Intervention Protocol Facilitation Book

KOPLOW, KATHERINE-PRT 5360
Intervention Protocol

Program Title: Coping Skills Resources

General Statement of Purpose:
This program provides interventions that improves the ability of the client to develop coping
resources to manage difficult situations including times of being overwhelmed, intensified sensory
input, and environmental factors, especially during routine change.

Description:
Coping skills are taught and practiced within a small group, using the teach and repeat method.
Programs will identify clients trigger points that heighten anxiety and help develop ways of coping
during times of change. Provide resources to help comfort the client and provide them with
strategies that include seeking help, increasing use of language, taking a break, and defining needs
that help provide positive coping.

The program will use trial and error where the client will be placed in different situations and asked
to use their previously developed skills. Prior to this activity the therapist will help client realize an
appropriate balanced sensory diet and understand their triggers and stressors. Social stories will be
used to help talk the client through different situations and prepare them for the next activity. Once
the client has identified these key problem areas they will be placed into different scenarios to
practice the skills. The therapist will provide adequate transition time but will encourage the client
to try to engage like other friends and family members would in that given situation.

Client problems:
Problems might include:

Impairment in social interaction and communication
- Deficits in social-emotional reciprocity
- Deficits in nonverbal communicative behaviors used for social interactions
- Deficits in developing, maintain, and understanding relationships
Behavior
- Restricted, repetitive patterns of behavior, interests, or activities
- Stereotyped or repetitive motor movements, use of objects, or speech
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal and
nonverbal behavior
- Highly restricted, fixated interests that are abnormal in intensity or focus, strong attachment to
or preoccupation with unusual objects
- Hyper- or hypo- reactive of sensory input or unusual interests in sensory aspects of the
environment

Referral Criteria: Clients are referred to RT program if demonstrating any of the above problems.
Clients that have a difficult time handling change in their daily routine would benefit from this
program. Those clients that use vocal stimulations or object fixation during a time of discomfort or
change will benefit from learning new ways to handle transitions. Clients that are lacking language
skills but have the ability to learn when provided extra resources would benefit in learning how to
communicate feelings with caregiver.

Contraindicated Criteria: Clients that are not recommended for this therapy are those who are on
a the farther end of the Autism Spectrum Disorder and are unable to work in a group setting, or who
have such intense object fixation that providing coping mechanisms at this point would not be
beneficial. Those who have language and social skill interactions but are unable to work with others
to express feelings either verbally or through alternative methods such as writing out feelings or
expressing through photos would not benefit from this therapy program.

Intervention activities or techniques:

Coping Tree
Coping Skills
Psychotherapy
Name of Activity: Coping Tree

Population: Children with Autism Spectrum Disorder (ASD), with diverse cultures and race, receiving
care for emotional, behavioral, and psychiatric problems.

Age: Latency aged, 6-14 years old.

Group Size: 6

Setting Considerations:
Comfortable environment. This activity can be done in many locations. It requires the use of
tables and chairs for the craft. If possible, and weather permitting, it would be nice to do it
outside under/near trees.

Group Stage Considerations:
Storming and Norming stage
- Clients need to be willing to test out a new concept or skill.
- Clients need to be committed towards the group and task. Trust should be built and the client
should be willing to work towards individual and group goals.

Purpose/Goals:
To expand coping skills by identifying specific coping skill components.

Supplies Needed:
colored paper (tree colors)
markers and colored pencils
glue
pens
stencil of parts of a tree (roots, branches, trunk, leaves, fruit)
The Giving Tree by Shel Silverstein

Intervention Description:
A tree is a universal and familiar object that can be used as a metaphor. There are six parts of a tree:
root, bark, trunk, branches, leaves, and fruit. This intervention will correspond the six parts of a tree
with six coping components: attitudes, patterns, goals, activities, strength, and trust.
Start group with a review of group rules. Ask members to follow the rules and review
consequences for noncompliance.

Ask if anyone has anything they want to share before getting started.
Start asking questions about the different parts of a tree:
a) The root does what for the tree? (It provides a foundation, or it is the beginning of a
tree)
b) How does the trunk help the tree? (It supports it, or it holds it up)
c) What do the branches do? (They balance the tree, or they maintain its equilibrium)
d) What function do the leaves or fruit serve? (They are the end result, or they represent
the active part of the tree)
e) Why does a tree need nourishment? (Its necessary for growth, or without water, air or
care it wont live)
Have clients cut out the parts of a tree.
Explain the different parts of the tree and how they can correlate to a coping skill and a way that
the client can be in control of themselves.

