Learning To Change Lives - The Strategies and Skills Learning and Development Approach (PDFDrive)
Learning To Change Lives - The Strategies and Skills Learning and Development Approach (PDFDrive)
A. Ka Tat Tsang
Library and Archives Canada Cataloguing in Publication
1 Introduction 5
2 Social and Interpersonal Strategies and Skills as Human Action 20
3 Basic Principles of Strategies and Skills Learning and
Development 44
4 Problem Translation 61
5 Review of Current Strategies 95
6 Formulating and Designing Relevant Strategies and Skills 109
7 The Learning Process 126
8 Reception 141
9 Expression 151
vi Contents
10 Engagement 174
11 Managing Relationships 187
12 Instrumental Tasks 218
References 297
Index 321
Figures, Tables, Boxes, and Worksheets
Figures
Tables
Boxes
Worksheets
pivotal role in the entire writing and revision process of this book. Her
professionalism and the high-quality research assistance she provided
have made the writing of this book a most gratifying experience.
Finally, I have to emphasize that the development of SSLD is a result
of our collaboration with clients who share their problems and issues
with us, and who have in the process helped us learn new strategies
and skills, gain new insights, and develop new perspectives and con-
ceptual tools. Practitioner colleagues who have participated in SSLD
programs and consultation sessions in different parts of the world have
also enriched our experience and understanding by generously sharing
theirs. This book is, in a sense, my way of saying thank you.
This page intentionally left blank
Learning to Change Lives
Introduction
Application of SST
2005; Nanyang & Hughes, 2002; Parker & Asher, 1987; Trower, Bryant,
& Argyle, 1978).
Throughout the years, SST as an intervention has been studied ex-
tensively. A computerized bibliographical search in the summer of 2011
using the keyword “social skills training” returned 8,465 results on the
Scholars Portal (a digital repository of over 20 million scholarly arti-
cles included in databases hand-selected by subject specialists at the
twenty-one university libraries of the Ontario Council of University
Libraries). The following section provides a brief summary of the key
findings.
Effectiveness
Critique
ertoire of skills. The measure can then indicate a standard set of social
skills that practitioners can train people to acquire through a systematic
procedure, which should ideally be standardized and manualized. It
follows that the effective implementation of SST in a standardized man-
ner should almost uniformly raise the social competence of clients. In
this model, individual difference is supposedly measurable on some
standardized scales.
This is the model I more or less followed in my earlier SST prac-
tice. The idea of a parsimonious set of social skills that is relevant for
all, with everything being measurable and quantifiable, was pretty at-
tractive. When I first worked with autistic children back in 1980, for
example, I developed a standardized behaviour rating scale that was
applied to all of them. The scale covered different domains of auto-
stimulation, learning, social behaviour, and communicative behaviour,
and these items were arranged in an ordinal scale. The scale worked
reasonably well as a clinical tool to help my colleagues and me monitor
the progress of each child, but we also discovered that these children
had individual learning styles, preferred modes of interaction, and dif-
ferential aptitudes for various learning tasks. When we started work-
ing with parent-child dyads and ran simultaneous parent and children
groups, we found ourselves working with an increasingly complex set
of behaviours and processes, including parenting styles, attachment
patterns, and family dynamics.
At around the same time, I started an SST group for adults with
schizophrenic disorder. The diversity of their needs, circumstances,
characteristics, and capacity made it almost impossible to get them to
go through a standardized program. I allowed myself to focus on what
they needed to learn in order to address their particular needs instead
of prescribing standard skills for each of them to master. It later struck
me that learning transfer was almost never an issue when using this
approach. What we did most of the time was ask these clients to bring
in challenging situations they faced in real life, and then we would try
to figure out effective strategies and skills for dealing with them. The
fact that I was practising within a Chinese cultural context in Hong
Kong probably facilitated this flexibility. Some of the more standard-
ized practice based on Western social behaviours or skills, ranging from
how to greet a stranger to being assertive with one’s family members,
were modified to suit individual circumstances. What I experienced as
a practitioner was that the SST procedure was very effective when I
used observation learning, review, feedback, refinement, rehearsal, and
14 The SSLD Idea
real-life application procedures, but did not insist on using any stand-
ardized measure of social skills. When positive outcome was realized in
terms of observable behaviour or facts, such as moving out of seclusion,
socializing, making friends, finding and keeping a job, and completing
graduate school, I was adequately encouraged to continue my applica-
tion and refinement of the procedure.
Looking back, I realize that my preference for engaging with the
client’s reality in all its complexity over standardization and meas-
urement probably led me to the adoption of a more flexible (or what
some SST colleagues may call less disciplined) practice. Such practice
orientation gradually transported me from a linear categorical mode
of thinking and practice to a multiple-contingencies mode, which I
will explain in more detail later. At this point, it is perhaps sufficient to
say that my practice was guided by attempts to develop strategies and
skills to address the client’s specific needs and circumstances. Stand-
ardization, measurement, and quantification were pursued when they
were helpful to the process. I soon found myself developing many in-
novative procedures with my clients, and the positive results have kept
me actively involved in such processes till this day. The development
of SSLD as a distinct system was probably primed three decades ago
through a goal-oriented, client-need-driven, flexible, and open prac-
tice that privileged development and innovation over compliance and
model fidelity.
Apart from the objectives that we have already discussed – empha-
sis on the particular needs, circumstances, characteristics, and capac-
ity of the client; readiness to respond to real-life challenges; flexibility
in procedure and assessment; and adapting to the specific social and
cultural context – the development of SSLD has been concentrated on
observable behavioural change and careful documentation of the learn-
ing process. After decades of gradual modification and incorporation of
new elements, SSLD distinguishes itself from other SST procedures by
its focus on the underlying mechanism of learning and development,
an emphasis on multiple-contingencies thinking, and a broader scope
that covers not only skills for specific situations but also strategies for
more effective personal, interpersonal, and social functioning in the
long term. SSLD has a much wider range of application than SST, in-
cluding clinical and non-clinical populations; the capacity to engage
with intersecting diversities related to ethnicity, culture, gender, sexual
orientation, and so on; and an awareness of the rapidly changing so-
cial realities in an increasingly globalized environment. The model has
Introduction 15
compasses not only direct training and instruction but also coaching
through careful observation and feedback, facilitation of active and in-
dependent learning, and nourishing a space for creativity, innovation,
experimentation, and discovery. This allows the SSLD practitioner to
be helpful without necessarily being an expert in a specific problem
area, and supports the collaborative creation of new strategies and
skills by the client and the practitioner to manage unfamiliar situations
and address new challenges.
Another key feature of SSLD is multiple-contingencies thinking.
What is contingent is not fixed, but variable; it changes in relation
to the factors and processes that condition it. Whether someone ex-
periencing difficulties in relationships will seek professional help is,
for instance, contingent upon many factors such as the availability of
information and services, whether such help-seeking is socially ac-
ceptable or stigmatized in the community, previous experience of re-
ceiving help, ability to pay, expectancy regarding such help, and a host
of other considerations. While many people need to maintain a sense
of order in their lives, and imagine people, events, relationships, and
so on to be stable and predictable, they often do not appreciate that
such stability is often sustained by a large number of variables, factors,
and processes that do change across time and situations. In everyday
life, many aspects of human reality are contingent; and these multiple
contingencies interact with each other to produce complex situations,
which often challenge the neat and tidy theories that helping profes-
sionals espouse. Many theoretical systems in the helping professions
are articulated in linear, logical statements, often dealing with a limited
number of specific variables. Instead of thinking in terms of multiple
contingencies, broad, generic categories are used and simple, linear re-
lationships are imagined. Some of these theories make sweeping gener-
alizations with the assumption that everyone is the same. For instance,
some authors think that it is possible to argue whether cognition or
emotion is more primary and whether one therefore determines the
other. This question is of limited value in multiple-contingencies anal-
ysis. The reality is that the relationship between cognition and emotion
is never the same for everyone across all situations, and it does not re-
main constant over time. The precise relationship has to be considered
with reference to the multiple contingencies of personal characteristics,
current needs and circumstances, the goals to be attained by the indi-
vidual concerned, and contextual variables. For any given individual,
it is possible for emotion to take over and condition or even distort the
Introduction 17
Given the complex interaction among these factors and processes, any
starting point chosen in any given analysis can be regarded as arbi-
trary. Any event we focus on is likely the result of some other anteced-
ent factors and processes. In SSLD, we take the pragmatic approach of
tracing human action or behaviour back to its motivational origin as
a convenient first step. Most human behaviour – with rare exceptions
such as reflexes – is motivated, purposeful, or goal-directed. Social and
interpersonal behaviours are linked to personal needs, goals, wants,
and desires. Recognizing the motivational forces behind a particular
action is the primary step in SSLD. A person who is always behaving
in an aggressive manner towards others, for instance, is often seen as
an aggressive person, and many people (professionals included) will
try to do things to stop her or his aggressive behaviour. From an SSLD
Interpersonal Strategies and Skills 23
Cognition
Motivation Information processing Behaviour Environment
Drive Beliefs Strategies
Needs Values Skills
and
Desire Micro‐processes Social Reality
Mutual
Emotion / Affect
Conditioning &
Transformation
Biology Food, medication, injury, virus,
toxic material, surgery,
temperature, air quality, etc.
The idea that human action is mediated by cognition has a very long
history. Many traditional philosophies, religions, and teachings have
attempted to modify human action by changing how people think.
More recently, cognitive therapy has become increasingly popular as
a strategy for changing people’s behaviour (Chambless & Ollendick,
2001; Deffenbacher, Dahlen, Lynch, Morris, & Gowensmith, 2000;
Goode, 2000). The belief that cognitive processes can mediate human
behaviour is probably not to be disputed, but human service profes-
sionals and educators have long recognized the knowledge-action gap.
Thinking straight and knowing the right thing to do are inadequate
guarantees of corresponding action. Many therapists have included be-
havioural interventions and skills training as an adjunct to cognitive
therapy. The development of cognitive behavioural therapy (CBT) can
be seen as supplementing the limitations of purely cognitive interven-
tions (Cooper, 2008).
Instead of seeing cognitive procedures and behavioural learning as
two separate and discrete processes, the SSLD model recognizes the
role of cognitive mediation in the learning of skills and the develop-
ment of strategies for more effective personal, interpersonal, and so-
cial functioning. According to social cognitive theory (Bandura, 1986),
Interpersonal Strategies and Skills 27
of bodily states, for example, has been found to affect emotional re-
sponse and social behaviour (Dutton & Aron, 1974; Schachter & Singer,
1962). To give another example, a young girl who experiences erotic
attraction to another girl may think that she is sick or sinful, thus feel
intense guilt and shame and then actively avoid the other girl. Alter-
natively, she can accept same-sex attraction as a totally legitimate per-
sonal option and can then explore ways to engage with the girl she is
interested in.
Similarly, how we make sense of interpersonal and social realities
often plays a role in how we respond as social agents. For example, a
woman who is abused by her spouse may believe that it is “natural” for
women to submit to men, and that it is her duty to appease her spouse.
This woman may then change her behaviour to become even more sub-
servient. She may also feel resentful but not believe that the situation
can be changed, given the long history of oppression of women in her
immediate community. In this case, she might try to endure the situa-
tion for as long as she is capable. If she thinks that she is too weak or
disempowered to do anything but can call on members of her commu-
nity who are in a better position to intervene, she may attempt to seek
help from these individuals. Alternatively, it is possible for her to inter-
pret the situation as one that requires learning to be more autonomous,
independent, and assertive. Another possibility is for her to think of the
situation as a systemic social issue, and therefore one requiring collec-
tive action in addition to individual coping and resistance. In this case,
the woman may pursue the behavioural strategies of reaching out to
other women, learning more about social action and change, and ac-
cessing social resources and support systems.
Cognitive approaches or strategies are themselves contingent upon
other factors and processes. Dominant social discourses, norms, or con-
ventions play a significant role in conditioning how people think and
make sense of the world (O’Gorman, Wilson, & Miller, 2008; Richerson
& Boyd, 2005). In social cognitive theory (Bandura, 1986, 1991), the proc-
ess of internalizing social norms and values is understood in terms of
social learning. The internalized values are mediated by self-regulatory
mechanisms that involve factors and processes in other domains such
as interpersonal relationships and external environmental inducement.
In sum, sense-making and meaning-giving are key components of
our social responses. These cognitive processes are central to our under-
standing of our own needs, regulation of our emotional responses, as-
sessment of our social reality, and imagination of possible strategies or
Interpersonal Strategies and Skills 29
Individual A
Action /
Action /
Action Action
Reaction Reaction
Individual A
Source: Adopted from Bandura (1986), 27.
tional information, which might alter the direction of her escape. Had
the man said, “the stairwell is filled with smoke,” then she would more
likely change her escape route. This new information, or feedback, is an
important part in the cycle of interaction between the individual and
the environment. When applied to the interpersonal context (see Figure
2.2), a person’s reaction is experienced as feedback by the other person
in the interaction.
Within the SSLD model, the individual is seen as an active agent who
is autonomous and goal-directed, but actions and effects are not un-
derstood within a deterministic model. When the individual’s action is
effective, it has a higher chance of bringing about the desired outcome
in the person’s social reality. For example, if a person feels erotically at-
tracted to another person and wishes to set up a date, she or he needs to
perform a particular behavioural sequence which may involve calling
the other person on the phone, face-to-face conversation, email, note
writing, text messaging, or engaging an intermediary. Any of these will
involve a certain level of skilfulness, which will in turn affect the prob-
ability of success. Interpersonal attraction, however, does not work in
a simple, mechanistic manner. It is possible to imagine that even the
most socially effective person can still get rejected for a date, because
the other person might not be interested or could have her or his own
issues, such as social phobia or fear of intimacy.
The recognition of contingencies in interpersonal and social realities
takes SSLD beyond a rigid preoccupation with a singular goal – and be-
yond the naïve assumption that all goals can be realized simply through
32 The SSLD Idea
Case Illustration
ers. Given all the pressure and unpleasant circumstances he has to put
up with, he has a strong desire for pleasurable experiences, which he
can only find in drinking. The drinking may also serve as his pain relief
and anxiety reduction strategy. His aggression towards his family is a
desperate, and ineffective, means to gain control and mastery over his
environment, especially his interpersonal and social world.
In order to help this man, an SSLD formulation will suggest that trying
to reduce or suppress his problematic behaviours usually do not work
well, for without them his needs will remain unmet. A more thorough
treatment shall involve the learning and development of strategies and
skills which will be effective in meeting his needs. These can include
better interpersonal skills so that he can obtain the responses he desires
from others, such as empathic understanding, care, collaboration, emo-
tional support, and intimacy. He may have to learn alternative ways to
reduce pain and attain pleasure, which can be anything ranging from
developing a hobby to learning yoga, enjoying socializing with others,
listening to or playing music, or participating in team sports. In order
to establish a different lifestyle, he needs to be able to solve his cur-
rent problems, such as unemployment and tension with his family. The
learning of social skills and life skills such as job-searching, interview-
ing, and conflict-resolution skills can be very relevant. He may also
need to learn to manage his sources and level of stress, and to develop
effective coping strategies.
These strategies and skills can be learned and developed system-
atically through an SSLD program. It is expected that when he has
mastered these strategies and skills, he will become more effective
in meeting his own needs and achieving his desired goals in life. He
will then have little need for his original behaviours such as drinking
and aggression, which are therefore likely to be replaced by the newly
learned strategies and skills.
Avoidance of social
role demands
Needs / Goals
Interpersonal skills Manage pain
Control and mastery
Pleasure
Reduce anxiety
Effective pleasure-
seeking behaviours
Problem-solving
skills
Stress management
Legend
Problem behaviours / Current coping methods
Strategies and skills
Technical Advantages
Practical Advantages
Given all these advantages, SSLD has tremendous potential for being
adopted as a key intervention method across a wide range of human
service settings. The next section will introduce the basic principles of
SSLD practice, to be followed by more detailed descriptions of practice
procedures.
Chapter Three
upon client situations. The program design allows for ongoing moni-
toring to inform the development of specific intervention procedures
corresponding to client needs and progress.
In a preplanned or pre-packaged program, the first step is client se-
lection or matching. In a contingency-based approach, the first step is
problem translation – a procedure that translates the client’s presenting
issues into a set of learning objectives through careful analysis of the
client’s current behaviours and their underlying motivation. The spe-
cific procedures involved in problem translation will be detailed in the
next chapter. At this point, it should perhaps be emphasized that the
presenting issue is first understood by connecting it to possible client
needs. For example, a person who feels depressed after breaking up an
intimate relationship may present emotional difficulties such as anger,
confusion, depression, negativity, and so on; and behavioural manifes-
tations may include refusal to eat, social withdrawal, temper tantrums,
and other acts that may lead to self-injury. It is not easy to imagine what
a preplanned program for such an individual may look like. In a con-
tingency-based intervention, however, we will be exploring the needs
underlying such emotional responses. The needs supposedly met by
the partner in the terminated relationship, such as affiliation, intimacy,
companionship, emotional nurturance, sexual pleasure, self-esteem,
social approval, and the like, are not to be overlooked. There can be an
issue of adjusting to a different routine for one’s personal and social
life. Very often, a relationship that does not work out may also threaten
an individual’s sense of self, including self-esteem and the sense of con-
trol and mastery over one’s life. The need for emotional ventilation can
also be important in maintaining homeostasis and well-being. Practi-
tioners of a contingency-based approach will try to engage with the
client and establish a shared understanding of the client’s needs. This
understanding is critical as a first step and can release the client from
being obsessed with unhelpful ideas such as getting back together with
the ex-partner, which in some cases can be misconstrued as the client’s
goal. Once a shared understanding of the client’s needs is established,
we can then work with the client to set realistic goals that are func-
tionally related to these needs, such as effective emotional ventilation
and management of emotional responses, courses of action that will
increase self-efficacy and self-esteem, and the design of activities that
would lead to pleasure and personal fulfilment.
Table 3.1 summarizes the differences between preplanned interven-
tion and contingency-based intervention. It should be emphasized that
46 The SSLD Idea
the two approaches are not incompatible, and they can share similar
practice procedures such as observation learning, rehearsal and feed-
back, real-life practice, and so on. Preplanned programs have certain
advantages in terms of standardization, ease of mastery, and delivery.
By contrast, contingency-based practice is an open system allowing for
the creation of new strategies and methods in response to the specific
needs and circumstances of the client. It has the advantage of being
amenable to a much wider range of situations, but is more demanding
to learn and master as a system. In actual practice, some components
of preplanned programs can be used to build an intervention program
while allowing the practitioner to remain open and flexible to the cli-
ent’s presenting issues as well as the client’s unique but variable needs
and circumstances.
Multiple-Contingencies Thinking
on the assumption that people go through more or less the same steps
in achieving positive outcomes. For instance, a categorical understand-
ing of people’s conditions, such as depression or anxiety disorder,
is matched with a standardized practice such as cognitive therapy.
Multiple-contingencies thinking recognizes that human experiences
and outcomes are contingent upon a host of ever-changing variables
and processes. An issue that is apparently similar among all clients,
such as substance abuse, sometimes requires very different profes-
sional responses contingent upon specific client needs, characteristics,
and circumstances, including social and cultural context or situational
variables.
Closely related to the idea of multiple contingencies is the notion of
equifinality, which means that people can arrive at the same destina-
tion through different pathways. In practice, it means that clients can
achieve the same outcome by using different methods or following dif-
ferent trajectories of change. Subscribing to contingency-based think-
ing and program design means that we do not assume that every client
with the same problem – be it insomnia, social phobia, or depression
– has to go through exactly the same procedures in order to get better.
The actual process for each client can be different, and this again is con-
tingent upon personal as well as environmental factors and processes,
including the dynamics or chemistry between the client and practition-
er dyad or group. The intervention program has to be flexible enough
to respond to the diverse needs and circumstances of the clients, and to
allow sufficient space for them to pursue different trajectories towards
realizing their goals.
egies. After exploring what the client thinks the problem is, we move
on to examine what the client’s needs are and what the client is doing
with regard to those needs. Assessment of the client’s needs has to be
a collaborative process, and the practitioner cannot impose her or his
appraisal or analysis on the client. SSLD emphasizes good engagement
and building of a strong working alliance in the beginning phase of
the intervention – a recommendation based on extensive research in
the field of psychotherapy (Barrett-Lennard, 1962; Bogo, 2006; Gomes-
Schwartz, 1978; Hartley & Strupp, 1983; Luborsky & Crits-Christoph,
1988).
Following the break-up example given previously, once a shared un-
derstanding of the client’s needs has been established (e.g., self-esteem,
affiliation and intimacy, emotional healing), we will move on to set up
relevant goals (e.g., improved self-efficacy, establishing an intimate re-
lationship). We will then examine the client’s current coping strategies
(e.g., self-injurious behaviour, temper tantrums) and then assess their
relative effectiveness. The process will help us identify new strategies
and skills to be learned or developed (e.g., intimate emotional commu-
nication, reciprocation, expression of care and concern, creating pleas-
urable experiences).
thickness and shape is a skill. In one’s personal and social life, a set of
behaviours that draws desired attention to oneself is a skill. Similarly, a
set of behaviours that distracts undesired attention from oneself, which
is a goal in itself, is another skill. A social skill is a skill that is relevant
to an individual’s social situation.
