As I’ve written before, my clients often have highly maladaptive cognitive scripts, routinely utilizing one of three cognitive scripts. They act up, shut down, or use mood-altering substances. While these responses might not seem especially effective to someone with more adaptive cognitive scripts, they are predictable and therefore safe. Rose wrote that most youth with multiple life problems—as is the case with nearly all my clients— “seem to have dedicated and rigid strategies for dealing with problems and are disinclined to look at other possibilities" (p. 177).
Looking at other possibilities requires a willingness to try something new, to step outside your Comfort Zone, to take risks. For youth who have had lives filled with unpredictability, even the most painful known option can feel less risky than any unknown one. “Steve,” a former client, summed this up when he said, “What I like the most about drugs is that I know what to expect. I smoke. I get high. No surprises.” For youth like Steve, there is an inherent reinforcement in a life of “no surprises.” Unlike many of other aspects of his life, he knows what to expect when he uses. And, that predictability is appealing.
However, a life of "no surprises" can lead to a cycle of stuckness. A basic tenet of brain development is that what fires together wires together. Through repetition of the same behavior, neuronal connections are created and then reinforced. Just like tying shoes becomes easier over time as a result of neurons wiring together, cognitive scripts also become hard wired in the brain. In other words, the maladaptive scripts of acting up, shutting down and using become part of the individual’s brain structure.
This means that Steve, like many youth, is cognitively stuck. His brain is hard wired to respond to life in maladaptive ways. Facilitating for change requires helping these youth break this cycle of stuckness. Experiential learning provides an effective methodology for doing this, because it “challenge[s] participants to update, refine, and alter mental programs when they emerge” (Luckner & Nadler, p. 36).
This updating, refining and altering can occur thanks to neuroplasticity, “the brain’s ability to physically change in response to stimuli and activity” (Romer & Walker, p. 484). It is “the ability of neurons to change the way they behave and relate to one another as the brain adapts to the environment through time” (Cozolino, p. 75). Neuroplasticity allows us to create new cognitive scripts.
Paula Tallal of Rutgers University stated, “You create your brain from the input you get” (qtd. in Begley, p. 105). It seems to me that it logically follows that that if you change the input, you would change the brain. Therapy or counseling provides an effective methodology for changing the input in a controlled and intentional manner. Cozolino supports this conclusion by writing, “[T]he therapeutic context may enhance the brain’s ability to rewire through concurrent emotional and cognitive processing. Successful therapeutic techniques may be successful because of their very ability to change brain chemistry in a manner that enhances neural plasticity” (p. 300).
“An enriched environment is one that is characterized by a level of stimulation and complexity that enhances learning and growth… [E]nriched environments can include the kinds of challenging educational and experiential opportunities that encourage us to learn new skills and expand our knowledge” (Cozolino, p. 22-23). A study conducted by the University of British Columbia helps to support the conclusion by Priest and Gass.
In this study, mice that were provided exercise wheels developed neurons that were “dramatically different” from sedentary mice. These exercise wheels provided the mice a more enriched environment, and in response their neurons had more dendrites, which are responsible for receiving signals from other neurons. This means the thinking patterns of these mice was more complex, more able to solve problems, and more able to engage in lasting learning (Begley, p. 69).
Cozolino suggests that any therapeutic approach will provide the enriched environment he describes. It seems to me, though, that experiential learning is particularly well suited for enhancing neuroplasticity. Experiential learning takes the "talk therapy" of other methodologies and puts that learning into action. Experiential learning tests what other methodologies often leave as "inert ideas" (Whitehead, qtd. in Zull, p. 206). According to Zull, "Action forces our mental constructs out of our brains and into the reality of the physical world" ( p. 206). Without that active testing, these new ideas are unlikely to ever be integrated into new behaviors. Active testing, then, is what allows us to rehearse new cognitive scripts.
Neuroplasticity in Action
Priest and Gass outlined six characteristics of experiential learning: the participant is provided a direct and purposeful experience, the participant is appropriately challenged, the participant is presented with opportunities for synthesis and reflection, the experience provides for natural consequences, the experience emphasizes participant-driven change, and the experience has both present and future relevance (p. 146-147).
All six of these characteristics are important to assure the most beneficial learning experience possible. However, it seems to me that for facilitators of experiential learning in clinical settings, focusing on participant-driven change is especially relevant. “Challenges that force us to expand our awareness, learn new information, or push beyond assumed limits can all change our brains” (Cozolino, p. 291).
