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Re: [kidact] 11 year old with social skills problems

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  • louise hayes
    oh and an after thought. I would go for some contextual stuff too. Are there other kids in the library, could he start there? Or does your school have a chess
    Message 1 of 7 , Mar 17, 2011
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      oh and an after thought. I would go for some contextual stuff too. 
      Are there other kids in the library, could he start there? Or does your school have a chess group at lunch? Or a computer game group or something? 

      I know a lot of schools have a range of activities to help kids who cant face the brutality of a school yard.
      He surely wouldnt be alone in hating that. It would be nice if he had something to look forward to at lunch.

      Louise

      Dr Louise Hayes, 
      PhD, MAPS, Clinical Psychologist

      Senior Lecturer
      School of Behavioural, Social Sciences & Humanities
      University of Ballarat
      P.O. Box 663,
      Mt Helen, Victoria, 3353
      Phone: 0423 770 975
      email: louisehayes@...
      email: l.hayes@...

      On 17/03/2011, at 7:51 PM, louise hayes wrote:

       

      Hi Tamar,


      it is easy to get stuck with kids like this. 

      A couple of thoughts come to mind:
      - it seems he has a pattern of avoidance in difficult situations. (a) he goes to the library to avoid playtime, (b) he has escaped to under his desk in class, (c) he has tried to leave the school, and (d) his escape behaviour was again repeated in your session - when he was pressured he asked to leave,
      - first I would want to confirm this with observations, with the aim of getting a functional assessment. I would want to know what triggers the escape by seeing it a few times in the school if I could. This is important to know where to go next IMHO.
      - if you do this you may also find what triggers the "inappropriate" behaviour and the labelling from the kids (poor thing the year is only 5 weeks long and he must be already feeling that he is failing at yet another school).
      - The assessment should give you the knowledge to use the known triggers to create some gentle exposure in session with him, with the aim of helping him expand his repertoire of responses under stress.

      Importantly, 
      - I would be wanting to get a good working relationship with him first, so that he knows I am on his side, and then, with his permission, try the exposure and new skills response. I would do this at a very low level - already agreed by him - letting him have some choice to start with, and some control over the session. The aim is to help him expand his repertoire of responses in the face of anxiety.
      And have stacks of fun with it. I would do whatever I could to make him enjoy it, so his is willing to increase his boldness. (e.g I'm currently in an iphone Bubblewrap game all star championship with one of my 10 year old clients - I get paid to play ;-)

      And,
      I would do a heap of work on his self as context stuff and defusion. I bet he thinks he is a loser.

      Good luck. Its very tough with this age.

      Louise









      Dr Louise Hayes, 
      PhD, MAPS, Clinical Psychologist

      Senior Lecturer
      School of Behavioural, Social Sciences & Humanities
      University of Ballarat
      P.O. Box 663,
      Mt Helen, Victoria, 3353
      Phone: 0423 770 975
      email: louisehayes@...
      email: l.hayes@...

      On 15/03/2011, at 8:35 PM, tamarblack wrote:

       

      Hi all,
      I have started working with an 11 year old boy who is a new student at the school I work at. He has attended two other schools where he did not make friends; at his last school he was physically and verbally bullied. I have seen him twice. At recess he is going to the library or to his teacher and will not approach any other students. The other kids are labelling him as "inappropriate" and not including him. On several occasions he has sat under his desk during class and has also tried to leave the school. In our sessions he has acknowledged that he desperately wants friends and feels what he's doing isn't working for him; we role play approaching other kids and joining in, but when it comes to recess his mind tells him to go the library and read so he can learn. He has some asperger traits but this has not been formally diagnosed. He has really low self esteem and is very pessimistic, he feels bad things come to him. I'm a bit stuck; I feel so much empathy for him and realy want to help him. He is not making any behaviour changes and when I challenged him about this last session he asked to leave. Would greatly appreciate some opinions.
      Tamar Black




    • Lisa Coyne
      Hi Tamar, This is great advice from Louise - I think she s right on the money - you should try everything she says!! To add to that, in my experience working
      Message 2 of 7 , Mar 17, 2011
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        Hi Tamar,

         