A strategy can be seen as more a complex sequence of behaviour, and
this is also instrumental or goal-directed. For example, in a job inter-
view situation, the job applicant will need skills that draw attention to
her or his favourable qualities, such as the skill of connecting: “Speak-
ing of teamwork, I had this experience of working with my team in
this challenging project …” The skill of answering challenging ques-
tions may be another example. A successful job search, however, does
not only depend on sophisticated skills but also on an effective overall
strategy, which requires relevant skills to support it and yet goes be-
yond the specific skills themselves. An effective strategy may, for exam-
ple, involve broadening one’s information sources to include personal
networks, web-based information, and active, unsolicited searching.
Each of these courses of action requires its own set of skills, such as
interpersonal skills, computer skills, and assertiveness and presenta-
tion skills. Strategy, therefore, is a more extensive and inclusive concept
than skill. In this book, we will sometimes use the term “strategy” to
include both the strategy and its relevant skills.
On top of the conceptual difference between the two terms, it should
also be pointed out that when thinking of strategies and skills instead
of just skills, we are also recognizing an important reality in personal
lives and interpersonal relationships; that is the relational context. In
some of the social skills training practices, attention is focused on the
given situation and on achieving one’s goal within that situation. In
social and interpersonal relationships, achieving one’s goal or having
one’s way in a specific situation may require one to be very skilful, but
it can nonetheless be a poor move strategically, especially when we are
thinking of the relationship over the long term. For instance, a salesper-
son who upstages her or his colleague might gain a new client or a new
account, but the damaged relationship and its demonstration effect – if
it is witnessed by other colleagues or team members – may backfire
and undermine the salesperson’s original goal. To borrow an analogy
from chess, a move can be very skilful and effective, such as a move that
protects a piece, but may be a bad one in the overall scheme of things if
it does not increase one’s chance of winning the game. Strategic think-
ing is an important feature of contingency-based SSLD, for it is recog-
Skills Learning and Development 51
nized that the value of a skill is to be assessed within the overall context
of the person’s needs and goals, and the relevant strategies employed
to attain them.
A third concept that needs to be introduced and clarified is that of
performance. Whereas both the trainer and the learner are often fo-
cused on learning the right strategies and skills, it is the ultimate per-
formance in real life that counts. A number of factors are known to have
an impact on the performance of even highly skilled players, including
anxiety, fatigue, or situational variables such as noise and distraction.
Good trainers and coaches usually anticipate situational factors that
may affect performance. In theory, however, we need to accept the fact
that performance is never completely consistent, and that personal and
environmental fluctuations are part of real life. In SSLD, we try to help
learners understand that mastering a strategy and attaining a skill do
not always guarantee optimal performance, and that interfering factors
need to be anticipated and managed. This due consideration of the ac-
tual context for performance facilitates the smooth transfer of learning
from the consultation room to real life.
In formulating and designing strategies and skills, an SSLD practi-
tioner is mindful of the ultimate performance to be produced by the
learner. It is not only necessary to see a clear, functional connection be-
tween the goal and the strategies and skills to be learned and devel-
oped; one must also see how the learner can master these strategies
and skills with sufficient proficiency to reliably produce an adequate
and effective performance. Figure 3.1 shows how a person experienc-
ing abuse is understood with regard to her or his needs, as well as the
alternative strategies and skills this person can learn in order to address
such needs more effectively.
Once objectives are determined and the relevant strategies and skills
have been identified, we will move on to the actual learning and devel-
opment phase. The procedure involved has been developed and well
documented by practitioners of social skills training. The first step is
to help the learner develop a sense of the skill that will eventually be
performed. According to social cognitive theory, the major mechanism
of human learning functions through modelling or observation learn-
ing, which involves the learner observing another agent, known as the
model, in the actual performance of the skill to be learned. In social
52 The SSLD Idea
Appease
Needs / Goals
Social networking Safety
Order
Self-esteem / efficacy
Relationship
Interpersonal skills
Income
Accessing / utilizing
services
Occupational / Managing emotions
financial competence
Legend
Current coping methods
Strategies and skills
Whenever learners are ready to try out new behaviours in real life, they
are encouraged to do so. Very often, this real-life practice is a result
of a process of in-session classroom learning aiming at difficult tasks,
such as dealing with mean and undermining criticisms coming from
one’s spouse, parent, or boss. Another example could be for an individ-
ual with a long history of severe mental illness and social isolation to
start developing intimate relationships. It is, however, also possible for
learners to experience changes in real-life behaviours even when they
have only received minimal input from the program. One prominent
example is the use of homework exercises, which has been found to be
very useful by practitioners of cognitive behavioural interventions and
social skills training (Kazantzis, Deane, Ronan, & L’Abate, 2005). Cer-
tain homework exercises are well-tested and involve very low risk,
such as recording a behaviour targeted to be changed, or simple exer-
cises such as communicating positive feedback to a family member or
trying to initiate a conversation with a colleague at work.
Regardless of the complexity, level of difficulty, and timing of the
real-life practice, it is always important for the learner to have an op-
portunity to report back and obtain further feedback through review
Skills Learning and Development 57
with the trainer and/or fellow learners in a group. This process will
lead to incremental improvement of the skill to be mastered, and some-
times may even generate innovative strategies and skills as a result of
the interactive learning process.
4. Evaluation
The final step in the learning of strategies and skills is the confirmation
of successful completion. This final evaluation is made with reference
to the needs of the learner, which have been identified earlier in the
learning process, and the goals set collaboratively between learner and
practitioner. Such evaluation with concrete and observable outcome
markers makes the procedure explicit to both the client and the service
provider, and therefore facilitates accountability and service quality as-
surance. The evaluation process itself is process-oriented, emphasizing
the lessons learned and how the learner has come to master the new sets
of strategies and skills. This is a deliberately empowering process aim-
ing at increasing the learner’s self-efficacy or the belief in one’s capac-
ity in managing situations in one’s personal and social life. This focus
on learning will also allow the learner to adopt a similar approach to
problem solving in the future. Problems experienced by the learner will
hopefully be translated into an understanding of one’s needs, and then
into goal-directed learning and development.
This page intentionally left blank
PART TWO
Problem Translation
Social withdrawal
Reporting paranoid
delusion
Needs
Cognitive: Make sense of
Practical life skills threatening/overwhelming
circumstances
Security, self protection, anxiety
reduction, affiliation
Stress and anxiety
Help: Understanding support,
management
assistance
Cognitive strategies
Communication skills
Legend
Current coping methods
Strategies and skills
we try to clarify the meaning by requesting that the client provide such
markers or indicators. For instance, if a client says that she wants her
partner to understand her better, we would like to know what observa-
ble behaviour from the partner will indicate or mark good understand-
ing for the client. If another client wants to have a good relationship
with his partner, we would again ask what a good relationship might
look like and what behaviours by each party would mark this relation-
ship. If a client wants to become more independent, we will ask for
behavioural markers of independence.
Client-Centred Orientation
Multiple Markers
Inference Needs
E.g., Mastery over the
environment, security,
sensory pleasure
tion, and so on. For example, when a male client says that he is seeing
a male friend a lot, one has to know what “seeing” means (what they
actually do together) and what is meant by “a lot” (frequency), as well
as what the relationship means to the client (e.g., socializing, getting/
giving support, intimate sexual relationship). Similarly, when a parent
says her child is “out of control,” the meaning is not fixed but is contin-
gent upon several factors, including sociocultural and personal ones.
The critical role of framing can be illustrated by two cases. In the first
case, a young girl describing how her mother is being “good” to her
provides behavioural markers such as giving her pocket money, driv-
ing her home from school, taking her out shopping, and so on. Another
girl describes similar behaviours from her mother but frames them in
a negative sense. She complains that her mother discourages her from
doing part-time work to earn her own pocket money, and uses her
mother taking her home from school and accompanying her on shop-
ping trips as examples of the mother’s restrictive control.
Inference
ing a strong need to please others and feel accepted by them. This is
an inference that can and should be tested. In SSLD practice, the prac-
titioner’s inference has to be tested against the client’s perception and
behaviour. When a client rejects an inference, the general principle is
to avoid arguing with the client, but to consider the client’s alternative
explanation carefully. The client may, for instance, say that he does not
have a strong need to please these friends or to gain their acceptance;
it is simply his belief that one should be generous towards friends. In-
stead of arguing with the client, we may invite the client to examine his
interpretation in juxtaposition with the complains he has made against
his friends, or to explore what will be a more desirable pattern of inter-
action and reciprocation between him and his friends, including how
his friends are responding to his own needs and expectations.
When an inference is made, the result is a conceptual construct. The
practitioner may use constructs such as need for domination, ambiva-
lence, or even psychopathological or diagnostic constructs such as pas-
sive aggression, symbiosis, borderline personality, enmeshed family
relationships, and the like. In SSLD, the value of a construct is assessed
with regard to how it helps the learner to make sense of, and attain
mastery over, the behaviour(s) this construct refers to. If we infer that
the client has a specific psychological need, a behaviour pattern or ten-
dency, or a personality type, the value of these constructs is assessed
in terms of whether they will facilitate the client’s cognitive processing
of information and lead to positive behavioural change. The client’s
agreement with the trainer’s inference does not constitute a positive
clinical outcome and is not sought in SSLD practice. It is only useful if
the construct is recognized by the client, and when it helps to produce
actions that will bring about change in the client’s behaviour and her or
his social or interpersonal reality.
haviours that are ineffective in meeting the client’s needs or that are
socially inappropriate, which usually means that such behaviour will
lead to negative social consequences for the client, thus compromising
her or his chance of need gratification and goal attainment.
The concept of need is valuable in SSLD to the extent that it is help-
ful in understanding and changing the client’s situation. For instance,
Mary, a fifty-year-old woman, needs to be in control in interpersonal
situations, and she is aware of this need. Her goal is to feel in control,
which in her case includes the ability to negotiate and maintain a sta-
ble and mutually gratifying relationship with her boyfriend of fourteen
years. SSLD intervention then focuses on helping her to learn and de-
velop effective strategies for achieving her goal.
In another example, John, a forty-year-old man, believes that he has
very spiritual needs that are not being met. He has inferred this from
his sense of futility despite his material and social success, low energy
level, and a generally lousy mood. In an SSLD exploration, we seek
to understand the behavioural markers of spiritual fulfilment, which
John describes as: (1) having more energy to start new initiatives, which
includes going to work on time, less procrastination or missing dead-
lines, and regularly attending an early morning yoga class; (2) being
more connected with others, which translates into maintaining better
relationships that go beyond superficial exchanges – meaning more
intimate sharing of emotional experience and putting more time and
resources into those relationships both by himself and others; and (3)
liberating himself from his materialistic and consumption-oriented
lifestyle, which translates into selling his luxurious SUV, significantly
reducing his spending on clothing and fine dining, financial contribu-
tions to an international development agency, and signing up for four
weeks of volunteer work in South America.
Needs Assessment
This section will list a number of needs commonly found among clients.
As clarified above, these needs are not conceptualized as objective reali-
ties applicable to all human beings. Instead, the list is intended to help
practitioners make sense of the client’s specific circumstances and to
document the client’s needs profile. The list is not intended to be com-
prehensive or exhaustive. The items are not discrete, but can overlap
with each other and relate to each other functionally. They are not listed
Problem Translation 73
0
Esteem Affiliation Achievement Sensory Order/ Stability Freedom
pleasure
Waters, & Wall, 1978; Ainsworth & Bowlby, 1965; Bowlby, 1958,
1969, 1988, 1999; Cassidy & Shaver, 1999). People negotiate rela-
tionships with others that have different levels of intimacy, rang-
ing from a good rapport in one-time encounters to long-term
committed relationships. This also includes erotic and sexual
relationships.
Another important aspect of human connection is that we build
relationships with groups and communities, not only with indi-
viduals. To some people, membership in a certain group (e.g., a
prestigious social group, profession, or a noble class) or connection
to a community (ethnic, religious, political, or cultural) is essential
to their sense of identity and experience of well-being. The need
to belong or to be accepted can sometimes override other needs,
including the need to survive. This set of needs include constructs
such as loyalty, commitment, comradeship, or martyrdom. This
particular connection can also be extended to explain altruistic be-
haviour, civic participation, volunteerism, and the like.
9. Cognitive need for meaning and order. The need to make sense of and
ascribe meaning to one’s experience is arguably the most power-
ful human drive for cultural and intellectual development. On a
personal level, most people need to maintain a cognitive structure
that allows them to experience their life in the world as meaning-
ful, orderly, and coherent. Some people have an almost compulsive
need for this experience and can become cognitively very rigid. In
practice, clients having a need for cognitive order may ask ques-
tions like: Why was I the person to be paralysed after this car ac-
cident? Why did my lover leave me? How can my parents do this
to me? Taking these questions as denial is not the best way to work
with the client. In a sense, we need to recognize cognitive needs as
legitimate. This can also include the need for information, which
has been recognized as a civil right in liberal-democratic societies.
The need for information, as mentioned in point 2 above, can play
an important role in an individual’s sense of security; information
or knowledge can be empowering in that it increases an individu-
al’s probability of acquiring control over the situation to be dealt
with.
10. Emotional needs. Emotional needs can come in many forms. Very
often, practitioners think of emotional needs in terms of the need
for emotional caring or support from others, which is closely
Problem Translation 77
Needs, as we can now see, are rarely purely biological. The way needs
are experienced, articulated, and met are almost always conditioned
by social forces; and most needs-driven human behaviour takes place
within a social and interpersonal context. The very idea of needs is a
result of social construction, and as such it is shaped by ideology and
social discourses. There is a regulatory system that names, legitimizes,
and prioritizes human needs. As mentioned above, certain needs, such
as sex, are more heavily regulated, whereas others, such as the need
for more attractive looks or fashionable clothing, are socially facilitated
and encouraged (although the latter can also be sexually motivated).
Intimately tied to the social regulatory system is a political economy,
which pervades into what we consider the most private domains of life,
such as intimate romantic relationships (Illouz, 1997). Human needs
and desires are simultaneously aroused and disciplined; these complex
and sometimes contradictory measures are often combined with mar-
ket forces. The prevailing social discourses of body shape, food, and
health, for example, are articulated in a complex network of messages
involving books, audio-visual materials, workshops, courses, clinics,
hospitals, media, advertising campaigns, marketing strategies, and an
overwhelming array of products. Parallel to the market economy is
a similar process in public policy and social programs, which deploy
public resources according to dominant values, or the values of those in
power. In America, for example, public funding for certain programs,
such as abortion services for women, is contingent upon the political
and religious values espoused by the administration. An inquiry into
the mechanism of social regulation of human needs and desires and
the associated political economy is beyond the scope of this book, but a
number of related issues are fundamental to the practice of SSLD.
The most critical question, in my opinion, is the role of the SSLD
practitioner as a social agent. SSLD practitioners are supposed to help
clients to develop strategies and skills that are effective within their
social contexts. This can easily be read as getting clients to behave in
ways that are socially appropriate and therefore conform to prevail-
ing social conventions and values. Following this line of reasoning,
SSLD practitioners can be seen as agents of social control, trying to
substitute behaviours that are deviant with more conformist ones. It
should be emphasized that SSLD practice is not confined to changing
the individual. Based on the idea of mutual conditioning and trans-
Problem Translation 79
Unconscious Needs
clients become more aware of their own needs and what they desire in
life. The intervention usually increases their autonomy and self-effica-
cy, and it fosters positive expectancy with regard to the realization of
personal and/or collective goals. Instead of being restricted by what
one is not conscious of, the intervention expands the client’s awareness
and self-understanding as well as fostering a better appreciation of the
relationship between social reality and her or his own thoughts and
actions. This will then be supported by an increased capacity for goal
attainment, fulfilment, and self-actualization.
SSLD practice therefore encourages a critical awareness of prevailing
ideologies and social discourses, and aims at opening up maximum
space for clients to articulate their needs, desires, and goals in life. Our
role is to help clients achieve what they desire, and not to impose our
own ideological preferences or commitments on them. For example, if
a couple desires to have a lavish wedding and their goal is to get jobs
with better pay, we may help them to explore the psychological needs
that they are aiming to meet with the lavish wedding, but we will not
turn the intervention into a social analysis class on consumerism and
the institution of marriage. Similarly, if clients have internalized reli-
gious or cultural values that are different than our own, it is important
for us to respect that. For instance, a newly immigrated taxi driver be-
lieves that his eldest child should give up going to university and help
support his ever-growing family – his wife is pregnant with their sixth
child. He is valuing a big family over educational attainment for his
children, and contraception is not an option given the religious values
shared by him and his wife. In this case, we do not seek to change his
religious commitments but will instead explore what he, his wife, and
his family believe to be important needs and what they imagine as a
more desirable state for the family and its members.
This, however, does not mean that we simply go along with our cli-
ents’ values and ideas even when they can be damaging to the clients
and/or their significant others. By focusing on their needs and desires,
and remaining open and flexible with our own thoughts and ideas, we
can often arrive at workable solutions. A student of mine working in the
child protection service once came across a young girl whose parents
were arranging for her to be sent back to Africa to be circumcised, as
the procedure was illegal in Canada. My student approached this case
by first recognizing the parents’ wish for a happy life for the daughter
– establishing a shared understanding of their goal as the first step of
engagement. She then got the parents to imagine their daughter’s life
Problem Translation 83
in Canada and what role female circumcision might play in her life as
she grows up in this country. She then realized that the parents believed
that if their daughter were not circumcised, no one in their community
would marry her. My student, after listening to their negative experi-
ence of the immigration and settlement process, was able to re-present
the parents’ observations of how young people from their country had
changed after coming to Canada. She then invited the couple to imag-
ine how many of the young people in their culture would grow up not
following their parents’ teachings and instructions. The couple claimed
that the majority of the young people were becoming Westernized, less
traditional, and less obedient. She then asked them to imagine what
would happen twenty years from now. The conversation then led to
estimating the percentage of young men from their culture who would
insist on marrying a circumcised bride twenty years later in Canada.
The father estimated it to be less than half. At that point, the student
found common ground with this couple.
Needs Profile
In documenting a client’s needs profile, the first step is to list all the
needs identified (see Worksheet 4.1). Each item entered has to be clear-
ly indicated by specific behaviour markers. It is also important that
each item is recognized by the client. In case agreement has not been
achieved, separate entries can be made specifying which is the client’s
inference or label and which is the practitioner’s. After a list has been
prepared, each item can be assessed with regard to its significance and/
or relevance as perceived by the client, its urgency, and its manageabil-
ity. This assessment will enable the client and the practitioner to jointly
determine which need or needs should be worked on first.
Articulation of Goals
Once the needs to be addressed have been prioritized, they can be fur-
ther translated into goals. The translation of needs into goals allows the
client to imagine possible gratification, and as such it is an empowering
process that helps to foster positive expectancy. The practitioner, how-
ever, has to be careful in facilitating realistic formulation of goals. Goals
that appear unrealistic to the client may lead to skepticism or cynicism
and can be alienating. Clients who have repeatedly experienced failure
and frustration need to feel connected to goals that are attainable. In
case the client has a much more pessimistic assessment regarding the
86 Basic SSLD Procedure
feasibility of a goal, the general principle is, again, not to argue with
the client. It is usually more helpful to resort to incrementalism – get-
ting the client to see how an incremental step towards a larger goal can
realistically be achieved. For example, a bi-ethnic lesbian with severe
mental illness who has been out of work and living a relatively isolated
life for over a decade may have difficulty imagining how she can be
gainfully employed, develop a fulfilling intimate relationship, and re-
connect with her family and community, even though she is clear that
these are exactly what she needs and desires. She can be invited to think
in terms of what needs have to be accomplished first for one of these
goals to be achieved. In this case, the client identifies that not worrying
about the return of major psychotic symptoms and being able to keep a
healthy daily routine will be a helpful first step.
The principle of incrementalism is also relevant in the reverse situa-
Problem Translation 87
other models of practice. The major tasks are: (1) engagement with the
client towards building a working alliance; (2) gaining a good under-
standing of the client’s problems or issues and their underlying needs;
(3) assessment and clinical formulation according to the intervention
model. The behaviour focus of SSLD, however, means that the inter-
viewing is also done in a slightly different way. This section will high-
light the key features of behaviour-focused interviewing.
As the name suggests, this kind of interviewing is focused on behav-
iour. This behavioural focus is supposed to help the client, and therefore
should not be allowed to turn into an obstacle for clients in their pres-
entation of issues, articulation of their experiences, and description of
their circumstances. In inviting the client to become behaviour-focused,
we are not trying to substitute the client’s language with behavioural
language, but rather to let behavioural language facilitate clarity in ar-
ticulation and expression. The client’s initial presentation of problems
and issues typically includes both behavioural and non-behavioural
elements. For example, when asked about her situation in the first ses-
sion of counselling, a woman with a diagnosis of anorexia described
herself as “a complicated person” who is “sneaky and devious” – these
are non-behavioural descriptions. Her narrative also contained behav-
ioural descriptions, such as how much and what she ate every day as
well as what medication she was taking.
