Sequencing a progression of activities can be an important part of assuring the greatest learning—or changing—opportunity possible. Stanchfield wrote that sequencing is “the careful ordering of group activities based on the group’s needs, goals and setting” (p. 34). From this perspective, thoughtful sequencing of activities is important because it will help “maximize learning opportunities and the emotional and physical safety of the group” (Stanchfield, p. 34).
To help assure this happens, ordering activities in a logical order is clearly important. For example, if I were facilitating a short session on a ropes course, I would most likely start with an icebreaker or warm-up activity to help focus the group’s energy and establish a collective environment. Following this warm-up activity, I'd lead a more challenging activity, such as a problem solving initiative. Only after the successful completion of these “easier” activities would the group move to the ropes course’s built elements.
Until reading Zull and now Stanchfield, I’ve never thought much about sequencing activities. The above ordering of activities is just how you do it—start small and get bigger. That seemed so obvious to me that there was no reason to think about it. This sequencing helps assure good group dynamics and safety in the progressively challenging activities. It also provides the facilitator the opportunity to continuously assess the group’s functioning level as the challenge level increases. Finally, careful sequencing of activities helps assure the group’s success.
Progress Toward a Goal
However, another value in the careful sequencing of activities is creating a sense of movement. Zull wrote, “Pleasure in learning… comes from the perception of progress toward a goal” (p. 234). It seems to me that careful sequencing of activities can help reinforce this progress.
If a series of activities were all of an equal level of challenge, there would be no forward movement. If a series of activities progressed in a manner that didn’t seem intentional, any movement that did happen would seem confused and unconvincing. If, however, the day starts by playing Elbow Tag, undoubtedly includes a setback or two along the way, and ultimately ends with our hero dangling on a zip-line, the progress is undeniable. The progress is a story.
Like a story, effective sequencing has a beginning, middle and end. And, it seems to me that effective sequencing creates a sort of story from the experience. Stories are essential to learning, involving all areas of the brain, allowing us to “package events and knowledge in complex neuronal nets, any part of which can trigger the others” (Zull, p. 228). Remember the setback and you'll remember the whole story.
Beyond simply helping learning to stick, though, Zull wrote that the undeniable progress of this sequencing is also reinforcing and even motivates a desire to learn. He wrote, “Achievement itself is rewarding, and that may simply be because it is recognized as movement” (p. 62). Elsewhere, he wrote, “People cannot stay motivated enough to learn unless they experience some success” (p. 238). Hanging from a zip-line must certainly qualify as success under most any circumstance.
Cycle of Learning
“Stories engage all parts of the brain” (Zull, p. 228). If the goal is to facilitate change, structuring experiential learning as stories makes sense to me. Sequencing has another function, though, and that is assuring that learning occurs.
Kolb defined a four stage learning cycle, which consists of experience, reflection, abstraction and active testing (Zull, p. 13). For true learning to occur, all four stages must happen and "all are necessary for learning that is important, long lasting and meaningful” (Jacobson & Ruddy, p. 14).
According to Zull, this sequencing of the learning cycle parallels the manner in which the brain processes information. When an experience occurs, the cerebral cortex has three functions in processing the information regarding that experience. These are sensing, integrating and acting (Zull, p. 15). These natural biological functions of the brain are paralleled in Kolb’s learning cycle. As Zull stated, “[T]he learning cycle arises naturally from the structure of the brain” (p. 19).
The Four Ps
Most of the treatment groups I lead are focused on building skills and nearly every session includes experiential activities to help illustrate and/or practice new information. Based on the information above, as well as what has been effective for me in the past, I’ve been thinking about how I sequence group sessions.
I’ve realized that my most effective group sessions generally follow a four-step sequence. I’ve named these steps Prepare, Present, Practice and Process.
Prepare – Warm-up the participants’ brains.
A few ways I do this include using an opening activity, having participants conduct peer interviews related to the topic, and creating “brainstorm posters” that serve as a sort of collective pre-test. Not only does this step warm-up the brains of participants, but it also starts the session off by acknowledging prior knowledge.
Present – Share the new information.
At their core, the treatment groups I facilitate are psychoeducational in nature. That means there is new information to be presented during most sessions. When sharing this new information, I always strive for what I think of as “more do and less you.” In other words, the less I lecture, the better. In addition, Zull suggests limiting the amount of new information to three or four items at one time (p. 184).