        This is great advice from Louise – I think she’s right on the money – you should try everything she says!!  To add to that, in my experience working with kids like this, it is important to carefully tease apart with them what they value, and how they are “valuing.”  This is incredibly important because many kids who are bullied and desperate to be friends with other kids are engaging in social approach, or attention seeking behaviors that are for the purpose of making thoughts of “I am a loser” or “If I don’t have friends, I am a miserable failure,” etc.  Sometimes, social approach, when it’s intention is to make those things go away, appears to other kids as desperate, and will be aversive to them.  In addition, engagement in those sorts of behaviors for that purpose, although that*looks* like the child is “approaching,” may actually be a sign of more experiential avoidance. Thus, doing values work with this type of child is very difficult, and tricky.  The reason it’s tricky is that you, as the therapist, and certainly, your client, can’t control what others do.  So you can’t really work on “making bullies stop” (you could of course work with the school system, and that’s a good thing too, but that’s another conversation!), or “making other kids like” your client.  What you *can* do, however, is see what’s at the core of these behaviors – what makes it hurt so much when your client gets bullied? There’s a value there. So, once you get to that painful content, defuse, defuse, defuse, and then also see what’s most important to your little one.

         

        To illustrate, I had an 11 year old with very similar issues – she was a beautiful little girl, and I couldn’t imagine why she was bullied.  But her social approaches were awkward, sycophantic, and she tended to be either clingy or irritating to other kids in her social interactions.  We discovered that she had been working on getting kids to like her/getting bullies to stop, and I think that’s why her social approaches were so awkward – she was so in her head about what it meant to be rejected, that she wasn’t really attending to important social cues from the other kids, or learning from them.  So a bit later on, she was able to contact her value: to be loved and accepted just as I am and to be a really good friend.  Beautiful.  I am actually tearing up thinking of her – she was such a fabulous little one!  While we couldn’t work on changing other kids, we could certainly work on what it meant to be a good friend, what it meant to make space for other people to be who they were, etc.  And she could attend to how she was behaving – whether it was consistent with being a good friend, or whether it was for some other purpose (i.e., to make bad thoughts go away).  In learning what behaviors were consistent with being a good friend, she also had opportunity to observe when others engaged in those behaviors/ when they didn’t, so eventually she would be able to pick and choose children with whom to have relationships – and also to not seek relationships with those who didn’t engaged in “good friendship” behaviors.  It’s interesting to me that sometimes kids who are bullies want more than anything to be friends with those bullies – to be accepted by them is somehow more important than learning how, and when, and with whom, to develop healthy friendships….


        We did a lot of defusion about her thoughts of being a loser – we did monsters on the bus, we labeled each other (she was big loser, I was world’s worst therapist).  By the way, what you ask your client to do, you must do – I firmly believe that in working with children. All of this was a ton of fun.

         

        We also did some work, as you might have guessed reading the above, on her social approach skills, as well as her responses to being bullied.  We role played. I had her show me, through role play, what she did when she was bullied (she wilted, cried, looked at the floor, or curled up in a little ball, which made her more of a target).  I let her bully me – and I pretended to be her – first I did what she had been doing, and asked her how it felt to bully me.  I can tell you, she was pretty good at it!  Then, I told her I was going to try something different.  When she said mean things, I simply stood my ground, looked her in the eyes, and said, “Ok.  And?”  Every time she said a mean thing, I responded the same way.  Then I asked her how that was for her – she said it was much harder to bully me when I was looking at her – and she had a harder time thinking of what to say!  Wasn’t that interesting, I said.  Her homework, then, was simply to try out these two responses to mean things kids said, and to see what happened.

         

        She came back in the following week, and I asked her how it went. She said that the bullies were still there, and they did say mean things, but that it somehow felt “different” when she made eye contact and said “and.” When I asked her how different, she made a muscle with her arm, and said, I felt…powerful!” And she *got* that she could be herself, despite what the bullies were doing.  And she *got* that the words they were saying were just that – words.  Over the next few weeks, while she continued to use this approach, lo and behold, she said the bullies were starting to leave her alone, most likely, I think, because they no longer got a big response out of her – in essence, after we did defusion, she was approaching scary situations, and basically *not rewarding the bullies for their behavior*.  And she felt like she had more room to move about in her life.

         

        We worked on her doing other things that were consistent with her being a good friend – calling a child and asking for a playdate once per week (you must engage parents in supporting this), and continuing to call other kids if the first few weren’t able to do so – or to suggest other dates that might work.  This started with kids she was friendly with at past schools (she had been placed in a new school due to the bullying), but then began to extend to kids at her school where she was.  During her last session, she had been invited to a birthday party – she was ecstatic!