A behaviour-focused interviewer may be interested in translating
“a complicated person” and “sneaky and devious” into behaviour
markers. This can be done by asking the client questions such as: you
said you’re a complicated person, how does this show in what you
do, what you think, or the way you experience things? Alternatively,
we can ask: what are the things you do that make you think you are
sneaky and devious? This is usually not difficult to do, but it should
be emphasized that we should not translate every non-behavioural
component of the client’s narrative into behaviour markers; we should
focus only on those parts that are seen as related to the key issues that
the client may want to work on. When we are about to zoom in and
get a behavioural focus, we need to first determine if defining “a com-
plicated person,” or developing behaviour markers for “sneaky and
devious,” should be a focus of attention with this client. In this par-
ticular case, the client was not too concerned with herself being com-
plicated; the sneaky and devious part was most relevant in terms of
her attempts to hide her anorexia and binge eating from her family. As
a general principle, when we want to focus on a non-behavioural de-
Problem Translation 89
manipulative, or you said you have been a loser all your life. Then we
add the specific questions, like: What are the things you/she/he do(es)
that make you think so? What do you do when you’re angry? The fol-
lowing vignette with a client with clinical depression can illustrate how
we can get on to behaviour markers.
practitioner: You said you feel depressed all the time, so what do you do
when you feel depressed?
client: Nothing. I just do nothing.
practitioner: So when you’re depressed and doing nothing, where are you?
client: Home, I just stay in my room.
practitioner: Where in your room would you be? Bed, sitting on a chair
somewhere?
client: I spend quite a bit of time lying on my bed, not sleeping, though, and I
sometimes sit on my bed as well, not doing anything, I don’t really have a lot
of space in my room, it’s kind of small. [Note: there may be a wish for more
space]
practitioner: How much time would you say you spent lying in bed yester-
day, not counting the time you were sleeping at night?
practitioner: You said you do not feel comfortable going out of your own
room when your family is there.
client: Yes, they want to watch shows that I do not like, and I don’t feel like
asking them to change channels or whatever, but I end up listening to their
programs even when I stay in my room, so I sometimes play music with my
headset on, even when I’m not really listening, and that’s the time when I
feel most miserable, thinking about the past, and the friends and activities
that I used to enjoy.
iour focus for a while and reopen the narrative space for the client to
talk more about things that are of interest to him or her.
It is usually helpful for us to provide a summary, connecting behav-
iour-focused translations to the client’s presenting issues. For example,
we might say:
Earlier in the session you said you have been a loser all your life. You said
that you are now thirty-five and you feel you have not accomplished a
thing. You are not happy with the fact that you did not finish college, and
you believe you have a problem holding on to a job, although you have
actually worked in this one for over a year and a half. It appears that you
really want to see yourself getting some kind of further training and edu-
cation so that you can move ahead in your career. You also feel that you
might be able to do better if you were able to deal with authority figures
who are critical of you.
The key point that we need to remember in the interview is that the
behaviour-focused translation is geared towards a shared understand-
ing between the client and the practitioner. The process should help
clients to see the connection between their needs and wishes and the
actions they are taking to address them. While we are focusing on be-
haviour markers in order to gain clarity and specificity, we must remain
mindful of the significance of the client’s behaviours, what they mean
to the client, and their current and/or potential effectiveness with re-
gard to the goals that the client desires. A summary of the behaviour-
focused interviewing procedures is given in Box 4.2.
92 Basic SSLD Procedure
Name:
Week Starting:
Target Behaviour:
Hour
Starting Monday Tuesday Wednesday Thursday Friday Saturday Sunday
4:00 a.m.
5:00
6:00
7:00
8:00
9:00
10:00
11:00
12:00 p.m.
1:00
2:00
3:00
4:00
5:00
6:00
7:00
8:00
9:00
10:00
11:00
12:00 a.m.
1:00
2:00
3:00
the client, pictures of what she wears to the dates), but it is usually more
effective to observe the client’s actual behaviour directly.
In-Session Role-Play
day life is within the same physical premises, and it may sometimes
make sense to use the actual location.
In addition to the physical setting, the interpersonal and social fea-
tures are important dimensions of the simulation. In many cases, they
can be more important than the physical features. For example, a client
having difficulty with authority figures needs to role-play with collabo-
rators who can convincingly play the role of an overbearing and in-
timidating authority character. In individual work, the practitioner can
usually do an adequate job; however, there are some situations where
the client may bring in people she or he knows to be collaborators. Col-
leagues of the practitioner can sometimes be invited to be collaborators
as well. There are also settings where professional simulators are hired
to do the role-plays. The advantages of professional collaborators in-
clude convincing acting, more effective improvisation, sensitivity and
responsiveness to the client’s needs, and consistent performance. They
do, of course, incur additional cost. In group work, members can usu-
ally provide an adequate pool of talent, but external collaborators can
also be invited – again, with the fully informed consent of all the group
members involved.
During a simulation, clients can sometimes be asked to reverse roles
and play the person that they are dealing with in real life. People who
are learning to prepare for job interviews, for example, can benefit by
100 Basic SSLD Procedure
literally sitting on the other side of the table. Reverse role-play can
sometimes be done with the practitioner or a collaborator taking on the
client’s role, but it is possible to let the client play both roles, very much
like the two-chair method in gestalt therapy (Yontef & Simkin, 1993),
only that the focus here is on behaviour instead of emotional responses.
This does not mean that we totally disregard emotional processes. It is
helpful, and in some cases even necessary, to let the client process her or
his feelings and emotions before focusing on her or his behaviour. The
playing of both sides can be very helpful in expanding the client’s per-
spective. It can reduce anxiety, if that happens to be an interfering factor
in the client’s interpersonal or social performance. One of the beneficial
side effects of this role-play is an increase in the client’s sense of mas-
tery, and therefore self-efficacy, for in playing the role of the other per-
son, clients will be taken out of a habitual mode of emotional response,
which can be overwhelming and immobilizing for some of them.
If the client feels prepared for it, this dual role-play can be a useful
assessment tool. For example, a teenager complaining about how he is
having a problem with his father who is described as sadistically criti-
cal and undermining can be asked to role-play a recent conversation
with his father. The advantage of this procedure is that the client will be
working with the character he presented in session, and that represents
his reality. It can be more effective than a simulation role-play by a col-
laborator who might not necessarily deliver a convincing enactment of
the father’s behavioural patterns.
Our focus, however, stays with the client, rather than the other char-
acter the client role-plays. Our assessment is firmly anchored in the
functionality and effectiveness of the client’s behaviour. The client is
constantly reminded to think in terms of the function of her or his spe-
cific responses: “What were you trying to accomplish by doing/saying
that?” and, “To what extent did you achieve your objective by doing/
saying that?” To answer the second question, we obviously have to take
into account the reaction of the other party. Helping the client to see
the connection between her or his behaviour and the reaction of other
people helps to develop interpersonal sensitivity, which is an essential
component of interpersonal effectiveness. We can reinforce this per-
spective by saying something like, “Your goal was to pacify him, and
reduce the tension, and then you said … and we then see him becoming
even more hostile and critical.” This can be followed by a prompt such
as, “Now that you have a chance to look at what you did and how oth-
er people responded, would you think of doing anything differently?”
Review of Current Strategies 101
Assessment of Effectiveness
Adult client with a long • More assertive with • Direct communication of emotional
history of schizo- regard to own needs needs and personal preferences
phrenic disorder and preferences • Refusal of unreasonable demands/
wanting to improve • Building mutually requests
relationship with gratifying and sup- • Dealing with criticism
family members portive relationships • Increasing emotional sensitivity
• Communicating emotional support
• Self-disclosure
• Building commonalities and
connection
boundary between them is not rigid, but is quite nebulous. The dif-
ferentiation is offered as an aid in conceptualizing client behaviour,
and the concepts are intended for pragmatic purposes – they are useful
only when they are helpful in the intervention process. It is possible
that practitioners and clients can conceptualize the same behaviour se-
quences either as strategies or skills. The most important points are:
whether the conceptualization helps clients get a clearer understanding
of their situation; what the connection is between behaviour and goals;
and what can be done to become more effective in terms of their agen-
tive, interpersonal, and social functioning.
Strategies
Developing trust
Cultivating intimacy
Composite Skills
Self-disclosure, building common ground
Emotional engagement, empathic responses
Micro-processes
Using “we” language, sharing childhood experience
Reflection of feelings, emotional joining, positive affect
After finding out what the client is doing to address her or his needs,
determining whether those actions and behaviours are functionally
relevant, and assessing the effectiveness of the client’s current skills, a
review of the current strategy process should help us learn something
about the client’s behavioural inclinations and learning style. Some cli-
ents refer to principles a lot, some are spontaneous in their responses,
some demand structure and systematic instructions, some show a lot of
initiative, some are hesitant to participate in role-plays, and some are
thrilled by them. Attending to particular patterns and learning styles
can facilitate engagement with clients and help to motivate them in the
learning process. This is consistent with the contingency-based think-
ing of SSLD in that we do not assume a similar response pattern and
learning style for every client, and in that we allow for individual dif-
ferences.
Review of Current Strategies 107
Endnotes
circumscribed view on their needs and goals than we do, which is not
uncommon when working in psychiatric and mental health settings.
In such situations, the general principle is to establish and work on
the highest common factor. Given the incremental character of SSLD
practice, we can work whenever there is common ground, and shared
understanding will generally be expanded upon successful completion
of shared tasks.
For instance, when we are working with clients with serious mental
health issues who are returning to community living after an extended
period of hospital and residential care, the idea of an overall set of strat-
egies that addresses their housing, employment, social, personal, and
emotional needs can appear unrealistic, remote, or even overwhelm-
ing or threatening to them. It would probably be better if we work
with them to first identify priority areas and then to develop a simple,
manageable strategy. Successful completion of the first task – say, for
instance, finding housing – will break a pattern of passivity and nega-
tive expectancy, empower the client, enhance the client’s self-efficacy,
and set up a tentative positive expectancy for developing subsequent
tasks.
When working with clients who are not in the position to make de-
cisions, such as in the cases of young children, seniors with demen-
tia, or clients with developmental challenges, it is important to work
with their caregivers or legal custodians. We should, nonetheless, try to
understand as much as possible what the client’s own preference may
be and give it due consideration in our formulation of an intervention
plan. As well, whenever it makes sense, we will try to explain our for-
mulation and plan to the best of the client’s understanding.
The more we can translate the ultimate goal (e.g., improved couple re-
lationship, social integration) into specific tasks (e.g., learning to listen
to each other and understand each other’s needs, overcoming social
phobia, and initiating interpersonal contact), the easier it is for clients
to understand the process of the SSLD intervention and develop posi-
tive expectancy regarding the eventual outcome. The composite tasks
can be organized into a list of learning objectives. Each learning objec-
tive is to be achieved through a number of specific learning modules.
In SSLD, a learning module is a self-contained unit of learning activity
with specified objectives, procedures, and learning outcome.
Formulating Relevant Strategies and Skills 111
Once the learning tasks are mapped out with reference to the final goal
or outcome desired by the client, we can move into action. The selec-
tion and sequencing of specific learning objectives and the modules to
address them have to be informed by a good assessment of the client’s
strategies and skills; the procedure for this assessment has been pre-
sented in the preceding chapter. Most clients would have already mas-
tered some of the relevant composite skills required for their specific
strategies. Our task now is to clearly identify the necessary strategies
and skills to be learned and developed. For example, if we are working
with a couple trying to improve their relationship, the composite tasks
or learning objectives may include (1) improving the communication
pattern; (2) creating more shared experiences that are pleasurable for
both partners; and (3) helping the partners to support each other in
their personal growth and development.
Couple communication has been studied extensively, and many
programs for improving couple relationships have already been devel-
oped (e.g., Chee & Conger, 1989; Gurman & Jacobson, 1986; Jacobson &
Margolin, 1979; Jakubowski, Milne, Brunner, & Miller, 2004; Lee, 1991;
Perez, 1996; Reardon-Anderson, Stagner, Macomber, & Murray, 2005).
It is obviously possible that many couples can benefit from preplanned
programs that are available, and these programs and/or components
can be used when they are appropriate. The SSLD approach does not
seek to reinvent the wheel, but simply tries to get the best program for
Figure 6.1. Example of Learning Program Organization
When it comes to the actual in-session work with clients, the design
of specific learning modules is the centrepiece of SSLD intervention.
There are a number of building blocks for the design of specific learn-
ing modules for SSLD programs. The first is the selective application of
learning modules that are currently available.
Ready-Made Modules
ized and managed, and how they can interact with their children, then
the purpose of improved communication will be considered achieved.
This is consistent with the behaviour-oriented character of SSLD.
The second question we ask is what needs to have happened for
the couple to be able to come to such an agreement and shared under-
standing. This will likely lead to a list of conditions such as (1) they are
willing to talk to each other; (2) they can listen to each other; (3) they
can understand where the other party is coming from even if they do
not agree; (4) they see how the other party’s value is related to her or
his earlier life experiences, including cultural and family exposure; (5)
they understand how the expressed value is often driven by underly-
ing needs, such as a need for security, affiliation, esteem, and the like;
(6) they appreciate that although their expressed values are different,
they are similarly espousing values that are functionally related to their
respective needs; (7) they recognize that there are usually more ways
than one to address these needs; (8) they accept that different values do
not always dictate completely incompatible actions, and that compro-
mise and concession are possible; (9) they try to imagine that the values
people espouse do not have to be rigidly adhered to; (10) they appreci-
ate that they do not uphold these values with the same valence in all
situations, and they do make concessions and modifications with re-
gard to the purpose of each situation; (11) they believe that when there
is increased understanding, trust, mutual respect, and appreciation
between two individuals, it is easier to negotiate common purposes
even when underlying values may vary; (12) they are willing to explore
ways to improve understanding, trust, mutual respect, and apprecia-
tion; and (13) they believe that the above is achievable through SSLD
procedure and by working with their current practitioner.
This list may appear a bit long when it is written out, but most expe-
rienced practitioners actually go through a very similar internal process
when they respond to complex client situations. Having an anticipated
list of necessary steps to take will make it possible for us to begin to put
a program together. There are, for example, specific learning modules
to help get people who have opposite or incompatible positions with
regard to attitude, opinion, positions, and assumptions to listen to each
other and come to some form of concession or compromise. The Listen-
ing Triad Exercise (Pfeiffer & Jones, 1974), which was designed for this
purpose, will be described in more detail in the chapter on reception
(Chapter 8, p. 145). In the case where such ready-made modules are not
available, which is the focus of this section, having more small steps
120 Basic SSLD Procedure
specified will allow the practitioner to at least try to tackle the compos-
ite tasks one by one.
these family members, even when their demands are sometimes exces-
sive. They need to develop and learn assertive responses which will
not damage their relationships. The desired outcome in this particular
case is to be able to say no in a nice way so that the relationship is not
negatively affected.
2. Brainstorming
talk to family members might remove her burden. This solution obvi-
ously does not work for people who do not have husbands. We can,
however, pursue how the husband might say no to others, and see if
that can be adopted to become part of what the women can say. The
idea of getting help and support from a significant other can also be
elaborated in other ways, such as getting a trusted person to help a cli-
ent to rehearse assertive expressions or actions.
Extracting potentially useful ideas or elements from clients will con-
tribute towards the generation of strategies and skills. This process of
building from components also feeds well into an incremental learning
procedure. When a number of strategies and skills finally emerge from
collaborative creation, we will go through the same process of break-
ing them down into incremental steps to be learned, which has been
discussed above.
Once the strategies and skills to be learned have been spelled out, cli-
ents can then go through the process of learning through in-session ob-
servation learning, simulation, role-plays, and rehearsal, which will be
described in more detail in the next chapter. With collaborative creation,
the outcome definition and brainstorming segments serve the purpose
of instruction and provide a good cognitive template for the strategies
and skills to be learned. As elements or components are suggested by
the clients themselves, it is usually easier for them to participate in the
in-session learning activities. Clients often feel empowered and excited
that they have contributed to the creation of a solution for their own
problems, which can also be used later by people experiencing similar
difficulties.
When the strategies and skills are simulated and rehearsed in-session,
there is always an opportunity to make modifications and refinements.
As real-life conditions and circumstances are represented in-session,
clients will learn to deal with those specific contingencies, such as a
family member responding negatively to an assertive statement made
by a client. Getting members to work on the spot to deal with such
contingencies and challenges is usually an energizing and interesting
process. The positive side effects of this process are most valuable in
strengthening client self-efficacy.
Formulating Relevant Strategies and Skills 125
Endnotes
Learning by Doing
Homework
The 4Rs
When clients are ready, they are encouraged to apply their learning in
their real lives. The 4Rs of real-life practice, report back, review, and
refinement are crucial steps in establishing the newly acquired strate-
gies and skills in the lives of clients. In SSLD practice, the 4Rs have to
132 Basic SSLD Procedure
be concrete and specific. For example, when clients say that they had
a good conversation with their boss or partner or customer, we need
to have specific behavioural indicators of what a “good” conversation
means. Our understanding will be clearer when specific verbalization
and/or behavioural outcomes (e.g., changing my work shifts, helping
out with the dishes, purchasing my product) are reported. Learning to
report real-life practice experiences and illustrating them with behav-
ioural markers and/or factual indicators is also a communication skill
that many clients need to learn.
Following a similar line of thought, review and refinement can only
be done effectively when there is either detailed reporting or recording.
When it is advisable and when privacy rights are duly respected, elec-
tronic recording of real-life performance will form the best basis for re-
view and refinement. This is what we do in training psychotherapists.
Another good example is when parents bring back a video recording of
how they engage their child in reading. Such recordings enable specific
and concrete feedback that would otherwise be impossible.
Incrementalism
Notes on Setting Up
try to refrain from dictating the set-up and the process, and we provide
structure and give directions with due consideration of the learning
needs and styles of our clients.
Termination
ensure that we do not use our professional work with our clients to ad-
dress unmet personal needs in our own lives. The structure and design
of SSLD practice facilitate a clear understanding of goals and how they
are to be accomplished within the context of a professional relation-
ship, which is shared by both the client and the practitioner. As clients
and practitioners make progress together, clients are increasingly em-
powered with an enhanced sense of self-efficacy. Reluctance to leave
the SSLD program and/or the practitioner is rare. When it happens, a
review of the progress should be performed to identify unmet or unad-
dressed needs, both of the practitioner and of the client. These needs
should then be addressed through a program with an explicit emphasis
on movement towards client independence and autonomy.
Summary
Building Blocks
In this section, we will introduce basic building blocks for SSLD prac-
tice, covering (1) receptive skills such as attentive listening, recognizing
emotional content, attitudes and positions, and sensitivity to under-
lying needs; (2) expressive skills involving articulation, presentation,
and/or disclosure of factual data, opinions, needs, and goals, as well as
emotional content; (3) interactive skills like engagement and intimacy
building, which involve processes such as building common ground,
maintaining an open and safe narrative space, communicating posi-
tive emotions, expanding mutual understanding, and creating a shared
private space; and (4) instrumental skills that usually target a particu-
lar functional task or accomplishment, such as selling something to a
customer, borrowing money from a banker, or getting someone from
another department to agree with your proposed work plan. Such task-
oriented instrumental strategies often involve complex skills, such as
getting the other person to see things from your perspective, making
your proposition look attractive, invoking a sense of obligation, or ne-
gotiating common ground.
As shown in Table P3.1, each of the sets can involve a wide spectrum
of strategies, skills, and corresponding micro-processes. No one can ac-
tually give an exhaustive list of all the possible strategies and skills,
and there are often unusual circumstances that call for creativity and
innovation. The table gives an example of a template that supports a
better conceptualization and organization of skills components that we
might want to include in the learning plan. Again, we emphasize that
we do not believe that everyone should learn the same sets of skills;
rather, they should learn the skills that are called for in their given cir-
cumstances.
138 Building Blocks
Reception
Factual Content
Upon hearing the news of a friend’s child 1. Young people without a degree are
dropping out of university. much more likely to be unemployed.
2. Bill Gates did not finish his undergrad.
work and career; (3) she will be able to afford to stop working when she
has a baby; and (4) she will be a better caregiver for her baby than any
other woman.
The ability to identify and decipher attitudes and opinions can be
learned through systematic exposure to social situations and a variety
of statements coming from different perspectives and positions. This
learning can be facilitated by simulated or role-played conversation as
mentioned above. During the simulation of specific social situations,
the learner can be asked to recognize attitudes, opinions, and assump-
tions contained in specific utterances. Electronic recording and play-
back, together with feedback from the collaborator and the practitioner,
can usually help to improve the learner’s ability to recognize attitudes
and assumptions.
