aut ism dige st .

co m

http://autismdigest.co m/so cial-anxiety-and-so cial-skill-co mpetencies/

Social Anxiety and Social Skill Competencies

by Michelle Garcia Winner, CCC-SLP Autism Asperger s Digest | November/December 2011 Social skills challenges dont stand alone. Our social skills are social behaviors that impact how others think and f eel. In turn, how people respond to us af f ects how we think and f eel. Many students with higher-level social learning challenges are aware they do not learn as easily as do their peers, and that others are not as accepting of them as they would like. T his awareness impacts how they f eel about themselves. T he research is clear that anxiety and depression of ten comingle in individuals with ASD and ADHD, which adds extra variables when designing a treatment program f or these individuals. In our culture certain issues, such as social anxiety and depression, are usually handled by our mental health systems and prof essionals such as psychiatrists and psychologists. Prescription medication and/or cognitive behavior therapy are of ten the main treatment choices to help lessen the symptoms. It may be time that we stop to reconsider our perceptions about social anxiety and which prof essionals are solely responsible f or treatment. From my experience working with hundreds of individuals with varying levels of social learning problems, anxiety and depression may be the direct result of an individuals social learning challenges. T his expanded line of thinking means those of us who teach social skills and social thinking also need awareness of treatment concepts related to anxiety. Two Types of Anxiety At our Social T hinking Center in San Jose, CA, my colleagues and I have engaged in persistent clinical study of the heterogeneous nature of individuals with ASD and related social learning challenges. We have observed there are two main types of anxiety manif ested by persons with dif f erent levels of social learning problems. Our clients who tend to have reasonable to high verbal intelligence, who may start with a language disorder but acquire more spontaneous verbal language but are very literal, struggle to deal with change, have poor social self -awareness, and exhibit a f orm of anxiety we ref er to as world-based anxiety. T heir anxiety of ten stems f rom situations that may not be happening around them in the manner they predict, based on their more rigid interpretation of their world and related events within it. For example, this type of person may have a dif f icult time coping with a substitute teacher or a schedule change. T his type of social learner (one we ref er to as our Emerging Social Communicator) does not appear to have huge amounts of social anxiety, given this groups signif icant lack of self -awareness. So, while their anxiety can be signif icant, it is of ten not related to how people think and f eel about them. On the other hand, we work with students who also have solid to strong verbal intelligence and solid language skills but who have tremendous social anxiety. T his type of student tends to be less literal. By upper elementary school they adapt f airly well to changes in routine or schedule but can experience massive and pervasive f ear related to social interactions. Not coincidentally, individuals in this group also have strong social self -awareness and f requently a bend toward perf ectionism, making them unf orgiving of any social error they make, no matter how subtle. While both types of students may have dif f iculty with social interaction, it is our experience that those with world-based anxiety need a very dif f erent type of anxiety treatment approach than do those with social anxiety. (For more inf ormation on our dif f erent levels of the social mind, read our f ree article, T he Social T hinkingSocial Communication Prof ile by Winner, Crooke & Madrigal, 2011, at socialthinking.com)