         

        One other thing to note is that it is important to get parents on the same page as you, otherwise they could do things that are unhelpful rather than gently and compassionately supporting a) defusion, b) the emergence of new, fledgling social behaviors, c) letting their *child* do things to help, rather than jumping in to help their child (of course, there are things that parents *can* and *should* do when it comes to bullying – like keep teachers and school administrators aware of the situation, and to gather information from the school as well, etc), which can sometimes send the message that the child is “broken” and can’t do for themselves (which of course supports all of the child’s avoided thoughts that she herself is indeed “broken”).

         

        One other thing that you can have the child do (and I didn’t do it with this case, but have done it with others) is to have the child engage her teachers as a support team.  You can ask the child to say something similar to what one might do in a commitment exercise: Say that she has been having trouble with being bullied, describe what she’s been doing that hasn’t necessarily worked, and then say what her value is (i.e., being a good friend, or whatever), and ask the teacher for help in supporting her.  In doing this, there’s a safety net – the teacher can more closely track the bullying, and be ready to jump in if it escalates, but can also support the client’s efforts to stand her ground, and develop behavior consistent with “being a good friend.”  It also makes an explicit opportunity for the teacher to reward (immediately) emerging social skills (or if your client has no social skills deficits) performing appropriate social skills.

         

        Phew. That’s a lot, and I hope it was helpful – good luck with the case – Louise is right – it is *really* easy to get stuck – here’s to hoping some of these comments will be useful.

         

        Take good care,

         

        Lisa

         

      • louise hayes
        LIsa, that is beautiful. I m tearing up too. What a fabulous example of values work in a non-talky active and fun way. I have to smile at the world s worst
        Message 3 of 7 , Mar 17, 2011
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          LIsa, 
          that is beautiful. I'm tearing up too. What a fabulous example of values work in a non-talky active and fun way.

          I have to smile at "the world's worst therapist" ;-) She would have loved that. And my guess is that it would have helped her get the concept that our thoughts can be so far from reality.  

          cheers,
          Louise


          Dr Louise Hayes, 
          PhD, MAPS, Clinical Psychologist

          Senior Lecturer
          School of Behavioural, Social Sciences & Humanities
          University of Ballarat
          P.O. Box 663,
          Mt Helen, Victoria, 3353
          Phone: 0423 770 975
          email: louisehayes@...
          email: l.hayes@...

          On 18/03/2011, at 12:18 AM, Lisa Coyne wrote:

           

          Hi Tamar,

           

          This is great advice from Louise – I think she’s right on the money – you should try everything she says!!  To add to that, in my experience working with kids like this, it is important to carefully tease apart with them what they value, and how they are “valuing.”  This is incredibly important because many kids who are bullied and desperate to be friends with other kids are engaging in social approach, or attention seeking behaviors that are for the purpose of making thoughts of “I am a loser” or “If I don’t have friends, I am a miserable failure,” etc.  Sometimes, social approach, when it’s intention is to make those things go away, appears to other kids as desperate, and will be aversive to them.  In addition, engagement in those sorts of behaviors for that purpose, although that*looks* like the child is “approaching,” may actually be a sign of more experiential avoidance. Thus, doing values work with this type of child is very difficult, and tricky.  The reason it’s tricky is that you, as the therapist, and certainly, your client, can’t control what others do.  So you can’t really work on “making bullies stop” (you could of course work with the school system, and that’s a good thing too, but that’s another conversation!), or “making other kids like” your client.  What you *can* do, however, is see what’s at the core of these behaviors – what makes it hurt so much when your client gets bullied? There’s a value there. So, once you get to that painful content, defuse, defuse, defuse, and then also see what’s most important to your little one.

           

          To illustrate, I had an 11 year old with very similar issues – she was a beautiful little girl, and I couldn’t imagine why she was bullied.  But her social approaches were awkward, sycophantic, and she tended to be either clingy or irritating to other kids in her social interactions.  We discovered that she had been working on getting kids to like her/getting bullies to stop, and I think that’s why her social approaches were so awkward – she was so in her head about what it meant to be rejected, that she wasn’t really attending to important social cues from the other kids, or learning from them.  So a bit later on, she was able to contact her value: to be loved and accepted just as I am and to be a really good friend.  Beautiful.  I am actually tearing up thinking of her – she was such a fabulous little one!  While we couldn’t work on changing other kids, we could certainly work on what it meant to be a good friend, what it meant to make space for other people to be who they were, etc.  And she could attend to how she was behaving – whether it was consistent with being a good friend, or whether it was for some other purpose (i.e., to make bad thoughts go away).  In learning what behaviors were consistent with being a good friend, she also had opportunity to observe when others engaged in those behaviors/ when they didn’t, so eventually she would be able to pick and choose children with whom to have relationships – and also to not seek relationships with those who didn’t engaged in “good friendship” behaviors.  It’s interesting to me that sometimes kids who are bullies want more than anything to be friends with those bullies – to be accepted by them is somehow more important than learning how, and when, and with whom, to develop healthy friendships….


