (big dissapointment), Walk in and its sitting there waiting with a $10 price tag on it (Horray!).

Cartoon time: After identifying the three possible outcomes, Stan and I drew the following simple preparation cartoon to illustrate the scenario (visually representing what the experience might look like and how he might respond), adding thought bubbles to represent feelings and possible reactions. This is what we came up with:

At the end of the session, Stan and his mother reviewed the cartoon together and took a picture for reference later on (to look at when preping before entering the store). She will get back to me on the results.

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Grandmother’s Wisdom

During difficult periods in my life where I’ve felt that I was just not doing enough for myself, my family, my clients, etc…I would often go seek the advice of my Nana (grandmother). She would sit and listen without judgment while I poured over any number of struggles. Many times, I would share frustration at not being able to help my clients in a more comprehensive way. When working with homeless young adults, I would regularly feel my efforts were simply not enough to make the changes I knew they needed. Many times, I could not help these individuals beat their addiction, get reunited with their families, or find a stable home. One day, after explaining this feeling of inadequacy, my grandmother shared a qoute which has stayed with me since:

“It is better to light a single candle than to curse the darkness”. 

This quote has served as a personal mantra, specifically in my work, ever since. For me, it is important to recognize the little things I can influence (teaching subtle but helpful interventions). To do what you can and not get caught in what you cant. Lastly, we never know what impact our role can have on someone else’s life. It may come immediately (decision to go to rehab) or it may come years later.

Thanks for reading.

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Dave Nelson is a licensed counselor in Georgia and founder and executive director of The Community School(http://www.thecommunityschool.net/) –  an alternative junior high and high school for individuals on the autism spectrum. A few years back, The Community School was featured in The New York Times for its innovative approach to working with individuals on the autism spectrum. I was lucky enough to visit this school several years ago as a graduate student and was amazed by the learning environment Dave and his inspiring staff had created. 

The following post illustrates wonderfully well the intervention of Storyboarding as well as providing a great visual example of the technique.

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 Dave Nelson: “Individuals who have challenges in relating and communicating often experience fragmented, confusing thinking.

 Storyboarding is a technique that allows an individual to illustrate actions, statements, thoughts and feelings by reflecting on and sequencing an order of events. A therapist, parent, teacher or other helping partner can help a participant to retell his experience of a situation by drawing images that portray the participant’s perspective.  Ultimately, these images should be depicted in sequence, from the beginning of an event to some logical end.  Storyboarding is intended to capture specific moments when an individual might be struggling not only to comprehend the actual events but also to link the events to feelings, ideas, and an awareness of the emotions of others.

 When beginning a storyboard, it is important to first create a blank template. This can be drawn as a series of connected blank boxes, like a comic strip. The facilitator should allow the participant to retell his interpretation of events, drawing out characters and objects in each box. The goal is to be playful and inquisitive in the interaction to support the individual’s ability to sequence his thinking, describe his emotional experience, and clarify confusing moments.  It is not important to correct the individual’s retelling, at least not in a “right/wrong” sort of way.  What typically works better is for the facilitator to ask elaborating questions and make expanding comments (e.g., “I wonder when the teacher came in the room”, or “Were you smiling in this picture?”).

 As the pictures depicting the sequence of events evolve, spoken words and thoughts can be added.  Spoken words are usually represented by a bubble with a line drawn to the character’s mouth; thoughts are represented by thought bubbles.  Emotions can be represented by facial expressions.

 How much content the facilitator adds is a function of the ability of the individual to relate his own experience.  In some cases, it may make more sense for the facilitator to draw most of the story, relying on the individual only to correct or enhance details.  In other cases, the individual can take the lead in generating the story, and the role of the facilitator may be primarily in asking elaborating questions.

In the following example, I was working with an adolescent female who had recently “gotten in trouble” at school.  She was having a hard time explaining why she had gotten in trouble, or what had even happened.  I knew it was something about a red jacket, but the young woman (I’ll call her Jerry) was not able to easily explain what had happened.  Starting with a blank whiteboard, I drew out a blank panel and asked Jerry, “Where was the jacket?”

 She responded that it was in Chorus class, and this provided the starting point for our story.  Gradually, the story that evolved is that Jerry had seen a jacket left behind at the end of Chorus class, the teacher had asked her to leave it, and Jerry became fixated on having the jacket.  In the moment, Jerry was not able to describe her feelings to the teacher, only able to repeatedly state, “Can I have it?  Can I have it?”

 As I drew more of the story for Jerry, she was able to attach specific feelings to the pictures (e.g., “anxious”) and to describe much more complex aspects of her experience (e.g., “I couldn’t stop thinking about the jacket and I feel bad that I wasn’t able to listen to the angry teacher.”)

 The result of this activity, which took about thirty minutes, was that Jerry now had a much more organized memory of what had happened, and she had an experience of being able to reflect on her own personality traits and tendencies.  She also got the chance to relive some of the desire and anxiety in a supported, reflective way.  Over time, this kind of activity should result in Jerry being able to compare and contrast emotional experiences more effectively, which will lead to increased emotional regulation and mood management.  This activity will also strengthen Jerry’s ability to visualize events and describe them, which will in turn lead to improved reading comprehension and stronger inferential thinking.”

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