• Clinical Services

    Theory of Change

    People are the sum total of what they think. Change occurs only when they think differently.

    What is cognitive behavior management all about?

    All clinical services operated by the Assessment & Clinical Services division use cognitive behavior technology. This technology is based on social learning theory and helps the child/family identify the Thinking, Feeling, Behaving pattern which is leading to the child's problems in living, and to address the feelings and behavior through a process of examining the core thoughts.

    Thinking -------------> Feeling -----------------> Behavior

    When you experience an event, you have an immediate judgmental thought about the experience followed by feelings which are appropriate to the judgment. The judgment is made on the basis of experiences of the past and the judgments you made about these experiences. We are constantly appraising the world about us and talking internally about what we see. We see a driver on the road and think "S/he's hogging the road!" and this thought may cause us to feel angry. The anger may result in an action or behavior which later you would consider unwise. However, we will often continue to carry the notion that it was the other driver that caused the problem when actually it was the thought and resultant feelings which caused the anger. If, for example, your thought was 'that poor woman is confused and doesn't know what to do', you may feel compassion and give him/her a lot of room to make mistakes. While you have been delayed in both situations, by the same event, you feel and therefore will probably act differently.

    Since each person is an individual, with his/her own experiences, each person sees the world through his/her own personal frame of reference. This creates little problem, unless your frame of reference leads to thoughts which are unrealistic and/or cause you to behave in ways that are self defeating [e.g., cause problems in living]. This may happen, for example, if you generalize from limited experience. If you have two teacher who treat you in a way that you believe is unfair, you might generalize that all teacher are unfair, or all teachers don't like you. If this happens, you might tend to feel angry or mistreated, and are likely to act in ways that actually causes teachers to think you don't like them. Given that the teacher is also operating on thoughts and feelings, it is easy to see how a vicious circle of negative behavior starts which is not helpful to either person in meeting their own personal goals. The moral of this story is well articulated by Dr. Farkas when he states, "Don't believe everything you think!"

    There are in fact, several specific cognitive (thinking) errors which show up in people with problems in living and limit their thinking. These are not unusual errors that are caused by intellectual deficits or anything like that - they are, in fact, the same kinds of errors that are made by philosophers. They are human errors which exaggerate very common rules of logic to a level that is unhelpful and need to be addressed.

    View the Eight Limited Thinking Patterns

    What is the process of cognitive change?

    There are essentially three intervention concepts of cognitive behavior management:

    Cultural restructuring: a process of seeding or priming the environment with thoughts, rituals, and icons which lead the individual members of the culture to think differently about an experience.

    Skill Building: a process of teaching a specific skill (mental or physical) which is needed to carry out a behavior.

    Cognitive restructuring: a process of training an individual become aware of, attend to, analyze, seek alternatives to, and adapt their thoughts if they so desire.

    From these three modes of intervention an infinite number of intervention techniques can be developed. In each case, however, there is first a need to first make sure that the subject understands the language and concepts. Once these are clear, the subject becomes the master of the situation, directing the helper toward what s/he wants to change and then learning how to change.

    Thus, the process is based on the personal goals of the subject. In this context, goals can be defined as subject defined need - which is often quite different than the need defined by the experts on the outside. Questions of resistance and compliance become moot.

    The actual process, after language and concepts, includes these five steps: Click here to view the five steps


    Obviously, none of this is mystical or difficult to learn. While it may take a well trained practitioner to help someone with highly valued negative thoughts, a person can very well do the process themselves for many situations. Many of the techniques developed from this basic process can be used by parents, teachers and others who manage people. Business leaders are as much concerned with the behavior of their staff as teachers are of their students and parents are of their children. The same principles apply.

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