          We did a lot of defusion about her thoughts of being a loser – we did monsters on the bus, we labeled each other (she was big loser, I was world’s worst therapist).  By the way, what you ask your client to do, you must do – I firmly believe that in working with children. All of this was a ton of fun.

           

          We also did some work, as you might have guessed reading the above, on her social approach skills, as well as her responses to being bullied.  We role played. I had her show me, through role play, what she did when she was bullied (she wilted, cried, looked at the floor, or curled up in a little ball, which made her more of a target).  I let her bully me – and I pretended to be her – first I did what she had been doing, and asked her how it felt to bully me.  I can tell you, she was pretty good at it!  Then, I told her I was going to try something different.  When she said mean things, I simply stood my ground, looked her in the eyes, and said, “Ok.  And?”  Every time she said a mean thing, I responded the same way.  Then I asked her how that was for her – she said it was much harder to bully me when I was looking at her – and she had a harder time thinking of what to say!  Wasn’t that interesting, I said.  Her homework, then, was simply to try out these two responses to mean things kids said, and to see what happened.

           

          She came back in the following week, and I asked her how it went. She said that the bullies were still there, and they did say mean things, but that it somehow felt “different” when she made eye contact and said “and.” When I asked her how different, she made a muscle with her arm, and said, I felt…powerful!” And she *got* that she could be herself, despite what the bullies were doing.  And she *got* that the words they were saying were just that – words.  Over the next few weeks, while she continued to use this approach, lo and behold, she said the bullies were starting to leave her alone, most likely, I think, because they no longer got a big response out of her – in essence, after we did defusion, she was approaching scary situations, and basically *not rewarding the bullies for their behavior*.  And she felt like she had more room to move about in her life.

           

          We worked on her doing other things that were consistent with her being a good friend – calling a child and asking for a playdate once per week (you must engage parents in supporting this), and continuing to call other kids if the first few weren’t able to do so – or to suggest other dates that might work.  This started with kids she was friendly with at past schools (she had been placed in a new school due to the bullying), but then began to extend to kids at her school where she was.  During her last session, she had been invited to a birthday party – she was ecstatic!

           

          One other thing to note is that it is important to get parents on the same page as you, otherwise they could do things that are unhelpful rather than gently and compassionately supporting a) defusion, b) the emergence of new, fledgling social behaviors, c) letting their *child* do things to help, rather than jumping in to help their child (of course, there are things that parents *can* and *should* do when it comes to bullying – like keep teachers and school administrators aware of the situation, and to gather information from the school as well, etc), which can sometimes send the message that the child is “broken” and can’t do for themselves (which of course supports all of the child’s avoided thoughts that she herself is indeed “broken”).

           

          One other thing that you can have the child do (and I didn’t do it with this case, but have done it with others) is to have the child engage her teachers as a support team.  You can ask the child to say something similar to what one might do in a commitment exercise: Say that she has been having trouble with being bullied, describe what she’s been doing that hasn’t necessarily worked, and then say what her value is (i.e., being a good friend, or whatever), and ask the teacher for help in supporting her.  In doing this, there’s a safety net – the teacher can more closely track the bullying, and be ready to jump in if it escalates, but can also support the client’s efforts to stand her ground, and develop behavior consistent with “being a good friend.”  It also makes an explicit opportunity for the teacher to reward (immediately) emerging social skills (or if your client has no social skills deficits) performing appropriate social skills.

           

          Phew. That’s a lot, and I hope it was helpful – good luck with the case – Louise is right – it is *really* easy to get stuck – here’s to hoping some of these comments will be useful.