The Listening Triad Exercise (Pfeiffer & Jones, 1974) is a procedure
often used in interpersonal relationship training programs to help
people learn to listen to the views of others and respond effectively in
everyday conversations, especially in the case of argument or a differ-
ence in opinion. The exercise is usually done in a group context, where
members break into smaller groups of three. Two of the members will
engage in a conversation involving an argument or difference in opin-
ion. For example, they can take different views on abortion and start a
debate. The third member will serve as the umpire to enforce the rules
of the exercise. The rules are quite simple: one member can start the
conversation or argument, and it does not matter who starts first, but if
agreement is not readily reached, coin-flipping or drawing lots should
easily resolve the situation. To begin the exercise, the first speaker will
present her or his view. Then the other person can respond. The only
thing is that before the second person can present her or his views, she
or he has to first repeat all the points made by the first speaker to the
satisfaction of both the first speaker and the umpire. After the second
speaker has accurately repeated the first speaker’s points and then pre-
sented her or his own points, the first speaker can respond. Again, the
first speaker has to repeat all the points made by the second speaker
before he or she can add new points. The umpire will ensure that each
speaker’s arguments are both listened to and repeated before new ar-
guments can be made. This exercise, through ensuring careful and ac-
curate listening to other people’s attitudes, opinions, positions, and
assumptions, is a very effective procedure for resolving differences and
enhancing mutual understanding. I have used it extensively in couple
counselling with very good results.
146 Building Blocks
Emotional Content
partners’ small acts (as well as their variation), such as the clothes and
accessories they wear, the dishes they prepare, the things they bring
home, or the items they rearrange or move around the house. Clients
will also learn to appreciate the little things their partners do with or for
their parents, friends, business associates, and the like. Among family
members, there are routines that often become invisible and unappre-
ciated. We can think of the countless trips parents take when driving
their children to various activities, the copious loads of laundry done
over the years, and the many meals prepared. In the musical Fiddler on
the Roof, the question “What is love?” is answered by reference to these
apparently humdrum, repetitive acts.
Expression
Self-Expression Is Purposeful
Self-Presentation
keting. There was also a woman who was trying to reintegrate into the
social world, including her husband’s social circle, after a long period
of illness and relative social isolation. These individuals had very dif-
ferent personalities, subscribed to different cultural orientations, and
preferred different styles of interpersonal interaction, but they all went
through similar learning procedures in terms of their self-presentation.
Physical Appearance
take some risks, and the time to really focus on minute details of their
appearance. In such exercises, what participants often found was that
their physical appearance was not an isolated feature of their presenta-
tion of self. More often than not, participants noticed that their posture,
facial expressions, and the simple way that they greeted people could
often make a bigger difference than the make-up and the clothes they
wore.
Positive Self-Statement
Positive reframing does not always come as a natural gift; most people
actually need to learn to do it. One of the ways to learn positive refram-
ing is to practise reframing negative statements through repeated
exercises.
The following are some of the strategies that may be of help:
1. Looking for the Positive through the Other Side of the Coin
There is a structural duality to most human realities, meaning that there
is always a positive and a negative side. To get to this, one can ask
the questions: is there anything good about this? what could have
been worse? The Friar Lawrence example in Box 9.3 illustrates this
process.
6. Humour
Humour almost always involves taking a different perspective and trigger-
ing an emotional response that is incompatible with the negative affect
associated with the original event. For example, a man in a treatment
group for insomnia and sleep-related issues jokes about another mem-
ber’s complaint of a snoring partner by saying, “That’s annoying, okay, but
I am sure you do not want another woman to take your place.”
Self-Introduction
And,
tained easily in an SSLD group setting, but the ultimate goal is always
for people to be able to identify people they can work with in their eve-
ryday lives. In one-on-one counselling or consultation, the practitioner
can sometimes offer the feedback, and the use of collaborators can be
helpful as well.
Apart from what is spoken, the importance of non-verbal behaviour
has been well established (Argyle, 1983, 1988; Knapp & Hall, 2007). Fa-
cial expression, posture, and demeanour can all play a role in producing
a good performance. Specific behaviours such as eye-contact, gestures,
handshakes, and hugging can also be learned and refined with helpful
feedback in an SSLD context. A point that should be noted here is that
in an increasingly globalized world, cultural diversity is becoming an
ever greater part of our social reality. As different cultures have varying
conventions regarding what is appropriate, the mastery of appropri-
ate etiquette is often necessary for intercultural encounters. Particular
cultural communities have specific conventions with regard to things
like dress code, physical distance, eye contact, greeting gestures, formal
addresses or salutations, bodily contact, gender-based segregation of
social space, exchange of gifts, and even serving or not serving food or
drink. Some communities are very tolerant of outsiders not knowing
and following their rules, while there are others who can be more easily
offended. When we are new to a cultural community, we may want to
seek consultation from an insider or a knowledgeable informant with
regard to appropriate self-presentation.
I can give as an example my own personal experience in various cul-
tural contexts. In Toronto, for example, it is not uncommon for family
and friends to give each other a hug when they see each other, but that is
not practised among the Hong Kong Chinese community I come from.
It took me a while to figure out the more subtle rules regarding when
and whom to hug, and the additional conventions regarding kisses on
the cheek. The actual set of rules can become quite complicated when
I try to spell it all out. For example, there is the question of whether to
initiate the hug or wait till you see the other party getting ready for it,
such as by opening her or his arms; and the question of how to respond
to other cues when you see a former graduate student dressed in her
traditional ethnic costume. We have to learn that when we are dealing
with the huge diversity of people coming from different ethnic, cul-
tural, and religious backgrounds (Toronto claims over 160 language/
dialect communities), one needs to be very sensitive and careful so as
not to communicate the wrong message, be it lack of interest or impo-
162 Building Blocks
lite intrusion into personal space. I can give other examples such as
learning the toasting conventions when attending a formal dinner or
banquet in China, where there are significant regional differences. An-
other example is the use of formal salutations versus first names within
academia; there are huge differences on this point when one travels
internationally. Even if we only look within the one university where I
work, differences can still be found across the various disciplines and
departments. What I do need to add, however, is that such cultural di-
versity offers interesting and fascinating lessons to be learned and sig-
nificantly enriches my social and cultural life.
Presentation of Facts
Expression of Ideas
consideration is still what other people need and want, and how that
relates to our desired outcome in any given encounter.
Recognition of the other party’s needs and wants is often a good way
to preface our own expression of ideas. Being able to connect our ideas
to another person’s needs or interests will increase the chance that our
ideas get a positive reception. The emphasis on reciprocity reflects an
important value regarding human interaction and connection. A good
interpersonal or social encounter is not just about us getting our way
and achieving our goals without regard for others. More often than not,
being able to work towards mutual or reciprocal benefit is more gratify-
ing. Presenting our ideas is even more effective when we do not only
understand other people’s needs but also have a sense of their perspec-
tive or mindset, including the language they are most familiar with. As
I write this paragraph, for instance, a few philosophical ideas rooted in
my Chinese cultural background come through my mind, and many of
them will not be immediately relevant to the typical English reader. I
have come up with the idea of mutuality and reciprocity without going
into a lengthy discussion and critique of utilitarian individualism, for
I do not assume that all my readers subscribe to this ideology. Some of
you may be interested in learning more about my philosophical views
while others may be happy to move on to the more pragmatic ideas.
In a rapidly globalized environment where we get in touch with an
increasingly diverse set of people in our everyday lives, ideas have to
be packaged differently for different audiences. Flexibility and contin-
gency thinking are usually helpful. The following are some of the prin-
ciples to consider:
(1) Try to understand the other party’s needs and goals in the encoun-
ter or interaction.
(2) Have a sense of how the idea you are presenting fits into the con-
text of the other party’s circumstances.
(3) Present the idea with reference to the other party’s needs and cir-
cumstances.
(4) Use language, examples, and metaphors that are within the other
party’s scope of imagination; it is best to use what can be under-
stood by most of the people when working with diverse or hetero-
geneous audiences.
(5) Explain the unfamiliar in terms of the familiar: when it is neces-
sary to use new or unfamiliar concepts or examples, try to connect
them to what the audience is familiar with, and provide back-
ground information and explanations.
Expression 165
(6) Stay attuned to the other party’s responses; watch for signs of in-
terest, attention, engagement, and resonance, or boredom, puzzle-
ment, disagreement, and resentment.
(7) Whenever appropriate, seek direct feedback from the other party
to see if your idea has been understood.
Expression of Needs
punitive behaviour. Some people who need to deal with the pain
caused by traumatic experiences earlier in life, but who do not have a
good understanding of this, may resort to the use of alcohol, chemical
substances, or gambling.
In everyday life, being able to effectively communicate one’s own
needs clearly increases one’s chance of having those needs met. Yet,
as in the case of emotional expression, not all needs are considered le-
gitimate or acceptable by society. The expression of sexual needs by
seniors living in nursing homes, for example, is often met with negative
responses (Bauer, McAuliffe, & Nay, 2007; Kamel, 2001). Unmet and
conflicting needs are often found at the base of human suffering and
tragedy, including in situations such as crimes and wars. Being able
to express one’s needs and negotiate their gratification is obviously a
valuable skill to be mastered.
The problem translation procedure described in Chapter 4 provides
a good basis for practitioners to identify needs that are sometimes not
obvious to clients, and allows them to provide useful feedback. In situ-
ations where there is little conflict and adequate trust, the communi-
cation of needs can be more direct and explicit. In more challenging
situations where there is risk of interpersonal incompatibility or con-
flict, more sophisticated strategies and skills have to be learned and
developed. In SSLD practice, two principles are often helpful in the
development of such strategies and skills. One is trying to help the
other party to see things from your perspective and facilitating their
empathic response. The other is to negotiate maximum common
ground between two parties.
Trying to get people to see and experience things from your perspec-
tive is not always easy, for most people naturally stick with their own
perspective. As was suggested earlier in the section on the expression
of ideas, being attuned to the other party’s position and experience can
be very helpful. Using language that the other party is familiar and
comfortable with is another strategy. Very often, a direct and explicit
statement such as, “I need to have more personal space” can be effec-
tive. Connecting our needs with what the other person can do may be
particularly helpful, such as, “If you could do that, it would make me
feel much better.” Whenever possible, we try to put the other person in
the subject position of a sentence instead of placing them as an object.
People usually feel better when they are in an agentive position and are
capable of doing something that makes a difference.
What we may want to avoid in most situations are confrontational
Expression 173
(1) I don’t know why there is always something wrong with your
flights. Now I am going to be without my TV for the next twelve
hours.
(2) My system is broken; please see if you can fix it.
(3) I understand that you are busy right now, but when you have time
later, would you mind taking a look at the system? It doesn’t seem
to be working.
Expressions of our own needs and wishes are usually more effective
when they recognize the other party’s needs and position, and when
they express our needs without being accusatory.
Another helpful approach is to try to establish a common goal and
create a win-win situation. When that is not really possible, we can at
least try to negotiate compatibility or some compromise that the other
person can live with. This is sometimes called an assertive-responsive ap-
proach – and this has to be distinguished from the kind of assertiveness
advocated by practitioners of assertiveness training. In the traditional
approach to assertiveness training (e.g., Smith, 1975), the emphasis is
on “what I want” and “what I need,” or “what my rights are.” Asser-
tive-responsiveness, by contrast, is about meeting our own needs (as-
sertiveness) while at the same time having regard for other people’s
needs and rights (responsiveness).
Chapter Ten
Engagement
As Gergen (1991) observed over two decades ago, most people living in
the developed world are living in a postmodern era, and we are expe-
riencing a rapid increase in the number of individuals we meet in our
lives. This increase in quantity is also associated with increased diversi-
ty in terms of geographical location, ethnicity, culture, profession, per-
sonal background, and so on; and must have been growing over the last
twenty years. From a social psychological perspective, many people are
overwhelmed with this increased quantity and complexity of contacts
and interactions. People’s overall life satisfaction and well-being are to
a large extent conditioned by the quantity, nature, and quality of the
relationships they have with others, ranging from brief encounters to
longer-term relationships. Learning to effectively engage with others
so that we can attain our desired goals in life is arguably central to our
quest for well-being. In the last two chapters we have dealt with recep-
tion and expression, the two fundamental aspects of communication
and interaction. In this chapter, we will explore the strategies and skills
involved in interpersonal and social engagement, which is the first step
in building relationships.
Engagement
1. Agenda management.
2. Positive responding: providing reinforcing feedback.
3. Finding commonalities and maximizing shared interest.
4. Strategic self-disclosure.
view of their potential compatibility, believing that people are not in-
terested in them or are even potentially hostile. They do not think that
they have something to offer with regard to the personal needs of the
other party. In an SSLD program, we directly involve these individuals
in role-playing situations that they dread and record them for subse-
quent playback and review. In the review process, we obviously pay
attention to their performance, covering details such as posture, physi-
cal interpersonal distance, facial expression, eye contact, meshing, non-
verbal behaviours, tone quality, content of their utterances, and so on.
Review of these micro-processes focuses on how the client can present
themselves as a more acceptable or pleasant participant in social inter-
actions. The recorded role-play reviews also help them to assess the
other party’s experience more realistically. Whether it is a member of
the group, a therapist, or a collaborator role-playing with them, they
will have a chance to learn about the other person’s needs and on-the-
spot experience through direct questioning, if they want. This exercise
often helps them to appreciate the room for compatibility.
Specific skills enhancing compatibility in the initial contact and en-
gagement phase include topic management, positive responding, max-
imizing commonality and mutuality, and strategic self-presentation
(Box 10.1). Assuming that the initial building blocks of reception and
expression skills described in the preceding sections have already been
established, an individual should now be capable of positive self-pres-
entation, listening, expression, and so on. What is important now in
the engagement process is to get the other party interested in continu-
ing the interaction with us, and to create positive conditions for this
interaction. Successful engagement enhances the chance of achieving
whatever instrumental objectives we might have (e.g., trying to sell a
financial product, requesting assistance, negotiating a deal), or it can
improve the prospect of a rewarding relationship in the longer term.
178 Building Blocks
usually recognize what the other party is currently talking about. For
example, we can say something like, “I know you’re eager to find a
[nursing home] placement for your mother, and I can relate to the frus-
tration you are experiencing, but we need to know a bit more about
her health conditions in order to be able to assist you to make the best
arrangement for her.” In training programs, participants sometimes ex-
press the concern that if we are accommodating listeners, we will end
up spending too much time listening to people, but testing this out in
simulated exercises in-session usually shows that it actually takes less
time to accomplish our agenda if we stay tuned in to the other person’s.
In contrast, in high-tension or high-conflict interactions, we see people
trying to talk over each other, which can sometimes deteriorate into a
shouting game and leave very little room for effective communication
or engagement.
Most people enjoy being valued and taken seriously. An easy way to
indicate attention and careful listening is by repeating what the other
party has expressed. It can be simple things like, “I know you don’t
drink coffee,” or, “You said you hated trains,” or it can be implied posi-
tions or needs such as, “You will have some problem with the fur she
is wearing” (the other person has expressed views on animal rights).
In training psychotherapists and counsellors, one thing we emphasize
is to be respectful and nonjudgmental. Very often people express their
opinions in a strong manner, which can come across as rigid, judgmen-
tal, or even offensive. Using derogatory labels such as addicts, losers,
morons, and the like also has a high probability of conveying negative
judgment. The use of phrases like “those people” is often a linguistic
marker of distancing, exclusion, and judgment. Sometimes we may in-
advertently make sweeping statements that apply to people we are in-
teracting with, which can silence or alienate them. Something like, “No
decent human being would leave her child unattended in the house,”
or, “I don’t think any person with even minimal intelligence will buy
into that crap,” can turn some people off immediately. These statements
can often be positively reframed, for example, “The child needs con-
stant attention,” or “There are people who will try whatever means im-
aginable to cheat us.”
Another well-known strategy in positive responding is to say some-
thing positive about the other party. We may be paying a compliment
to the other person’s appearance or the positive implications of the per-
son’s actions. We want to do this with sincerity; challenging ourselves
to find something we genuinely appreciate in the other party not only
helps to facilitate interpersonal engagement but it may actually contrib-
ute to our own long-term well-being by reinforcing a positive outlook
and mindset in our own lives. In SSLD workshops we have an exercise
in which participants will take turns receiving positive feedback from
the other members of the group. It is usually a fun-filled session that
unleashes a lot of creativity. In a recent workshop on sleep and insom-
nia, one member said to another, “You’re the most humorous and posi-
tive insomniac I have ever come across.”
Positive responding can be more focused when there are behaviours
we wish to reinforce in the other party. For instance, a baby-boomer
parent can thank his daughter for helping her grandparents learn to
use the Internet, pointing out that the action literally expands the life-
world of the old folks and contributes to family solidarity, communica-
tion, and sharing. As another example, if we are meeting with another
party and wish for them to see us again, it usually helps to point out
Engagement 181
something special about the meeting and what it does or means to us.
We can, for example, talk about how a dollar spent on dining can gen-
erate six dollars’ worth of economic activities (and therefore we need
to do it more often to contribute to the economic well-being of society).
What we say can often be helped by a little research into the history
of the place (e.g., “this restaurant first started operating one hundred
years ago”), the special circumstances of the day (e.g., “the coldest day
in February in thirty years” or “since I was born”), or the other party’s
interests (e.g., “this place only serves organic and fair trade products”
[a subject from the other person’s Facebook account]). Another exer-
cise we ask SSLD group participants to do is called “you are the first
person.” In this exercise, we have to think of something that the other
party is the first person to say or do. Examples can range from, “You
are the first person to tell me the difference between a latte and a cap-
puccino,” or “to define for me what an overture is,” to “this is the first
time someone has really been able to explain the subprime meltdown
to me,” or “the connection between Heidegger’s concept of time and
Stephen Hawking’s.”
In interpersonal and social situations, some negativity is almost in-
evitable, and what we have learned in the earlier section on positive
reframing should come in handy in these cases. The ability to reframe
positively clearly enhances our capacity for successful engagement, but
there are situations in which positive reframing may not be the best
response. Imagine when someone is sharing an extremely unpleasant
or even traumatic emotional experience; in this case, constant positive
reframing may be experienced as emotional distancing, which can be
counterproductive in our attempt to engage. What we have learned
from studying psychotherapy and the counselling process is that when
there is obvious emotional content, some form of empathic response is
most conducive to the development of trust and emotional bonding.
Positive reframing that is prefaced with an empathic response is more
likely to be effective when we are dealing with emotionally charged
situations. For example, when a friend has just found out that he has
prostate cancer, our response can be something like, “It’s awful news
for anyone, it must be tough for you, but I guess it’s better to find out
sooner rather than later.”
Eugene was thirty years old when he was referred for psychotherapy.
He had a major breakdown while he was in undergrad, reporting audi-
tory hallucinations, and he shifted into a mode of extreme social with-
drawal. In the eight years before the commencement of treatment he
had been living at home with his parents, but maintained minimal con-
tact with them. He reported pervasive fear of physical injury to his brain,
which he valued as the organ essential for learning, understanding the
meaning of life, and enjoying life. He lived in a neighbourhood with many
high-rise buildings and was concerned with possible falling objects that
might cause damage to his brain. He was also very concerned about
food safety, worrying that microorganisms or toxic ingredients might
damage his brain. The client did psychotherapy for thirteen weekly ses-
sions and made significant progress, and then participated in a self-help
group that met monthly. The following is a summary of my notes from
this case.
Engagement
The engagement process emphasized empathic listening, focusing on
the client’s underlying unmet needs. I avoided an authoritative diagnostic
stance, and was careful not to show any judgment of his expressed
fears.
N3C Assessment
• Needs for security, safety, learning, achievement, enjoyment, and
pleasure.
• Circumstances: under medication, good family support, lack of activity
and occupation for over eight years.
• Characteristics: insecure, suspicious, motivated to improve his situa-
tion, believes in “scientific knowledge” and that knowledge is the key to
happiness in life.
• Capacity: intelligent, good self-regulatory and executive functions.
Goal Setting
• Being able to do something he would enjoy, such as reading and going
to the library, with due regard for physical safety.
• Explore more enjoyable activities in life.
184 Building Blocks
ing to the library – that at least got him outside of his house. He gradu-
ally moved on to do more things, and he later agreed to join a self-help
group for individuals with schizophrenic disorder. The expansion of his
variety of activities paralleled his scope of interest, and he eventually
became much more socially active. He started off as someone who had
difficulty talking to friends on the phone, but after a couple of years
in the group, he was hosting gatherings for other members at home.
His interest in reading expanded into that of writing, and he eventu-
ally even contributed articles to newspapers. During that process, he
participated in a much wider variety of social activities and led a much
more interesting life. What I learned from this case was that expanding
one’s own range of interests and activities enhances our capacity for
developing common or shared interests with others, and that showing
interest in the other party’s experience goes a long way in facilitating
interpersonal engagement.
Managing Relationships
weigh the perceived benefits, the theory predicts that the people will
choose to leave the relationship. This formulation was further devel-
oped by a number of scholars (e.g., Blau, 1964; Cook, 1986; Emerson,
1981), but it has also been criticized for being too rational, being too
influenced by the dominant social values of its time, not taking into ac-
count the nonlinear quality of relationships, and being too entrenched
in an individualist culture (Heath, 1976; Miller, 2005).
The SSLD model construes human experience in terms of the multi-
ple domains of functioning as well as the role of the social environment,
including dominant discourses, values, and cultural influences. We also
recognize the fact that many people feel trapped in dysfunctional rela-
tionships even though they may be convinced that they should leave.
