Eunice Lerma, Ph.D, LPC, CSC
Richard J. Ricard, Ph.D, LPC-Intern
Courtney Heard, M.A., LPC-Intern
Troy Tillmon, M.S
Teen Talk Program
 Partnership between DAEP and Texas A&M University-
Corpus Christi; Department of Counseling Education &
Psychology; Counseling and Training Clinic.
 Students meet twice a week in same gender, small group or
individual counseling sessions to discuss topics relating to
teenagers of today.
 These counseling sessions are conducted by counseling
interns and counselor education doctoral students from
Texas A&M University-Corpus Christi.
Overall Program Objectives
1. Create a positive counselor/student relationship that
emphasizes the role of the counselor as a helper
interested in each student’s overall health and
wellness.
2. Mental health counselors in training will have the
opportunity to work with at-risk youth while building
an understanding of the school system.
3. Students will receive appropriate responsive
counseling services specifically based on their needs
Group and Individual Topics
 Determined during the first initial meeting by the student and
counselor.
 Topics often include:
 anger management
 conflict resolution
 coping skills
 date violence
 building healthy relationships
 social skills
 grief
 team building
 self-efficacy/self-esteem
 enhancing intrinsic motivation
Dialectical Behavioral Therapy
 A goal of DBT is to enhance client coping skills and facilitate an
awareness and acceptance that change is constant.
 DBT aims to replace maladjusted emotional and behavioral
responses to change with behaviors that will reinforce nonemotionally and behaviorally charged adaptation.
 DBT is shown to be effective in treating a variety of clinical diagnoses
included eating disorders, substance abuse, and emotional and
behavioral problems (Feigenbaum, 2007; Nelson-Gray et al., 2006;
Rakfeldt, 2005).
Session 1:Group goals and guidelines; norms and
individual goals; validation of members
 Purpose
 Group goals and
guideline
 Norms and ind. Goals
 Validation of members
 Activities
 Confidentiality
 Group norms
 Establishing counseling
relationship
Building Group Cohesiveness
Skittles Game
 Red…What is your favorite color?
 Orange…If you can travel anywhere
where would you go?
 Yellow…Name one thing people
may not know about you?
 Green…Who is your favorite artist?
 Purple…Name two things that help
you relax?
Validating Conversational Partners
 Students practice listening and responding to
conversational partners using appropriate
 Paraphrasing
 Clarifications and questions
 Reflection of feelings
 Students participate in structure role plays with
counselor and group members act as coaches.
Session 2: Being Responsible; Knowing my thoughts,
feeling my feelings and choosing my behaviors
 Purpose
 Acceptance of my thoughts,
 Activities
 Exercise in mindful focus of
feelings and behaviors




attention
Validation of student
perceptions
Psychoeducation on the
distinction of thoughts,
feelings and behaviors
Practicing in choice of
behavioral response
Radical Acceptance
Thoughts/Feelings/Behaviors/Events
Feeling
Thought
Event
Behavior
Robot
Session 3: Describing how I feel
 Purpose
 Learning how to
contact, describe,
express emotions
 Emotional regulation
 Activities
 Glossary of feeling
words
 Talking about our
internal states
 Awareness of body
sensations
Mood Charades
Mood Jenga
Mind your own business…
Interpersonal sense? Individual Sense?
2. We have internal business.*
1.




What we think
What we feel
What we believe
How we each make sense of the world
Session 4: Dealing with powerful
feelings
 Purpose
 Learning to manage
difficult emotional
experiences ( distress
Tolerance)
 Activities
 Mindful coping
strategies
 Riding the wave of
emotional experiences
Riding the Emotional Waves
 Tolerating difficult or
overwhelming feelings involves
accepting that Emotions Ebb
and Flow
 Ride out emotional highs like
waves. Crashing waves are
followed by flow of calm and
recovery.
 Resist the temptation to fight
emotional experiences.
Metaphors of Rip tide and
negotiating currents at the
beach are introduced.