Experiential learning regularly utilizes activities intended to push participants beyond their assumed limits, or to step outside their Comfort Zone. This provides participants the opportunity to test their assumptions and reject those they discover to be faulty. Because this testing is participant-driven, it is more developmentally appropriate for teens than more prescriptive counseling methodologies.
Zull wrote, “When we test our ideas, we are changing the abstract into the concrete. We convert our mental ideas into physical events” (p. 208). Converting mental ideas into physical events is exactly why experiential learning is an especially effective methodology for ending the cycle of stuckness. I would add, though, that once a mental construct has been forced into the physical world and discovered to be faulty, it is likely to be abandoned.
Rehearsing Change
As we have seen, experiential learning provides an effective method for testing and rejecting. Experiential learning provides two additional methods for helping end the cycle of stuckness. First, this methodology provides participants an opportunity to practice alternative behavioral choices. When used effectively and chosen for their relevance to the clinical work at hand, experiential learning allows youth like Steve to alter their cognitive scripts by putting new learning into practice in ways that will be memorable and concrete. In other words, experiential learning provides an opportunity to rehearse new scripts.
Second, experiential learning provides participants the opportunity to engage in healthy risk taking. For youth like Steve who prefer a life of no surprises, acting up, shutting down and using are so germane to their maladaptive scripts that these behaviors have become normalized. Thus, they are no longer perceived as risky.
In the Stages of Change model, these youth are pre-contemplative. Part of the appeal of pre-contemplation is that it feels safe (Prochaska, Norcross & DiClemente, p. 74). These youth often exhibit significant cognitive dissonance, perceiving high-risk situations as risk-free. This is, perhaps, the ultimate maladaptive script and part of their stuckness is their inability to see it. Helping them become unstuck requires helping them to reframe this dissonance, so that they move through the Stages of Change. Helping them become unstuck requires that they come to see risky behavior as risky.
Priest and Gass have cataloged significant affective gains from participation in experiential learning. These include new self-confidence, enhanced willingness to take good risks, improved self-concept, increased logical thinking, and greater reflective thinking (p. 19). These affective gains would be useful for anyone engaged in the change process, but they are particularly useful for someone stuck in pre-contemplation.
As illustrated, the use of experiential learning in clinical settings seems an obvious and valuable choice, leading to a “more enriched, complex, and potentially resilient brain” (Cozolino, p. 298). Experiential learning provides an excellent methodology for assuring this treatment outcome, by providing an “enriched environment to enhance brain development” (Cozolino, p. 291). These developments result in increased confidence and optimism regarding the ability to change. This is vital in helping assure that youth like Steve will actually utilize their new developed, more adaptive cognitive scripts.
“The concept of neuroplasticity suggests that the brain is highly malleable and is subject to continual change as a result of experience, so that new connections between neurons may be formed or even brand-new neurons generated” (The Dalai Lama, qtd. in Begley, p. 24). By providing rich opportunities to test assumptions, practice new behaviors, and engage in healthy risk taking, experiential learning inevitably enhances neuroplasticity, thereby leading to lasting changes in cognitive scripts. It is through this learning, rehearsing, and ultimate using of new, more adaptive cognitive scripts that youth like Steve can break their cycle of stuckness.
Works Cited
Begley, S. (2007). Train Your Mind, Change Your Brain. New York: Ballantine Books.
Cozolino, L. (2002). Neuroscience of Psychotherapy, The. New York: W. W. Norton & Co.
Luckner, J. & Nadler, R. (1992). Processing the Experience. Dubuque, IA: Kendall/Hunt Publishing.
Priest, S., & Gross, M. (2005). Effective Leadership in Adventure Programming. Champaign, IL: Human Kinestics.
Prochaska, J., Norcross, J., & DiClemente, C. (1994). Changing for Good. New York: Harper Collins.
Romer, D. & Walker, E. (2007). Adolescent Psychopathology and the Developing Brain. New York: Oxford University Press.
Rose, S. (1998). Group Therapy with Troubled Youth. Thousand Oaks, CA: Sage Publications.
Zull, J. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
Showing posts with label neuroscience. Show all posts
Showing posts with label neuroscience. Show all posts
Saturday, December 6, 2008
Saturday, October 25, 2008
Getting Unstuck
According to the Yale Medical School web site, cognitive script is "the term used for the themes that flow habitually through our thoughts. These cognitive scripts can influence both our emotions and our behavior. They have been described as the tapes we play repeatedly in our heads—those things we tell ourselves over and over again, often without conscious awareness."
