Flashcards in Social Skills Deck (9)
In some cases, the most devastating effects of psychological and mental disorders are their effects on the social aspect of life. Humans are social creatures and thrive on interaction with others. Without this, depression and isolation are inevitable, leading to further detrimental consequences on one’s mental health. Equipping people who otherwise have no social skills or practice in social skills with the necessary tools is becoming a prominent technique in psychotherapy.
What is 'Social Skills' training
Social skills training is a type of psychotherapy that works to help people improve their social skills so they can become socially competent. SST is predominantly a behavioural therapy but cognitive therapy can also be used in some situations to maximise the success of SST. This psychotherapy can be done one-on-one or in a group situation.
Who can benefit from 'Social Skills Training'
SST is mainly used for individuals that are diagnosed with certain mental or psychological disorders and whose symptoms involve poor social functioning. However, anyone who wants to improve their social skills and social confidence can benefit from this psychotherapy.
The major disorders that are accompanied with social dysfunction are:
Social anxiety disorder or social phobia
It is important to remember that, although SST can be very effective in helping people learn the necessary skills, it is very rare for SST to be a stand alone therapy. There are always underlying reasons why people are experiencing social difficulty and these too need to be treated, either with drugs or a combined psychotherapy.
What is involved in Social Skills training?
Social skills training will almost always be combined with some other type of psychotherapy, most often cognitive-behavioural therapy.
The amount of time needed to complete an SST program varies depending on how well you are learning the techniques and how much confidence you have in using the skills in a social environment.
Typically, eight one-hour sessions are standard.
Identifying the problem
Firstly, the major social problem needs to be identified. For example, are the problems with socialising predominantly a fear of large gatherings of people? Or speaking to people at work? In order to figure out the major problems, the patient and psychologist work together through discussion. Sometimes the psychologist may want to observe the patient’s behaviour; this is mainly with inpatient settings or children in the classroom.
The underlying psychology behind the social problems also needs to be determined. Sometimes social problems are a result of a mental illness (e.g. schizophrenia), or they may have arisen from a past trauma. Once these problems and reasons have been determined, your psychologist can determine what skills need to be focused on, how best to teach the skills, and what other therapies are required to help with the underlying issues.
Setting the goals
As with any type of psychotherapy, your psychologist will help you develop specific goals for the therapy. This will include a broad overall goal as well as focused goals that may change from session to session. For SST, the broad overall goal may be the ability to socialise comfortably in the staffroom, whereas the individual goals will be skill-specific (e.g. learning how to greet someone, ask how they are and respond appropriately).
Once each goal or skill is mastered, the goal for the next session becomes more difficult. Keeping the overall goal in mind will help you overcome times when you feel like giving up on the therapy.
Before you are expected to perform the skill, your psychologist will model the skill you are focusing on, so that you can see exactly what you need to do before attempting to do it yourself.
After your psychologist has modelled the skill, you will be asked to roleplay. This practice is a very important aspect of SST. It may feel odd to roleplay, but until you have practised the skill, it is hard to use it outside the safety and confinement that therapy sessions provide.
Your psychologist will provide feedback at the end of each session. This feedback will help you to identify your strengths and weaknesses, and the things you especially need to work on and practise.
In between sessions, your psychologist will set little “homework” challenges that you are required to do in your own time throughout the week. Usually the homework will carry on directly from the session, so that you practise the new skill you learnt. Depending on your success at meeting the challenge, you will focus on a new, more difficult skill in the next session.
Children and SST
How you socialise as a child is different to socialising as an adult, so social skills training for children is different to that for adults. Not only do people of different age groups socialise differently, but they are also associated with different psychological and mental dysfunctions. Therefore, social skills training will be very different in terms of goals and teaching methods between different age groups. The basic implementation plan, however, is the same.
Regardless of whether a child is diagnosed with a psychological disorder or not, it is very important to develop social skills in childhood. Any child with a social problem can be referred to a psychologist; this will greatly benefit them in the future. Minor social problems in childhood can turn into serious antisocial or anxious problems in the future.
SST for bullying and peer pressure
Bullying and peer pressure are very prominent issues in primary schools. A lot of the time, children who have not quite developed social skills are isolated and picked on. Not only does this severely damage children’s self-confidence, but it also causes them to withdraw from most aspects of school life.