Session 5: Interacting with others.
Working for what you want
 Purpose
 Learning how to
communicate effectively
with others
 Activities
 Collect Social
Interaction
questionnaire
Social Interactive Questionnaire
1. Have you had conversations or contacts, more than a quick hello, with any of the following people that were encouraging or
discouraging during the week? Bubble in one letter closest to your answer for each person or persons.
Conversation with others:
Family Members
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
Best Friend
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
Friends
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
Teacher
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
Staff/Counselor
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
(d) don’t have a boyfriend/girlfriend
Girlfriend/Boyfriend
(a) mostly encouraging
(b) mostly discouraging
(c) no contact or not much contact
(d) don’t have a boyfriend/girlfriend
Social Interactive Questionnaire
2. Think about this week compared to last week. Bubble in one letter closest to how you feel.
(a) this week is better than usual
(b) this week is typical
(c) this week is worse than usual
3. Happiness Rating: How happy have you been this past week? Select one.
(a) very happy
(b) mostly happy
(c) mostly unhappy
(d) very unhappy
4. Think about the most significant event that occurred to you this past week. Please write
at least 2-3 sentences about it and how it affected you.
Role Playing
 Parent/Child
 Scenario
 Your friend invited you
to a party where there is
going to be illegal
activity. You have to
report the next day to
probation. What do you
do?
 Teacher/Student
 Scenario
The teacher tells you to sit
down and do your work.
Your friends turn around
and say “She just punked
you.” What do you do?
Session 6: Practicing Positive Interaction
skills/conflict management
 Purpose
 Healthy interpersonal
skills
 Activities
 DBT Dear Man practice
 Song Lyrics
DEAR MAN
 Describe
 Express
 Assert
 Reinforce
 Mindful
 Appear Confident
 Negotiable
Song Lyrics
 “Never mind what haters say, ignore them 'til they fade
away.” Live your life by TI
 “My, shoulders are strong I prove 'em wrong
I ain't doing nothing but moving on…” Tie my hands by Lil
Wayne
 “Don’t forget that impossible is nothin’, your environment
is irrelevant. Just don’t let your emotions over power your
intelligent. Refuse to give up, your mistakes will define you”
TI featuring John Legend Slide Show
Session 7: Coping with difficulties
 Purpose
 Distress Tolerance
 Activities
 DBT Self-Soothing;
Improve the moment
Session 8: Figuring out what I want and
committing to SMART goals in life
 Purpose
 Behavioral Planning
based on valued goals
 Close Groups
 Activities
 Committed action
worksheet
 Sound Track of your life
Committed Action Worksheet
(Olerud & Wilson, 2002)
A part of my life that I value is ______________.
My intention for this part is _________________.
The committed actions that I’m willing to take include the
following (be sure to note when you’ll begin these
actions): ______________________________________
Soundtrack of your life
 My life now
 Kobe Bryant—Lil Wayne
 Picture World Up—Lil
Wayne
 Heat—Lil Wayne
 In the future
 Who said I couldn’t make
it—TI
 Rolling in the Deep—Adele
 I’m the boss—Rick Ross
SMART Goals
 Specific—not too big or small
 Measurable— “I know when I have met them.”
 Agreed/Accountable/Attainable– “I will make myself
accountable.”
 Realistic– “Do I really have a chance to meet this?”
 Timely– “Can I do this in the near future?”
Evaluation of Intervention Impact on Student
Behavior
 Number of participants: 63
 Total number of sessions: 340 (average 5 per group/individual)
 Assessment: The Youth Outcome questionnaire (YOQ) (Burlingame,
Wells, Lambert, 1996)—Pre and post test
 Preliminary analysis (fall semester): Students participating in the
counseling groups are benefiting from the intervention.
 Students experienced statistically and clinically significant
reductions in reported conduct problems (F(1,57)= 6.1, P<.017 and
hyperactivity (F (1,57)= 5.6,p< .022).