An Expanded Approach to Social Anxiety Treatment If social learning problems are the catalyst f or comingled social anxiety in these individuals, it behooves us to tailor our treatment strategies and lessons accordingly. We need to begin treatment by primarily working with our clients on increasing social knowledge and related social skill competencies (i.e., engaging them in learning about Social T hinking). As their competencies evolve we then need to expand our f ocus to address their social anxiety as it links back to understanding social situations and the people they encounter. My colleagues and I came to this conclusion af ter researching traditional social anxiety treatment programs and attempting to implement these strategieswith limited successwith our students with social learning challenges (e.g., Aspergers Syndrome, High Functioning Autism, ADHD). More traditional social anxiety curriculums of ten teach the socially anxious person to recognize and embrace the idea that others welcome their participation and f riendship. T his is where I struggled. While I work with many clients with social learning challenges whom I personally like, the reality is their peer group is not embracing them. To ask my clients to look f or signs that a peer was ready to bef riend them, assuring them if they just werent so anxious the response would be positive, was like setting them up f or f urther rejection and disappointment. My response was to create a dif f erent teaching pathway. Af ter years of teaching them improved social competencies, I began to really talk to my students about how f ar they had come to help them recognize the progress they were making in being more socially approachable and appropriate. It was important to review this with them on a regular basis, as treatment progress in social learning is of ten slow and steady. For many of my clients, it took years to make signif icant gains in social interpretation and related social responses. As a treatment provider I also had to keep in mind that each year my clients showed social progress their peers also intuitively advanced in their own social awareness, which kept our clients skill base still lagging behind that of their peers. While this strategy was slow and methodical, most of our students showed progress. As our clients became able to state and demonstrate their improved competencies, we then were able to use that inf ormation to help them make realistic decisions about which people to pursue f or social activities and/or f riendships. Choosing an appropriate social partner who is f riendly toward you became an important discussion topic, as some of our clients have unrealistic social expectations about who they want as f riends. An unspoken but readily observable f act of the school yard or even an of f ice work group is that dif f erent people in the same community have dif f erent levels of social status. If a client pursues f riendships with a person or a group of people who are thought to have higher social status, our client stands the risk of being made f un of or even bullied. Of course, we do not condone the negative reactions of the higher-status peers, but this is a reality of our social world we need to openly explore with our students. In f act, our own students, when they perceive they are of higher social status than another student, may even bully that student! Ultimately we discuss that not just any peer is a potential, suitable f riend and even f riends of similar status may not choose to be f riends with another person f or a whole host of reasons. T he more our students understand the complexities of social relationships and peer groups, the less random the social world appears, and the more conf ident our students can be in deciphering social inf ormation. It is this growing conf idence in skills and abilities that will lead to a less anxious social response. Once we reach this point with our clients, we then discuss the wall of social anxiety that may be f urther preventing them f rom using their more evolved social thinking and social relatedness skills. Had we tried to do this earlier in the therapeutic process, our students could not have appreciated the extent to which their social anxiety and their social competencies were entwined. In our clinic we would of ten observe that our clients were f ar more socially competent when relaxed and comf ortable, yet when f aced with anxiety their social competencies plummeted. It was a vicious cycle, with anxiety f eeding social f ailure, which in turn f urther exacerbated their anxiety. T he Spirals of Social Success and Failure My goal was to f ind a way to help our clients decrease anxiety while increasing their social competencies.

T he result was a treatment strategy called the Spirals of Social Success and Social Failure. I developed this approach f or high-level teens and young adults who had f irst developed social competencies and were now ready to explore social anxiety. We discovered this teaching strategy helped motivate them to challenge their anxiety by giving them alternative strategies to use when stressed by specif ic social situations. An overview of the social concepts we shared with clients, as well as the description of the spirals, f ollows. Social anxiety has deep tentacles; once it disrupts our functioning it likes to keep that power in place! Once it inhabits a person, anxiety will not go away without a f ight. T his means as our students recognize they have increased social competencies, they have to actively work at reducing their anxiety. T his involves learned strategies, as well as their own shif t in perception in making a choice in the moment: are you going to def ault to anxiety or use your strategies? Some of the key social learningsocial anxiety reduction strategies we teach our clients include: 1. Take ownership; be personally accountable for what you need to learn. Af ter many years of working with adolescents, I realized that while I understood they had social learning dif f erences, as long as I prompted them to use their strategies, I was the one taking ownership of their problems. Now I realize that as I teach them these strategies, they have to work at using them, which f irst means they have to realize these strategies are theirs and not ours (the teachers and parents). 2. Accept that your job is to become more comfortable with social discomfort. T he neurotypical teen and adult world is f illed with social discomf ort. Using strategies does not mean our clients wont f eel discomf ort. T heir job is to work at learning how to be comf ortable with the f act they will be uncomf ortable socially at times! T he mentors job is to encourage the client to use the treatment strategies even when experiencing discomf ort. 3. Recognize and celebrate the small steps of progress being made. We need to help our students f eel intrinsically proud of themselves f or their progress. Avoid using token rewards f or progress as these provide extrinsic but not intrinsic motivation. 4. Use your inner coach, rather than your self -def eater voice, inside your head. You and I use an inner coach or private voice in our heads to encourage and motivate ourselves through dif f iculties. Our inner coach may say to us: You can do this! Just do it and get it over with! Remember last time this wasnt as bad as you thought it was going to be, so just go do it! Unf ortunately, many of our students have a self -def eater voice in their heads. T his voice discourages rather than encourages: Youre bad at this. Youve never been able to do this, so you wont be able to do it now. Individuals who have a loud self -def eater voice in their heads will def ault to avoiding the uncomf ortable task at hand; those with an inner coach have a f ar better chance of pushing themselves through the uncomf ortable task. We need to help our students be realistic about their strengths and challenges while reinf orcing their choice to use their inner coach as much as possible. 5. Stop making excuses for avoiding social encounters. T hose with strong self -def eater voices tend to f ind a lot of benign excuses f or avoiding the task at hand. Many of our students dont recognize that what they are saying is, in f act, an excuse f or not pushing themselves through an uncomf ortable moment. Instead, they automatically def ault to their excuses. Our strategy is to explore the personal excuses they make as we assign them tasks that provide opportunities to practice social competencies and use their anxiety-reducing strategies. Once students begin to notice and then take ownership of the f act they are making excuses, they f urther progress. 6. Your brain always learns; whether it learns positive or negative ways to cope, it is always learning! We discuss how our brains are always learning, all the time, that anytime we are awake we are learning f rom our experiences. If we def ault to what we are accustomed to doing, we constantly teach our brains we can only do it the way we have done it bef ore. If students want to teach their brain a new set of skills, they have to try to do things dif f erently. T his idea may seem elementary, but it can be dif f icult f or our concrete-thinking, rule-bound students to change the way they do things, especially their thinking patterns. I of ten ask them a direct question: Do you want to teach your brain you cant