SST for these children aims for peer group acception. The training is a combination of cognitive-behavioural and social learning. It focuses on:
Encouraging attitudes and behaviours which enhance positive social interactions (i.e. prosocial behaviour); and
Building coping strategies for dealing with peer pressure and bullying. This is will also work positively on self-esteem.
Throughout the sessions, basic social skills are also taught, depending upon what specific social area the child struggles with.
SST for adolescence and adulthood
Kurtz and Meuser, 2008
A meta-analysis of randomized, controlled trials of social skills training for schizophrenia was conducted.
Results reveal a large weighted mean effect size for content-mastery exams (d 1.20), a moderate mean effect
size for performance-based measures of social and daily living skills (d 0.52), moderate mean effect
sizes for community functioning (d 0.52) and negative symptoms (d 0.40), and small mean effect
sizes for other symptoms (d 0.15) and relapse (d 0.23). These results support the efficacy of social
skills training for improving psychosocial functioning in schizophrenia
One of the core deficits of schizophrenia is cognitive impairment, including working memory, problem solving and attention. Along with the psychotic symptoms, these make many schizophrenic patients socially incompetent. The lack of cognitive functions means that teaching these patients to act socially is very difficult. Therefore, the training is very structured. Each skill is broken up into smaller parts to make it easier for the patient to remember and follow through.
The social skills program for schizophrenics are based upon their negative or affective symptoms. The social skills commonly focused on are:
Smiling: People with schizophrenia tend to have flattened emotional and facial responses due to the side effects of their medication. Learning how to give a simple smile can make all the difference.
Showing appropriate emotional responses: A negative symptom of schizophrenia is inappropriate responses in social situations (e.g. laughing when others are being serious and vice versa). SST aims to train schizophrenics to recognise when laughing is appropriate and when they should be serious.
Sustaining conversations: Knowing how to ask and answer questions, give and receive compliments.
Listening: In order to respond to others it is important to listen effectively. SST teaches how to actively listen to others.
Schizophrenia is a disorder with many symptoms and side effects. Social skills training is not a stand alone treatment option.
SST for Social Phobias and Anxiety
Hollandsworth et al (1978)
A 30-year-old recent college graduate, exhibiting extreme anxiety and deficient verbal skills in job interviews, was treated with a social-skills training procedure that included instructions, modelling, behavior rehearsal, and videotape feedback.
Three target behaviors--focused responses, over coping statements, and subject-generated questions--were presented using a multiple-baseline design. Galvanic skin-response activity was monitored during pre- and posttraining in vivo job interviews.
In addition, independent judges unobstrusively rated the subject's social-communicative behaviors in his temporary worksetting before and after training. Training resulted in expected changes for all three target behaviors and a decrease in the rate of speech disturbances.
Physiological data supported the subject's report that training enabled him to deal with his anxiety more effectively during job interviews. Training was found to generalize to novel interview questions and different interviewers.
Furthermore, unobtrusive measures of eye contact, fluency of speech, appropriateness of verbal content, and composure supported the subject's report that training generalized to his daily social interactions on the job.
Social phobia is a subtype of anxiety disorder. It is the fear of social situations. A person may have social phobia since childhood, or it may have developed throughout adolescence or adulthood. Regardless of the cause, SST training alone will not fix the situation. SST can be very effective in combination with other psychotherapy programs (e.g. self-management skills training) for treating the underlying anxiety causing the fear.
There are many reasons a person could have developed social phobias or social anxiety. It is important to first gain insight into why the person has the condition, and what aspect of socialising they are fearful of. The social skills commonly focused on in social phobias are:
Appropriate speech volume: People with social phobias tend to speak very quietly, making it difficult for them to communicate with others.
Intonation: Learning which words to emphasise in conversation is important for conveying different meanings.
Expressing opinions: It is very difficult for some people to express their opinions on certain topics, particularly when the environment seems intimidating (e.g. the workplace). SST helps people learn how to voice their feelings in a non-threatening manner.
Self-confidence: People who are fearful in social situations are, more often than not, the people who get bullied and walked over because they cannot stand up for themselves. SST helps people learn how to stand up for their own rights.
Awareness: People with social anxiety are often irrational about how much others are judging them. No one else can tell when your palms are sweaty and your heart is racing, but when people obsess over these physiological processes, they become more stressed and anxious. SST teaches people to focus on what is happening in the social environment rather than their internal physiology.