Mendel Psychological Associates' blog » Social Skills Groups

Radio: autism and social skills

Dr. Mendel — Sat, 31 Dec 2011 02:29:29 +0000

Last month I was a guest speaker at Breathing Underwater radio show at WCOM. We talked mostly about autism and social skills groups that I lead. You can hear the podcast of the show:

Dr. Mendel at WUNC Radio

WCOM is a community radio station with a studio in downtown Carrboro, North Carolina, broadcasting a 100-watt signal from an antenna at Scroggs Elementary School in Southern Village in Chapel Hill at 103.5 FM.

Autism and Health Insurance

Dr. Mendel — Tue, 16 Mar 2010 19:35:51 +0000

On March 5th, 2010, Raleigh’s News and Observer published an article about insurance companies not covering mental health and “behavioral” treatment for individuals with Autism Spectrum Disorders (ASD), including Aspergers. I have been leading social skills groups for children and teenagers with Aspergers and other ASD’s for over a decade and have been confronted repeatedly with the fact that various insurance companies do not cover this service if a child’s diagnosis is an ASD. They do, however, cover the same services if a child has a different diagnosis, such as an Anxiety or Mood Disorder, or Attention Deficit Hyperactivity Disorder (ADHD). Since problems with social interactions are at the heart of Aspergers and Autism, this, to me, is a supreme – and infuriating – irony. These children and adolescents are generally extremely socially awkward and often oblivious to social cues and the nuances of social interaction the rest of us find natural and obvious. Participation in a social skills group with similar peers is the ideal way to help such youngsters. Through such groups, these children learn to interact more and more appropriately. They make friends, first in group, and eventually outside of group as well. Their behavior becomes less awkward and they become able to compromise, to take turns, and to see things from the perspective of others, generally for the first time in their lives. While I have no doubt that this type of intervention is the best way to help kids and adolescents with ASD’s, I certainly understand and share the frustration of their parents when this best practice is not covered.
Fortunately for their parents’ pocketbooks – though unfortunately for the children themselves – many of the kids with whom I work have other diagnoses in addition to Autism or Aspergers. Many have Anxiety Disorders or Obsessive Compulsive Disorder. Others have Mood Disorders, in part because as they approach adolescence and begin to realize how different they are from their peers, their social isolation and repeated experiences of rejection become increasingly frustrating to them and they become depressed, dejected, and withdrawn. When a diagnosis other than Autism is present, my social skills groups are generally covered by their insurance. But this service – so essential and beneficial to treat their core disorder: Autism – is not covered on that basis. This, to me, is utterly ridiculous. I would call on all insurance companies to recognize that Autism Spectrum Disorders are brain-based mental health problems like any other and to cover effective and appropriate treatment of ASD’s through interventions such as social skills groups.

Joining a Social Skills Group

Dr. Mendel — Mon, 27 Jul 2009 16:41:13 +0000

Perhaps the most frequent call or e-mail I receive is to inquire about joining one of the Social Skills groups I lead. So, the following is a description of the groups and of the procedures for joining.

I lead three groups – one for 5^th and 6^th graders, one for 7^th and 8^th graders, and one for high school students. Children and teenagers with a variety of psychiatric diagnoses are in these groups, but the common thread is that all of these kids have been on the fringes of social groups throughout their lives. These are kids who have struggled chronically to make friends and keep friends; many or most have suffered teasing, rejection, bullying, and humiliation at the hands of their peers. Some of the kids in my groups have the diagnosis of Aspergers Disorder; others have High-Functioning Autism. Others are extremely shy or socially anxious. Still others do not have a specific diagnosis along these lines but are awkward socially and have various difficulties with their peers.

When these kids join one of my groups, they quickly realize – typically within the first session or two –that here is a totally different social setting. Here is a place where there will be no teasing, where they can fit in and find a sense of belonging for which they have yearned so desperately. They see that here are other kids who have had similar experiences and suffered similar pains over rejection and teasing as they have. In short, here is a place where they can fully fit in with and be accepted by their peers. I find that kids in these groups generally love the groups and look forward to coming each week. For many, the group is a highlight of their week.

All of my groups are non time-limited; that is, there is no start date and end date. Kids join the groups at various points and remain in the group until they, their parents, and I feel that they have gotten what they need and can from group and they are ready to move on. At that point, we have a graduation ceremony (and pizza party) to commemorate their time in group and what they have gained through group.

Currently, the youngest group meets on Wednesdays from 3:30 to 4:45, the middle school group meets on Thursdays from 5:00 to 6:15, and the high school group meets on Thursdays from 6:30 to 7:45. The fee for each group is $80.00 per group session. The maximum size for the younger two groups is 6 students, while the high school group has a maximum of 8 students. (It is an interesting and, I think, heartwarming story how the maximum size for the high school group increased from 6 to 8. At one point, we had a boy waiting to join group a few weeks before another boy was set to graduate. I asked the group how they would feel if we briefly had 7 students in the group, so he could join now rather than waiting for the graduation. They responded enthusiastically, saying that of course he could and asking if we could just have more kids in the group all the time. One said, “That way we could make even more friends.” Here are a group of kids who have generally dreaded social interactions because of their negative and painful experiences with their peers. Now, they look forward to these interactions and welcomed the opportunity to meet new potential friends.)