In my experience, substance-abusing teens generally have three basic cognitive scripts: act up, shut down, and use. With such limited options, these youth are stuck continuously rerunning these same maladaptive scripts, perpetuating already internalized beliefs that they are ineffective, incapable, and unable to make more adaptive choices.
Every time a youth uses the same maladaptive script, it becomes more likely that he will use it again. This is basic neuroscience. Hebb wrote, “[A]ny two cells that are repeatedly active at the same time will tend to become ‘associated,’ so that activity in one facilitates activity in the other" (qtd. in Siegel, p. 26). In other words, “Experience, gene expression, mental activity, behavior, and continued interactions with the environment are tightly linked in a transactional set of processes” (Siegel, p. 19).
These processes begin at birth. Repeated similar experiences lead the mind to make generalized representations that form the basis of mental models used to “interpret present experiences as well as anticipate future ones” (Siegel, p. 29-30), suggesting that an individual is most likely to respond to life events in standard, predictable and learned ways.
Cognitive scripts are learned. For an individual who experienced a positive childhood environment, her scripts will be adaptive and flexible. However, when a youth has only maladaptive scripts, eventually acting up, shutting down, and using can become so normalized that these scripts are no longer seen as problematic.
“Jennifer,” a former client, had a history of running away, shoplifting, and abusing marijuana. When I worked with her, she was on her third treatment episode. Jennifer lived in a group home with a drug testing policy and continued use would result in her losing her placement. Yet, she continued to use. Some drug counselors would say she was in denial or resistant to treatment. This seems overly simplistic to me. Jennifer couldn’t be successful because she had no mental model of success. All Jennifer knew was acting up, shutting down, and using. All Jennifer knew was being stuck.
If creating change in our clients is about helping them write new, more adaptive scripts, how do we make that happen? I’ve always believed the answer is not to provide endless didactic lectures. Rather, the answer is to present clients opportunities to try new behaviors. As they practice these new behaviors, new neural connections are being made and new cognitive scripts are being written. In other words, they are starting to get unstuck.
Beyond the Comfort Zone
In my experience, substance-abusing teens and other at-risk youth continue to engage in maladaptive behaviors until they break their cycle of stuckness. If this is true, then it seems to me that the goal of substance abuse treatment should be to help clients create new, more adaptive cognitive scripts. It seems to me that the first step in this process is encouraging participants to risk going outside their Comfort Zones.
There's a paradox among many of my clients. While they have done things I consider extremely high risk—like getting high on drugs acquired from a stranger who is inherently a criminal, exchanging sex for drugs, or stealing to support their habit—they almost universally present as risk-adverse. I'm frequently perplexed by how to confront this Risk Dichotomy, which my clients are usually unable to recognize. It seems those things have become so normalized to them that they are no longer perceived as risky.
For these clients, staying stuck seems safe. Acting up, shutting down, and using are solidly within their Comfort Zones, so don't seem like risky behavior. This cycle keeps the youth stuck—and every time this cycle repeats itself, it becomes more likely the youth will stay stuck. What fires together wires together. That's basic neuroscience. And, every time that happens it becomes more likely to happen again.
Getting unstuck requires the individual to step outside her Comfort Zone and experiment with new behaviors. This is much riskier—not to mention harder—than sticking with rigid, predictable responses. However, it is only through trying new behaviors that the individual will have the opportunity to develop more adaptive cognitive scripts.
Through participation in experiences that move them outside their Comfort Zones, experiential learning provides substance-abusing teens an opportunity to test their assumptions and reject those they discover to be faulty. It seems to me that this testing and rejecting is vital for movement through the Stages of Change, especially those stages most likely to be encountered in a treatment setting—pre-contemplation, contemplation, and preparation.
For a pre-contemplative client, testing and rejecting “increases the likelihood of serious consideration of change” (DiClemente, p. 27). For a client in the preparation stage, testing and rejecting fosters the likelihood of “a considered evaluation that leads to a decision to change” (DiClemente, p. 27). For a client in the preparation stage, testing and rejecting increases self-efficacy and can result in “an action plan that will be implemented in the near term” (DiClemente, p. 27).
You’re Freaking Me Out!
If opportunities to test and reject assumptions are necessary for movement through the Stages of Change, so, too, is some discomfort. According to Cozolino, “[M]oderate stress triggers the release of neurohormones that enhance cortical reorganization and new learning” (p. 24). In addition, Zull wrote, “Plasticity in the brain probably depends more on signals from the emotional centers than it does on new sensory input” (p. 223).
