Social Skills Training

SST is a major component of treatment in Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Social Anxiety Disorder, and in other social-behavioral difficulties (shyness, etc).

Deficits in social thinking, social communication and interaction, social motivation, and social-emotional processing contribute to difficulties across a variety of settings such as school, work, and close relationships. Individuals often face isolation, loneliness, underemployment, anxiety, and depression due to their confusion with unwritten social rules.

It is important that social skills training is broad-based; group members learn social thinking (why we do things), managing related emotions, as well as practicing social behaviors (how to do things), which contrasts with just masking or faking (hiding deficits).

One of our specializations has become the diagnosis and treatment of Autism Spectrum Disorders (ASD) over the past twenty-five years. We provide diagnostic and treatment services related to ASD for all age groups, ranging from early childhood to late adulthood.  Our clients’ diagnoses mostly fall within the older categories of Asperger’s Disorder (AS), Pervasive Developmental Disorder-NOS (PDD NOS), High Functioning Autism (HFA), Nonverbal Learning Disabilities (NVLD), and other related disorders.  In addition, many clients have co-existing disorders, including Anxiety, ADHD, Mood Disorders, etc.  The treatment modalities include individual, couple’s and family therapy, consultations with parents, and group therapy focusing on social skills training

Although we label our program as “Social Skills Training (SST)”, our group therapy encompasses a whole array of therapeutic interventions, aimed at facilitating social growth and increasing social competence. We use didactic instruction, behavioral modeling and rehearsal, role plays, stage acting, and practice in a face-to-face format.

Over the past 25 years, we have grown our SST programs into year-round, ongoing groups allowing new members to enter at any time. Usually, we may have between 15-30 clients participating in six to seven groups that range from pre-school groups to groups for adults. At any given time, we offer multiple groups based on the social development of current members. We attempt to keep the ages of our group members within 2 years (grades) of one another.

We aim to teach fundamental skills needed for successful everyday social interactions. The consequences of social skill deficits become more apparent as children mature and fitting in with peers takes on more importance. Our groups are experiential in nature in that social learning occurs in real-time with the members of the group. We focus on developing a trusting relationship between the group leader and participants. We use this relationship to facilitate the development of social-emotional skills while considering each participant’s individual needs when creating a curriculum for our groups.

Groups for 5–7-year-olds include a play-based cognitive-behavior therapy approach called “Replays” combined with traditional play therapy and mirror work to facilitate emotion recognition and expressiveness. These approaches are integrated with small training modules of social skills such as: Listening, Using Nice Talk, Trying When It’s Hard, Waiting Your Turn, Dealing with Feeling Mad, etc.

Groups for pre-teens include components of a drama-based affective relational intervention, video-based skills training, use of movies for social stories and social autopsies, and didactic modules on the “hidden curriculum”, onset of puberty issues as well as social skills, such as Joining In, Expressing Affection, Expressing Disagreement, and School Survival Skills, etc.

Groups for younger and older teens include drama-based interventions, major focus on biological and social aspects of puberty, preparation for transition to life after high school, career development, use of movies for social autopsies, and training in friendship and relationship skills. Teens often come to the group with particular topics to discuss and time is granted to their pressing social concerns.

Groups for young adults (after high school) focus on the transition toward adulthood, including challenges of college studies, adult friendships and relationships, employment, independence, social awareness, and coping with adult ASD issues.

Participation in our SST starts with a screening process aimed at finding the best fit for all participants. The screening for SST participation is often preceded by clinical assessment and individual sessions. The process of screening and assignment to group takes into account diagnosis, professional observations, parent comments, age, interest similarities, social skill development, degree of self-control, and safety concerns. In some cases, symptoms of other co-existing disorders (for example, ADHD) need to be brought under control before someone can join a group. Group participation starts with a 3-4 session trial period to make sure there is a good fit between the new member and the group. However, the structure and content of our SST may not be appropriate for all participants. Sometimes group assignment is changed to find a better fit. In other cases, individual treatment may be necessary for an extended period before group assignment is reconsidered.

Each SST group is led by one of our mental health professionals. Our groups typically include 3-6 participants; the small group size ensures that participants’ individual needs and social growth can be attended to within the framework of the group. Groups meet once a week or bi-weekly; we advise parents that at least 80% attendance is necessary to benefit from the group. We also encourage and facilitate participants’ contacts with each other as well as social activities outside of group sessions, such as attending birthday parties, movies, outings, etc.

The ultimate goal of our SST program is to facilitate social growth and increase social competence. Each participant has an individual plan that includes short-term and long-term goals of social growth. Due to the nature of developmental delays, progress and changes may often be uneven, slow, and subtle. Skills training requires a lot of repetition, reinforcement and practice at generalization across time, people and settings. We monitor individual and group goals; we collect reports from teachers and significant others and conduct assessments to track changes. Our SST program benefits those with ASD diagnoses, as well as benefitting those with diagnoses of ADHD, Mood Disorder, Anxiety, OCD, etc.  

Parents of all participants receive intermittent feedback and are involved in our program in many ways. First, all parents receive email updates that include the focus of and activities during group, skills addressed, and encouragement to actively practice skills at home. Second, parents may participate in regular or intermittent parent training, parallel with their participating child’s SST treatment. These training sessions address a wide range of parental concerns in the home as well as interactions with schools and other agencies. Parenting work ranges from acceptance of a young child’s developmental challenges to ways to exert persistent parental “push” to help teens moving into adulthood. Third, those parents who do not participate in ongoing parent training are requested to meet for updates three times a year. This review includes updates on their child’s or teen’s social progress, the results of our regular assessment of social skills development, our review of strengths and weaknesses, and recommendations for home-based practice and interventions. Finally, we also regularly seek feedback from parents concerning their child’s progress.

The list below provides a few examples of the goals and issues our groups often work on:  

• Thinking on your feet and being flexible

• Providing constructive feedback

• Ability to read nonverbal language

• Coping skills: Relaxation

• Use of eye contact/attention

• Self-advocacy

• Conversations: initiating, joining in, maintaining, ending

• Emotional self-regulation

• Showing empathy

• Listening and observing

• Dealing with teasing and bullying

• Being a good sport

• Being friendly and being a friend

• Dating and relationships

• Skills of executive functioning

• Social thinking

• Theory of mind