The procedure for joining group is as follows:

I always have the first session with parent or parents. In this session, I obtain a thorough history and background, including a clear sense of the problems and concerns. I learn about the child’s interests and his social history, including peer interactions and friendships. The fee for the initial intake is $180.00
Then, I have an individual session with the child or teenager. A portion of this session is spent with the child and his parent(s), with a portion one-to-one with me. This meeting is largely so that he and I can get to know each other, so he doesn’t walk into his first group meeting not knowing the other kids or me. I also learn about his perspective on social situations and what areas of his life aren’t going as well as he’d like.
Finally, during that meeting, we develop a behavioral contract. All of the kids in each of my groups are on individual behavioral contracts, based on their particular areas of difficulty. They work on these at home and the contracts are reviewed between parent(s) and child on a daily basis, with the parent scoring the child’s performance on each goal. The child gets points from these contracts which they can use, along with points they earn during the group itself, to purchase items from the “reward closet.” This serves as big motivator for many of these kids.

In reading this, many of you may have noticed that I always refer to a child or adolescent as “he.” Currently, all of the kids in each of my groups are male. I am open to including girls in group if there are 2 or more ready to join group. Over the years, I have had occasional referrals of girls to my groups, but it always seems to be just one at any given point in time and neither or nor her parents want her to be the only girl in a group of boys. There have been some occasions when 2 girls have been members of a middle school or high school group and this has gone quite well. I would welcome this opportunity again, since learning to interact with members of the opposite sex is certainly among the most vital social skills.

It is my great pleasure to offer these groups to kids with pressing social needs. I hope this blog entry provides all of the information needed for you, as a parent, to move ahead with getting help for your child.

Learning to make friends

Dr. Mendel — Thu, 11 Jun 2009 00:59:18 +0000

As many of you know, I lead several social skills groups for kids and teenagers with Aspergers and High-Functioning Autism. Six group members has always been my maximum for my groups. Recently, a boy was ready to join the high school group a little while before another boy was going to graduate from the group. I brought up the idea with the group of briefly having seven members and asked whether that would be alright with them.

They responded enthusiastically: not only was it alright with them to have seven group members for a short period of time, why not expand the group more generally? Why not have eight or even ten teenagers in the group? As one boy put it, “that way we can make even more friends!”

I found that moment moving and profound. Here was a set of kids most of whom had always been on the fringes of any social group, kids who rarely if ever had friends. These kids had chronically been the target of teasing, bullying, rejection and humiliation. But here, in this group, they had discovered that social interactions with peers could be rewarding and fun. They welcomed the opportunity to meet more kids because having that opportunity would enable them to “make even more friends.”

That view, and the sea-change it represents from the experience these kids have had previously in social settings, is what these groups are all about.

Social Skills Groups: The Cure for Social Avoidance

Dr. Mendel — Tue, 17 Feb 2009 04:00:00 +0000

Craig had pretty much never had a friend. Every social interaction was torture for him. He had been a target of teasing, ridicule, and bullying from the time he was a very young child. He had been hurt so many times by social rejection that it had become the norm for him. He even began to welcome it, stating that he preferred not to have any of his peers in his life: it was better to be alone than to be continually hurt. It was clear to me, and to his parents, that a social skills group would be perfect for him.

But Craig felt differently. He adamantly refused to join the group. His response, in my experience, is fairly common. And it’s really not surprising. For kids like Craig, social interactions have always been sources of pain and torment. They assume that every group experience will be negative. Why in the world would they want to join a social group?

Yet, social skills groups are ideal for kids like Craig. They see very quickly that these groups are totally different than any social situation they’ve ever experienced: this is a place in which there is absolutely no teasing, insults, or humiliation. They also see that the group is filled with kids who have struggled with the very same things they have. These kids – often for the first time in their lives – feel a sense of belonging and acceptance. They start to develop friendships with the other members of the group. As these friendships grow, so too does the child’s self-confidence. Over time, his newfound social skills become increasingly strong and stable. Eventually, he starts to apply them in the social world outside of the social skills group. His social abilities improve and he starts to make friends. Finally, social interactions need not mean pain and misery, but can instead bring closeness, joy, and affection.

Aspergers and Social Skills Group

Dr. Mendel — Fri, 09 Jan 2009 04:18:08 +0000

More often than any other question, I am asked to describe my social skills groups. I lead three groups, for upper elementary school students, middle school students, and high school students. While no particular diagnosis is required for a child to be in one of these groups, most have diagnoses of Aspergers Disorder or High-Functioning Autism. Others struggle with social anxiety or extreme shyness. What all the kids in these groups have in common is that they have trouble making friends and interacting comfortably with their peers. These are the kids who have always lived on the fringes of their peer group. They are teased, bullied, tormented, and ostracized.

And something magical happens when they join the group. Quickly, they realize that here is a place where they will not be taunted or humiliated. Here, they will not experience bullying and social rejection. They see that there are other kids like them, dealing with the same struggles, sharing the same longings for social connection and a sense of belonging. For many if not most of these kids, group is the first safe peer setting they have ever known.

These children thrive in this environment. They form friendships with one another; together, they practice social skills that seem so natural to many of us: making eye contact, listening without interrupting, giving feedback, asking questions. After a while, I’ll hear from them and their parents that they’ve begun making friends outside of group. They start to carry their new skills outside of group and practice them in “the real world” of the classroom and playground.

For me, leading these groups – getting to know these wonderful children, seeing them blossom and flourish, watching their confidence and competence grow – is one of the most rewarding things in my life.