Practice – Put the new information into action.
Experiential learning provides rich opportunities to practice alternate behaviors and engage in healthy risk taking. This is at the very core of the use of experiential learning in clinical settings. Neuroscience provides additional insight. Sensory input from an experience is most valued by the brain (Zull, p. 145). In addition, the brain remembers what the body does. In other words, experiential activities build new neuronal networks that hopefully contain more adaptive behavioral choices.
Process – Create connections.
This step is about making links between the new information, the practice step and the real world. Without these connections, transfer of learning is unlikely to occur and change won’t happen.
This final step helps assure integration of my model with Kolb’s learning cycle. It is such an important part of experiential learning that it warrants further exploration in the future. As such, I will hold of saying much about it for now.
Works Cited
Jacobson, M. & Ruddy, M. (2004). Open to Outcome. Oklahoma City, OK: Wood'N'Barnes Publishing.
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.
Saturday, September 27, 2008
Tuesday, September 23, 2008
What I Did Last Summer
This past summer, I was provided the opportunity to create an adventure therapy component for my treatment groups. I put together a series of eight day-long hikes that all youth enrolled in my Monday group, which has a focus on motivational enhancement, went on.
Hikes included the Snoqualimie Tunnel, Denny Creek, Boulder River and Twin Falls, among others. None of these would be considered especially challenging by an experienced hiker. However, many of my clients were stepping outside their Comfort Zone just by participating. I felt choosing accessible hikes to enjoyable locations provided an effective introduction to adventure therapy for these youth.
My principal goal for the hikes was to integrate nature experiences into the treatment process. Just being in the wilderness was a powerful and therapeutic experience. In addition, I hoped to provide my clients opportunities to experientically discover the inherent spirituality of nature, and increase group cohesion. Having led adverture therapy outings with youth before, I was also looking forward to the many opportunities to explore nature as an amazing metaphor for recovery, sobriety, change and moving forward.
More than that happened. These hikes built group cohesion and trust within the participants that transferred from the outings and into the group room, leading to more meaningful treatment experiences. This is true not just with the youth who participated, but even with their group-mates whom have experienced the positive modeling of the hikers.
Occassionally during adventure outings amazing personal breakthroughs occur. I've witnessed them in the past and know these can be powerful. This didn't happen during Summer 2008. What I did clearly observe, though, are slow, steady steps--the steps that take you up the side of a mountain, through a glacier-fed creek, or into a pitch-dark tunnel. Those are all places the participants didn't think they could go, maybe didn't want to try, but went anyway this summer. All while taking slow, steady steps toward a life free from substance abuse.
On hikes, I'm generally goofy and spin sometimes over-the-top metaphors about rocky paths, slippery slopes, the destination being worth the journey, and--well, you get the idea. Slow, steady steps, though, now that's the real life stuff of recovery. That may be the best possible metaphor to leave lingering in the minds of the youth who spent the summer hiking with me.
Hikes included the Snoqualimie Tunnel, Denny Creek, Boulder River and Twin Falls, among others. None of these would be considered especially challenging by an experienced hiker. However, many of my clients were stepping outside their Comfort Zone just by participating. I felt choosing accessible hikes to enjoyable locations provided an effective introduction to adventure therapy for these youth.
My principal goal for the hikes was to integrate nature experiences into the treatment process. Just being in the wilderness was a powerful and therapeutic experience. In addition, I hoped to provide my clients opportunities to experientically discover the inherent spirituality of nature, and increase group cohesion. Having led adverture therapy outings with youth before, I was also looking forward to the many opportunities to explore nature as an amazing metaphor for recovery, sobriety, change and moving forward.
More than that happened. These hikes built group cohesion and trust within the participants that transferred from the outings and into the group room, leading to more meaningful treatment experiences. This is true not just with the youth who participated, but even with their group-mates whom have experienced the positive modeling of the hikers.
Occassionally during adventure outings amazing personal breakthroughs occur. I've witnessed them in the past and know these can be powerful. This didn't happen during Summer 2008. What I did clearly observe, though, are slow, steady steps--the steps that take you up the side of a mountain, through a glacier-fed creek, or into a pitch-dark tunnel. Those are all places the participants didn't think they could go, maybe didn't want to try, but went anyway this summer. All while taking slow, steady steps toward a life free from substance abuse.