 Students benefit was directly related to the number of sessions they
attended
While these results are preliminary, they suggest that our intervention is
having the intended impact on student behavior. The lessons learned from our
efforts to organize and conduct clinical groups on DAEP campuses seems easily
generalizable to other DAEP settings and include:
1. Obtaining and maintaining administrative support for the intervention.
2. Securing a workforce that is manageable ( and no cost to campus) because
of university collaboration.
3. Investment in a theoretical model that has empirical validation ( DBT) with
typical presenting issues of students at DAEP campuses.
Questions?
Contact Information
Dr. Eunice Lerma
eunice.lerma@ccisd.us
Courtney Heard
cheard0604@gmail.com
Dr. Richard J. Ricard
richard.ricard@tamucc.edu
References
Academic Information Management, Inc. (2001). A guide to successful practices: What works for disciplinary
alternative education programs? Identifying patterns of success in Texas DAEP schools. Austin, TX: Author.
Akos, P. (2005). The unique nature of middle school counseling. Professional School Counseling, 9, 95-103.
Bachelor, A. (1995). Clients’ perception of the therapeutic alliance: A qualitative analysis. Journal of
Counseling Psychology, 42(3), 323-337.
Balser, B.H. (Ed.). (1957). Psychotherapy of the adolescent. New York: International.
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.
Bandura, A. (1989). Perceived self-efficacy in the exercise of control over AIDS infection. In V.M. Mays, G.W.
Albee, S.F. & Schneider (Eds.), Primary prevention of AIDS: Psychological approaches (pp. 128-141).
Newbury Park, CA: Sage Publications.
Bemak, F., & Chi-Yung Chung, R., (2005). Advocacy as a critical role for urban school counselors: Working
toward equity and social justice. Professional School Counselor, 8, 196-202.
Bemak, F., & Conyne, R.K. (2004). Ecological group work. In R.K. Conyne & E.P. Cook (Eds.), Ecological
counseling: An innovative approach to conceptualizing person-environment interaction (pp. 195-217).
Alexandria, VA: American Counseling Association.
Blos, P. (1962). On adolescence. Oxford, England: Free Press of Glencoe.
Bronfrenbrenner, U. (1979). The ecology of human development: Experiments by nature and design.
Cambridge, MA: Harvard University Press.
Bronfenbrenner, U. & Morris, P.A. (1998). The ecology of developmental processes. In W. Damon (Ed.),
Handbook of child psychology, 1, 993-1029. New York: Wiley.
References cont.
Coleman, D.A. (2002). The affect [sic] of high school disciplinary alternative education programs on students with longterm multiple referrals. Unpublished dissertation.
Chung, R.C., & Bemak, F. (2002). The relationship of culture and empathy in cross-cultural counseling. Journal of
Counseling and Development, 80, 154-159.
David, A.B., & Erikson, C.A. (1990). Ethnicity and the therapist’s use of self. Family Therapy, 17(3), 211-216.
Diamond, G.M., Hogue, H.A., & Dakof, G.A. (1999). Alliance building interventions with adolescents in family therapy: A
process study. Psychotherapy: Theory, Research, Practice, Training, 36(4), 355-368.
Draguns, J.G., & Tanaka-Matsumi, J. (2003). Assessment of psychotherapy across and within cultures: Issues and
findings. Behavior, Research, and Therapy, 41(7), 755-776.
Education Commission of the States. (2007). Recent state policies/activities: Alternative education. Denver, CO: Author.
Retrieved March 21, 2007, from http://www.ecs.org/ecs/ecscat.nsf/
WebTopicView?OpenView&count=300&RestrictToCategory=Alternative+Education
Erikson, E.H. (1963). The life cycle completed: A review. New York: Norton.
Everall, R., & Paulson, B. (2002). The therapeutic alliance: Adolescent perspectives. Counseling and Psychotherapy
Research, 2(2), 78-87.