           

          Take good care,

           

          Lisa

           



        • tamarblack
          Thank you so much Phil, Louise and Lisa for your wonderful suggestions. Things have improved greatly; however its one step forward two steps back with this
          Message 4 of 7 , Apr 24 6:01 PM
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            Thank you so much Phil, Louise and Lisa for your wonderful suggestions. Things have improved greatly; however its one step forward two steps back with this boy. The school have implemented supervised lunchtime activities every day, especially for him, and he now has an intergration aide for every recess and lunch and in some of his classes. I am training the intergration aide in ACT and working with his parents. At the first session after this post he said he didn't want to go with me that day, and looked really ill at the idea. I said that's ok let's still catch up. I had brought along a bag of my kids musical instruments and suggested that we try singing our difficult thoughts. I used my favourite Louise Hayes line why don't we try this as an experiment and see what happens. He asked whether I had a guitar. So off we went and found a guitar. He says I can't really play guitar and he wouldn't even pick it up. At first he wouldn't share any difficult thoughts and kept telling me lots of positive thoughts. I modelled difficult thoughts and began to sing them. He copied; singing "I'm not a very good mummy". And then I suggested that maybe we could do a dance at the same time. Then came the magic of ACT. He suggested an african dance, and sang his heart out "I'm mean, no one likes me, they don't want to play with me, I'm mean to my parents, my sister, my grandparents". And this was while waving his hands in the air and stamping his feet. I joined in the dancing too and we both laughed and laughed. Then he picked up the guitar and began to play. Now before we started you could feel the tension, he was so resistant and I was so fused with my expectations of myself as the therapist. Perhaps the greatest flexibility and willingess was around the venue; I didn't do this in my office because I didn't want to risk anyone knocking on the door or worse walking in. I needed a quiet space with no windows or see through door. The only available space was the uniform shop, I thought it was a great opportunity to model some flexibility so there we stood in between the clothing racks!
            This defusion exercise did so much for building rappore. Every time he sees me now at school in the yard or corridor he comes up and says hello and wishes me a nice day or similar. He has started playing with kids at school; they responded really well to him, however if he experiences any difficulties it sets him straight back to the library, and when things get too challenging or difficult in my sessions he asks to go back to class.
            Regards
            Tamar