On hikes, I'm generally goofy and spin sometimes over-the-top metaphors about rocky paths, slippery slopes, the destination being worth the journey, and--well, you get the idea. Slow, steady steps, though, now that's the real life stuff of recovery. That may be the best possible metaphor to leave lingering in the minds of the youth who spent the summer hiking with me.
Saturday, September 20, 2008
Here I Go!
I've recently finished The Art of Changing the Brain, by James Zull. This book is packed full of interesting information on the biology of learning. The author did an excellent job of providing the information needed to understand this potentially challenging topic, so even if you have little understanding, you should be able to jump right in.
Zull wrote, “The main message [of this book] is that learning is change. It is change in ourselves, because it is change in the brain. Thus the art of teaching must be the art of changing the brain” (p. xivv). Zull builds on this statement throughout the book, exploring ways to use what is known about neuroscience in the process of teaching, and more important to my focus here, in facilitating for change.
Although the book is focused on teaching, the material presented is equally relevant to counseling and group facilitation. Over the last couple years I’ve started viewing myself more as a facilitator than a counselor. To me a counselor is someone who gives advice, and I try to avoid that most of the time!
In my experience, teens just aren’t much for advice taking. More importantly, though, I have come to believe that treatment is inherently an experiential learning process and hope to help clients reach their own decisions, building whatever necessary skills as we go. If I’m doing good work, what I’m really doing is facilitating the process of change, not providing advice. Like any facilitator, what I'm doing is providing opportunities.
As I started reading Zull and realized how teacher-focused it was, I had a bit of a challenge accepting that the material could apply to me. I don’t even like being called a counselor; I certainly don’t want to consider myself a teacher! Teachers provide new information and I operate on the assumption that my clients already know what they need. Sure, they're likely missing certain skills and frequently don’t have some factual information, but if treatment is an experiential process, than doesn't being effective in my work means not giving advice (at least not too often) and not teaching new information (at least not too much)? Isn't that what a facilitator does?
Having finished the book, I’ve altered my take on this a bit. It seems to me there’s really not much difference between teaching, counseling and facilitating—at least when they are done well. I still see myself as a facilitator, because that fits best with my approaches to counseling and fostering change, and I like how that role name fits. However, the distinctions between the three seem less relevant to me.
Prior Knowledge
One idea from Zull that has especially impacted me is the importance of prior knowledge. Zull wrote, “[P]rior knowledge is the beginning of new knowledge” (p. 93). He expanded on that with this statement: “When we speak of prior knowledge, we are speaking of something physical. It builds as brains physically change, and it is held in place by physical connections” (p. 94).
According to Zull, that physical something consists of all the neuronal networks that exist in our brains. “Whatever the neuronal networks are in the student brain, a teacher cannot remove them” (p. 101). So, rather than try to eliminate these neuronal networks, which won’t be effective anyway, it is more effective to build upon them. Taking this idea a small step further, it seems to me that prior knowledge actually provides a foundation that allows the teacher/facilitator/counselor to start in progress with the process of change. Prior knowledge, even if not entirely accurate, gives you a head start in facilitating change.
With that in mind, it seems only reasonable to have this first blog entry address what I already believe about that work I do. Core to my counseling approach is that everyone has cognitive scripts. Simply put, cognitive scripts are learned responses to situations. They are habits of both though and behavior. Like any habit, if I do something enough times it becomes automatic. This idea has roots in basic brain development. What wires together fires together. If someone is wired for adaptive cognitive scripts, that person is unlikely to have major problems in life. However, if someone is wired for maladaptive scripts, that person is stuck.
My clients are stuck. They have brains wired to make bad choices. In some cases, that wiring results from their environment. In other cases, it is due to genetic predisposition. In most cases, it seems to me that the maladaptive scripts result from a combination of these factors. Regardless of the causation, though, the cognitive scripts of my clients are usually limited to three options: acting up, shutting down, and using.