The maintenance of dysfunctional relationships can be very painful and
destructive to the parties involved, and is often regarded as pathologi-
cal by some mental health professionals. In practice, psychotherapists
and other mental health professionals find many of their clients deeply
entrenched in relationships with negative cost-benefit balances.
According to social exchange thinking, when partners in a relation-
ship have needs and goals that are incompatible, or when the gratifi-
cation of needs is inequitable between partners, the relationship will
become charged with tension or conflict, making it difficult to sustain.
Many relationships in real life afford gratification of some needs even
when there is tension and conflict. A good example can be found in
marital relationships. Many couples experiencing high tension or con-
flict still stay in their relationships because certain needs are still being
met. These needs can be shelter, company, social status, financial secu-
rity, identity, familial support, social approval, and so on. A review of
people’s relationships will reveal that many of them are characterized
by tension, frustration, or conflict, but very often they still choose to
maintain those relationships. An SSLD analysis shares the view with
social exchange analysis that these people are still motivated to carry
on the relationship and that some of their needs are still being gratified
even in these apparently negative or dysfunctional relationships.
One of the reasons is the survival value of relationships, mentioned
above. Starting in childhood, we learn that our needs are mostly met
within the context of interpersonal and social relationships. We get
food, shelter, company, protection, emotional support, pleasurable ex-
perience, and so on from our parental figures, siblings, friends, and ex-
tended family. When we grow older, we obtain knowledge, recognition,
employment, and other forms of social reward through an expanding
Managing Relationships 189
Relationship Building
ing of the needs they are seeking to meet in any given relationship.
The quality of a relationship is therefore assessed with reference to the
needs profile of the participants. People in a relationship can achieve
more effective communication and negotiation of common goals, and
can learn new ways to enhance the relationship, by making it more
effective in meeting the respective needs of the parties involved. This
can be done by combining some of the composite sets of strategies and
skills described earlier in this book. The problem translation procedure
described in Chapter 4, for instance, can be very helpful in achieving a
better understanding of a participant’s needs. As well, reception skills
can enhance people’s ability to assess the needs of the other parties in
a relationship, while expression skills increase the odds of one’s needs
being recognized and addressed.
Compatibility
a safe space for open expression of the participants’ needs, met or un-
met; (2) applying problem translation analysis to the current situations
of both partners; (3) examining and managing perceived incompatibil-
ity; (4) negotiating maximal compatibility through innovative refram-
ing; and (5) developing strategies and skills that will improve need
gratification for both parties.
The factors that are conducive to positive engagement are usually help-
ful in further development of a relationship, and the skills related to
reception, expression, and engagement are all relevant. When people
move on from satisfactory engagement to develop a longer-term re-
lationship, they usually pursue more activities together. In theory, in-
crease in shared activities should also lead to increased exchange of
information and deepened understanding between the participants.
In real life, however, a lot of relationships can carry on with shared
activities without significant deepening of understanding, and some-
times even without substantial exchange of information. One example
of this is family members who live in the same house and spend a lot
of time together, such as while having meals, watching TV, or doing
chores, but seldom communicate much. Another example is members
of a club based on a particular activity or hobby. People can go to the
club for years and play chess or badminton with each other without
much deepening of their mutual knowledge or understanding. Such a
relationship can still be experienced as good or gratifying by the mem-
bers concerned. When their expectations are met, and no one demands
additional content, the equilibrium is maintained. People who pursue
relationships like these sometimes find that they satisfy their other
needs as well, such as the need for a sense of belonging or identity, or a
sense of order, routine, or stability. The relationship experienced by the
individual may be more oriented towards the collective, be it the family
or the club, than towards individual members.
Some of us believe that most people want to develop relationships
with more depth or intensity, yet we have to recognize that such depth
and intensity can be threatening to some people, even when they actu-
ally desire them. Managing intense and intimate relationships requires
a certain emotional capacity. Psychoanalytic wisdom has it that a solid
sense of self, or identity, is a prerequisite for intimacy (Erikson, 1950,
1959). In SSLD language, we can say that a capacity for intimacy re-
192 Building Blocks
Sharing
Apart from activities and signifying acts, talking about things that mat-
ter is another key process in deepening and strengthening relationships.
This includes the sharing of ideas that are central to one’s life-world,
which can be a religious faith, a spiritual commitment, a political posi-
tion, a value, a commitment to a social or humanistic cause, devotion
to music or art, or – in Paul Tillich’s (1973) words – “matters of ultimate
concern.” Our life-world is structured by such ideas, which relate to
each other in very complex and variable ways. For some people, there
is a superordinate idea, belief, or principle, and all other ideas are sub-
ordinate to it. Some people do not have such a hierarchical organization
of ideas, and they can have more fluid relations with each other. More
over, some people hold on to ideas in a more stable, consistent manner,
while others go through more transition and change. On top of all this,
not everyone has a clear sense of the ideas, principles, and values that
are conditioning their lives. Some people have difficulty understanding
how they think and what they believe, let alone telling others.
Sharing is actually a form of communication that emphasizes mutu-
ality. In SSLD, the composite reception skills of listening and decipher-
ing factual, attitudinal, motivational, and emotional content in other
people’s utterances are often applied not only to enhance one’s under-
standing of others but also to improve self-understanding. This is most
effectively done in a group-learning context, including smaller groups
such as families or couples. The feedback people obtain through in-
teracting with others can often contribute to a better understanding of
their own views, attitudes, feelings, needs, and goals. In a sense, most
SSLD intervention programs involve interactional exercises through
which the clients learn to communicate more effectively, while at the
same time learning more about themselves through feedback. When
people learn to develop stronger relationships through sharing, they
combine the composite skills of reception, expression, and engagement
while emphasizing content that is personally significant.
Such content can include ideas like the ones suggested above. It can
also include needs and goals, feelings, and experiences. In general, the
breadth and depth of sharing progresses with the development of a
relationship. Content conducive to the deepening of a relationship can
include experiences that have had a major impact on one’s life or per-
sonality development (e.g., childhood trauma, life-transforming events
such as war), aspects of self that are not easily understood or accepted
196 Building Blocks
have shared many intimate details of their lives and yet have difficulty
living with each other. In many of these cases, the parties concerned
have gone through years of shared activities and sharing of personal
experiences, including those they are not proud of or will not share
with others because of their social implications, but the quality of their
relationship is on a downward spiral. What is worse in some of these
cases is that the partners or family members use what was shared in
trust and confidence against each other, causing tremendous damage
and resentment.
Name of member:
Subject (the person you want to appreciate more):
Date: From to
Discover
Between now and the next session, you have to discover a few things
that you genuinely appreciate about your chosen subject. Examples
include:
• Positive responses towards you or other people: anything nice, such as
compliments, help, service, assistance, gifts, kindness.
• Any positive quality of the subject: skills, experience, attitude, appear-
ance, value.
Document
Keep a record of what you have discovered and the display methods that
you think will be appropriate for these discoveries:
Display
• Direct feedback: telling the subject directly. Cards, emails, text mes-
sages, and so on are okay (caution: AVOID sarcasm or anything that
can be construed as sarcasm).
• Open acknowledgment: choose an appropriate context to openly indi-
cate your appreciation. It can be a family gathering, work-team meet-
ing, party, or Facebook posting (caution: make sure that it is something
that the subject would not mind others hearing about; do not proceed
and resort to direct feedback when in doubt).
• Recognition event: stage a small recognition event for your subject
(e.g., preparing a small award to be presented, making an address)
with an appropriate audience (can be just the two of you, a close circle
of friends, your family, or in front of the children).
200 Building Blocks
Some people may worry that encouraging the other person to grow
and develop will decrease the other person’s need for the current re-
lationship, and therefore undermine the very relationship that they
are trying to strengthen. Many people in a romantic relationship tend
to do this, as do some parents. This leads to an important issue in
how we view relationships. People are motivated by different needs
and drives when they get involved in relationships. Abraham Maslow
(1943, 1971) distinguished between two types of drives: one type he
called D drives, referring to deficiency, and the other type he called B
drives, referring to being. The D drives, based on the need for things
such as food, shelter, and safety, can be satiated. B drives, which are
based on the need for qualities such as truth, goodness, beauty, unity,
perfection, and completion, can be fulfilled but not satiated. This view
is echoed by Rogers’s (1961) view on personal development.
The SSLD view, grounded in multiple contingencies analysis, is that
people are differentially motivated. Many people develop relation-
ships for the more instrumental reasons of satisfying their basic needs,
and people who are seeking personal growth or mutual self-enhance-
ment are likely to be in the minority. Even people who desire ongoing
growth, development, or transcendence probably do not seek them in
all relationships. The self-actualizing individual may still maintain re-
lationships that are more mundane. Considering the network of rela-
tionships within a person’s life-world, we will probably find that most
relationships are more instrumental in nature and are not intended to
be developed into a context for ongoing growth and self-actualization.
Hopefully there will be some relationships within each person’s life-
world that have the potential to facilitate or support continual growth
and being-oriented quests. A summary of relationship building strate-
gies can be found in Box 11.1. As a learning system, SSLD supports
clients in all kinds of relationship building, ranging from those instru-
mental in meeting ordinary needs to those associated with existential
or transcendental quests. Based on this position, the principles of (1)
staying attuned to each other’s needs and aspirations, and therefore
knowing what the relationship means and is expected to provide; (2)
developing an appreciative stance; and (3) pursuing mutual self-en-
hancement, should be able to help enrich most relationships.
lationship to stay strong over the course of a lifetime, but the needs
and aspirations of two partners often cannot remain complementary. It
is actually difficult for two individuals to have compatible needs and
aspirations through a lifetime during which both parties are growing
and changing. Recognizing the reality of individual growth and change
over times, especially within a social context where people are exposed
to an ever-increasing array of individuals with whom they can form
significant relationships, the chance of an intimate relationship being
maintained over a long time is not high. In SSLD, the priority is to
develop and manage relationships so that they work for the partici-
pants in terms of meeting their needs. Relationships can sometimes be
transformed to achieve this goal, but if the personal and emotional cost
of staying in the relationship outweighs its benefits, the relationship
can be adjusted in its significance and intensity – or even terminated
if that turns out to be the best possible option for the client. This posi-
tion brings us to the topics of transforming and terminating significant
relationships.
Transformation
SSLD practice, we recognize that the shift from getting what we need
from one relationship to another is not a simple, mechanical process
of switching, for it involves emotional investment, and sometimes ad-
ditional processing of emotions is necessary. The section on emotional
work covered earlier in Chapter 9 will be relevant here. A parent whose
child is growing and becoming increasingly independent may, for in-
stance, feel unwanted. We can infer from this that the parent needs to
feel needed, useful, or important. In this case, quite a few strategies
may work, such as getting recognition from other caring relationships,
volunteering in community service, getting more involved in work or
career, starting a business, keeping a pet, and so on. Yet the transition
process has to be managed appropriately. This usually involves manag-
ing the emotional significance of the relationship.
When relationships are transformed, people sometimes feel disap-
pointed, abandoned, betrayed, rejected, or unfairly treated. Such emo-
tions can feed into emotional processes that are connected to a wide
range of possible feelings including resentment, anger, sadness, shame,
or even a more existential sense of futility or emptiness. Such emotional
experiences often have a cognitive underlay. Recognition of such emo-
tional and cognitive processes is necessary in helping clients who are
going through relationship transformation. A lesson learned through
my years of working with people going through various kinds of re-
lationship transformation or termination is that it is important to pre-
serve the self, or the sense of self, of the client. Very often, even with
people who are highly competent in interpersonal and social function-
ing, they need to feel that what they have invested in a relationship is
being valued, acknowledged, and appreciated. Our help is likely to be
more effective if we show recognition of such additional needs, which
may sometimes go unmet, because the other person may never come
to show such appreciation or positive regard – or it may not happen till
much later.
Sometimes we also need to recognize that although the need can be
met through an alternative arrangement, the particular mode or inten-
sity of gratification cannot be readily substituted. To some people, being
appreciated and valued by someone you help as a volunteer in a chil-
dren’s shelter brings similar satisfaction as caring for your own child,
yet for some people the two are very different. It is the same way that
some people have no problem with diet drinks and sweeteners, while
for others the craving for the real thing cannot be completely quenched
208 Building Blocks
Termination
with their ex. There are people who experience separation and divorce
as more than just the transformation or termination of a relationship;
it can be seen as a disruption of the entire order of their life-world, a
threat to their sense of identity, a loss of social status, a financial crisis, a
severe personal failure, trauma, and so on. When children are involved,
it is important to note that the separation or divorce usually means sig-
nificant transformation of the parent-child relationship as well as dis-
ruption of the children’s lives.
Given the huge variation from case to case, the needs to be addressed
and the strategies and skills to be learned and developed will vary
accordingly. While we can follow similar steps to those described in
relationship transformation, management of relationship termination
can sometimes demand more intensive intervention. Using separation
and divorce as an example, the termination of a spousal relationship
has an impact on multiple areas of a person’s life-world, often includ-
ing the person’s sense of self. While some people make the transition
more easily and are soon able to find gratification and fulfilment in
new relationships, some people have to almost totally reconfigure their
life-world. The range of strategies and skills to be learned and devel-
oped will obviously be very different for these cases, and it is probably
not possible for us to have a standard procedure for them. Following
a contingency-based approach, SSLD intervention may include the fol-
lowing components:
Death
Going through the death of a loved one shares some similar processes
with that of terminating a significant relationship, such as the expe-
rience of loss and varying degrees of disruption to one’s life-world.
Death is the most absolute termination of a relationship, and a process
over which we often do not have much control. Its inevitability and
irreversibility make it one of the most difficult events in human life.
Unlike the breaking up of intimate relationships, which can be a result
of an interactive process that the client can participate in, death is usu-
ally experienced as something that happens to the other party beyond
the client’s control. The SSLD approach to helping people deal with the
death of a significant person is characterized by a number of principles
or features, which will be listed below.
214 Building Blocks
with this and its implications on your life now and in the future.”
First, we are recognizing what the client needs and wishes to ac-
complish. The learning paradigm implies the possibility of change
and improvement, and thereby infuses hope. The explicit future
orientation takes the client outside the confines of a retrospective
frame. The SSLD approach almost always entails positive refram-
ing. In this way, the need to learn something is less likely to be
taken as inadequacy or pathology, which is sometimes implied in
other clinical approaches. Once clients are engaged in a program of
learning, they are already in a proactive mode instead of a passive
mode that is more likely to feed into the experience of aloneness,
vulnerability, and helplessness.
Transformation or Termination
Summary
Instrumental Tasks
Instrumental Tasks
Most of our life goals are accomplished within interpersonal and social
contexts. We often find ourselves in situations in which we have goals
that are more instrumental, meaning that we only wish to get things
done and do not necessarily want to develop a relationship with the
person after the goal has been accomplished. The relationship is only
developed for a practical purpose, so it is either incidental or secondary
to the instrumental goal. In everyday life, people try to attain instru-
mental goals in a huge range of possible scenarios. One can be trying
to talk oneself out of a traffic ticket, searching for a job, looking for a
trustworthy driver to hire a vehicle on an excursion to an unfamiliar
destination, finding the best deal on a car, applying for an immigrant
visa, or purchasing or selling a property. Given the diverse possibili-
ties, this chapter obviously cannot cover them all. As a matter of fact,
there is already a significant amount of literature on such topics in the
form of self-help books, DIY (do-it-yourself) manuals, guides, and ad-
vice columns. The purpose of this chapter is to outline general SSLD
principles that can be applied to most situations in which people wish
to achieve their instrumental goals.
Self-help guides are usually written by experts who know the area rea-
sonably well. Much of the information they contain can be very use-
ful. As will be discussed later, we believe that knowledge is power
and these guides and manuals can therefore be very helpful if used
Instrumental Tasks 219
Knowledge Is Power
Stay Goal-Oriented
not always a bad thing, if we can somehow manage to meet these needs
effectively. What is less satisfactory is that our original plan to address
a particular need or goal can be derailed by a vague promise of meeting
other needs that eventually will not pan out.
Having clearly thought out and well-defined outcomes helps us stay
goal-oriented. For instance, if we are planning to do some major home
renovations, we need to know the purpose. If we are thinking of sell-
ing the house, the ultimate outcome is maximum financial benefit. Our
decision should be guided by the marginal increase in sale value for
every dollar we put in, and we need to be imagining the prospective
buyer’s perception. If we are renovating for our own use instead, we
may want to focus on our subjective utility. Renovating a house to suit
our tastes and preferences before putting it up for sale is not an effective
goal-oriented strategy. Giving too much thought to what friends, fam-
ily, and neighbours may like instead of what we would enjoy the most
ourselves is similarly problematic, unless we have underlying needs
for approval and acceptance that cannot be gratified through means
other than renovating the house. Those needs can probably be more
effectively and more economically met by consulting a counsellor or an
SSLD practitioner than by renovating our homes.
The home renovation project and the need to impress one’s friends,
family, and neighbours are actually good examples to illustrate the
principles of multiple contingencies and how instrumental tasks fit into
a bigger and more complex project. In a home renovation project, we
need to coordinate a host of variables, and the outcome can be mul-
tifaceted. We may consider space utilization for different members of
the household and their respective needs and circumstances, which can
be functions of age, health status, work-related demands, and so on.
We may also consider the prospective turnover of people living in the
house such as the arrival of a baby, adult children leaving home, an
older person moving to a senior’s facility, and the like. The budget we
are working with is often a key part of the formula. The availability of
options and services in different geographical areas can also condition
our plan. In Asia, for example, the availability of inexpensive labour
and professional services and the lack of a do-it-yourself culture or tra-
dition make contracting out more popular than in North America. The
Instrumental Tasks 225
able to cite her ex-boyfriend as an example, although that man had died
several years ago.
During that session, the woman came to a revised understanding of
what she needed, from the integrity of her body to a love that is more
accepting and unconditional. This understanding would be useful in
informing the treatment decision she would have to make later. This
is a good illustration of how needs and goals can change while the po-
sition of staying goal-oriented remains. From this point onwards, we
can imagine how making treatment decisions regarding this woman’s
breast cancer may be regarded as primarily instrumental tasks, but
having an understanding of the multiple contingencies related to the
client’s needs and circumstances will probably be helpful.
come back to the mastery of very specific skills. The major emphasis in
the learning process, as pointed out in the beginning of this chapter, is
to enable the learner to actually perform the instrumental task and at-
tain the desired goals. Designing a learning program for instrumental
tasks can take in composite skills in reception, expression, and com-
munication, and more situation-specific components either designed
by the SSLD practitioner or through collaborative creation. In-session
practice, including simulation role-play and video-assisted review and
feedback, is routinely used in SSLD programs. Take-home exercises
and rehearsal in real life are also regularly employed procedures.
Assisting people in job-hunting, for instance, is an instrumental task
that SSLD practitioners in different service settings can get involved
with. It can be clinical practitioners helping individuals with severe
mental health issues, community development workers helping wom-
en who have been full-time homemakers for a long time, corporate
consultants working with middle-aged executives who have been laid
off, settlement workers helping new immigrants, student counsellors
working with university graduates, and so on. The process involves a
set of instrumental tasks such as accessing employment information,
strategic self-presentation through CV packaging, designing web pages
and other web-based platforms, or preparation for interviewing and
other forms of performance assessment.
I have been on both the recruitment side and the application side
of this game. I have also trained head-hunters and helped job appli-
cants for various positions in different industries. In my experience, the
knowledge-action gap is bigger with the tasks that involve interperson-
al interaction than with those that do not. Tasks such as interviewing
for a job, speaking in public, or participating in a group usually cause
more anxiety and self-doubt in people. With tasks not involving face-
to-face interpersonal contact, such as doing research online, writing an
application letter, or putting a CV together, people seem more capable
of translating knowledge to action and following relevant instructions
and guidelines. Related to this is the phenomenon that many people are
better prepared for the non-interactional tasks and actually start pre-
paring for them earlier than the interpersonal ones. Many people, for
example, have their CV ready and update their Facebook or personal
website regularly, but will only come to prepare for the interview, pres-
entation, or group exercise pretty close to the actual day.
There are reasons for this, such as the socialization and the education
we receive. Schools put a disproportionate emphasis on cognitive tasks,
Instrumental Tasks 229
and we have been asked to perform tasks that are primarily based on
reading and writing thousands of times since elementary school. By
contrast, syllabi in formal education pay very little attention to the
learning and development of interpersonal skills. Presentation skills
are covered to some extent but systematic training on interpersonal
skills is usually lacking or inadequate. SSLD relies heavily on experi-
ential skills learning, which facilitates transfer to real-life performance
situations. Covering the spectrum from strategy to skills and micro-
processes provides comprehensive support to someone who wants to
learn to perform better in those interactional situations.
Back to the job-hunting example, the spectrum can include an over-
all game plan for job searching, mobilization of social capital, the use
of consultants, and strategic presentation of oneself, focusing on how
to maximize one’s advantage over prospective competitors. In terms
of skills, learners need to combine good listening skills with receptive
skills, such as in deciphering the position taken by the prospective em-
ployer. Effective presentation, expression, and communication skills
can include formal presentation, strategic self-disclosure, or group-
work skills.