-The root: 1. YOUR ANCHOR: How you think/ what keeps your
grounded?
a) What is a word for how you think? (Attitude)

- The trunk: 2. YOUR SUPPORT: Where you go for help/ who
encourages, cares and helps you?
b) What is a word for where you go for help? (Support)

- The branches: 3. YOUR BALANCE: How do you maintain/take care
of yourself?
c) What is a word for how you maintain or take care of yourself? (Balance)

- The leaves: 4. YOUR SOURCE OF ENERGY: What you do with your
life/ what keeps you going/ what gives you hope?

- The fruit: 5. YOUR REWARD: What do you want for yourself?
d) What is a word for what you do with your time? (Meaningful activities)

- The bark 6. YOUR PROTECTION: what is your defense
mechanism, what works and what doesnt?
e) Where doe your strength come from? (Inner strength/spirit)

Glue together the tree and write their answer to the coping skill on the designated part of the
tree. (Ex: SUPPORT is written on the trunk of the tree and client might write my support
comes from my dad, he helps me when Im frustrated.)

Special Considerations or Risks:
If a child needs additional attention, be prepares to have a tech sit next to them for additional
prompting, encouragement and direction.
Be aware of specific behavior plans that have been designed by the clients treatment team.
Facilitator should be aware of the skill level each group member has. Because ASD is so varied,
some members might not be able to engage in the activity.

Possible Discussion Questions:
1. Remembering
o How many coping skills/strategies were you able to come up with?
o What is the best coping skill, for you personally, that we discussed today?
2. Understanding
o What is a word for how you think?
o What is a word for where you go for help?
o What is a word for how you maintain or take care of yourself?
o What is a word for what you do with your time?
o Where doe your strength comes from?

3. Applying
o How does your attitude towards things help you to cope better in a hard situation?
o Where you go for help?
o Who encourages, cares and helps you?
o How do you maintain/take care of yourself?
o What do you want for yourself?
o What is your defense mechanism?

4. Analyzing
o What works and what doesnt work?
o What motive is there for you to use these coping skills?
o How can being grounded help you in hard situations?
o What do you want to do with your life/ what keeps you going/ what gives you hope?
o What keeps your grounded?

5. Evaluating
o Is there a better solution than getting upset?
o What do you think you can do in the future with these new skills?
o How would you handle _________ situation?
o How would you feel if you had complete control of how you handled situations?
o Do you believe the resources you identified can help you?

6. Creating
o Can you design a plan to help you next time you feel overwhelm or upset?
o How would you test your coping skills in a safe environment?
o What would happen if you shared your coping skills with your support system and
friends?

Possible Group or Individual Assignments:
Challenge group to incorporate their coping skills into their daily life as homework and check
up on them during next RT group.

Modification or Adaptations:
There should be previously made trees for those who have difficulty crafting.
Be prepared to verbalize the entire activity and conduct group discussion rather than individual
reflection.
Have a large tree made and have clients write on the large tree or have them verbalize and you
write on the tree.
Be prepared to define and modify the questions depending on cognitive ability of each group
member.

Source: Life Management Skills V, pp. 8, S.E.A.L.S. III pp. 1

K. Koplow, TRS, CTRS
March 5
th
, 2014

Musical Coping
Coping Skills
Game-like activity

Name of Activity: Musical Coping



Group Size: 6

Room should have comfortable chairs and room to play the game musical chairs. Day room
would work for this kind of activity. Should be able to close the door so music doesnt affect
surroundings. Make sure that music is loud enough and participants are able to have a writing
surface if needed.

Forming and Storming
- Clients have the opportunity to get to know each other more by sharing their favorite music
and opening up by expressing themselves through a song.
- Clients are also able to test out a new concept or skill.

Purpose/Goals:
To introduce the concept of using music as a coping skill.