In other words, it is emotions—especially stress—that make our brains learn and change. Experiential learning is an excellent methodology for creating this change environment. In most experiential activities, there is a high level of perceived risk. In some cases, such as white water rafting or high ropes activities, this perceived risk is physical. In other cases, this perceived risk could be emotional or social.
Whether physical, emotional, or social, the perception of risk in experiential activities will likely result in a sense of disequilibrium. According to Luckner and Nadler, “Disequilibrium refers to an individual’s awareness that a mismatch exists between old ways of thinking and new information” (p. 19). "Vincent," a former client, provided an example of disequilibrium during a group activity.
I talk about appropriate risk-taking frequently during group sessions, and often use an activity called Pass the Mousetraps to illustrate this idea. As the title suggests, this activity involves passing around set mousetraps. Actually, this activity also includes tripping mousetraps with hands.
Although completely safe when certain parameters are followed, this activity appears to be fairly risky. In fact, while sitting in a room filled with teens tripping mousetraps, Vincent, a former client, blurted, “You’re freaking me out!” and quickly left the room. For Vincent, the perceived risk was simply too high, even after my extremely detailed safety directions prior to the activity.
Watching his group-mates trip mousetraps with their hands created too strong of a mismatch for Vincent. He believed this to be extremely dangerous behavior, yet nobody was being injured. Unable to revise his thinking quickly enough to reflect the reality of the situation, Vincent had no choice but to flee. Later, Vincent stated, “I left because I was sure someone was going to get hurt. And I couldn’t figure out why that wasn’t happening.” Vincent wasn't worried someone might get hurt; he was upset because what he expected to happen didn't.
With all my clients, disequilibrium appears when acting up, shutting down, and using become no longer effective. When faced with this scenario, a participant is confronted with one of two choices: assimilation or accommodation. According to Piaget’s developmental theory, when presented with new information an individual tries to assimilate it, or fit it into his existing understanding of the world. If this is impossible, the individual is forced to accommodate the new information by altering his schema, or mental models (Kassin, p. 343). When presented with an experience that requires accommodation, an individual is forced to alter his cognitive scripts.
Experiential learning is rich in these opportunities. Marie—the client discussed in my earlier posting Reflecting on Reflection—and her experience on the hike is a good example. Marie was confronted with two choices. She could give up by sitting on the side of the mountain and refusing to continue the hike, or she could resume the hike even though it was difficult and clearly outside her Comfort Zone. When Marie chose to continue the hike, she was required to accommodate this new option and alter her cognitive scripts.
I believe that these opportunities are one of the major values of experiential learning in treatment setting. Priest and Gass wrote, “By responding to seemingly insurmountable tasks [found in many experiential activities], participants often learn to overcome self-imposed perceptions of their capabilities to succeed” (p. 18). It seems to me that by definition, insurmountable tasks only exist outside one’s Comfort Zone. Perhaps, then, taking the risk of tackling an insurmountable task means a participant will automatically be more open to becoming unstuck.
For Marie, an insurmountable task was accomplished and the change was almost immediate. In Vincent’s case, he never tripped a mousetrap with his bare hand, but he did confront a powerful mismatch. What he expected didn’t happen and to accommodate that new experience, he needed to alter his cognitive scripts.
So, what does being slightly less afraid of a mousetrap has to do with sobriety? As a result of his experience that day, Vincent discovered that mousetraps aren’t inherently dangerous after all. This new learning required him to rearrange information in ways that formed new neural networks based on actively testing and rejecting an outdated belief. And, perhaps, with that was born a new perspective: There are possibilities other than those you’ve always believed to be true. Experiential learning helps participants become unstuck by helping them create new, more adaptive cognitive scripts and helping them discover those other possibilities.
Works Cited
Cozolino, L. (2002). Neuroscience of Psychotherapy, The. New York: W. W. Norton & Co.
DiClemente, C. (2003). Addiction and Change. New York: Guilford Press.
Kassin, S. (2004). Essentials of Psychology. Upper Saddle River, NJ: Prentice-Hall.
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.
Siegel, D. (1999). Developing Mind, The. New York: Guilford Press.