For my clients, acting up, shutting down, and using are solutions that have been effective in the past. Of course, effective doesn't necessarily mean adaptive. Rather, it means the behavior helped the individual meet her/his needs at that time. Since her/his needs were met by the behavior, it was repeated and became hardwired. This is basic behaviorist stuff. Do something, like the outcome, do it again.
Helping my clients move forward requires helping them get unstuck from this behaviorist loop, and that means helping them develop new, more adaptive cognitive scripts.
Zull's concept of prior learning would imply that my goal as a facilitator/counselor/teacher should not be to eliminate these maladaptive scripts, and that seems somewhat revolutionary to me. Instead, Zull suggested that it would be more effective to start with them. This bit of neuroscience would seem to support motivational interviewing, an "evidence-based approach to overcoming the ambivalence that keeps many people from making desired changes in their lives" (Miller & Rollnick, dust jacket), takes this approach also. More to come on that in the future!
Growth Zones
Getting unstuck means making changes and that’s hard. There are many reasons that change is hard, but I believe there are two factors that are especially relevant. The first is that brains are lazy. More accurately, brains are efficient and will automatically default to what is already known—those neurons that have fired together over and over in the past, those well rehearsed cognitive scripts whether they’re adaptive or not. The second factor that makes getting unstuck hard is that change is risky because it requires stepping outside your Comfort Zone.
A popular model in the experiential learning field is Growth Zones. I use this model with my clients regularly, and have found it to be useful for them in conceptualizing the process of change. Imagine an archery target with three rings. The innermost ring is an individual’s Comfort Zone. Here there are no challenges and no risks, but also no learning or change.
Most people spend most of their time in their Comfort Zone, and that's reasonable and appropriate. However, it is only when you move outside your Comfort Zone and enter your Change Zone, the middle ring, that you have the opportunity for growth or new learning. With this opportunity comes risk, though, because the outcome is uncertain. Should you go too far from your Comfort Zone, straying past your Change Zone and into the outermost ring, you'll end up in your Crisis Zone. At this point, you’re no longer learning or growing.
Comfort, Change, and Crisis are my names for these three zones. I like the alliteration and I like that it reinforces the idea of change. Most versions of this model call the three zones Comfort, Learning, and Panic.
Risking Change
Since making changes means taking risks, I believe success in the work I do requires the intentional creation of an environment where taking risks feels less risky. Doing that requires acknowledging that change is risky, exploring good risks versus bad risks, and providing opportunities to practice safe risk-taking. I believe that one of the best ways to provide opportunities to practice safe risk-taking is through experiential activities.
Experiential learning provides opportunities for participants to:
1. Test their pre-existing assumptions and reject what they no longer find effective;
2. Practice alternate behaviors; and,
3. Engage in healthy risk taking.
For many of my clients, risk-taking is something of a paradox. They’ve regularly engaged in behaviors that most people would considered extremely high risk—illicit drug use, illegal activities and so on. However, when it comes to making changes they are often extremely risk-adverse. They would often rather continue engaging in maladaptive, no longer effective behaviors than even consider doing anything different. At least that’s what they say and that’s what they do.
In fact, I believe most of my clients actually have more complex feelings about changing their behaviors, initially presenting with a certain amount of cognitive dissonance apparent in their words and actions. However, this risk-taking paradox is definitely a barrier to becoming unstuck for my clients.
It seems to me that this paradox is rooted in one simple fact: the Known, which is always inside someone's Comfort Zone, is safer than the Unknown, which is outside someone's Comfort Zone. For many of my clients, high-risk behavior is Very Much Known. Or at least the chaos created by the high-risk behavior is Very Much Known.
Nearly all of my clients have histories of trauma, abuse, neglect, or (at the very least) dysfunctional family systems. The cognitive scripts of these clients include chaos. It is hard-wired in their brains. In addition, stress releases neurochemicals that act on the brain’s reward center in the same way that meth, cocaine and other stimulants do. What a double whammy!
For these youth, high-risk behavior has become normalized. It exists inside their Comfort Zones and so no longer seems risky. In addition, when they engage in high-risk behavior, the behavior is reinforced because they get high. Perhaps there is no paradox here. Perhaps this behavior is completely understandable.