their thinking patterns. I of ten ask them a direct question: Do you want to teach your brain you cant do something, or do you want to teach your brain you can do something? Hopef ully their answer is a can-do response, and we circle back to our other strategies to help them retrain their brain. Visualizing the Spirals of Social Success and Failure Visual representations are strongand welcomedtools in helping our students understand the interrelationships that exist in social thinking and social processing. To help our students understand the concepts outlined in this article, I developed two graphic representations of the thought processes used in working through social situations. T he Spiral of Social Success summarizes these concepts: You will encounter some stress approaching this situation. In the past your anxiety would prompt you to bail out of this situation. Instead of starting by doubting yourself , explore what strategies you can use to help yourself deal with the uncomf ortable social situation. Use your inner coach to remind yourself how much better you will f eel once you use your strategies that you are capable of using these strategies as well as choosing specif ic strategies to use. You f eel better about yourself when you are demonstrating your abilities or social competencies. T his encourages you to use the strategies. In doing so, you are training your brain that you can do it better than you have done it bef ore! Conversely, the Spiral of Social Failure illustrates what happens when our clients f ail to embrace their sociallearningsocial-anxiety reducing strategies: You encounter the same stressf ul situation, one you previously avoided. Your anxiety prompts you to think of excuses f or why you wont engage in this situation today. Your self -def eater voice assures you that you cant do it and that you have never been able to do it. You have negative emotions about your inability to get through this situation. You avoid putting yourself in the situation. You teach your brain one more time that you cannot do it! Your memory now ref lects your inability and your self -def eater voice grows stronger. T he purpose of the Spirals of Social Success and Social Failure was to help our students understand how best to place the strategies they were learning in the context of their own f unctioning. Our students helped us adjust the spirals so the wording more clearly matched their own experiences and emphasized how they related to the content of each spiral. T his visual presentation paired with lessons that taught them the key concepts outlined in the graphicsincreased accountability, self -learning, letting go of excuses, and embracing changeled to some very positive results. T hey discovered they could choose positive behavioral responses to anxiety-laden situations and retrain their brains to learn new ways of acting and reacting. While the situations still caused anxiety, our clients gained conf idence in attempting to push through their anxiety, f urther reinf orced by the success they could achieve within the interaction. However, this learning process takes time. It may take years to help our students, through active learning of these strategies, to get them onto the Spiral of Social Success. Some level of anxiety is inherent in every social situation we encounter. T his set of strategies does not of f er a cure f or the anxiety experienced by individuals with social learning challenges. However, it can help minimize some of the anxiety by helping our students better appreciate how anxiety af f ects us and giving our students a toolbox of options to use when anxiety arises. Such coping strategies are benef icialnot just f or individuals with social learning challenges, but f or us all! Michelle Garcia Winner is the f ounder of Social T hinking. She works in her clinic in San Jose, CA, has written numerous books, and speaks internationally. Visit her website, socialthinking.com, f or more inf ormation.

Copyright Autism Aspergers Digest. 2012. All Rights Reserved. Distribution via print is prohibited without written permission of publisher.