Yale Medical School. (n.d.). Glossary. Retrieved October 22, 2008, from
http://info.med.yale.edu/psych/3s/glossary_items/cog_script.html
Zull, J. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
In my experience, substance-abusing teens generally have three basic cognitive scripts: act up, shut down, and use. With such limited options, these youth are stuck continuously rerunning these same maladaptive scripts, perpetuating already internalized beliefs that they are ineffective, incapable, and unable to make more adaptive choices.
Every time a youth uses the same maladaptive script, it becomes more likely that he will use it again. This is basic neuroscience. Hebb wrote, “[A]ny two cells that are repeatedly active at the same time will tend to become ‘associated,’ so that activity in one facilitates activity in the other" (qtd. in Siegel, p. 26). In other words, “Experience, gene expression, mental activity, behavior, and continued interactions with the environment are tightly linked in a transactional set of processes” (Siegel, p. 19).
These processes begin at birth. Repeated similar experiences lead the mind to make generalized representations that form the basis of mental models used to “interpret present experiences as well as anticipate future ones” (Siegel, p. 29-30), suggesting that an individual is most likely to respond to life events in standard, predictable and learned ways.
Cognitive scripts are learned. For an individual who experienced a positive childhood environment, her scripts will be adaptive and flexible. However, when a youth has only maladaptive scripts, eventually acting up, shutting down, and using can become so normalized that these scripts are no longer seen as problematic.
“Jennifer,” a former client, had a history of running away, shoplifting, and abusing marijuana. When I worked with her, she was on her third treatment episode. Jennifer lived in a group home with a drug testing policy and continued use would result in her losing her placement. Yet, she continued to use. Some drug counselors would say she was in denial or resistant to treatment. This seems overly simplistic to me. Jennifer couldn’t be successful because she had no mental model of success. All Jennifer knew was acting up, shutting down, and using. All Jennifer knew was being stuck.
If creating change in our clients is about helping them write new, more adaptive scripts, how do we make that happen? I’ve always believed the answer is not to provide endless didactic lectures. Rather, the answer is to present clients opportunities to try new behaviors. As they practice these new behaviors, new neural connections are being made and new cognitive scripts are being written. In other words, they are starting to get unstuck.
Beyond the Comfort Zone
In my experience, substance-abusing teens and other at-risk youth continue to engage in maladaptive behaviors until they break their cycle of stuckness. If this is true, then it seems to me that the goal of substance abuse treatment should be to help clients create new, more adaptive cognitive scripts. It seems to me that the first step in this process is encouraging participants to risk going outside their Comfort Zones.
There's a paradox among many of my clients. While they have done things I consider extremely high risk—like getting high on drugs acquired from a stranger who is inherently a criminal, exchanging sex for drugs, or stealing to support their habit—they almost universally present as risk-adverse. I'm frequently perplexed by how to confront this Risk Dichotomy, which my clients are usually unable to recognize. It seems those things have become so normalized to them that they are no longer perceived as risky.
For these clients, staying stuck seems safe. Acting up, shutting down, and using are solidly within their Comfort Zones, so don't seem like risky behavior. This cycle keeps the youth stuck—and every time this cycle repeats itself, it becomes more likely the youth will stay stuck. What fires together wires together. That's basic neuroscience. And, every time that happens it becomes more likely to happen again.
Getting unstuck requires the individual to step outside her Comfort Zone and experiment with new behaviors. This is much riskier—not to mention harder—than sticking with rigid, predictable responses. However, it is only through trying new behaviors that the individual will have the opportunity to develop more adaptive cognitive scripts.
Through participation in experiences that move them outside their Comfort Zones, experiential learning provides substance-abusing teens an opportunity to test their assumptions and reject those they discover to be faulty. It seems to me that this testing and rejecting is vital for movement through the Stages of Change, especially those stages most likely to be encountered in a treatment setting—pre-contemplation, contemplation, and preparation.
For a pre-contemplative client, testing and rejecting “increases the likelihood of serious consideration of change” (DiClemente, p. 27). For a client in the preparation stage, testing and rejecting fosters the likelihood of “a considered evaluation that leads to a decision to change” (DiClemente, p. 27). For a client in the preparation stage, testing and rejecting increases self-efficacy and can result in “an action plan that will be implemented in the near term” (DiClemente, p. 27).
You’re Freaking Me Out!
If opportunities to test and reject assumptions are necessary for movement through the Stages of Change, so, too, is some discomfort. According to Cozolino, “[M]oderate stress triggers the release of neurohormones that enhance cortical reorganization and new learning” (p. 24). In addition, Zull wrote, “Plasticity in the brain probably depends more on signals from the emotional centers than it does on new sensory input” (p. 223).