Supplies Needed:
Something to play music, be it a computer or stereo
CDs or list of music downloaded to share with group
Chairs
Pens and paper

Group members should come to group having already given the facilitator a name of their favorite
song.
Start the group by playing musical chairs. Use a variety of genres of music while playing and
play until there is a winner.
Talk about the different types of music (Jazz, rock, soul, religious, country, orchestral, classical,
easy listening, nature themes, choral)
Try to associate them with expressions and feelings.
Share each group members personal song. Have members sit in a comfortable position and
listen and journal about how the music makes them feel and words and lyrics that stand out.
Have members express different things that they need help coping with. Translate their feelings
into words of emotion and have them identify 3 emotions or situations that they need help
coping with. Start to identify different styles and kinds of music that might help them release
those feelings and cope during that situation.
Have group members share personal ways that music has affected them.
Try to connect members that share similar interests and coping mechanisms while using music.

Since clients are sharing their own music, music must be listened to and approved before
sharing occurs with the group.
Ensure that all music is group appropriate and something that will contribute to the group in a
positive manner

1. Remembering
o How many different types of music do you know?
o What is you favorite type of music?
o Describe what happened when the music stopped and you were running around trying to
find a chair?
o Which other group member has similar taste in music to you?
o What is a favorite musical memory?

2. Understanding
o What would happen if you where in a place where music was playing that you didnt like?
o Can you explain how you felt when you didnt have a chair to sit in?
o Can you tell me what the main idea behind you favorite song?
o What differences exist between your song choice and your peers song choice?
o What do you think the main idea behind this group is?
o When listening to your favorite music how does it make you feel?

3. Applying
o Could you use music as a coping skill?
o What factors would change if instead of getting upset you pulled out your iPod and listened
to your favorite song?
o Can you name a situation where using music to help you cope might he helpful?
o Which kind of music helps during stressful periods?

4. Analyzing
o Can you explain what happened inside when you were listening to a song you didnt like?
o Can you distinguish between being upset due to your environment and being upset due to
internal issues?
o What are some motives behind using music to help you calm down?
o What could be a positive outcome if you spent time listening to music when you identified
yourself needing a coping skill?
o Do certain songs trigger memories? How do you deal with those?

5. Evaluating
o Is there a better solution to letting someone know you are upset due to your environment
than getting upset about it?
o Do you think telling someone that the noise in the room is making you upset or anxious is a
good or bad thing?
o How would you handle a situation where the noise was too loud?
o Do you believe that listening to your favorite song could be a good coping skill?
o How can you use music as a coping skill?

6. Creating
o Can you design a playlist of music that helps match your mood?
o Could you write your own song about how you are feeling?
o Would you consider journaling about the way different kinds of music make you feel?
o How many ways can you use music to help you during your day?
o Have you considered using your resources to help you deal with loud environments?

Challenge group members to listen to music when they find themselves upset. Have them
journal their experience and bring it back to RT group the next week as well as share with
others their experience.
Give clients a list of song that they can listen to when they are upset.
See if they can create their own playlist of music that helps them when they are experiencing
different emotions.

Look up music in a computer room during group.
Clients might need help discovering music for their playlist or for the group sharing. This
should be figured out before so clients are able to have the resources to participate.
Arrange for staff worker to help supervise client while discovering music online.
Provide a CD or iPod so client can have music to listen to during free time.
Be aware that children on the ASD might have sensitivity to loud sounds and noises. Playing
music during group might make some upset if the noise is hard for the client to listen to.

Source: Life Management Skills V, pp. 12

March 5
th
, 2014

Calming Bottles
Coping Skills
Craft

Name of Activity: Calming bottle



Group Size: 6

Day room where a craft can be done. Make sure there is enough room to do a craft. The glitter
will get everywhere; consider being in a room without carpet for easy clean up.
Water has to be warm to help melt the glue to make sure you have access to an outlet.

Forming
-This group would be best to help group members get to know each other and build
relationship together. The casual conversation that takes place during the craft could help build trust,
and eliminate anxiety, discomfort, and allow for testing out of group.

Purpose/Goals:
To encourage cooperative social interactions by taking-turns and sharing using coping skills to
remain calm and comfortable in situation.

