Saturday, October 18, 2008

Talking Despite Themselves

Zull wrote that reflection is an attempt to find unity in experiences (p. 154). He continued, “We get our data quickly, but it takes longer to see the unity it in" (p. 163). I believe that discovering this unity is especially important when using experiential activities in clinical settings. Without connecting the activity to the real world, transfer of learning will not occur. Processing a learning experience helps assure that this transfer happens.

Processing is “an activity that is structured to encourage individuals to plan, reflect, describe, analyze and communicate about experiences” (Luckner & Nadler p. 8). In experiential learning settings, a typical processing session involves participants answering facilitator-asked questions following some type of experience. Some participants are resistant to this approach, especially initially. In my experience, processing sessions that are simply facilitator-led question-and-answer sessions often lack depth. It seems to me this can be especially true when working with teens in treatment, where the youth are often reluctant to participate in the first place and may lack the skills necessary to be introspective.

Mandated to Change
Nearly all the youth I work with enter services in the pre-contemplation stage-of-change. They are there due to probation, other court involvements, school requirements, family pressures, or other external reasons. For them, treatment is viewed as the lesser of two evils, and minimal effort is all they initially will commit. The compelling nature of experiential activities works well with these youth for encouraging participation. However, attempting to lead these youth to process deeply can be painful at times!

There is a special challenge involved in working with these mandated youth, and the work can be filled with paradoxes. I consider their treatment voluntary, but not participating could result in a probation violation. I never force clients to participate in experiential activities, but not participating could be considered non-compliance. I try to minimize the coercive aspect of this throughout all dimensions of treatment, but mandated clients are always aware of it.

That said, although the mandated client is required to participate, that doesn’t mean she can’t choose to do so. Indeed, that is exactly what I always hope will occur with these clients, that their thinking will move from “I have to be here” to “I want to be here.” When this happens, I see it as a clear sign of movement through the stages-of-change.

Whether clients are mandated to treatment or not, one of the advantages of experiential activities is that the activities are inherently engaging. Priest and Gass refer to these as “activities that provide compelling tasks to accomplish” (p. 17). Even most reluctant clients want to participate in them, at least after an appropriate “I’m not doing that” protest. Perhaps they believe that the activities aren’t really treatment and therefore acceptable. That’s fine with me. I know there’s much more to juggling rubber chickens than meets the eye.

Reflection Skills
Reflection takes skill and developing this skill requires practice (Stanchfield, p. 134). In my experience, it is common for youth in treatment to lack the skills necessary to reflect. As a way to help my clients develop this skill, I’ve recently added a new element to my group sessions. At every session, we now start with a Question from the Box. I’ve created about 60 questions, which I have on strips of paper. At the start of each group session, a participant draws a slip out of the box and all the youth take turns answering the question.

Some of the questions are directly recovery oriented, such as “Describe the last time you felt like using.” Others are about self-disclosure, such as “Share something about yourself that nobody here knows.” Still others are simply for the sake of practicing reflection skills, such as “If you were a super hero, what would your super-power be?”

Recently, group members have spontaneously started asking each other follow up questions, which suggests to me that this processing practice is having a positive impact. In a simple, safe way, these Questions from the Box are providing my clients an opportunity to improve their skills at self-reflection. In some cases, though, it seems to me that a lack of reflective ability may suggest more than simply a skills deficit. It might indicate a history of trauma, abuse and/or neglect.

Many of the youth I work with have such histories. For these participants, introspection may be something they’ve spent years actively avoiding. Their use of alcohol and other drugs may be part of that effort to avoid introspection. Their other maladaptive behaviors may also be part of that pattern of avoidance. Yet, here I am as the facilitator, pushing them to do exactly what they have been trying to avoid. No wonder they seem reluctant.

It seems to me that providing opportunities to practice reflection is an important aspect of any treatment program. Once learned, the ability to think reflectively is a valuable skill these youth will take with them and be able to apply to life in general. Since so many of my clients have histories of trauma or neglect, facilitating for change means finding ways for my clients to feel safe while being reflective.