Another way to conceptualize this paradox occurred to me as I wrote this blog post: For these chaos junkie youth, maybe high-risk behavior isn't really in their Comfort Zone. After all, they generally do exhibit cognitive dissonance and generally are able to identify problems related to their behavior (not always the problems I've identified, but problems nonetheless).
I wonder if this cognitive dissonance means that the high-risk behaviors of these youth are, in fact, not in their Comfort Zone. I wonder if maybe these youth are stuck in their Crisis Zone.
Most treatment strategies for these youth are about trying new behaviors. In other words, most treatment strategies for these youth involve getting them to leave their Comfort Zones. However, they can't leave if they aren't even there. Maybe this treatment approach is backward. Maybe what should be happening is these youth should be nudged back into their Comfort Zone. Hummm...
Stages of Change
Another model of change I utilize frequently is the Stages of Change. This model states that any change requires progression through a series of stages. These stages include Pre-contemplation, Contemplation, Preparation, Action and Maintenance. Without progressing through all stages, lasting change won't happen.
In the past, most chemical dependency treatment was focused entirely on Action. Upon entering treatment, the client was expected to immediately stop all using. If that didn’t happen, the client was consider in denial or resistant to treatment and was often discharged. Not very effective. Would an M.D. discharge a cancer patient because the cancer didn't go away immediately? I hope not.
Alternatively, the client was perhaps compliant, attending all group sessions and having nothing but clean UAs. In this case, the client would be rewarded for her/his success. However, compliance has nothing to do with change, at least to in my opinion. Compliant clients are relapses waiting to happen.
The Stages of Change model suggests that you meet the client where she/he is and work on facilitating movement to the next stage. Discovering the motivation to move is the key to progressing through the Stages of Change.
There’s also the Recycle or Relapse stage, which is an important part of this theoretical model. In the Recycle stage, the individual cycles back through some of the earlier stages. When working with clients attempting to create any kind of change, I believe it is important to remember that relapse is not a sign of failure. Instead, relapse is a vital part of the change process and an important learning opportunity.
Relapse is experiential learning. It allows the client to test her/his pre-existing assumptions and reject what they no longer find effective, practice alternate behaviors, and engage in some healthy risk taking by learning something new. What didn’t work? What do you need to do differently? How can you move forward now, better prepared and with greater understanding of your personal challenges for staying clean?
Recently, I’ve been thinking about how an individual’s Stage of Change is their Comfort Zone. It seems to me there must be some interesting dynamic between these two models, but I don’t yet know what. It also seems to me that there is likely much more to discover in the crevasse between facilitating change and traumatic stress. I’m ready to go explore!
Works Cited
Zull, James. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
Zull wrote, “The main message [of this book] is that learning is change. It is change in ourselves, because it is change in the brain. Thus the art of teaching must be the art of changing the brain” (p. xivv). Zull builds on this statement throughout the book, exploring ways to use what is known about neuroscience in the process of teaching, and more important to my focus here, in facilitating for change.
Although the book is focused on teaching, the material presented is equally relevant to counseling and group facilitation. Over the last couple years I’ve started viewing myself more as a facilitator than a counselor. To me a counselor is someone who gives advice, and I try to avoid that most of the time!
In my experience, teens just aren’t much for advice taking. More importantly, though, I have come to believe that treatment is inherently an experiential learning process and hope to help clients reach their own decisions, building whatever necessary skills as we go. If I’m doing good work, what I’m really doing is facilitating the process of change, not providing advice. Like any facilitator, what I'm doing is providing opportunities.
As I started reading Zull and realized how teacher-focused it was, I had a bit of a challenge accepting that the material could apply to me. I don’t even like being called a counselor; I certainly don’t want to consider myself a teacher! Teachers provide new information and I operate on the assumption that my clients already know what they need. Sure, they're likely missing certain skills and frequently don’t have some factual information, but if treatment is an experiential process, than doesn't being effective in my work means not giving advice (at least not too often) and not teaching new information (at least not too much)? Isn't that what a facilitator does?
Having finished the book, I’ve altered my take on this a bit. It seems to me there’s really not much difference between teaching, counseling and facilitating—at least when they are done well. I still see myself as a facilitator, because that fits best with my approaches to counseling and fostering change, and I like how that role name fits. However, the distinctions between the three seem less relevant to me.
