Social Skills

Question 1

Underlying Theory

Answer 1

• In some cases, the most devastating effects of psychological and mental disorders are their effects on the social aspect of life.
• Humans are social creatures and thrive on interaction with others. Without this, depression and isolation are inevitable, leading to further detrimental consequences on one’s mental health.
• Equipping people who otherwise have no social skills or practice in social skills with the necessary tools is becoming a prominent technique in psychotherapy.

Question 2

What is ‘Social Skills’ training

Answer 2

• Social skills training is a type of psychotherapy that works to help people improve their social skills so they can become socially competent.
• SST is predominantly a behavioural therapy but cognitive therapy can also be used in some situations to maximise the success of SST.
• This psychotherapy can be done one-on-one or in a group situation.

Question 3

Who can benefit from ‘Social Skills Training’

Answer 3

• SST is mainly used for individuals that are diagnosed with certain mental or psychological disorders and whose symptoms involve poor social functioning.
• However, anyone who wants to improve their social skills and social confidence can benefit from this psychotherapy.
• The major disorders that are accompanied with social dysfunction are: AutismSchizophreniaSocial anxiety disorder or social phobiaIt is important to remember that, although SST can be very effective in helping people learn the necessary skills, it is very rare for SST to be a stand alone therapy.
• There are always underlying reasons why people are experiencing social difficulty and these too need to be treated, either with drugs or a combined psychotherapy.

Question 4

What is involved in Social Skills training?

Answer 4

• Social skills training will almost always be combined with some other type of psychotherapy, most often cognitive-behavioural therapy.
• The amount of time needed to complete an SST program varies depending on how well you are learning the techniques and how much confidence you have in using the skills in a social environment.
• Typically, eight one-hour sessions are standard.Identifying the problemFirstly, the major social problem needs to be identified.
• For example, are the problems with socialising predominantly a fear of large gatherings of people? Or speaking to people at work?
• In order to figure out the major problems, the patient and psychologist work together through discussion. Sometimes the psychologist may want to observe the patient’s behaviour; this is mainly with inpatient settings or children in the classroom.The underlying psychology behind the social problems also needs to be determined. Sometimes social problems are a result of a mental illness (e.g. schizophrenia), or they may have arisen from a past trauma. Once these problems and reasons have been determined, your psychologist can determine what skills need to be focused on, how best to teach the skills, and what other therapies are required to help with the underlying issues.Setting the goalsAs with any type of psychotherapy, your psychologist will help you develop specific goals for the therapy. This will include a broad overall goal as well as focused goals that may change from session to session. For SST, the broad overall goal may be the ability to socialise comfortably in the staffroom, whereas the individual goals will be skill-specific (e.g. learning how to greet someone, ask how they are and respond appropriately).Once each goal or skill is mastered, the goal for the next session becomes more difficult. Keeping the overall goal in mind will help you overcome times when you feel like giving up on the therapy.ModellingBefore you are expected to perform the skill, your psychologist will model the skill you are focusing on, so that you can see exactly what you need to do before attempting to do it yourself.RoleplayingAfter your psychologist has modelled the skill, you will be asked to roleplay. This practice is a very important aspect of SST. It may feel odd to roleplay, but until you have practised the skill, it is hard to use it outside the safety and confinement that therapy sessions provide.FeedbackYour psychologist will provide feedback at the end of each session. This feedback will help you to identify your strengths and weaknesses, and the things you especially need to work on and practise.Homework!In between sessions, your psychologist will set little “homework” challenges that you are required to do in your own time throughout the week. Usually the homework will carry on directly from the session, so that you practise the new skill you learnt. Depending on your success at meeting the challenge, you will focus on a new, more difficult skill in the next session.

Question 5

Children and SST

Answer 5

• How you socialise as a child is different to socialising as an adult, so social skills training for children is different to that for adults.
• Not only do people of different age groups socialise differently, but they are also associated with different psychological and mental dysfunctions.
• Therefore, social skills training will be very different in terms of goals and teaching methods between different age groups. The basic implementation plan, however, is the same.
• Regardless of whether a child is diagnosed with a psychological disorder or not, it is very important to develop social skills in childhood.
• Any child with a social problem can be referred to a psychologist; this will greatly benefit them in the future. Minor social problems in childhood can turn into serious antisocial or anxious problems in the future.

Question 6

SST for bullying and peer pressure

Answer 6

• Bullying and peer pressure are very prominent issues in primary schools.
• A lot of the time, children who have not quite developed social skills are isolated and picked on.
• Not only does this severely damage children’s self-confidence, but it also causes them to withdraw from most aspects of school life.
• SST for these children aims for peer group acception. The training is a combination of cognitive-behavioural and social learning.
• It focuses on:
  Encouraging attitudes and behaviours which enhance positive social interactions (i.e. prosocial behaviour); and
  Building coping strategies for dealing with peer pressure and bullying.
• This is will also work positively on self-esteem.Throughout the sessions, basic social skills are also taught, depending upon what specific social area the child struggles with.

Question 7

SST for adolescence and adulthood- Schizophrenia

Answer 7

Kurtz and Meuser, 2008

• A meta-analysis of randomized, controlled trials of social skills training for schizophrenia was conducted.
• Results reveal a large weighted mean effect size for content-mastery exams (d 1.20), a moderate mean effectsize for performance-based measures of social and daily living skills (d 0.52), moderate mean effectsizes for community functioning (d 0.52) and negative symptoms (d 0.40), and small mean effectsizes for other symptoms (d 0.15) and relapse (d 0.23).
• These results support the efficacy of socialskills training for improving psychosocial functioning in schizophreniaOne of the core deficits of schizophrenia is cognitive impairment, including working memory, problem solving and attention.

                           Wallace and Liberman, 1985

• Patients exposed to social skills training evidenced significantly greater acquisition, generalization, and durability of social skills; their social adjustment in the community was rated as better by significant others; and they experienced fewer relapses and rehospitalizations.

Question 8

SST for Social Phobias and Anxiety

Answer 8

Hollandsworth et al (1978)

A 30-year-old recent college graduate, exhibiting extreme anxiety and deficient verbal skills in job interviews, was treated with a social-skills training procedure that included instructions, modelling, behavior rehearsal, and videotape feedback. Three target behaviors–focused responses, over coping statements, and subject-generated questions–were presented using a multiple-baseline design. Galvanic skin-response activity was monitored during pre- and post training in vivo job interviews.

Question 9

SST in vocational uses

Answer 9

Work is an essential part of our lives and society. Studies show that when people do not work, they feel depressed and unsatisfied. Thus, situating mentally ill people in the workplace has become a primary aim of rehabilitation. In order for people to maintain a job, they must have the necessary social skills. The lack of these is why many people are unable to stay employed.It is best to adapt vocational SST to a specific job. It is very difficult for mentally ill patients to generalise workplace social skills to any environment, as different jobs require different relations.