01/2011: Teaching Social Skills
The next few PsychBits will describe manualized descriptions of how to increase concrete skills - for now, we will look at ways to increase social skills in individuals with Asperger's.
This excerpt is taken from the journal of Psychiatry, 40 Psychiatry 2010 [ V O L U M E 7 , N U M B E R 8 , A U G U S T ]
PRACTICE POINT: TEACH PATIENTS ABOUT LEVELS OF EMOTION
Individuals with ASDs commonly have a low frustration tolerance and significant irritability. They may report that they alternate from calm to extreme anger very quickly. There have been several studies that suggest individuals with ASDs have difficulty understanding and interpreting their own emotions. If they are not able to recognize less intense emotions in themselves, they will not be able to develop skills to help themselves calm down prior to “losing control”.
Knowledge of emotions often has to be explicitly taught to individuals with ASDs. Visual supports can help make abstract and difficult to understand topics (i.e., emotions) more concrete for individuals with ASDs. A visual support in the form of an emotion thermometer can be created to help the individual identify emotions between the extremes. The emotion thermometer visual can take many different forms, e.g., drawing of a thermometer on a piece of paper with emotions listed in ascending order from happiness to anger. The thermometer should be created with the patient over the course of several sessions. The patient should choose the emotions that are placed on the thermometer with assistance from the therapist. On the emotion thermometer, the halfway point can be a neutral or “typical” emotion, such as “fine” or “content.” There can be 4 to 5 emotions below “content” on the thermometer visual that describe positive emotions in ascending order (e.g., proud, surprised, happy, elated). Then there should be 4 to 5 emotions above “content” that describe negative emotions in ascending order (e.g., upset, sad, frustrated, angry, livid).
The visual concept represented by the thermometer is that as emotions become more negative, the mercury in the “thermometer” rises. It may be helpful to start with only one side of the thermometer (negative or positive emotions). Giving the patient only one-half of an emotional spectrum on which to focus at a time may keep him or her from feeling overwhelmed. After he or she has mastered understanding and naming the emotions on one side of the thermometer then the other end can be addressed. Once the emotions have been decided upon and placed appropriately on the thermometer, the next step is to build knowledge on what those emotion labels mean (i.e., what each emotion “looks like” and “feels like”). It is important to have the person define the emotions. If he or she is having trouble defining them, the individual can look them up in a dictionary, if necessary. The thermometer visual can then be utilized to help the individual identify his or her own emotional state.