Prior Knowledge
One idea from Zull that has especially impacted me is the importance of prior knowledge. Zull wrote, “[P]rior knowledge is the beginning of new knowledge” (p. 93). He expanded on that with this statement: “When we speak of prior knowledge, we are speaking of something physical. It builds as brains physically change, and it is held in place by physical connections” (p. 94).
According to Zull, that physical something consists of all the neuronal networks that exist in our brains. “Whatever the neuronal networks are in the student brain, a teacher cannot remove them” (p. 101). So, rather than try to eliminate these neuronal networks, which won’t be effective anyway, it is more effective to build upon them. Taking this idea a small step further, it seems to me that prior knowledge actually provides a foundation that allows the teacher/facilitator/counselor to start in progress with the process of change. Prior knowledge, even if not entirely accurate, gives you a head start in facilitating change.
With that in mind, it seems only reasonable to have this first blog entry address what I already believe about that work I do. Core to my counseling approach is that everyone has cognitive scripts. Simply put, cognitive scripts are learned responses to situations. They are habits of both though and behavior. Like any habit, if I do something enough times it becomes automatic. This idea has roots in basic brain development. What wires together fires together. If someone is wired for adaptive cognitive scripts, that person is unlikely to have major problems in life. However, if someone is wired for maladaptive scripts, that person is stuck.
My clients are stuck. They have brains wired to make bad choices. In some cases, that wiring results from their environment. In other cases, it is due to genetic predisposition. In most cases, it seems to me that the maladaptive scripts result from a combination of these factors. Regardless of the causation, though, the cognitive scripts of my clients are usually limited to three options: acting up, shutting down, and using.
For my clients, acting up, shutting down, and using are solutions that have been effective in the past. Of course, effective doesn't necessarily mean adaptive. Rather, it means the behavior helped the individual meet her/his needs at that time. Since her/his needs were met by the behavior, it was repeated and became hardwired. This is basic behaviorist stuff. Do something, like the outcome, do it again.
Helping my clients move forward requires helping them get unstuck from this behaviorist loop, and that means helping them develop new, more adaptive cognitive scripts.
Zull's concept of prior learning would imply that my goal as a facilitator/counselor/teacher should not be to eliminate these maladaptive scripts, and that seems somewhat revolutionary to me. Instead, Zull suggested that it would be more effective to start with them. This bit of neuroscience would seem to support motivational interviewing, an "evidence-based approach to overcoming the ambivalence that keeps many people from making desired changes in their lives" (Miller & Rollnick, dust jacket), takes this approach also. More to come on that in the future!
Growth Zones
Getting unstuck means making changes and that’s hard. There are many reasons that change is hard, but I believe there are two factors that are especially relevant. The first is that brains are lazy. More accurately, brains are efficient and will automatically default to what is already known—those neurons that have fired together over and over in the past, those well rehearsed cognitive scripts whether they’re adaptive or not. The second factor that makes getting unstuck hard is that change is risky because it requires stepping outside your Comfort Zone.
A popular model in the experiential learning field is Growth Zones. I use this model with my clients regularly, and have found it to be useful for them in conceptualizing the process of change. Imagine an archery target with three rings. The innermost ring is an individual’s Comfort Zone. Here there are no challenges and no risks, but also no learning or change.
Most people spend most of their time in their Comfort Zone, and that's reasonable and appropriate. However, it is only when you move outside your Comfort Zone and enter your Change Zone, the middle ring, that you have the opportunity for growth or new learning. With this opportunity comes risk, though, because the outcome is uncertain. Should you go too far from your Comfort Zone, straying past your Change Zone and into the outermost ring, you'll end up in your Crisis Zone. At this point, you’re no longer learning or growing.
Comfort, Change, and Crisis are my names for these three zones. I like the alliteration and I like that it reinforces the idea of change. Most versions of this model call the three zones Comfort, Learning, and Panic.
Risking Change
Since making changes means taking risks, I believe success in the work I do requires the intentional creation of an environment where taking risks feels less risky. Doing that requires acknowledging that change is risky, exploring good risks versus bad risks, and providing opportunities to practice safe risk-taking. I believe that one of the best ways to provide opportunities to practice safe risk-taking is through experiential activities.
