CHAPTER 1: INTRODUCING THE SKILLS SYSTEM
Introduction
Bernice Johnson Reagon, an African-American scholar and song-writer wrote "Life's challenges are not supposed to paralyze you, they're supposed to help you discover who you are." (Lewis, 2009). Fully experiencing life's challenges, being present within the current moment can be excruciatingly difficult in some circumstances. Painful emotions and overwhelming thoughts may bombard the individual, blurring self-reflection and the course ahead. The person may not choose to be paralyzed; it is what happens when devastating events occur and/or he/she lacks effective coping skills.
Developing adaptive coping skills can help the person manage life's challenges rather than being paralyzed by them. Knowing how to effectively handle emotions, thoughts, and actions assists the person to balance his/her needs with the demands of the situation in ways that help him/her to reach personal goals. Although the individual may experience adversity, having the ability to make effective choices that reflect his/her personal perspective can increase fulfillment. As abilities to tolerate discomfort and active management of situations improves, so does the individual's capacities for self-discovery and self-determination.
The Skills System.
The Skills System is a set of nine skills and three system rules that helps the individual to cope with life's challenges. This simple framework guides the person through the process of becoming aware of the current moment, directing attention, and activating behaviors that are in service of personal goals. The person learns a to follow steps that mobilize inner wisdom in each unique situation. As the skills and the guidelines are integrated into the context of the person's life, abilities to demonstrate effective coping behaviors within challenging situations increase. Each situation provides the person with an opportunity for self-discovery and active participation in events. The individual is no longer paralyzed; he/she is a Skills Master.
Designed for all learners.
Learning new, more adaptive patterns of behavior is a challenging task for anyone. This is especially difficult when the individual must manage complicating factors such as mental health issues, intellectual impairment, physical problems, and/or difficult life circumstances. These life challenges may increase stress, as well as, impact the individual's abilities to learn new information.
The Skills System and the curriculum contained in this guide are designed to help individuals who experience learning challenges. For example, an individual who is diagnosed with an intellectual disability or mental illness, may have difficulty focusing attention, remembering information, and utilizing concepts within complex situations. The Skills System itself and the teaching strategies contained in the manual are constructed to maximize learning, integration, and ultimately generalization of the skills into life's contexts. Even an individual who cannot read and/or write can learn and use the Skills System.
Compatible with Dialectical Behavior Therapy (DBT).
The Skills System was developed as an accessible alternative for individuals with cognitive impairment who were participating in DBT therapy (Linehan, 1993). The standard DBT skills (Linehan, 1993b) were not specifically designed for individuals with intellectual disabilities, yet the general concepts are vastly helpful for this population. Merely modifying the teaching of the standard curriculum is not sufficient to capture the essence of DBT in a way that promotes generalization of the DBT principles and skills by this population. The Skills System utilizes DBT principles, while the language and format is adapted to address the needs of individuals who experience significant learning challenges. The Skills System may be conceptualized as Pre-DBT skills; the remedial structure of the Skills System model offers the individual the basic self-regulation skills, upon which the standard skills can be added.
Overview of the Skills System.
There are nine skills in the Skills System; these nine skills form the Skills List. There are also three System Tools that guide utilization of these nine skills. Table 1.1. highlights the Skills List and the System Tools.
TABLE 1.1. Skills List and System Tools
The Skills List
1. Clear Picture
2. On-Track Thinking
3. On-Track Action
4. Safety Plan
5. New-Me Activities
6. Problem Solving
7. Expressing Myself
8. Getting It Right
9. Relationship Care
System Tools
Feelings Rating Scale:
• 0-1-2-3-4-5 scale for rating the intensity of emotions
Categories of Skills:
• Skills 1-5 are All-The-Time Skills
• Skills 6-9 are Calm Only Skills
Recipe for Skills:
• Add one skill for every level of emotion. (e.g., at a level 2 emotion, use 3 skills)
The Skills List.
Getting started with a Clear Picture.
Skill 1 is Clear Picture. The individual begins using Clear Picture when he/she notices any change in his/her internal or external experience. The person takes a few seconds to quickly collect more information about the current moment by (1) taking a Breath, (2) doing a Body Check, (3) Noticing Surroundings, (4) Labeling and Rating Emotions using the 0-1-2-3-4-5 Feelings Rating Scale, (5) Noticing Thoughts, and (6) Noticing Urges. These six steps of reflection are the Clear Picture Do's.
Using On-Track Thinking.
Skill 2 is On-Track Thinking. Once the individual has a Clear Picture of his/her internal and external circumstances in the moment, the person does On-Track Thinking. The steps of On-Track Thinking are: Stop, Step back, & Think about what I want, Check the Urge, Turn It to Thumbs-up, and Make a Skills Plan. On-Track Thinking helps the person pause, self-reflect, and make a strategic plan within the moment.
Taking an On-Track Action.
Skill 3 is On-Track Action. Once the participant gets a Clear Picture and does On-Track Thinking, he/she takes an On-Track Action. An On-Track Action is the person's first step in the direction of the goal. The individual may create an On-Track Action Plan, Switch Tracks, Accept the Situation, and/or Let It Pass and Move on.
Managing risky situations with Safety Plans.
Skill 4 is Safety Plan. If there are risks in the area, a Safety Plan is helpful. There are three kinds of Safety Plans: Thinking, Talking, and Written. The risk levels are labeled as Low, Medium, and High, depending on the severity and proximity of the danger. Safety Plans prompt an individual to either Focus on a New-Me Activity, Move Away, or Leave the Area to safely manage the increasing levels of risk.
Doing New-Me Activities.
Skill 5 is New-Me Activities. New-Me Activities are beneficial activities in which a person participates. New-Me Activities serve four basic functions. Focus New-Me Activities assist the client to focus attention, while other activities promote distraction. Some activities help the person feel good, and others are intended to be fun. The participant learns to evaluate what his/her needs are in the moment and choose a New-Me Activity that fits best.
Problem Solving.
Skill 6 is Problem Solving. Problem Solving is a multi-step process that guides a person to fix problems in his/her life. The participant gets a Clear Picture of the problem, reviews multiple options for solving it, and checks-the-fit of the choices. Developing plans A, B, and C can help the participant be prepared for inevitable obstacles that occur.
Expressing Myself.
Skill 7 is Expressing Myself. Expressing Myself assists the individual to communicate effectively with people. It is vital for the participant to learn about various types of expression so that the person can choose means of communication he/she feels is best in each situation. Additionally, understanding the function of self-expression helps the participant understand how and when to utilize it effectively.
Getting-It-Right.
Skill 8 is Getting-It-Right. Getting It Right is used specifically f