Provided by Joel Szkrybalo, PhD
Social skills are an essential part of everyday life. Knowing how to greet others and form favorable first impressions; actively listening; engaging in the give-and-take of conversations; reading and reciprocating nonverbal communication; joining others in games and tasks; finding acceptable ways to express feelings such as anger or anxiety; appreciating other people’s feelings and perspectives; resolving conflicts – these are just some of the skills that allow us to navigate the rich and ever-changing landscape of social relations.
Most children and teenagers are quite successful in acquiring social skills. Some children and teenagers, though, encounter challenges that impede the development of social skills. They may have difficulty focusing their attention on relevant social cues. They may impulsively violate social norms and face disapproval or teasing. They may struggle to manage feelings of anger, sadness, or anxiety in social situations. They may misunderstand the perspectives and feelings of others around them, leading to confusion and conflict. Since competence in social relations is one of the cornerstones of healthy self-esteem, children and teenagers with social skills difficulties often feel isolated, disliked, and even worthless. Other important areas of their lives can also be negatively impacted: school performance, family relationships, and mental health.
Fortunately, social skills can be learned through systematic teaching and practice. The goal of the Social Skills Group Therapy Program at Comprehensive Mental Health Services (CMHS) is to facilitate the growth of essential social skills using a highly structured, small group approach.
What is the basic format of the Social Skills Group Therapy Program at CMHS?
The program consists of 10 hour-long sessions meeting once a week. The sequencing of groups closely tracks the skills that children and teenagers draw upon as they get to know someone over time: from greeting, listening, conversing, interpreting nonverbal cues, and joining in group activities, to acting prosocially, dealing with teasing, managing feelings, perspective-taking, and resolving conflicts. Members of the group are actively involved in creating group rules during the first session. Under Dr. Szkrybalo’s leadership, the rules are used to keep the group members on-task, increase their sense of belonging, and provide a safe environment to practice skills, make mistakes, and learn from one another. Mutual respect and confidentiality are stressed from the outset.
Each group session is structured to assess and correct group members’ knowledge base about particular skills. Then, all group members are given opportunities to enact these skills in carefully scripted role plays. Dr. Szkrybalo seeks to maximize the learning experience by encouraging an active and constructive exchange among group members, helping each member realize his or her impact on others through targeted feedback.
Parents are invited into the group for the final 5-10 minutes to receive a summary of what was covered, including hand-outs that allow them to continue working on the skills with their son or daughter. In some cases, “homework” is assigned in between groups, to help members generalize their developing skills into other important settings, such as school, neighborhood, and planned and unplanned social gatherings.
At the conclusion of the 10-session program, Dr. Szkrybalo meets separately with the parents of all group members to provide additional feedback, along with recommendations for building on newly developed or refined social skills. Of course, any child or teenager in need of additional services may take advantage of the tightly coordinated, multidisciplinary expertise available at CMHS.
How is a group put together?
Groups range in size from 4-6 children or teenagers in order to enhance group cohesion, provide individualized attention, and promote varied learning experiences. Ages range from 7-17. Certain criteria also determine how a group is put together. First, before being enrolled in a group, all children or teens must undergo a 1-hour screening interview with Dr. Szkrybalo to assess their baseline social skills level and to ensure that the group will be a good fit. Second, groups are constructed so that members do not differ too much from one another in terms of age and gender. Typically, group members are no more than 1-2 years apart in age, and groups are either same-sex or mixed-sex in composition; if mixed, equal numbers of males and females are sought. Third, no two group members may come from the same school or neighborhood. This final criteria helps maintain confidentiality, allowing group members to practice their social skills without worrying that others in their school or community will know about it.
Groups run throughout the year. When parents first call and speak with Dr. Szkrybalo their contact information is entered onto a wait list. Once there are enough children, or teens, to start a group Dr. Szkrybalo contacts all parents to arrange for the screening interviews. The group sessions begin shortly after all screening interviews are completed. The day and time of the group depends upon the availability of all group members and parents.
Who is the typical group member?
Group members have social skills delays for a variety of reasons. Some may have underlying conditions -- such as attention deficit/hyperactivity disorders (ADHDs), higher functioning autistic spectrum disorders, or mood disorders – that negatively affect their social skills. Others may have issues with social anxiety or shyness. Still others may struggle with learning differences that interfere with how they process social information.
Since the Social Skills Group Therapy Program is short-term and intensive, it draws heavily upon verbal skills. Children and teens with significant language-based learning disabilities may not derive as much benefit from the program. Likewise, children and teens with more serious impulse control problems, aggressive behaviors, and poor compliance with authority may not be suitable until these issues are more fully addressed. Finally, children and teens on the lower functioning end of the autistic spectrum may need a group therapy approach of greater duration than the Program offered at CMHS.
What kind of results might one expect?
Each child and teen is different, so it is often difficult to identify precisely the type and extent of benefits each member will derive from the group. Based on reports from former group members, parents, teachers, and other mental health providers, many group members display greater comfort in social situations, apply their improved skills in multiple settings such as schools and family gatherings, and develop more and better social connections to peers. Many also display a more nuanced understanding of social cues, other people’s perspectives, and ways for resolving problems with peers. Finally, a sizable number of former group members have shown signs of increased self-confidence as well as more positive and stable self-esteem.
While the Social Skills Group Therapy Program seeks to place children and teens on a more favorable trajectory of social skills development, parents play an essential role in facilitating change during the Program and beyond. With that in mind, Dr. Szkrybalo provides vital information to parents at the end of each session and at the conclusion of the Program to promote and solidify each member’s gains.
How is this program different from social skills groups offered elsewhere?
The Social Skills Group Therapy Program at CMHS is constructed to maximize social skills improvements in a relatively short period of time. As such, certain features of the Program distinguish it from other types of social skills groups. For one, the requirement that no two group members come from the same school or neighborhood ensures anonymity and diminishes challenges to group cohesion, which can occur when two members know each other and form an alliance or become adversarial with one another or the remaining group members. School-based social skills groups often have to contend with such challenges. In addition, the highly structured and intensive nature of the Social Skills Group Therapy Program make it especially suitable for children and teenagers with relatively good verbal skills and a sound foundation of basic social skills to build upon. Group members are not too divergent in their baseline social and emotional functioning. The screening interview helps to create the “best fit.”