Experiential learning provides opportunities for participants to:
1. Test their pre-existing assumptions and reject what they no longer find effective;
2. Practice alternate behaviors; and,
3. Engage in healthy risk taking.
For many of my clients, risk-taking is something of a paradox. They’ve regularly engaged in behaviors that most people would considered extremely high risk—illicit drug use, illegal activities and so on. However, when it comes to making changes they are often extremely risk-adverse. They would often rather continue engaging in maladaptive, no longer effective behaviors than even consider doing anything different. At least that’s what they say and that’s what they do.
In fact, I believe most of my clients actually have more complex feelings about changing their behaviors, initially presenting with a certain amount of cognitive dissonance apparent in their words and actions. However, this risk-taking paradox is definitely a barrier to becoming unstuck for my clients.
It seems to me that this paradox is rooted in one simple fact: the Known, which is always inside someone's Comfort Zone, is safer than the Unknown, which is outside someone's Comfort Zone. For many of my clients, high-risk behavior is Very Much Known. Or at least the chaos created by the high-risk behavior is Very Much Known.
Nearly all of my clients have histories of trauma, abuse, neglect, or (at the very least) dysfunctional family systems. The cognitive scripts of these clients include chaos. It is hard-wired in their brains. In addition, stress releases neurochemicals that act on the brain’s reward center in the same way that meth, cocaine and other stimulants do. What a double whammy!
For these youth, high-risk behavior has become normalized. It exists inside their Comfort Zones and so no longer seems risky. In addition, when they engage in high-risk behavior, the behavior is reinforced because they get high. Perhaps there is no paradox here. Perhaps this behavior is completely understandable.
Another way to conceptualize this paradox occurred to me as I wrote this blog post: For these chaos junkie youth, maybe high-risk behavior isn't really in their Comfort Zone. After all, they generally do exhibit cognitive dissonance and generally are able to identify problems related to their behavior (not always the problems I've identified, but problems nonetheless).
I wonder if this cognitive dissonance means that the high-risk behaviors of these youth are, in fact, not in their Comfort Zone. I wonder if maybe these youth are stuck in their Crisis Zone.
Most treatment strategies for these youth are about trying new behaviors. In other words, most treatment strategies for these youth involve getting them to leave their Comfort Zones. However, they can't leave if they aren't even there. Maybe this treatment approach is backward. Maybe what should be happening is these youth should be nudged back into their Comfort Zone. Hummm...
Stages of Change
Another model of change I utilize frequently is the Stages of Change. This model states that any change requires progression through a series of stages. These stages include Pre-contemplation, Contemplation, Preparation, Action and Maintenance. Without progressing through all stages, lasting change won't happen.
In the past, most chemical dependency treatment was focused entirely on Action. Upon entering treatment, the client was expected to immediately stop all using. If that didn’t happen, the client was consider in denial or resistant to treatment and was often discharged. Not very effective. Would an M.D. discharge a cancer patient because the cancer didn't go away immediately? I hope not.
Alternatively, the client was perhaps compliant, attending all group sessions and having nothing but clean UAs. In this case, the client would be rewarded for her/his success. However, compliance has nothing to do with change, at least to in my opinion. Compliant clients are relapses waiting to happen.
The Stages of Change model suggests that you meet the client where she/he is and work on facilitating movement to the next stage. Discovering the motivation to move is the key to progressing through the Stages of Change.
There’s also the Recycle or Relapse stage, which is an important part of this theoretical model. In the Recycle stage, the individual cycles back through some of the earlier stages. When working with clients attempting to create any kind of change, I believe it is important to remember that relapse is not a sign of failure. Instead, relapse is a vital part of the change process and an important learning opportunity.
Relapse is experiential learning. It allows the client to test her/his pre-existing assumptions and reject what they no longer find effective, practice alternate behaviors, and engage in some healthy risk taking by learning something new. What didn’t work? What do you need to do differently? How can you move forward now, better prepared and with greater understanding of your personal challenges for staying clean?
Recently, I’ve been thinking about how an individual’s Stage of Change is their Comfort Zone. It seems to me there must be some interesting dynamic between these two models, but I don’t yet know what. It also seems to me that there is likely much more to discover in the crevasse between facilitating change and traumatic stress. I’m ready to go explore!
Works Cited
Zull, James. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
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