Within the academic job market, I have coached doctoral students
with regard to their market-readiness, which is part of their overall
game plan. The plan involves research on the job market, including cur-
rent and prospective openings. Major national and international trends
are taken into consideration. Another important factor is whether the
student is planning to apply to research-oriented universities or more
teaching-focused institutions. Knowing the kind of job one is interested
in will have an impact on how the program of doctoral studies is man-
aged. Students interested in faculty positions in world-class research-
oriented universities, for instance, are encouraged to focus on building
an impressive research and publication track record before they defend
their doctoral thesis. Some students will have to consider if they are
prepared to resettle to another city or not, weighing their needs and cir-
cumstances as well as those of their partners and families. Depending
on the student’s background and specific area of research interest, they
will have to strategically build connections with researchers in their
area through thesis committee membership, conference participation,
correspondence, research collaboration, and so on.
Apart from having a good game plan, students have to be prepared
for the actual job-search procedure. For instance, part of the ritual of
academic hiring is a lunch or dinner attended by the search committee
230 Building Blocks
and the candidate, which is less constrained by the rules and conven-
tions applicable to the formal interview procedure. Over a semi-formal
meal, search committee members are trying to assess the suitability of
the candidate with regard to multiple agendas. For instance, it may not
be politically correct to enquire about a candidate’s class background,
specific religious or political views, social resourcefulness, or fundrais-
ing ability in an interview. Over lunch or dinner, people can talk more
freely about leisure activities, vacations, and social lives. It is also a so-
cial skills assessment exercise in real life. Some candidates will use such
opportunities to demonstrate their social grace and interpersonal en-
gagement skills, or to strategically disclose information that can affect
their chances favourably, such as personal connections with influential
characters in the field. They can also establish a favourable connection
with members of the search committee over a diverse range of possible
topics – from wine to skiing, skin care, or art collection.
One of the principles I mentioned above can be integrated into this
particular performance: the principle of empowering oneself with
knowledge and information. I usually encourage students applying to
academic jobs to research the profile of the academic department they
are applying to, including the individual profiles of faculty members.
People are usually pleased when their work is known and appreciated,
even when they are aware that it is part of the homework that the can-
didate has done. Similarly, research into workload, compensation pack-
ages, and benefits at the target institutions and comparable institutions
can empower the candidate in the negotiation of these aspects.
In corporate recruitment contexts, group interaction formats are used
to assess many dimensions of personality and interpersonal skills. Most
group process skills can be acquired through SSLD, including group
dynamics analysis, careful listening, thematization and summary,
timely and appropriate intervention, managing agenda development
and topic shifts, negotiating multiple agendas, facilitation, use of free
information and following leads, management of conflict and tension,
and so on. These skills, however, are not supposed to be attained at the
last minute, but take several learning and practice sessions involving
simulated group processes, video recording and review, feedback, and
progressive refinement. Some of these learning tasks require attention
to micro-processes such as turn-taking, interruption of other people’s
utterances, self-referencing, assimilation of other participants’ content,
reframing, and a host of others. To date, only very few people realize
the significance and the advantage of developing these group skills,
and those who do are more likely to be ahead of the game.
Instrumental Tasks 231
Apart from the learning of strategies and skills, and inclusive of the
related micro-processes, job hunting can usually be regarded as an
instrumental task within a more complex project. There are often as-
sociated or parallel processes, such as balancing personal life, family
obligations, and social demands. In a globalized job market, the need
for resettlement is increasingly common and it can affect relationships,
the growth and development of children (if they are part of the pic-
ture), adjustment to different sociocultural environments, health care
arrangement, financial planning, and many other aspects of life. Man-
aging the instrumental task of job hunting within the context of the
complex project of maintaining quality of life for oneself and the signifi-
cant others in one’s life-world can all be integrated in an SSLD formula-
tion. In practice, people who require SSLD service in job hunting very
often benefit from related work on the clarification of personal goals,
management of significant relationships, stress management, and over-
all emotional and interpersonal capacity building.
It is tempting for SSLD practitioners to think that our intervention
can play a decisive role in our clients’ successes with their job hunts,
but we have to realize that there are environmental forces that can be
more powerful. Major market shifts, economic downturns, changes in
public or corporate policy, structural adjustments in a given industry,
regional or seasonal fluctuations, changes in the administration, and
many other factors beyond our control can have impacts on the out-
come of our clients’ job hunts. When people experience setbacks or do
not get the jobs they desire, one of the principles we mentioned above
should be reinforced – when it is instrumental, do not get personal. It
is important to maintain the clients’ sense of self-efficacy. In SSLD, the
practitioner should always help people to believe that they are worth-
while, regardless of whether a particular employer decides to hire
them or not. The practice of positive reframing, which was introduced
in chapter 9, can be helpful in such circumstances. When self-efficacy
is not severely compromised, it is usually easier for people to be more
flexible and creative with their overall game plan, opening themselves
up to more options that can eventually address their needs.
Summary
The building blocks introduced in the last section can be combined flex-
ibly to form SSLD intervention programs in response to specific client
needs and circumstances. Over the last three decades or so, I have ap-
plied SSLD – either in its current form or in its earlier form as social
skills training – to a wide variety of settings, be it through direct prac-
tice myself or through my role as program designer, consultant, super-
visor, trainer, or coach. A network of colleagues and graduate students
in North America and Asia has worked closely with me in the develop-
ment of numerous programs for a wide spectrum of clients in many di-
verse settings. In terms of substantive areas, SSLD has addressed issues
such as chronic schizophrenic disorder, infantile autism and autistic
spectrum disorders, dating and intimacy, couple relationships, insom-
nia and sleep-related issues, social phobia, interpersonal relationships,
substance abuse, Internet addiction, youth at risk, parenting, cross-
cultural communication, front-desk reception, management training,
human resources, community organization and development, leader-
ship training, health promotion, weight management, immigrant set-
tlement services, and caregiver training and support. SSLD programs
have been delivered in community service organizations, hospitals and
health care systems, university-based service units, private practices,
and corporate contexts. Numerous training programs for practition-
ers in a wide range of disciplines have been conducted internationally.
Over the last few years, SSLD’s application has experienced steady
growth both in terms of the scope and type of settings.
It is not possible to describe the entire range of SSLD applications,
which is expanding even as this book is being written. Readers can
234 SSLD Practice
Why SSLD?
SSLD is often compared with solution focused therapy (de Shazer &
Berg, 1975; Miller, Hubble, & Duncan, 1996). Solution focused therapy
(SFT) relies heavily on cognitive procedures such as focusing on the so-
lution rather than the problem, the miracle question, exploring excep-
tions, and the like. The transfer of in-session cognitive understanding
or reformulation to real life behaviour is often taken for granted. SSLD
does not assume that cognition always determines action, nor that in-
session cognitive change will automatically be transferred to behav-
ioural change in everyday life. SSLD recognizes that the performance
of certain actions, such as handling criticisms or mediating conflicting
agendas among family members, often requires experiential learning
efforts.
Another key emphasis of SSLD, which does not receive the same at-
tention in SFT, is the notion of needs. In SFT, the client is encouraged
to imagine a solution, or a problem-free situation. In SSLD, goals and
desired outcomes are established on the basis of a more thorough un-
derstanding of one’s needs. Goal setting in SSLD practice is often done
in sequential steps. Care has to be taken to avoid simplistic problem-
solution thinking. When people are asked to imagine solutions, it is
easy for them to follow simple linear logic. Moving directly from prob-
lem to solution can create formulations that make sense on the surface
but do not address the underlying needs. For example, a teenage girl
who is doing sex work to make enough money to have cosmetic sur-
gery performed on her nose may imagine that when all her problems
are solved, she will find herself waking up with a fixed nose. While we
do not rule out the possibility that having the nose fixed may be exactly
what some people need, it is also possible that people who want to have
their noses fixed do not really need the surgery. The underlying needs
can be peer approval, sexual self-image, mastery over one’s body, or ex-
pression of resentment and hostility. Similarly, someone with the prob-
lem of excessive credit card debt as a result of uncontrolled spending
may imagine a solution of having all his debts cleared and not having
the same impulse to spend. Understanding the underlying needs such
as gaining social approval, psychological stimulation, pleasure derived
Learning and Applying SSLD 239
Motivation Interviewing
SSLD can be seen as a practice system sharing some features with other
systems, while it distinguishes itself with other features. The most im-
portant characteristic of the SSLD system is perhaps multiple contin-
gencies thinking, which frees the practitioner from thinking in terms
of fixed categories, avoiding simple linear formulations assumed to be
applicable to all clients in all situations. Cognition does not always de-
termine emotion, nor the other way around. Skills learning is beneficial
to many clients, but some clients may be able to learn in their natural
environment. Some clients need more guidance and support from their
practitioner, some of them collaborate with their practitioner to generate
the skills, and some may even teach their practitioners new strategies
and skills. The multiple contingencies model allows much flexibility in
practice, while at the same time it provides a conceptual framework that
allows practitioners to locate what they are doing and where they are
heading with their clients. The six domains of the life world – environ-
Learning and Applying SSLD 241
fective regardless of what system they practice, even if they are using
SSLD.
Following this line of reasoning, it is important for practitioners to
pay attention to the factors and processes associated with positive client
change. A system is valuable when it can be used to support effective
engagement with the client, enabling the development and mainte-
nance of a functional working alliance. The system should support the
practitioner’s work by offering a framework for making sense of the
case in hand, providing direction for professional action. The guide-
lines and instructions for specific procedures should empower the
practitioner by enhancing a sense of professional efficacy. Practition-
ers are likely to benefit from an attitude of openness and active learn-
ing, instead of religious adherence to any given system. With regard
to the client, a good practice system is one that empowers the client in
a similar manner. Clients can learn to make sense of their own situa-
tion or circumstances, and pursue alternative constructions of reality,
including new options for thinking and taking action. Whereas SSLD
strives to do these, we are mindful of the fact that positive change can
take place through other pathways as well. What we are offering is a
procedure explicitly designed with due regard for such reality, and a
clear understanding that it is the collaborative as well as the agentive
decisions and actions taken by practitioners and clients that ultimately
produce the positive change and desired outcome.
Another dimension relevant to the evaluation of a practice system is
its role in the intended agenda of change. Wolberg (1986) classified psy-
chotherapy into three types: supportive, reeducative, and reconstruc-
tive. SSLD is developed primarily within an educational paradigm and
is perhaps not the treatment of choice when reconstructive psychother-
apy is indicated or desired. SSLD is not insight-oriented, although it
does help clients to gain a better understanding of their needs, circum-
stances, characteristics, and capacity. The educational paradigm trans-
lates clinical issues into an understanding of needs and corresponding
strategies and skills, and in the process it blurs the boundary between
clinical and non-clinical issues, thus taking the system beyond the ther-
apeutic space and frame. This feature of SSLD can be seen either as
a limitation or strength, contingent upon the goal to be pursued and
preferences regarding approach and process.
Practitioners in various areas of health, mental health, social work,
and human services can find SSLD relevant to their work. In a sense, all
these professional colleagues are working with clients with needs that
244 SSLD Practice
Applying SSLD
As mentioned above, SSLD, in its current and earlier versions, has been
applied to a very extensive range of settings. This range of application
is sometimes difficult for some colleagues to imagine, but it actually
reflects the system’s capacity for responding to diverse demands and
multiple contingencies. It is expected that SSLD application will con-
tinue to grow, and part of the purpose of this book is to articulate a
common ground for communication, sharing of experience, and accu-
mulation of experience, knowledge, and skills. In this section, I will
suggest a number of coordinates to help colleagues locate their work
within the extensive terrain of SSLD, and in relation to the work of oth-
ers. The first dimension is the substantive area of practice or interven-
tion. The second dimension is the mode of intervention. An additional
dimension is the service setting.
Substantive Areas
To state that SSLD can be applied to almost any area of human serv-
ice may sound like an exaggerated claim, but three decades of prac-
tice experience attest to its robust applicability. I started using social
skills procedure in psychotherapy and counselling for individuals with
mental health concerns in the late 1970s. My own personal history as
a student activist led me to experiment with a methodical application
of social learning principles in community organization and activism
at around the same time. We used systematic training to help disen-
franchised community members learn to talk to other members and
motivate them to participate, organize, analyse issues, articulate their
agenda, convene meetings, talk to the press, negotiate with government
officials, and so on. When I was first asked to work with children with
autism in 1980, I found that the major intervention models, which have
been dominated by operant conditioning formulations, very limiting.
I started to target the building of imitative learning capacities in these
children, while at the same time running parallel programs for parents
to learn to apply social skills training techniques at home. We expe-
rienced extremely encouraging results. Within a few years, the social
skills training model was applied to address a wide spectrum of mental
health and social issues.
The application continued to grow in the next few decades, with col-
leagues and students accumulating valuable experience and providing
252 SSLD Practice
Mode of Application
Service Settings
Organizing, engagement,
persuasion
Needs
Water
Holding community
meetings
Negotiating with
government officials
Legend
Current coping methods
Strategies and skills
conflicts and arguments did occur on some occasions. The task was
also too much of a demanding chore for some of the old folks. Another
strategy was to pay a local gangster who practically ran a water supply
service, but this was something that only a few families were able to
afford.
In this particular case, the community change process basically in-
volved the learning and development of new strategies and skills by
some community members. With the help of the community develop-
ment worker, members learned to get organized. Some of them mas-
tered specific skills in engaging and persuading their neighbours to
join a campaign. Other skills learned by the leaders include holding
community meetings, talking to the press, and negotiating with local
Learning and Applying SSLD 257
1. Engagement
After the problem translation is done, the community and the SSLD
practitioner will have established a shared understanding of the com-
munity’s N3C and agreed-upon goals towards which to work. The
N3C assessment includes a survey of community capacity, including
resources, knowledge, and skills. The community will then have to fig-
ure out what actions are likely to be strategic, in the sense that they
are more likely to lead to the achievement of community goals. The
next step is to identify what strategies and skills are needed, compared
to what is currently available from within the membership. This com-
munity capacity audit will indicate the strategies and skills that have
to be acquired by the community. Such capacity, knowledge, and skills
are usually unevenly distributed in a community, with some members
being better endowed or equipped with certain skills and knowledge.
A key condition for successful community work is the development
of indigenous leadership that is capable of building, mobilizing, and
coordinating community capacity.
Box 13.1 provides a scale for assessing community capacity by meas-
uring the level of participation and leadership behaviour of the mem-
Learning and Applying SSLD 259
Leadership
a group of leaders to share the power and the roles, instead of only
having one leader who would become dominating. It is not unusual
for someone with charisma to emerge as a leader, attracting willing fol-
lowers while at the same time marginalizing other members with good
leadership potential. Without becoming unduly formal, it is advisable
to introduce democratic power sharing and leadership arrangements
that will prevent the newly formed community organization from the
negative processes of power play and interpersonal rivalry or conflict.
The emergence of indigenous leadership from within means that the
community is increasingly capable of taking care of its own affairs, and
therefore needs less direct input from the community worker. It is very
probable that the community, as a collective, actually possesses more
knowledge and skills than what the worker has. The development of
leadership in a community is associated with an ongoing re-negotia-
tion of the roles of the community worker, with a careful transfer of
knowledge, skills, power, responsibility, resources, roles, and so on to
the community leadership.
Organizational Development
Summary
The Relationship
EBP 3.0
EBP 3.0 recognizes the complexity of human reality. While many as-
pects of human reality are socially constructed, not all aspects are
equally malleable or plastic. There are aspects of human reality that
are better understood in terms of formulations similar to physical laws,
such as the mechanical realities involved in a car accident leading to
broken bones. There are aspects that are more heavily conditioned by
social discourses or practices, such as what constitutes an accident, or
impaired driving. There are aspects of reality that are contingent upon
personal constructions, which can be idiosyncratic, such as whether an
automobile accident is experienced as a traumatic event or not. To in-
sist that a singular epistemology can apply equally well to all human
situations is more an article of faith than a pragmatic engagement with
human reality. In EBP 3.0, we do not assume a fixed epistemological
position but adopt positions in a contingent manner, considering the
specific circumstances, the key aspects of reality to be dealt with, and
the pragmatic objectives to be accomplished.
In EBP 3.0, we do not only emphasize the client’s agency in the col-
laborative process of therapeutic change but also recognize their poten-
tial role in knowledge production. The assumption of an authoritative
voice by professional practitioners and researchers effectively excludes
clients or service users from the knowledge production process. Such
exclusion increases the risk of professional hegemony and deprives us
of potentially valuable information, perspectives, and insights. Back in
the early 1980s, Reason and Rowan (1981) advocated for a collabora-
tive approach to research. Researchers in the social sciences and hu-
manities have become increasingly aware of the diverse possibilities in
knowledge production. Attempts to involve people we work with or
serve in the knowledge production process are gaining acceptance in
the research community (e.g., Bray, Lee, Smith, & Yorks, 2000; Duncan,
Miller, & Sparks, 2004; Israel, Eng, Schulz, & Parker, 2005).
6. Equifinality
ent pathways. In EBP 3.0, the concept is applied both to practice and
knowledge production. In practice, the concept of equifinality allows
us to imagine that the same desired outcome can be achieved through
different methods and procedures. We now have considerable evi-
dence that different systems of psychotherapy can often lead to similar
positive outcomes (Duncan, Miller, Wampold, & Hubble, 2010). In re-
search, the idea is that the same research question can often be pursued
through different means. For example, the question of whether SSLD is
an effective intervention can be addressed by using objective standard-
ized measures, subjective client-directed measures, third party obser-
vation of electronically recorded sessions, or practitioner assessment
of outcome. We can imagine the use of naturalistic designs, retrospec-
tive interviews with clients, and experimental or quasi-experimental
designs. What is the best method is contingent upon a host of consid-
erations, including the specific information sought, the intended uti-
lization of research findings (e.g., to refine the system or to apply for
funding), the context (resources, facilities, or constraints), the interest of
the constituencies (funders, clients, practitioners, service unit/organi-
zation, or researchers), timeline, problem or issue (e.g., suicide preven-
tion, parenting skills, disaster relief, or community health education),
and so on.
case with multiple issues and challenges, and a summary of the inter-
vention and outcome (Box 13.2).
Suna was in her early forties, though she looked much older. She came
from a very poor village in Asia and immigrated to Canada twelve years
ago, sponsored by her husband. Her husband’s physical and sexual
abuse of her had started in her home village even before they got mar-
ried. He hit her and forced her to have sex whenever he visited. Her fam-
ily was aware of that but still encouraged her to get married and move
to a new country as they wanted to have the substantial financial gift her
husband had offered. Her elder brother, in particular, indicated to her that
she had been a financial burden to the family, and he wanted her to leave
home as soon as possible. The abuse continued after immigration, in-
cluding sexual violation and physical assault, and she gave birth to three
children, who were 4, 6, and 9 at the time of intake. The eldest and the
youngest were girls. She suspected that her husband was doing some-
thing “unusual” with the girls. She had limited English ability and had
few friends. She had little understanding of the legal system and almost
no knowledge of available services. She did not understand the roles of
the professionals she had come across. She left home and lived on the
streets for two weeks but found it difficult to survive on her own. She had
been to the emergency room on a couple of occasions but she was care-
ful not to attract law enforcement attention. She felt powerless and be-
lieved that her husband would eventually get her regardless. She went to
see a family service social worker after an emergency room social worker
and a police officer suspected family violence and suggested she seek
help. She was then referred to a women’s shelter.
Suna appeared traumatized when she showed up for intake. She looked
scared, her body was all tensed up, and she made no eye contact with
people, including the receptionist and the social worker. The social worker
created a safe space for her to tell her story, in a very soft and inhibited
voice. She emphasized her helplessness and powerlessness in her nar-
rative. She also reported on how her previous contact with the referring
social worker had been stressful because she always asked her what she
planned to do and what her imagined solution would look like. She also
felt judged by the family service worker who seemed to have a problem
with her plan to take care of herself first, instead of taking her children
Learning and Applying SSLD 281
with her. The only positive aspect of her story was how she found some
satisfaction in a part-time caretaker job. The worker was sensitive to her
need for security, personal space, and a sense of agency, and was careful
not to communicate judgment or expectations that might be perceived as
overwhelming demands. Suna experienced a gradual narrative shift from
helplessness and passivity to an awareness of her needs and desired
changes. She enjoyed talking about her experience, particularly when she
felt understood and supported. Towards the end of the session, Suna was
working collaboratively with the worker on immediate physical safety.
N3C Assessment
• Needs: Security, safety, self-esteem, affiliation, independence.
• Circumstances: Victim of intimate partner violence, immigrant, limited
English, no family support, no social network, limited financial resourc-
es, culturally reinforced shame about intimate partner violence and
strong sanction against involving law-enforcement.
• Characteristics: Extremely low self-image, deep sense of powerless-
ness, difficult to establish trust.
• Capacity: Resilience, strong executive function, excellent emotional
regulation ability, ability to articulate her own experience and her needs
and wants.
Goal Setting
• Her own safety.
• Personal space, including freedom from socially enforced maternal
role.
• Independence – she wanted to be financially self-sufficient through
working.