            --- In kidact@yahoogroups.com, louise hayes <louisehayes@...> wrote:
            >
            > LIsa,
            > that is beautiful. I'm tearing up too. What a fabulous example of values work in a non-talky active and fun way.
            >
            > I have to smile at "the world's worst therapist" ;-) She would have loved that. And my guess is that it would have helped her get the concept that our thoughts can be so far from reality.
            >
            >
            > cheers,
            > Louise
            >
            >
            > Dr Louise Hayes,
            > PhD, MAPS, Clinical Psychologist
            >
            > Senior Lecturer
            > School of Behavioural, Social Sciences & Humanities
            > University of Ballarat
            > P.O. Box 663,
            > Mt Helen, Victoria, 3353
            > Phone: 0423 770 975
            > email: louisehayes@...
            > email: l.hayes@...
            >
            > On 18/03/2011, at 12:18 AM, Lisa Coyne wrote:
            >
            > >
            > > Hi Tamar,
            > >
            > >
            > >
            > > This is great advice from Louise – I think she's right on the money – you should try everything she says!! To add to that, in my experience working with kids like this, it is important to carefully tease apart with them what they value, and how they are "valuing." This is incredibly important because many kids who are bullied and desperate to be friends with other kids are engaging in social approach, or attention seeking behaviors that are for the purpose of making thoughts of "I am a loser" or "If I don't have friends, I am a miserable failure," etc. Sometimes, social approach, when it's intention is to make those things go away, appears to other kids as desperate, and will be aversive to them. In addition, engagement in those sorts of behaviors for that purpose, although that*looks* like the child is "approaching," may actually be a sign of more experiential avoidance. Thus, doing values work with this type of child is very difficult, and tricky. The reason it's tricky is that you, as the therapist, and certainly, your client, can't control what others do. So you can't really work on "making bullies stop" (you could of course work with the school system, and that's a good thing too, but that's another conversation!), or "making other kids like" your client. What you *can* do, however, is see what's at the core of these behaviors – what makes it hurt so much when your client gets bullied? There's a value there. So, once you get to that painful content, defuse, defuse, defuse, and then also see what's most important to your little one.
            > >
            > >
            > >
            > > To illustrate, I had an 11 year old with very similar issues – she was a beautiful little girl, and I couldn't imagine why she was bullied. But her social approaches were awkward, sycophantic, and she tended to be either clingy or irritating to other kids in her social interactions. We discovered that she had been working on getting kids to like her/getting bullies to stop, and I think that's why her social approaches were so awkward – she was so in her head about what it meant to be rejected, that she wasn't really attending to important social cues from the other kids, or learning from them. So a bit later on, she was able to contact her value: to be loved and accepted just as I am and to be a really good friend. Beautiful. I am actually tearing up thinking of her – she was such a fabulous little one! While we couldn't work on changing other kids, we could certainly work on what it meant to be a good friend, what it meant to make space for other people to be who they were, etc. And she could attend to how she was behaving – whether it was consistent with being a good friend, or whether it was for some other purpose (i.e., to make bad thoughts go away). In learning what behaviors were consistent with being a good friend, she also had opportunity to observe when others engaged in those behaviors/ when they didn't, so eventually she would be able to pick and choose children with whom to have relationships – and also to not seek relationships with those who didn't engaged in "good friendship" behaviors. It's interesting to me that sometimes kids who are bullies want more than anything to be friends with those bullies – to be accepted by them is somehow more important than learning how, and when, and with whom, to develop healthy friendships….
            > >
            > >
            > > We did a lot of defusion about her thoughts of being a loser – we did monsters on the bus, we labeled each other (she was big loser, I was world's worst therapist). By the way, what you ask your client to do, you must do – I firmly believe that in working with children. All of this was a ton of fun.
            > >
            > >
            > >
            > > We also did some work, as you might have guessed reading the above, on her social approach skills, as well as her responses to being bullied. We role played. I had her show me, through role play, what she did when she was bullied (she wilted, cried, looked at the floor, or curled up in a little ball, which made her more of a target). I let her bully me – and I pretended to be her – first I did what she had been doing, and asked her how it felt to bully me. I can tell you, she was pretty good at it! Then, I told her I was going to try something different. When she said mean things, I simply stood my ground, looked her in the eyes, and said, "Ok. And?" Every time she said a mean thing, I responded the same way. Then I asked her how that was for her – she said it was much harder to bully me when I was looking at her – and she had a harder time thinking of what to say! Wasn't that interesting, I said. Her homework, then, was simply to try out these two responses to mean things kids said, and to see what happened.
            > >
            > >
            > >
            > > She came back in the following week, and I asked her how it went. She said that the bullies were still there, and they did say mean things, but that it somehow felt "different" when she made eye contact and said "and." When I asked her how different, she made a muscle with her arm, and said, I felt…powerful!" And she *got* that she could be herself, despite what the bullies were doing. And she *got* that the words they were saying were just that – words. Over the next few weeks, while she continued to use this approach, lo and behold, she said the bullies were starting to leave her alone, most likely, I think, because they no longer got a big response out of her – in essence, after we did defusion, she was approaching scary situations, and basically *not rewarding the bullies for their behavior*. And she felt like she had more room to move about in her life.
            > >
            > >
            > >
            > > We worked on her doing other things that were consistent with her being a good friend – calling a child and asking for a playdate once per week (you must engage parents in supporting this), and continuing to call other kids if the first few weren't able to do so – or to suggest other dates that might work. This started with kids she was friendly with at past schools (she had been placed in a new school due to the bullying), but then began to extend to kids at her school where she was. During her last session, she had been invited to a birthday party – she was ecstatic!
            > >
            > >
            > >
            > > One other thing to note is that it is important to get parents on the same page as you, otherwise they could do things that are unhelpful rather than gently and compassionately supporting a) defusion, b) the emergence of new, fledgling social behaviors, c) letting their *child* do things to help, rather than jumping in to help their child (of course, there are things that parents *can* and *should* do when it comes to bullying – like keep teachers and school administrators aware of the situation, and to gather information from the school as well, etc), which can sometimes send the message that the child is "broken" and can't do for themselves (which of course supports all of the child's avoided thoughts that she herself is indeed "broken").
            > >
            > >
            > >
            > > One other thing that you can have the child do (and I didn't do it with this case, but have done it with others) is to have the child engage her teachers as a support team. You can ask the child to say something similar to what one might do in a commitment exercise: Say that she has been having trouble with being bullied, describe what she's been doing that hasn't necessarily worked, and then say what her value is (i.e., being a good friend, or whatever), and ask the teacher for help in supporting her. In doing this, there's a safety net – the teacher can more closely track the bullying, and be ready to jump in if it escalates, but can also support the client's efforts to stand her ground, and develop behavior consistent with "being a good friend." It also makes an explicit opportunity for the teacher to reward (immediately) emerging social skills (or if your client has no social skills deficits) performing appropriate social skills.
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            > > Phew. That's a lot, and I hope it was helpful – good luck with the case – Louise is right – it is *really* easy to get stuck – here's to hoping some of these comments will be useful.
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            > > Take good care,
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            > >
            > >
            > > Lisa
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