Feigenbaum, J. (2007). Dialectical behaviour therapy: An increasing evidence base. Journal of
Mental Health, 16(1), 51-68. doi: 10.1080/09638230601182094
Green, A.G. (2005). Urban school counseling: Implications for practice and training. Professional School Counseling, 8,
189-195.
Green, A.G., & Keys, S.G. (2001). Expanding the developmental school counseling paradigm: Meeting the needs of the 21st
century student. Professional School Counseling, 5, 84-95.
Hawkins, P., & Shohet, R. (1989). Supervision in the helping professions. London: Open University Press.
House, R., & Martin, P. (1998). Advocating for better futures for all students: A new vision for school counselors.
Education, 119, 284-291.
References cont.
Joint Select Committee to Review the Central Education Agency. (1994). Final report of the Joint Select Committee to Review
the Central Education Agency. Austin, TX: Texas Legislative Council.
Kazdin, A.E., & Wassell, G. (1999). Barriers to treatment participation and therapeutic change among children referred to for
conduct disorder. Journal of Clinical Child Psychology, 28, 160-172.
Klein, M. W. 1995. The American Street Gang, New York, New York: Oxford University Press.
Keys, S.G., & Lockhart, E.J. (1999). The school counselors role in facilitating multisystemic change. Professional School
Counseling, 3, 101-107.
Liddle, H.A., & Schwartz, S.J. (2002). Attachment and family therapy: Clinical utility of adolescent-family research. Family
Process, 41, 455-476.
Linehan, M.M (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York: Guilford Press
Masterson, J.F. (1968). The psychiatric significance of adolescent turmoil. American Journal of Psychiatry, 124(11), 1549-1554.
McCreight, C. (1999). Best practices for disciplinary alternative education programs in Texas. Laredo, TX: Texas A&M
International University.
McKay, M., Wood, J.C., Brantley, J. (2007). The dialectical behavior therapy skills workbook: practical DBT exercises for
learning mindfulness, interpersonal effectiveness, emotion regulation & distress tolerance . New Harbinger Publications.
Moore, R., & King, J. (2005). Tennessee's alternative schools. Nashville, TN: Office of Education Accountability.
Nelson-Gray, R. O., Keane, S. P., Hurst, R. M., Mitchell, J. T., Warburton, J. B., Chok, J. T, &
Conn, A. R. (2006). A modified DBT skills training program for oppositional defiant adolescents: Promising preliminary
findings. Behaviour Research and Therapy, 44, 1811-1820. doi: 10.1016/j.brat.2006.01.004
Oetzel, K.B., & Scherer, D.G. (2003). Therapeutic engagement with adolescents in psychotherapy. Psychotherapy: Theory,
Research, Practice, and Training, 40(3), 215-225.
References cont.
Rakfeldt, J. (2005). Dialectical behavior therapy with transitional youth: Preliminary findings.
Best Practices in Mental Health, 1(2), 61-75.
Ridley, C.R., & Lingle, D.W. (1996). Cultural empathy in multicultural counseling: A multidimensional process model.
In P.B. Pederson, J.G. Draguns, W.J. Lonner, & J.E. Trimble (Eds.), Counseling across cultures (4th ed., pp. 21-46.
Thousand Oaks, CA: Sage Publications.
Sabella, R.A., & Booker, B.L. (2003). Using technology to promote your guidance and counseling program among stake
holders. Professional School Counseling, 6, 206-213.
Sink, C. (2002). Comprehensive guidance and counseling programs and the development of multicultural studentcitizens. Professional School Counseling, 6(2), 130-137.
Tennessee State Board of Education. (2000, revised). Alternative school program standards. Retrieved March 22, 2007, from
http://www.state.tn.us/sbe/aternativeschool.htm
Texas Education Agency. (2006). 2006 comprehensive annual report on Texas public schools (Document No. GE07 601 04).
Austin, TX: Author.
Texas Education Code. (2005). Texas school law bulletin. St. Paul, MN: Thomson/West.
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), 63-79.
Weiner, I. (1992). Psychological disturbance in adolescence (2nd ed.). Oxford, England: Wiley.