Interpersonal Skills

S. no.

Area of assessment

Tool available

Self-esteem

Rosenberg self-esteem scale

Screening tool for behavioural and emotional problems in children and adolescents

Youth self report inventory

Family conflict

Family environment scale

Interpersonal dynamics between family members

Kinetic family drawing test

Elicit attitudes, beliefs and motivations about self and other aspects related to self

Sentence completion test

Incorporate findings from assessment to enrich treatment goals and use in therapy.

5.4.3 Beginning Phase

Therapy begins with goal setting to jointly arrive at problem areas which are workable. It is important to narrow the scope of goal setting so as not to aim to change personalities of parents/others and temperament of the adolescent completely but to find a healthy balance between the two. The role of the therapist to enable the adolescent develop skills to both build effective relationships, maintain them as well as effectively resolve conflicts as and when they arise which needs to be clarified at the outset.

Joint activities for teens and parents can be planned to enhance the bond between them and create opportunities for healthy interaction where the sole purpose of communication is not expression of what parents dislike in the adolescent and the adolescent’s complaints about perceived bad parenting. It can be helpful for parents to get connected to what is the ‘fad’ of the moment, what excites the adolescent and what would he/she view as a reward. Parents can also know about the role model that the adolescent aspires for and bring out the good in him or her.

Parenting tips that are shared at this stage are as follows:

(a)

Send clear signals to the adolescent that disrespectful behaviour will not be tolerated, without responding with anger to the agitated adolescent.

(b)

Do not say ‘No’ for everything. Let some things which are not grossly wrong slide.

(c)

Pick the right time to correct aberrant behaviour. When the teen is in a bad mood, that is not the best time to correct him/her about how badly he/she keeps their room.

(d)

Pick one point at a time. Do not begin with one problem behaviour and pile it with all other problem behaviours also at one go.

(e)

Talk about issues that need one-to-one attention where there is least distraction by, for example phone/other siblings/others who may happen to listen.

(f)

Celebrate small efforts and successes by the adolescent even when the big break through is not coming in.

(g)

Set aside quality time.

5.4.4 Middle Phase

The middle phase of therapy is focused on building social adaptive skills necessary for initiating and sustaining relationships, whether they may be with family, friends or romantic relationships. Being armed with realistic self-evaluation, healthy communication, conflict resolution and anger management can help the individual in different areas of relationship functioning.

5.4.4.1 Behaviour Change

The adolescent age group is often associated with mood swings and temperaments that are difficult to handle by those around them and are often a cause of disruptive relationships. In this step, adolescents are encouraged to reflect on their behaviour and see where there is a need for change.

Worksheet

(a)

Make a list of things you do which are good

(b)

Make a list of things you do which may cause trouble to others around you

(c)

Make a list of behaviours that you would like to do more often

(d)

Make a list of behaviours that you would like to do less

(e)

I want my family to support me in changing my behaviour by doing …. and not doing ….

(f)

Were there any things in the past 2 weeks that you thought you did without thinking and the consequences were not so nice?

(g)

What can you do next time before acting impulsively?

Parents and significant others can help the teen in behaviour change by following simple steps as follows:

(a)

Modelling: model the correct behaviour. It would not be very beneficial to scream at the adolescent in anger criticising the same action in him/her.

(b)

Give cues: when you pick up that the adolescent is getting frustrated or unable to express himself/herself or needs assistance but is uncomfortable asking for it, give subtle cues such as ‘look here’ and ‘you look frustrated’ amongst others.

(c)

Gradually withdraw adult support: encourage adolescents to think and act independently but also seek accountability and responsibility for actions. Be present to guide and offer advice in a manner and tone that the adolescent feels comfortable accepting.

5.4.4.2 Thought Monitoring and Modification

In this step, the role of the therapist is to psychoeducate the client about the T-F-A cycle which elucidates the relationship between thoughts, feelings and actions. By way of examples, it can be explained that the way we think influences the way we feel which in turn determines the course of action we take. The consequences of this action further fuel into the way we think and the cycle continues. In order to have desired results in terms of consequences, it is important to bring out a behaviour change which also stems from changing the way we think or perceive situations. The adolescent is explained about the negative automatic thoughts that tend to flood in as a situation presents itself. The salient characteristics of negative automatic thoughts are as follows: they are automatic, distorted, unhelpful, unreasonable and involuntary.

Cognitive biases are also included with examples of situations that the adolescent brings up where he/she felt misunderstood or a conflict opened up. Adolescents are encouraged to think about times when something they thought had an impact on something they did. For example, the client stopped talking to his friend because the latter refused to share his class notes with him. The client thought the reason was so as to get better marks than him, but in reality, his friend had incomplete notes which he did not want anyone else to know.

Worksheet

Think of one situation in the last two weeks where you had a disagreement with someone. Answer the following questions to elicit your negative automatic thoughts at work.

(a)

What is the evidence for my negative automatic thinking?

(b)

What alternative ways of looking at things are there?

(c)

What effect does thinking this way have on me?

(d)

Did I ‘predict the future, over-generalize, think selectively, think in terms of black and white or jump to conclusions’?

5.4.4.3 Building Effective Communication Skills

Good communication means ‘being able to tell others what you feel and think and being able to hear what others tell you about what they feel and think’. The adolescent is guided about effective communication to fulfil the following points:

(a)

Make communication positive, clear and specific.

(b)

Recognize that each individual sees things from a different point of view.

(c)

Be open and honest about your feelings and accept others’ feelings.

(d)

Ask questions for clarification on an issue.

(e)

Learn to listen.

(f)

Use ‘I-statements’.

Effective communication involves maintaining eye contact, using gestures such as affirmative nods, asking relevant questions, paraphrasing, not interrupting the speaker. The adolescent is encouraged to develop the habit of seeking help and not feeling rejected when the other does not ‘magically’ understand the need for help.

5.4.4.4 Use of ‘I-Statements’

The three components of an I-statement are as follows:

(a)

An ‘I-statement’ starts with letting people know whose feeling you are talking about: ‘I feel …’

(b)

An I-statement names clearly for people how you are feeling: ‘I feel happy/sad/angry/frustrated/lonely or whatever…’

(c)

An I-statement ends by explaining to people why you feel the way you do: ‘I feel happy when my friends call around to see if I want to hang around with them’.

Assertiveness is an important aspect of communication training essential to adolescence to train them in not giving into peer pressure. Activity can be started by exploring the meaning of assertiveness and how it differs from submissiveness as well as aggressiveness. The adolescent can explore situations in the past one month in interacting with others where he/she felt that being more assertive could have been beneficial. Pros and cons of aggressive and assertive behaviour can be discussed by making posters. Role-play situations to play out dialogues with the adolescent being the one giving pressure as well as resisting pressure can be enacted within session. Helping the adolescent understand their emotions alongside each step would further be a self-reinforcing feature that would encourage him/her to use more assertiveness.

Worksheet

Which of the following steps would lead to better communication?