Supplies Needed:
Water bottle
Water
Glitter glue and glitter
Tacky glue
Superglue (for therapist use only)
Water heater (electric tea kettle or access to hot water from bathroom)

Ask the children if they know what causes them to get upset, frustrated, agitated, distracted,
anxious, or stressed.
Explain that we will be making a calming bottle that they can play with when they are having
those emotions.
Make the calming bottle: put water, glues and glitter in the bottle. Have the therapist or tech
super glue shut the lid so the group members cant open the bottle.
Have kids play with their bottle and talk about how they feel when using it and when they might
use it.

The glitter bottles might become a fixation for this population of clients. Make sure the bottle is
used as a coping mechanism, a way to calm self when under anxiety and feeling frustration.

1. Remembering
o What happened when we added the glitter?
o Can you tell me why we used hot water?
o Who spoke about ____ being something that makes them frustrated?
o What do you like about your bottle?

2. Understanding
o Can you tell me why this would be a good coping skill?
o What was the main idea of this craft?
o What do you think you could do next after calming down?

3. Applying
o What would you change about your bottle or how it looks?
o Can you provide an example of when it would be helpful to use this coping bottle?
o Do you know another situation in your life where holding this bottle could help you?
o What question do you need to ask yourself to figure out when to use the coping bottle?

4. Analyzing
o How is this coping skill different then others that you use?
o Can you explain how you felt when using the coping bottle?
o What is the motive behind using the calming bottle to help you cope versus another
skill?
o What is the problem with the coping bottle?

5. Evaluating
o Is this a good strategy for you when trying to cope?
o Do you think this bottle is a good or bad thing?
o How effective is this during a hard situation?

6. Creating
o Can you turn your others coping skills into a tangible object?
o What would happen if you used sand instead of water and glitter?
o How many ways can you use this bottle?
o Can you create another way to help you calm down other than using the calming bottle?

Write down when you use the bottle and why, in a pocket journal that the clients carry around
with them.
Challenge the group to use their bottle once a day and see if it makes a difference at all.

Have bottle already made or have most of the stuff already put into the bottle so client just has
to add glitter or water.
Add other things into the water instead of glitter.
Do the activity with a larger bottle, sand and little treasures. Make a treasure hunt inside a
sandglass type container.

Source: Jamie, TRS at University Neuropsychiatric Institute

March 5
th
, 2014

Its Your Choice
Coping Skills
Psychotherapy


Name of Activity: Its Your Choice



Group Size: 6

Typical day treatment room/activity room with a table and chairs

Norming. Performing, Adjourning
- The group needs to be committed towards group goals and be ready to meet their individual
needs.
- The group needs to be willing to accomplish their task and be focused.
- Group should be willing to compliment each other and recognized others strengths.
- This intervention could be used to end a serious of groups and bring closure to the
experience helping challenge and lead the clients to end therapy in a positive and
encouraging way.

Purpose/Goals:
Help group members facilitate health choices and coping skills when lifes situations become
difficult.

Supplies Needed:
Pens/pencils
Color pencils/ highlighters
Its your choice! handout

Talk about the word choice and ask group to share how they react to various situations
(choice-Synonyms: free will, opportunity, selection, option and decision).
Pass out handout and read over it as a group.
Allow time for group members to review alone and fill out blank sections.
Have group circle or highlight the ones they used in a positive and negative way, using two
different colors
Talk about which coping strategies they want to keep and which ones they want to stop doing.
Talk about future ways to handle situations.
Ask group members to share what they wrote in the 3
rd
column.
Ask them all to pick one positive they are proud of and one negative they want to keep working
on.
Challenge group members to work on the negative coping strategy this week and journal about
it.
Process by helping give healthy choices and giving them the support necessary to make that
choice.

Depending where the client lies on the ASD they might need help filling out worksheet.
This activity could also be done verbally and have the facilitator read the positive and negative
ways to handle situations and talk as a group how individuals handle situations and which ones
they are proud of, and which ones they want to keep improving on.

1. Remembering
o How many positive strategies do you have? How many negative?
o Can you name the strategy you are going to work on?
o Which strategy do you feel proud of?
o Who spoke about a choice they made that you relate too?
o Who in the group will help you work on your negative strategy?
o What happened when you were filling out how you might handle a choice?
o What are some new strategies that you have developed?

2. Understanding
o Can you write in your own words how to change a negative choice into a positive
choice?
o What would happen if you handled the negative situations differently?
o Give an example of one of your positive strategies.
o Give an example of one of your negative strategies.