That Silly Amygdala
The amygdala is also where the fight-or-flight response is centered. The “fear center” of the brain, it is used primarily for analyzing experiences, assigning meaning to those experiences, and monitoring those experiences for danger (Zull, p. 59). When the amygdala senses danger, it communicates this to the body, so that the body can prepare to act (Zull, p. 60). Imagine a youth reluctant to attend group. Maybe he doesn’t think he has a problem and resent the mandate. Maybe she has a history of trauma. Maybe he doesn’t possess the skills to be introspective. It seems to me that these are exactly the type of situations that would be considered dangerous by the vigilant amygdala.

So what does this have to do with getting teens to talk? Well, according to Zull, there are times when the amygdala is less active, less vigilant. One of these times is when the cortical brain is busy with a cognitive task such as solving a puzzle (p. 60). Under those circumstances, the amygdala doesn’t have time to sense fear. It seems to me that presenting puzzles or other active processing approaches could be useful when working with reluctant-to-process teens. By keeping the cortical brain busy, they would be more likely to process.

Indeed, without knowing it, I’ve done this in the past. Occasionally I have Game Day in groups and one of my favorite games is Totika. Similar to Jenga, but with blocks of different colors, after successfully removing a block from the stack the player answers a color-coded question. About a year ago, we were playing Totika during a Game Day. While playing, “Carl”— street savvy, extremely guarded, and reluctant to engage in discussions, activities, or any self-disclosure—was asked to describe the worse day of his life. Without hesitation, he started talking about his mother’s death when he was four years old. Within moments, he was in tears as he continued telling his life story to the group.

For nearly a year now, I’ve been thinking about this incident, trying to figure out why Carl was suddenly willing to be introspective that day. Had he finally come to feel safe in the group environment? Was it simply that he was playing by the rules of the game? Had his need to talk about this overwhelmed his reluctance to engage? All of these are likely true to some extent, but it would seem that the task of carefully pulling a block out of the stack kept his cortical brain too busy to be fearful about sharing this experience.

Surely there are ways that I can more intentionally bring this knowledge about the amygdala into my groups in order help facilitate change.

Beyond Q & A
Totika is one example of ways to move beyond a traditional question-and-answer processing approach, to help assure a richer outcome for teens in treatment. “There are many innovative ways to engage a group in dialogue and reflection kinesthetically, emotionally, and socially that aren’t dependent on the facilitator’s leading a didactic question-and-answer session” (Stanchfield, p. 106).

One example is the use of consensus in processing. Stanchfield stated, “The value of practicing consensus in the context of developing group processing skills is that consensus is all about quality discussion and embracing and understanding the opinions of those with differing viewpoints” (p. 94). Stanchfield wrote about a processing activity that involved the providing the group a set of cards with metaphorical images on each, such as Chiji Cards (see www.chiji.com). The group’s goal is to choose one card by consensus that represented what they had achieved as a group.

I like this as a processing activity and have used it before. Not only does it function as an exercise in consensus, it turns processing into a decision making experience. Getting teens to process deeply can be challenging, so having participates engage in an activity like this can be an excellent choice. As Stanchfield wrote, “[P]articipants can become so involved in identifying with a card, and making an argument for their card, that they are unaware they are engaging in reflection” (p. 96).

As we have seen, if participants’ brains are engaged in such problem solving, they may truly be unaware they are processing. Even so, the reflection that occurs helps to assure transfer of learning. As a facilitator, becoming more intentional with processing approaches can also help assure the most value possible from participating in an experiential activity.

Works Cited
Luckner, J. & Nadler, R. (1992). Processing the Experience. Dubuque, IA: Kendall/Hunt Publishing.
Priest, S. & Gass, M. (2005). Effective Leadership in Adventure Programming. Champaign, IL: Human Kinetics.
Stanchfield, J. (2007). Tips and Tools: The Art of Experiential Group Facilitation. Oklahoma City, OK: Wood'N'Barnes Publishing.
Zull, J. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.