Summary
I have been working in academia since 1984, but I am not a typical aca-
demic, at least not according to North American convention. I am in-
terested in too many things, ranging from psychotherapy practice and
research to epistemology, discourse analysis, identity politics, cross-
cultural work, globalization, and immigration. I have done work in
sexuality, the health and well-being of seniors, and reproductive tech-
nology. I also have been actively promoting the development of social
work, psychotherapy, health and mental health practice in China. Such
diverse and apparently scattered interests can often cause suspicion in
colleagues and students. Well-intentioned colleagues have suggested
that I get more focused so that I can establish a program of scholarship
and research that will look more discrete and solid. I am, however, pas-
sionate about the things that I do, and do not want to be confined by the
narrow scope of knowledge production and dissemination supported
by the prevailing academic convention.
When I first took on an academic job, I thought I would be able to
combine my interests in practice, teaching, and research. The circum-
stances have changed dramatically over the last quarter-century of my
career. Now, working in a research-oriented university, the emphasis
is on competitive research funding and refereed publications, which I
do enjoy and have been moderately successful with, but the teaching
and the practice that I enjoy as well have been pushed to the margins,
or outside my job description altogether. What is known but often un-
acknowledged among my colleagues is that teaching actually does not
count for much. In a social work school, maintaining direct practice in
the same area that we teach is not even on the list for appraising per-
formance and academic “productivity.”
I think in an integrative manner, and I see threads that run through
my apparently diverse and divergent interests. When asked, I will tell
my colleagues and graduate students that my program of scholarship
and research aims at developing a multidisciplinary knowledge base
for human service in a globalized context. In practice and in profes-
sional and academic education, unlike in competitive research program
development, we need to engage with diverse bodies of knowledge. As
someone who cares and wants to do something about the well-being
of other human beings, many systems of knowledge are relevant. We
286 SSLD Practice
In this section we will explore the value base of SSLD. When we say
that knowledge is contingent, one of the contingencies is value. Val-
ues are associated with the positions we take and the perspectives we
use. Values are therefore intimately tied to knowledge, both in terms of
how it is produced and how it is mobilized or used. Pragmatism, for
instance, is a value-laden orientation. Whereas professions in the hu-
man services share certain core values such as respect for the person,
individual rights, and professional accountability, there are values that
are more emphasized in some professions. Equity and social justice, for
example, are accorded central significance in contemporary social work
in the West, at least in academic and professional discourse.
Diversity
Bauer, M., McAuliffe, L., & Nay, R. (2007, Mar). Sexuality, health care and the
older person: An overview of the literature. International Journal of Older Peo-
ple Nursing, 2(1), 63–8. http://dx.doi.org/10.1111/j.1748-3743.2007.00051
.x Medline:20925834
Beck, A.T. (1967). Depression: Clinical, experimental and theoretical aspects. New
York: Harper & Row.
Beck, A.T. (1970). Cognitive therapy: Nature and relation to behavior
therapy. Behavior Therapy, 1(2), 184–200. http://dx.doi.org/10.1016/S0005-
7894(70)80030-2
Beck, A.T. (1976). Cognitive therapy and the emotional disorders. New York: Inter-
national Universities Press.
Beck, A.T. (1999). Prisoners of hate: The cognitive basis of anger, hostility, and vio-
lence. New York: Harper Collins Publishers.
Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of de-
pression. New York: Guilford.
Beck, J.S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
Bednar, R.L., & Shapiro, J.G. (1970, Jun). Professional research commitment: A
symptom or a syndrome. Journal of Consulting and Clinical Psychology, 34(3),
323–26. http://dx. doi.org/10.1037/h0029339Medline:5523437
Berg, F.M. (1995). Health Risks of Weight Loss (3rd ed.). Hettinger, ND: Healthy
Living Institute.
Berger, P., & Luckmann, T. (1966). The social construction of reality: A treatise in
the sociology of knowledge. New York: Random House.
Bergin, A.E., & Lambert, M.J. (1978). The evaluation of therapeutic outcomes.
In S.L. Garfield & A.E. Bergin (Eds.), Handbook of psychotherapy and behaviour
change (2nd ed., pp. 143–89). New York: Wiley.
Berlin, S.B., Mann, K.B., & Grossman, S.F. (1991). Task analysis of cognitive
therapy for depression. Social Work Research & Abstracts, 27(2), 3–11.
Bertalanffy, L.V. (1968). General system theory: Foundations, development, applica-
tions. New York: George Braziller.
Blau, P.M. (1964). Exchange and power in social life. New York: Wiley.
Bogo, M. (2006). Social work practice: Concepts, processes, and interviewing. New
York: Columbia University Press.
Bohart, A.C., & Tallman, K. (2010). Clients: The neglected common factor in
psychotherapy. In B.L. Duncan, S.D. Miller, B.E. Wampold, & M.A. Hubble
(Eds.), The heart & soul of change: Delivering what works in therapy (2nd ed.,
pp. 83–111). Washington, DC: American Psychological Association. http://
dx.doi.org/10.1037/12075-003
Bolton, D. (2002). Knowledge in the human sciences. In S. Priebe & M. Slade
(Eds.), Evidence in mental health care (pp. 3–10). Hove: Brunner-Routledge.
Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the
300 References
& C.M. Lewis (Eds.), The process of group psychotherapy: Systems for analyzing
change (pp. 311–56). Washington, DC: American Psychological Association.
http://dx.doi.org/10.1037/10378-012
Chee, M., & Conger, J.C. (1989). The relationship between hetersocial and
homosocial competence. Journal of Clinical Psychology, 45(2), 214–22. http://
dx.doi.org/10.1002/1097-4679(198903)45:2<214::AID-JCLP2270450207>
3.0.CO;2-Z
Chu, S.H. (1999). Multicultural counselling: An Asian American perspective.
In D.S. Sandhu (Ed.), Asian and Pacific Islander Americans: Issues and concerns
for counselling and psychotherapy (pp. 21–30). New York: Nova Science.
Clark, M.M., Cox, L.S., Jett, J.R., Patten, C.A., Schroeder, D.R., Nirelli, L.M.,
Vickers, K., Hurt, R.D., & Swensen, S.J. (2004, Apr). Effectiveness of smok-
ing cessation self-help materials in a lung cancer screening population. Lung
Cancer (Amsterdam, Netherlands), 44(1), 13–21. http://dx.doi.org/10.1016/
j.lungcan.2003.10.001 Medline:15013579
Clarke, P. (1997). Interpersonal process recall in supervision. In G. Shipton
(Ed.), Supervision of psychotherapy and counseling: Making a place to think (pp.
93–104). Buckingham, UK: Open University Press.
Colvin, G. (2008). Talent is overrated: What really separates world class performers
from everybody else. New York: Penguin.
Cook, K.S. (Ed.). (1986). Social exchange theory. Beverly Hills, CA: Sage.
Cooper, B. (2003, Aug). Evidence-based mental health policy: A critical
appraisal. British Journal of Psychiatry, 183(2), 105–13. http://dx.doi
.org/10.1192/bjp.183.2.105 Medline:12893663
Cooper, M. (2008). Essential research findings in counselling and psychotherapy:
The facts are friendly. London, UK: Sage Publications Ltd.
Correctional Services Canada. (2008, Aug). Aboriginal offenders and incar-
ceration. Aborignal sex offenders: Melding spiritual healing with cognitive-
behavioural therapy. Retrieved 10 Apr 2009, from http://www.csc-scc.
gc.ca/text/pblct/so/aboriginal/toce-eng.shtml.
Crews, J., Smith, M.R., Smaby, M.H., Maddux, C.D., Torres-Rivera, E., Casey,
J.A., & Urbani, S. (2005). Self-monitoring and counseling skills: Skills-based
versus interpersonal recall training. Journal of Counseling and Development,
83(1), 78–85. http://dx.doi.org/10.1002/j.1556-6678.2005.tb00582.x
Curran, J.P. & Monti, P.M. (Eds.). (1982). Social skills training: A practical hand-
book for assessment and treatment. New York: Guilford.
Curry, S. (1993, Oct). Self-help interventions for smoking cessation. Journal
of Consulting and Clinical Psychology, 61(5), 790–804. http://dx.doi
.org/10.1037/0022-006X.59.2.318 Medline:2030194
Datamonitor. (2008, 31 Jan). Anti-aging and beauty attitudes and behaviours.
302 References
dren’s social skills: A review of methods and issues. School Psychology Re-
view, 13(3), 292–301.
Gresham, F.M., & Lopez, M.F. (1996). Social validation: A unifying concept for
school-based consultation research and practice. School Psychology Quarterly,
11(3), 204–27. http://dx.doi.org/10.1037/h0088930
Grimshaw, J.M., & Russell, I.T. (1993, 27 Nov). Effect of clinical guidelines
on medical practice: A systematic review of rigorous evaluations. Lancet,
342(8883), 1317–22. http://dx.doi.org/10.1016/0140-6736(93)92244-N
Medline:7901634
Grogan, S. (1999). Body image: Understanding body dissatisfaction in men, women
and children. London: Routledge.
Gurman, A.S., & Jacobson, N.S. (1986). Clinical handbook of marital therapy. New
York: Guilford.
Hagermoser Sanetti, L.M., & DiGennaro Reed, F.D. (2011, May). Barriers to
implementing treatment integrity procedures in school psychology re-
search: Survey of treatment outcome researchers. In C. St. Peter Pipkin
(Chair), Current Issues in Caregiver Training and Treatment Integrity. Sym-
posium conducted at the annual meeting of the Association for Behavior
Analysis International, Denver, CO.
Haines, A., & Jones, R. (1994, 4 Jun). Implementing findings of research.
British Medical Journal, 308(6942), 1488–92. http://dx.doi.org/10.1136/
bmj.308.6942.1488 Medline:8019284
Hanrahan, P., & Reid, W.J. (1984). Choosing effective interventions. Social Serv-
ice Review, 58(2), 244–58. http://dx.doi.org/10.1086/644190
Hardcastle, D.A., & Bisman, C.D. (2003). Innovations in teaching social work.
Social Work Education, 22(1), 31–43. http://dx.doi.org/10.1080/
02615470309131
Hartley, D., & Strupp, H.H. (1983). The therapeutic alliance: It’s relationship to
outcome in brief psychotherapy. In J. Masling (Ed.), Empirical studies of psy-
choanalytic theories (Vol. 1, p. 138). Hillsdale, NJ: Lawrence Erlbaum.
Hayes, S.C. (2004a). Acceptance and commitment therapy and the new behav-
iour therapies. In S.C. Hayes, V.M. Follette, & M.M. Linehan (Eds.), Mind-
fulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 1–29).
New York: Guilford.
Hayes, S.C. (2004b). Acceptance and commitment therapy, relational frame
theory, and the third wave behavioral and cognitive therapies. Behavior
Therapy, 35(4), 639–65. http://dx.doi.org/10.1016/S0005-7894(04)80013-3
Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (1999). Acceptance and commitment
therapy: An experiential approach to behavior change. New York: Guilford.
Health Canada. (2002). A statistical profile on the health of first nations in Canada.
Ottawa: Health Canada.
References 307
Heath, A. (1976). Rational choice & social exchange: A critique of exchange theory.
Cambridge: Cambridge University Press.
Heinssen, R.K., Liberman, R.P., & Kopelowicz, A. (2000). Psychosocial skills
training for schizophrenia: lessons from the laboratory. Schizophrenia Bul-
letin, 26(1), 21–46. http://dx.doi.org/10.1093/oxfordjournals.schbul.a033441
Medline:10755668
Henretty, J.R., Levitt, H.M., & Mathews, S.S. (2008, May). Clients’ experiences
of moments of sadness in psychotherapy: A grounded theory analysis.
Psychotherapy Research, 18(3), 243–55. http://dx.doi.org/10.1080/
10503300701765831 Medline:18815977
Ho, D.Y.F. (1995). Internalized culture, culturocentrism, and transcendence.
Counseling Psychologist, 23(1), 4–24. http://dx.doi.org/10.1177/
0011000095231002
Hollin, C.R. & Trower, P. (Eds.). (1986). Handbook of social skills training (2 vols.)
Oxford: Pergamon.
Homans, G.C. (1958). Social behaviour as exchange. American Journal of Sociol-
ogy, 63(6), 597–606. http://dx.doi.org/10.1086/222355
Horyn, C. (2007, 7 May). Fashion industry rallies to aid designer in trouble.
New York Times. Retrieved 10 Apr 2009, from http://www.nytimes
.com/2007/05/07/nyregion/07narciso.html?pagewanted+all.
Howard, K.I., Krause, M.S., & Orlinsky, D.E. (1986, Feb). The attrition dilem-
ma: Toward a new strategy for psychotherapy research. Journal of Consulting
and Clinical Psychology, 54(1), 106–10. http://dx.doi.org/10.1037/0022-
006X.54.1.106 Medline:3958294
Hsu, F.L.K. (1971). Psychosocial homeostasis and jen: Conceptual tools for ad-
vancing psychological anthropology. American Anthropologist, 73(1), 23–44.
http://dx.doi.org/10.1525/aa.1971.73.1.02a00030
Hubble, M.A., Duncan, B.L., & Miller, S.D. (Eds.) (1999). The heart & soul of
change: What works in psychotherapy. Washington, DC: American Psychologi-
cal Association. http://dx.doi.org/10.1037/11132-000
Hubble, M.A., Duncan, B.L., Miller, S.D., & Wampold, B.E. (2010). Introduc-
tion. In B.L. Duncan, S.D. Miller, B.E. Wampold, & M.A. Hubble (Eds.), The
heart & soul of change: Delivering what works in therapy (2nd ed., pp. 23–46).
Washington, DC: American Psychological Association. http://dx.doi
.org/10.1037/12075-001
Hughes, J.N., & Hall, R.J. (1987). Proposed model for the assessment of chil-
dren’s social competence. Professional School Psychology, 2(4), 247–60. http://
dx.doi.org/10.1037/h0090544
Hughes, J.N., & Sullivan, K.A. (1988). Outcomes assessment in social skills
training with children. Journal of School Psychology, 26(2), 167–83. http://
dx.doi.org/10.1016/0022-4405(88)90018-0
308 References
Katzenstein, P.J. (Ed.). (1996). The culture of national security: Norms and identity
in world politics. New York: Columbia University Press.
Kauffman, J.M. (2005). Characteristics of emotional and behavioral disorders of chil-
dren and youth (8th ed.). Columbus, OH: Merrill Prentice Hall.
Kazantzis, N., Deane, F.P., Ronan, K.R., & L’Abate, L. (Eds.). (2005). Using
homework assignments in cognitive behavior therapy. New York: Routledge.
Kazdin, A.E. (1977). Assessing the clinical or applied significance of behavior
change through social validation. Behavior Modification, 1(4), 427–52. http://
dx.doi.org/10.1177/014544557714001
Kiresuk, T., & Sherman, R. (1968). Goal attainment scaling: A general method
for evaluating comprehensive community mental health programmes.
Community Mental Health Journal, 4(6), 443–53. http://dx.doi.org/10.1007/
BF01530764
Kiresuk, T., Smith, A., & Cardillo, J. (1994). Goal attainment scaling: Applications,
theory, and measurement. London: Erlbaum.
Klein, W.C., & Bloom, M. (1995). Practice wisdom. Social Work, 40(6), 799–807.
Kleinman, A. (1982, Jun). Neurasthenia and depression: A study of somatiza-
tion and culture in China. Culture, Medicine and Psychiatry, 6(2), 117–90.
http://dx.doi.org/10.1007/BF00051427 Medline:7116909
Kleinman, A. (1986). Social origins of distress and disease: Depression, neurasthe-
nia, and pain in modern China. New Haven, CT: Yale University Press.
Klohnen, E.C., & Luo, S. (2003, Oct). Interpersonal attraction and personality:
What is attractive – self similarity, ideal similarity, complementarity or at-
tachment security? Journal of Personality and Social Psychology, 85(4), 709–22.
http://dx.doi.org/10.1037/0022-3514.85.4.709 Medline:14561124
Knapp, M.L., & Hall, J.A. (2007). Nonverbal communication in human interaction
(5th ed.). Wadsworth: Thomas Learning.
Koester, L.S., Brooks, L., & Traci, M.A. (2000, Spring). Tactile contact by deaf
and hearing mothers during face-to-face interactions with their infants.
Journal of Deaf Studies and Deaf Education, 5(2), 127–39. http://dx.doi
.org/10.1093/deafed/5.2.127 Medline:15454508
Kopelowicz, A., Liberman, R.P., & Zarate, R. (2006, Oct). Recent advances in
social skills training for schizophrenia. Schizophrenia Bulletin, 32(Suppl 1),
S12–S23. http://dx.doi.org/10.1093/schbul/sbl023 Medline:16885207
L’Abate, L. & Milan, M.A. (Eds.). (1985). Handbook of social skills training and
research. New York: Wiley.
Lambert, M.J. (1992). Implications of outcome research for psychotherapy
integration. In J.C. Norcross & M.R. Goldfried (Eds.), Handbook of psycho-
therapy integration (pp. 94–129). New York: Basic Books.
Lambert, M.J., & Barley, D.E. (2002). Research summary on the therapeutic
310 References
what works in therapy (2nd ed., pp. 113–41). Washington, DC: American Psy-
chological Association. http://dx.doi.org/10.1037/12075-004
Norcross, J.C., Prochaska, J.O., & Gallagher, K.M. (1989). Clinical psycholo-
gists in the 1980s: II. Theory, research and practice. Clinical Psychologist,
42(3), 45–53.
O’Gorman, R., Wilson, D.S., & Miller, R.R. (2008). An evolved cognitive bias
for social norms. Evolution and Human Behavior, 29(2), 71–78. http://dx.doi
.org/10.1016/j.evolhumbehav.2007.07.002
Ontario Aboriginal Health Advocacy Initiative. (2003). Aboriginal access to
health care systems. Toronto: Ontario Aboriginal Health Advocacy Initiative.
Orme, J., & Powell, J. (2008). Building research capacity in social work: Process
and issues. British Journal of Social Work, 38(5), 988–1008. http://dx.doi
.org/10.1093/bjsw/bcm122
Otnes, C.C., & Pleck, E.H. (2002). Cinderella dreams: The allure of the lavish wed-
ding. Berkeley: University of California Press.
Otto, H., Polutta, A., & Ziegler, H. (2009). Reflexive professionalism as a
second generation of evidence-based practice: Some considerations on
the special issue “What works? Modernizing the knowledge-base of social
work.” Research on Social Work Practice, 19(4), 472–8. http://dx.doi
.org/10.1177/1049731509333200
Pajares, F. (1997). Current directions in self-efficacy research. In M. Maehr &
P.R. Pintrich (Eds.), Advances in motivation and achievement (Vol. 10, pp. 1–49).
Greenwich, CT: JAI Press.
Palincsar, A.S. (1998). Social constructivist perspectives on teaching and learn-
ing. Annual Review of Psychology, 49(1), 345–75. http://dx.doi.org/10.1146/
annurev.psych.49.1.345 Medline:15012472
Parker, J.G., & Asher, S.R. (1987, Nov). Peer relations and later personal ad-
justment: Are low-accepted children at risk? Psychological Bulletin, 102(3),
357–89. http://dx.doi.org/10.1037/0033-2909.102.3.357 Medline:3317467
Pavlov, I. (1927). Conditioned reflexes. Oxford: Oxford University Press.
Perepletchikova, F., Hilt, L.M., Chereji, E., & Kazdin, A.E. (2009, Apr). Barriers
to implementing treatment integrity procedures: Survey of treatment out-
come researchers. Journal of Consulting and Clinical Psychology, 77(2), 212–18.
http://dx.doi.org/10.1037/a0015232 Medline:19309181
Perez, P.J. (1996). Tailoring a collaborative, constructionist approach for the
treatment of same sex couples. Family Journal, 4(1), 73–81. http://dx.doi
.org/10.1177/1066480796041016
Pfeiffer, J.W. & Jones, J.E. (Eds.). (1974). A handbook of structured experiences for
human relations training (Vol. 1). San Diego, CA: University Associates Pub-
lishers and Consultants.
314 References
Philips, B., Werbart, A., Wennberg, P., & Schubert, J. (2007, Mar). Young
adults’ ideas of cure prior to psychoanalytic psychotherapy. Journal of
Clinical Psychology, 63(3), 213–32. http://dx.doi.org/10.1002/jclp.20342
Medline:17211871
Polkinghorne, D.E. (1992). Postmodern epistemology of practice. In S. Kvale
(Ed.), Psychology and postmodernism (pp. 146–65). London: Sage.
Pope, B. (1986). Social skills training for psychiatric nurses. London: Harper &
Row.
Potter, J. (1996). Representing reality: Discourse, rhetoric and social construction.
Thousand Oaks, CA: Sage.
Potter, S.H. (1988). The cultural construction of emotion in rural Chinese social
life. Ethos, 16(2), 181–208. http://dx.doi.org/10.1525/eth.1988.16.2.02a00050
Quinn, M.M., Kavale, K.A., Mathur, S.R., Rutherford, R.B., & Forness, S.R.