3. Applying
o Do you know another instance where you could change the way you handle the situation
and make a better choice?
o Can you apply other coping skills you have learned to help you make more positive
choices?
o Would this information be useful if you had more examples of positive ways to handle a
choice?
o What are the results of handling a situation in a positive way?
o What are the results of handling a situation in a negative way?
o What is the main idea of this worksheet?

4. Analyzing
o What is the function of a positive coping skill?
o What conclusions might you make from looking at the positive and negative choices you
choose to make?
o What is the main idea of this group?
o What can you conclude about the way you make choices?
o What is the relationship between a positive choices and good coping skills?
o What are some of the motives you have for making a positive choice?
o What is a turning point that helped you change the way you respond to a decision?
o Can you distinguish between and positive and negative mindset when making a choice?

5. Evaluating
o What changes to what you wrote down as a way you handle making a choice do you
need to work on?
o How effective are strategies to help you make a positive choice?
o What influence will negative/positive choices have on your life?
o How would you handle ________ situation with your new coping skills?

6. Creating
o Can you design a plan to help you make better choices?
o Can you see a possible solution to change some of your negative strategies into positive
strategies?
o How would you test your new coping skills?
o Can you state a new rule you will try and follow when dealing with ____ situation?
o If you had access to all resources, how would you deal with ____ negative situation?

Journal about trying to improve on the negative coping strategy and bring results to next group.
Ask another group member or someone on their support team to help the individual when they
are handling a situation in a negative way.

Combine Musical Coping intervention and Its your Choice! to make intervention longer or
teach a practical positive choice skill.

Source: Life Management Skills V, p. 13

March 5
th
, 2014

Lifes Obstacles
Coping Skills
Challenge activity

Name of Activity: Lifes Obstacles



Group Size: 6

Outside space
Large activity room
In the middle of street/parking lot if it is safe and patients are allowed out.

Norming and Performing stages
-This activity would be a good for helping members gain a greater level of cohesiveness
and commitment towards group and individual goals, and work on building trust.
- Help focus on the task at hand and work on problem solving. Group members also have the
opportunity to encourage and compliment each other.

Purpose/Goals:
To identify lifes paths, obstacles and lessons learned and how to cope with the situation
presented

Supplies Needed:
Cones
Rings
Hula hoops
Balls
Rope
Dots

Explain how everyones life has ups and downs. People have disappointments; obstacles affect
their achievement and cause setbacks. People make mistakes but being able to handle these
difficult situations can help lead to growth and joy. Ask frontloading questions.
Ask group to give an example of a lesson they learned from an obstacle.
Have members do the obstacle course already set up. Make the group members go through the
maze one at a time.
After, ask them how they felt when there was a ROAD CLOSED?
Ask them what happened if they WENT TOO FAST.
What happened when they were waiting for another group member to finish and were STUCK
IN TRAFFIC.
What happened if they got distracted or werent PAYING ATTENTION.
Ask the group members some of the strategies they used to get through the obstacle course.
Ask group to talk about where they are in life currently: physically, emotionally and spiritually.
How did they get there?
Review each members current obstacle and have them talk about a way to cope with that.

Make sure group members are capable of going through obstacle course and listening to
directions.
Be aware of personal space issues.
If using a blindfold make sure the client is safe and guided appropriately to prevent any injuries.

1. Remembering
o When doing the maze where did you feel blocked? Where did you feel like you were
going too fast? When did you feel like you were stuck in traffic?
o When did you think you forgot to pay attention?
o How many obstacles did you encounter?
o What happened while you were waiting for your turn?
o Can you describe what happened when you got stopped or blocked?

2. Understanding
o What was frustrating for you?
o What do you think the main idea of this obstacle course was?
o Can you see the correlation between physical blocks and mental block?
o Can you give an example of a time when there was a ROAD CLOSED in your life?
o What happened when you go distracted or werent PAYING ATTENTION?
o Can you provide an example of how you dealt with the challenges?

3. Applying
o Do you think you can cross lifes obstacles alone?
o What happens when you go TOO FAST through life/ through the obstacle?
o Could these obstacles happen in real life?
o What factors would you change about how you deal with lifes obstacles after this
intervention?

