a) Communication Skills.
b) Anger Management & Assertiveness. c) Life & Social Skills.
d) Alcohol/Substance Abuse. e) Mental Health Management.
Daniel T Wilcox
Consultant Clinical & Forensic Psychologist Wilcox Psychological Associates
Mary Leyland Probation Officer
APPENDIX VI
Learning Disabilities Group Work
Introduction
Depending on the level of disability of clients involved in the group, the duration of each segment o f the programme may vary. Further, since intellectually disabled individuals find it especially difficult to acquire new skills and competencies in the areas focused upon, there is need to proceed cautiously and use a wide range of techniques to reinforce learning. These include: drama, art, role-play, relaxation, and imaginai work as well as various physically engaging activities. There is a particularly strong emphasis placed on using a multi-sensorial approach to treatment and a substantial reliance on homework to confirm that positive changes are occurring and being maintained.
Outline Programme
Module Exercises
1. Introductions * Paired introductions with feedback to group.
* Establishing Group Rules. * Workers facilitate identification o f group rules — Group Think with Flipchart.
* Group members are told that they are * Work is done to clarify different‘effort’ requirements for marked for attendance, appearance and each group member.
effort.
2. Motivation & Risk Assessment * Writing out and role playing offence stories.
3. Relationship Mapping * Bring family/significant others including Probation
Officer and Social Worker to session. * Social Atom exercise.
4. Establish contracts with clients and carers * Agree client needs and responsibilities for all the individual contributing.
* Clarifying aims and values for Individual * Group participation, board exercise - list out purpose(s)
and group success o f group.
* Introduce TRACK strategy. Therapy is about:
(working) Together
Respecting yourself and others (being) Accountable for your own actions (being) Committed to change and
Keeping Track
5. Understanding Self-Talk * * Establishing Cognitive Behavioural (C/B) *
Labels
* Develop Individual Body Tracing - * Review in Group
* Do Body Shape Presentations *
* Consequences o f Old Me Behaviour Dangerous Self Talk Versus
New Me/Smart S elf Talk 6. Health Sexuality & Masculinity
7. Finkelhor Steps
* Review Healthy Masculinity in relation to offending
Further Cognitive Behavioural Work * addressing S elf Talk patterns
Coping Skills *
Victim Harm - Reviews consequences to all concerned
Pen Exercise.
Paired exercise to discuss and define:
Smart S elf Talk, Dangerous Self Talk, Set Up Situations, Old Me and N ew Me.
Do Body Shapes with worker input. Identify above Self Talk Labels and add Consequences, Triggers, Alternatives, Stop & Go Statements.
Client’s individually present their body shape exercises, adding detail to their own work as relevant information emerges from subsequent presentations.
Emphasis on identifying pro-offending thoughts. Seemingly Irrelevant Decisions (S.I.D.’s) and ways to stop the Cognitive Behaviour offence chain earlier. Self fulfilling prophecy role play with group examples. Self Concept and “I like/I dislike”.
Body Image Exercises. Sex and Sexuality Education.
Write or Draw about the characteristics o f a “Good Man” and his relationships.
Board Exercise re: Abuse versus Non-Abuse and Sexual versus Non-Sexual thoughts.
Paired Exercises clarifying whether abuse is occurring in scenarios given to group members.
Use Chairs or Islands to review pro-offending thinking for each step in Group Exercises.
Use “Good Man” exercise. Identify someone who fits client’s criteria. Role-play this person through abuse steps to identify alternatives.
Do Finkelhor Steps with Smart Talk and Dangerous Talk at each o f the four steps. Use one group member in each chair to ‘help’ the individual who is doing the steps o f his offence story.
Group and paired work identifying behaviour patterns, e.g. ‘poor m e’, ‘left out’, ‘me first’, ‘bully’, ‘shut down’, ‘I can’t’.
Re-framing exercises involving role-play, impulse control work and assertiveness, communication skills etc. for modifying self talk patterns.
Individual work as needed.
Role reversal with victim to add detail to offence story. Also to get further information about empathie concern, emotional congruence, perspective taking and possible psychopathy.
Exercise in pairs identify someone you would wish to protect and not take advantage o f - sexual or non-sexual theme.
* What did you tell yourself about your offending to make it all right to do? * Review and refute distorted beliefs
10. Fantasy and Masturbation
11. Further Work on S elf Image and Social Competency
Identify social skills deficits and work to improve personal effectiveness
Review o f Pro-offending interests, moods and lifestyles
12. Consequences o f Abuse to Self
* Relapse Prevention
* Pairs and group work.
* Flipchart offence justifications. * Blame cake.
* Paired exercised in group.
* Collage exercise pro-offending attitudes. * Billboard homework - ‘Keeping Kids Safe’.
* List S elf Talk statements relating to targeting, grooming and overcoming the victim’s resistance and discuss in group.
* Flipchart - Misconceptions.
* Fantasy as the step before Finkelhor.
* Exercise - Is it okay to talk about secret fantasies?
* Why?
* Group and paired work identifying personal characteristics - Self Image building exercise e.g. “Things I like about me whether I’m in a good or bad mood”.
* Assisted Work with Social Skills Survey.
* Identify key areas to work on and incorporate into specific ‘effort objectives’ for group and outside.
* use o f Guided Fantasy/Imagery.
* Group and individual review o f offence related problems - Alcohol/Substance Abuse, Anger Management issues. Assertiveness work and Mental Health management as they relate to each group member. Exercises “Pendulum o f Responsibility”.
* Demonstrate ability to effectively use Stop statements, e.g. Police, Court, Prison, Family (Shame, Harm, Break- Up) and alternative realistic Go statements.
* Include significant others in the last module. * Exercises reinforcing ‘N ew M e’ self-image. * Identify specific new competencies. * List strategies to reduce risk.
* Use behavioural (bus example) exercise and evaluate response latency for hypothetical risk situations.
* Do Relapse Prevention Questionnaire.
Daniel T Wilcox
Consultant Clinical & Forensic Psychologist Wilcox Psychological Associates
Mary Leyland Probation Officer
West Midlands Probation Service