(1999). A meta-analysis of social skill interventions for students with emo-
tional and behavioral disorders. Journal of Emotional and Behavioral Disorders,
7(1), 54–64. http://dx.doi.org/10.1177/106342669900700106
Reardon-Anderson, J., Stagner, M., Macomber, J.E., & Murray, J. (2005). Sys-
tematic review of the impact of marriage and relationship programs. (U.S.
Department of Health and Human Services, Administration for Children
and Families). Retrieved 11 Feb 2009, from http://www.acf.hhs.gov/
programs/opre/strengthen/serv_delivery/reports/systematic_rev/sys_
title.html.
Reason, P., & Rowan, J. (Eds.). (1981). Human inquiry: A sourcebook of new para-
digm research. London: Wiley.
Rennie, D.L. (2000). Aspects of the client’s conscious control of the psychother-
apeutic process. Journal of Psychotherapy Integration, 10(2), 151–67. http://
dx.doi.org/10.1023/A:1009496116174
Rennie, D.L., & Toukmanian, S.G. (1992). Explanation in psychotherapy proc-
ess research. In S.G. Toukmanian & D.L. Rennie (Eds.), Psychotherapy process
research: Paradigmatic and narrative approaches (pp. 234–51). Newbury Park,
CA: Sage.
Richerson, P.J., & Boyd, R. (2005). Not by genes alone: How culture transformed
human evolution. Chicago: University of Chicago Press.
Robinson, L.A., Berman, J.S., & Neimeyer, R.A. (1990, Jul). Psychotherapy for
the treatment of depression: a comprehensive review of controlled outcome
research. Psychological Bulletin, 108(1), 30–49. http://dx.doi.org/10.1037/
0033-2909.108.1.30 Medline:2200072
Rogers, C. (1961). On becoming a person: A therapist’s view of psychotherapy. Lon-
don: Constable.
Rogers, E. (1995). Diffusion of innovations (4th ed.). New York: The Free Press.
References 315
Rosen, A. (1994). Knowledge use in direct practice. Social Service Review, 68(4),
561–77. http://dx.doi.org/10.1086/604084
Rosen, A. (2003). Evidence-based social work practice: Challenges and
promise. Social Work Research, 27(4), 197–256. http://dx.doi.org/10.1093/
swr/27.4.197
Rosen, A., Proctor, E.K., Morrow-Howell, N., & Staudt, M. (1995). Rationales
for practice decisions: Variations in knowledge use by decision task and
social work service. Research on Social Work Practice, 5(4), 501–23. http://
dx.doi.org/10.1177/104973159500500408
Rosenberg, E.L. (1998). Levels of analysis and the organization of affect. Re-
view of General Psychology, 2(3), 247–70.
Roth, A. & Fonagy, P. (Eds.). (1996). What works for whom? A critical review of
psychotherapy research. New York: Guilford.
Rothwell, P.M. (2005, Jan 1–7). External validity of randomised controlled tri-
als: “To whom do the results of this trial apply?” Lancet, 365(9453), 82–93.
http://dx.doi.org/10.1016/S0140-6736(04)17670-8 Medline:15639683
Rushton, J.P., Bons, T.A., & Hur, Y.M. (2008). The genetics and evolution of the
general factor of personality. Journal of Research in Personality, 42(5), 1173–85.
http://dx.doi.org/10.1016/j.jrp.2008.03.002
Rutherford, R.B., Jr., & Nelson, C.M. (1988). Generalization and maintenance
of treatment effects. In J.C. Witt, S.W. Elliott, & F.M. Gresham (Eds.), Hand-
book of behavior therapy in education (pp. 277–324). New York: Plenum Press.
Salter, A. (1949). Conditioned reflex therapy: The direct approach to the reconstruc-
tion of personality. Oxford: Creative Age Press.
Scarr, S., & McCartney, K. (1983, Apr). How people make their own environ-
ments: A theory of genotype → environment effects. Child Development,
54(2), 424–35. Medline:6683622
Schachter, S., & Singer, J.E. (1962, Sep). Cognitive, social, and physiological
determinants of emotional state. Psychological Review, 69(5), 379–99. http://
dx.doi.org/10.1037/h0046234 Medline:14497895
Schofield, W. (1964). Psychotherapy: The purchase of friendship. Englewood Cliffs,
N J: Prentice-Hall.
Schwartz, R.M., & Gottman, J.M. (1976, Dec). Toward a task analysis of as-
sertive behavior. Journal of Consulting and Clinical Psychology, 44(6), 910–20.
http://dx.doi.org/10.1037/0022-006X.44.6.910 Medline:993429
Segal, L. (1994). Straight sex: The politics of pleasure. London: Virago.
Segal, Z.V., Williams, J.M.G., & Teasdale, J.D. (2002). Mindfulness-based cogni-
tive therapy for depression: A new approach to preventing relapse. New York:
Guilford.
Seligman, M.E.P. (1974). Depression and learned helplessness. In R.J. Fried-
316 References
man & M.M. Katz (Eds.), The Psychology of depression: Contemporary theory
and research (pp. 83–113). Washington, DC: Winston-Wiley.
Seligman, M.E.P. (1991). Helplessness: On depression, development, and death (2nd
ed.). New York: W.H. Freeman.
Shapiro, D.A., & Shapiro, D. (1982, Nov). Meta-analysis of comparative
therapy outcome studies: A replication and refinement. Psychological
Bulletin, 92(3), 581–604. http://dx.doi.org/10.1037/0033-2909.92.3.581
Medline:7156259
Shaugnessy, A.F., Slanson, D.C., & Bennett, J.H. (1994). Becoming an informa-
tion master: A guidebook to the medical information jungle. Journal of Fam-
ily Practice, 39(5), 489–99.
Singer, D. (2007). The political economy of psychotherapy. New Politics, XI(2).
Retrieved 6 Aug 2011, from http://newpolitics.mayfirst.org/node/195
Singleton, W.T., Spurgeon, P., & Stammers, R.B. (Eds.). (1979). The analysis of
social skills. New York: Plenum.
Skinner, B.F. (1938). The behaviour of organisms. New York: Appleton-Century-
Crofts.
Skinner, B.F. (1953). Science and human behavior. New York: Free Press.
Smith, M.J. (1975). When I say no, I feel guilty. New York: Bantam Books.
Smith, S.W., & Travis, P.C. (2001). Conducting social competence research:
Considering conceptual frameworks. Behavioral Disorders, 26(4), 360–9.
Stajkovic, A.D., & Luthans, F. (1998). Self-efficacy and work-related perform-
ance: A meta-analysis. Psychological Bulletin, 124(2), 240–61. http://dx.doi
.org/10.1037/0033-2909.124.2.240
Stokes, T.F., & Baer, D.M. (1977, Summer). An implicit technology of generali-
zation. Journal of Applied Behavior Analysis, 10(2), 349–67. http://dx.doi
.org/10.1901/jaba.1977.10-349 Medline:16795561
Strain, P.S. (2001). Empirically based social skills intervention: A case for quali-
ty-of-life improvement. Behavioral Disorders, 27(1), 30–6.
Strelan, P. (2007). The prosocial, adaptive qualities of just world beliefs:
Implications for the relationship between justice and forgiveness. Personality
and Individual Differences, 43(4), 881–90. http://dx.doi.org/10.1016/
j.paid.2007.02.015
Taleb, T.N. (2005). The black swan: the impact of the highly improbable. New York:
Random House.
Tanenbaum, S. (2003, May). Evidence-based practice in mental health: Prac-
tical weaknesses meet political strengths. Journal of Evaluation in Clinical
Practice, 9(2), 287–301. http://dx.doi.org/10.1046/j.1365-2753.2003.00409.x
Medline:12787192
Tillich, P. (1973). Systematic theology (Vol. 1). Chicago: University of Chicago
Press.
References 317
Trower, P., Bryant, B., & Argyle, M. (1978). Social skills and mental health. Lon-
don: Methuen.
Truan, F. (1993, Sep). Addiction as a social construction: A postempirical view.
Journal of Psychology, 127(5), 489–99. http://dx.doi.org/10.1080/00223980
.1993.9914886 Medline:8271227
Tsang, A.K.T. (1979). Community participation scale. Unpublished manuscript.
Tsang, A.K.T. (1995). Negotiation of therapy agenda: Development of a process cod-
ing system (Unpublished doctoral dissertation). University of Toronto.
Tsang, A.K.T. (2000). Bridging the gap between clinical practice and research:
An integrated practice-oriented model. Journal of Social Service Research,
26(4), 69–90. http://dx.doi.org/10.1080/01488370009511337
Tsang, A.K.T. (2008). Psychotherapy integration and beyond: The MCM model.
Retrieved 29 Mar 2009, from http://kttsang.com/about/mcm/Brief_
Intro_to_MCM.pdf
Tsang, A.K.T. (2009, Dec). Evidence-based practice in social work. Keynote lecture
at the International Conference on Globalization and Family Changes: Pol-
icy Implications, Service Initiatives and Evidence based Practice. Chinese
University of Hong Kong.
Tsang, A.K.T. (2011a). Community Participation Scale (revised). Unpublished
manuscript.
Tsang, A.K.T. (2011b). EBP 3.0 for practice research. Unpublished manuscript.
Tsang, A.K.T., & Bogo, M. (1997). Engaging with clients cross-culturally: To-
wards developing research-based practice. Journal of Multicultural Social
Work, 6(3/4), 73–91.
Tsang, A.K.T., Bogo, M., & George, U. (2003). Critical issues in cross-
cultural counseling research: Case example of an ongoing project. Journal
of Multicultural Counseling and Development, 31(1), 63–78. http://dx.doi
.org/10.1002/j.2161-1912.2003.tb00532.x
Tsang, A.K.T., Bogo, M., & Lee, E. (2010). Engagement in cross-cultural clini-
cal practice: Narrative analysis of first sessions. Clinical Social Work Journal,
39(1), 77–90.
Tsang, A.K.T., George, U., & Bogo, M. (1997). Three key issues evaluation (3-KIE).
Toronto: Faculty of Social Work, University of Toronto.
Tsang, A.K.T., & George, U. (1998). Towards an integrated framework for
cross-cultural social work practice. Canadian Social Work Review, 15(1),
73–93.
Tsang, A.K.T., Irving, H., Alaggia, R., Chau, S.B.Y., & Benjamin, M. (2003).
Negotiating ethnic identity in Canada: The case of the “satellite children.”
Youth & Society, 34(3), 359–84. http://dx.doi.org/10.1177/0044118X02250124
Vachon, D.O., Susman, M., Wynne, M.E., Birringer, J., Olshefsky, L., & Cox, K.
(1995). Reasons therapists give for refusing to participate in psychotherapy
318 References
couple, 15, 42, 66, 82, 83, 107, 110, earthquake, 171, 193, 230; in Sichuan,
113, 115, 120, 153, 188, 195, 204, 171, 290
252, 253, 276; abusive relationship, eclecticism: epistemological, 270, 271,
200; counselling, 93, 105, 106, 117, 273
119, 120, 130 ,139, 141, 145, 147, emotion-focused therapy, 77
166, 169, 182, 190, 194, 196; dating, emotion work, 77, 168, 169, 170, 207,
194; divorce, 209; relationship, 210, 211, 265
212, 233; same-sex, 138 emotional significance, 193–4
creativity in relationships, 194 emotions and feelings, 165–8
crisis management, 84 empathic and interpretive under-
critical awareness, 82 standing. See Verstehen
critical thinking, 163 empathy, 118, 179, 257
cross-cultural communication, 252 empowerment, 33, 35, 36, 40, 54, 79,
242, 262, 279, 291, 292
dark side, 196 enactment, 54–6, 100
death, 213–16 engagement, 61–3, 174
dementia, 110 environment, 8, 14, 19, 21, 22, 23, 30,
demonstration, 6, 48, 50, 52, 53, 54, 31, 33, 37, 38, 54, 55, 68, 74, 79, 81,
129 101, 120, 130, 133, 155, 163, 164,
depression, 29, 34, 45, 47, 190, 122–3, 168, 175, 179, 182, 188, 196, 204,
126, 163, 208, 252, 263, 275, 276, 286 205, 206, 220, 231, 240, 252, 287,
desire, 23, 25, 38, 72, 74, 79, 80, 81, 82, 295; social, 79, 101, 188, 196
83, 86, 89, 91, 146, 151; politics of, epistemological eclecticism, 271
69, 78 equifinality, 47, 239, 241, 242, 274–5
developmental challenges, 42, 45, equilibrium and homeostasis, 77
110, 167, 254 equity, 291–3
diabetes, 241, 252 Erklären (causal explanation), 270
dialectical behaviour therapy, 7, 237 ethics, 255
diary, behavioural, 92–3, 94, 96, 131, evaluation, 29, 41, 57, 236, 237, 243
236 evidence-based practice (EBP), 8,
direct observation, 11, 52, 96, 97 242, 263, 267, 269, 270, 290, 294,
disciplinary practices, 81 295, 296; first generation (1.0), 271,
diversity, 9, 13, 15, 19, 136–9, 161–2, 272; second generation (2.0), 270;
164–5, 276–7, 293–4; cultural, 161, third generation (3.0), 270–7
162; sexual, 276, 293; working with evocation, 122, 123
intersecting diversities, 14, 19, expectation management, 56, 179,
276–7 184
drive, 23, 25, 75, 76, 77 expert trainer model, 6
drug metaphor, 263, 264, 265, 266, expression, 151–73; of emotions and
268 feelings, 76–7, 146–7, 165–71; of
324 Index
politics of desire, 78, 79; profile, pleasure, 23, 24, 34, 35, 38, 39, 45, 68,
61, 73, 83, 85, 86, 87, 190, 208; self- 72, 73, 74, 175, 183, 192, 197, 202,
identity, self-esteem, agency, 74; 208, 212, 238
socialization and internalization, pluralism, methodological, 270,
80–3; reference list, 72–7; token, 77; 273–4
unconscious, 79–83 political economy, 25, 78, 258, 269,
normalizing, 211–12 271, 272
nourishment and maintenance: of positive: expectancy, 85; reframing,
relationships, 197–201 156, 157, 158, 159, 160, 181, 216,
231; responding, 177, 179–81, 186;
obesity, 22, 252 self-statement, 156–60
observation learning, 13, 27, 33, 46, post-professional era, 247
51, 53, 121, 124, 128, 165, 219, 248. power, 33, 77, 254, 291–3
See also modelling practice: professional, inter-subjec-
operant conditioning, 7, 15, 30, 33, tive, 272–3; real-life, 46, 56, 112,
237, 251 123, 125, 131, 132
opportunity and marginalization, practice-based evidence, 278
84–5 pragmatism, 271–80, 289–91
oppression, 28, 84, 292 preplanned program, prepackaged
organizational development, 15, 252, program, 44–6, 49, 53, 65, 113, 115,
261–2 125
proactive health strategies (PHS),
pain, 22, 38, 39, 126, 167, 172, 249, 241, 252, 253
263; emotional, 34, 37; manage- problem translation, 37, 45, 46, 48–9,
ment of, 253; psychological, 96 61–94
parenting, 13, 175, 200, 208, 212, 233, production, knowledge, 268, 271,
275 272, 273, 274, 275, 285, 289
peer support, 250 psychoanalytic theory, 74
performance, 51, 67, 94, 99, 101, 102, psychological immunization, 121,
104, 105, 106, 125, 129, 130, 131, 125
133, 135, 138, 146, 154, 156, 161, psychotherapy, types of (Wolberg),
177, 218, 220, 228, 230, 231, 236, 243
238, 245, 253, 278, 279, 282, 285; public policy and social programs,
real-life, 55, 132, 229; social, 97, 78
100, 185, 211, 248, 249, 292, 294
pervasive developmental disorders, randomized controlled trials (RCT),
42, 107 264, 267–8, 295, 296
physical appearance, 152, 155–6, 183 rapport, 175
playback: of video, 6, 54, 55, 97, 143, rational emotive therapy, 237
145, 177, 250, 282 reactivity effect, 94
Index 327
reciprocal determination, 22, 30; 103, 143, 182, 184, 185, 233, 252,
need gratification, 187–9 261, 278
reciprocity, 164, 189 self-acceptance, 169
reconsideration, 215 self-disclosure, strategic, 111, 177,
reconstruction, cognitive, 42, 95; of 185–6
emotion, 169 self-efficacy, 36, 45, 55, 57, 82, 100,
recording, audio, 98, 99; video, 6, 54, 110, 124, 131, 157, 169
55, 97, 98, 99, 130, 132, 155, 230, self-empowerment, 253
250, 282 self-esteem, 45, 52, 157, 227, 249,
refinement, 13, 14, 27, 54, 55, 56, 123, 281
124, 131, 132, 230, 236, 254, 288 self-image, 22, 26, 27, 96, 126, 149,
reflection, 105, 263, 274 222, 238, 281
rehearsal, 13, 46, 55, 123, 124, 125, self-introduction, 159–62, 185
219, 228, 250 self-presentation, 102, 103, 111, 153,
relationship: building of, 114, 138, 154–9, 161, 177, 228, 249, 294
189–90, 191–3, 202; dysfunctional, self-report, 96, 97, 237, 296
188, 189; functional, 190, 192; seniors, 110, 250, 252, 285
transformation of, 203–8 separation-individualization
repertoire: of skills, 49, 115; of strate- (Mahler), 204
gies and skills, 12, 15, 49, 108, 216, settlement counsellors, 228
246, 291, 293 settlement workers, 247
report back, 56–7, 131–2 sexuality, 96, 196, 276, 285, 293
research: and knowledge building, sharing, 138, 195–7
294–6; practice and, 268–9, 277–9; signifying acts, 146–8, 167, 171, 193–
SSLD and, 263 4, 195, 197, 202
resolution, of emotion, 169, 212, simulation, 54–6, 97, 99, 123, 124,
215 133
respondent conditioning, 30, 33, skill, definition of, 49
237 social change, 78–9
retrospective orientation, 215 social class bias, 6
review, 56–7 social cognitive theory, 6, 22, 26, 28,
risk, risk taking, 56, 121, 125 30, 41, 51, 80, 237
role-play, 55, 97, 98, 99, 100, 105, social exchange analysis, or social
106, 112, 124, 133, 141, 142, 145, exchange thinking, 187, 188
149, 177, 184, 228, 282; in-session, social exchange theory, 187–8
97–101, 129–31; reverse, 99–100 social facilitation, 219
Romeo and Juliet (Shakespeare), 159, social learning theory, 6, 7, 15, 30,
160 237
social phobia, 31, 42, 47, 110, 111, 121,
schizophrenic disorder, 8, 63, 92, 102, 153, 176, 247, 252, 278
328 Index
social regulation, 78–9 stimulation, 23, 25, 27, 34, 175, 238;
social service, 281 auto-, 13; sensory, 23, 34, 72,
social skills therapy, 6 73
social skills training (SST): address- stimuli, 30
ing the challenges of, 10–12; ap- strategy, definition of, 50
plication of, 7–8; brief review, 6–7; stress management, 39, 231, 253
critique, 8–10; effectiveness, 8 stroke, 252
social work, 18, 33, 235, 243, 247, 270, study group, 246, 250, 296
285, 289, 294 subjective experience and meaning,
social worker, 84, 246, 280, 290 64–5
socialization and internalization, suicide, 212, 275
80–3 supervision, 117, 244, 245, 246, 250,
socio-economic development, 73 278, 283, 296
solution-focused therapy, 237, 238– symbolic mediation, 52–4, 129
9 systems theory, 274
South Asian, 84, 138
spirituality, 70 team building, 252
SSLD: basic premises and tenets, temporal structures, 215
32–8; compatability, 235; complex- termination, of relationship, 203, 204,
ity, 236; conceptual advantage, 205, 207, 209–13; of SSLD inter-
theory, values, 39–40; features, 15; view, 134–5
learning to become a practitioner, therapeutic family mediation (Irv-
244; logistics, 279; observability, ing), 209
236–7; potential and limitation, therapeutic relationship, 255, 265,
242–4; practical advantage, 41–3; 266
practice, 79, 80, 82, 83, 87, 101, 110, Third Wave CBTs, 237
120, 121, 122, 129, 131, 132, 134, trainer, 6, 15, 17, 20, 40, 49, 51, 53,
135, 137, 148, 162, 168, 172, 192, 57, 69, 101, 122, 129, 141, 153,
194, 197, 207, 214, 215, 219, 233–96; 233
practitioner, practitioners, 16, 18, transfer of learning, 51
20, 51, 62, 66, 78, 95, 117, 122, 127, transformation, 138, 169, 203, 204–8,
133, 134, 190, 193, 224, 228, 231, 209, 210, 213, 214, 216
236, 244–50, 253, 258, 277, 278, 283; transitional object, 77
relative advantage, 236; research trauma, 211
and, 263; technical advantage of, two-chair method, 100
40–1; triability, 236; values, 232,
235, 289–94 unconscious needs, 79–83
standardization, the limits of, 11–
12 Verstehen (empathic and interpretive
stigmatization, 40, 41 understanding), 270
Index 329
video recording and review, 97, 98, weight management, 219, 233, 241
130 well-being, 5, 29, 45, 76, 77, 157, 174,
volunteer, 67, 76, 104, 207 180, 200, 221, 231