4. Analyzing
o What did you gain from participating in todays session?
o How can this relate to you developing greater coping skills?
o What part of your life do you feel like you have run out of gas or got stopped by the
police?
o What strategies did you use to get through the obstacles?

5. Evaluating
o Who can help you in the future deal with transitioning?
o Is there a better solution to handling your ROAD BLOCKS?
o Do you think going fast is a good or bad thing?
o What changes to your current situation are you going to make?
o Do you believe that you can reflect on this physical obstacle course to help you with
your lifes challenges?
o How effective would it be to list out your obstacles and think about the way you are
handling them?

6. Creating
o Create a list of all the challenges you are facing. How are you dealing with them and
what coping skilling are you using to handle them?
o Why dont you devise your own key to get through your obstacles?
o Can you compare any thing you face when driving with the things you are facing in your
life right now?
o What would happen if your road was open and free? How do you get your life to be that
way? What skills are you using to help clear your path?

Give group members time to journal or write down obstacles they have encountered in their life.
And let them reflect on ways they can use their new coping skills to help over come those.

Add additional objects to the obstacle course to make it more challenging.
Have group members help each other through the course.
Blindfold the group member and require them to be guided by someone else or listen to
directions to make it through the course.
Have the group walk through it together if it is too challenging.
Take a drive and go through all the obstacles: being stopped at a light, waiting in traffic, going
too fast, being distracted and process based off a drive.

Source:
Rohnke, K. &Butler, S. (1995). Quicksilver. (pp. 146-147). Dubuque. IA: Kendall/Hunt Publishing
Company.

Life Management Skills VIII, p. 14

March 5
th
, 2014

Staff training/certification requirements:
Training:
-TRS licensing
- Experience working with children with autism
-Behavioral management training
Certifications:
-CTRS National Council for Therapeutic Recreation Certification
-First Aid

Risk management considerations:
- Therapist will be aware of outburst and violent reactions when clients are placed in new
situations
- Therapists will need to ensure that the surrounding areas are clear of any materials that could be
used to cause harm to others.
- Objects that could be used as a fixation should be eliminated but some children might not be
able to function without them.
- Therapists should be considerate of the lighting and noise in the room. The client should be able
to handle loud noises and communicate that different lighting is bothersome but while giving
instructions and teaching this could be a major distraction.

Outcomes expected:
- Based on the level of functioning of the individual the RT will provide methods and resources
to help the individual develop coping skills and provide them with resources to help during
difficult situations, especially routine change.
- Client will demonstrate new resources when place into a strange situation and required to use
coping skills to help them handle the change in routine.
- Based on the level of functioning of the individual the RT will provide social skills resources by
developing psychological, social and environmental resources.
- This will help the client develop resources to help engagement with others in an appropriate
way. The RT will provide mindful leisure opportunities to help them understand current
personal issues that prevent social interactions and build upon their virtuous leisure skills so
they can use their strengths to help them confidently engage with others. Client will demonstrate
new skills by successfully interacting with 5 people in five different settings

Program evaluation:
In order to ensure positive client outcomes, which match the desired outcomes for the leisure and well-
being model we will do direct observation of client in a normal setting and if their level of functioning
is high enough we will interview the client and see if they achieved their personal goals. Developed
program outcome evaluations and client outcomes will also be used to evaluate the program.

Katherine Koplow, TRS, CTRS
March 5
th
, 2014

Websites:
http://www.education.com/reference/article/strategies-help-children-autism-cope/
http://www.fraser.org/Fraser/media/Assets/pdfs/Developing-Appropriate-Coping-Skills-in-Children-with-Autism.pdf
http://www.hopenetwork.org/Behavioral-Health/Autism/Education/Autistic-Disorder/Tools-for-Parents/Skill-Building-
Activities.aspx
http://sfxhosted.exlibrisgroup.com/uutah/img/ajaxtabs/transparentpixel.png
http://parentcoachingforautism.com/2011/04/strategies-to-help-child-with-autism-cope-with-anxiety-and-stress/

Intervention Protocol Facilitation Book

Загружено:

Сведения о документе

Оригинальное название

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Intervention Protocol Facilitation Book

Загружено:

Авторское право:

Доступные форматы

KOPLOW, KATHERINE-PRT 5360

Вам также может понравиться