In other words, it is emotions—especially stress—that make our brains learn and change. Experiential learning is an excellent methodology for creating this change environment. In most experiential activities, there is a high level of perceived risk. In some cases, such as white water rafting or high ropes activities, this perceived risk is physical. In other cases, this perceived risk could be emotional or social.
Whether physical, emotional, or social, the perception of risk in experiential activities will likely result in a sense of disequilibrium. According to Luckner and Nadler, “Disequilibrium refers to an individual’s awareness that a mismatch exists between old ways of thinking and new information” (p. 19). "Vincent," a former client, provided an example of disequilibrium during a group activity.
I talk about appropriate risk-taking frequently during group sessions, and often use an activity called Pass the Mousetraps to illustrate this idea. As the title suggests, this activity involves passing around set mousetraps. Actually, this activity also includes tripping mousetraps with hands.
Although completely safe when certain parameters are followed, this activity appears to be fairly risky. In fact, while sitting in a room filled with teens tripping mousetraps, Vincent, a former client, blurted, “You’re freaking me out!” and quickly left the room. For Vincent, the perceived risk was simply too high, even after my extremely detailed safety directions prior to the activity.
Watching his group-mates trip mousetraps with their hands created too strong of a mismatch for Vincent. He believed this to be extremely dangerous behavior, yet nobody was being injured. Unable to revise his thinking quickly enough to reflect the reality of the situation, Vincent had no choice but to flee. Later, Vincent stated, “I left because I was sure someone was going to get hurt. And I couldn’t figure out why that wasn’t happening.” Vincent wasn't worried someone might get hurt; he was upset because what he expected to happen didn't.
With all my clients, disequilibrium appears when acting up, shutting down, and using become no longer effective. When faced with this scenario, a participant is confronted with one of two choices: assimilation or accommodation. According to Piaget’s developmental theory, when presented with new information an individual tries to assimilate it, or fit it into his existing understanding of the world. If this is impossible, the individual is forced to accommodate the new information by altering his schema, or mental models (Kassin, p. 343). When presented with an experience that requires accommodation, an individual is forced to alter his cognitive scripts.
Experiential learning is rich in these opportunities. Marie—the client discussed in my earlier posting Reflecting on Reflection—and her experience on the hike is a good example. Marie was confronted with two choices. She could give up by sitting on the side of the mountain and refusing to continue the hike, or she could resume the hike even though it was difficult and clearly outside her Comfort Zone. When Marie chose to continue the hike, she was required to accommodate this new option and alter her cognitive scripts.
I believe that these opportunities are one of the major values of experiential learning in treatment setting. Priest and Gass wrote, “By responding to seemingly insurmountable tasks [found in many experiential activities], participants often learn to overcome self-imposed perceptions of their capabilities to succeed” (p. 18). It seems to me that by definition, insurmountable tasks only exist outside one’s Comfort Zone. Perhaps, then, taking the risk of tackling an insurmountable task means a participant will automatically be more open to becoming unstuck.
For Marie, an insurmountable task was accomplished and the change was almost immediate. In Vincent’s case, he never tripped a mousetrap with his bare hand, but he did confront a powerful mismatch. What he expected didn’t happen and to accommodate that new experience, he needed to alter his cognitive scripts.
So, what does being slightly less afraid of a mousetrap has to do with sobriety? As a result of his experience that day, Vincent discovered that mousetraps aren’t inherently dangerous after all. This new learning required him to rearrange information in ways that formed new neural networks based on actively testing and rejecting an outdated belief. And, perhaps, with that was born a new perspective: There are possibilities other than those you’ve always believed to be true. Experiential learning helps participants become unstuck by helping them create new, more adaptive cognitive scripts and helping them discover those other possibilities.
Works Cited
Cozolino, L. (2002). Neuroscience of Psychotherapy, The. New York: W. W. Norton & Co.
DiClemente, C. (2003). Addiction and Change. New York: Guilford Press.
Kassin, S. (2004). Essentials of Psychology. Upper Saddle River, NJ: Prentice-Hall.
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.
Siegel, D. (1999). Developing Mind, The. New York: Guilford Press.
Yale Medical School. (n.d.). Glossary. Retrieved October 22, 2008, from
http://info.med.yale.edu/psych/3s/glossary_items/cog_script.html
Zull, J. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
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.
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.
Saturday, September 27, 2008
Sequencing Change
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.
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 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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