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VISN 5 MIRECC - VA Social Skills Training Program

 

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What is Social Skills Training for Serious Mental Illness (SST)?

Social Skills Training for Serious Mental Illness (SST) is an evidence-based practice for persons with schizophrenia (Dixon et al., 2010). SST is also commonly used effectively with people with other types of serious mental illness (SMI). The social skills model used is based on Social Skills Training for Schizophrenia: A Step-by-Step Guide (Bellack, Mueser, Gingerich, & Agresta, 2004). SST is a treatment procedure that has been developed to enhance interpersonal skills with the goal of improving community adjustment, quality of life and pursuit of personal goals. SST involves an initial individual session followed by group sessions. Before the first group session, group members meet in an initial individual session with a group leader to identify a personal goal or goal(s) to work on in the group. SST interventions are tailored to meet the real-life, current-day difficulties that affect the social experiences of each Veteran, but several common core elements are present regardless of which specific skills are being taught. SST is a structured format for teaching interpersonal skills that incorporates modeling, role plays and other behavioral learning activities.

For more information on SST, please click on the following links:

 

VA Social Skills Training for Serious Mental Illness (VA SST) Training Program

The VA Psychosocial Rehabilitation Training Program (VA PRT) is funded by the Office of Mental Health and Suicide Prevention at VA Central Office as part of an overall emphasis on increasing availability of evidence-based psychotherapy and other psychosocial treatments for Veterans. The program, based at the VISN 5 MIRECC of the VA Maryland Health Care System, provides training, technical support and consultation in evidence based psychosocial interventions to VA practitioners and mental health program leaders working with Veterans with serious mental illness (SMI) and their families. The program trains VA staff members in Social Skills Training for Serious Mental Illness (SST; Bellack, Muesser, Gingerich, & Agresta, 2004) through a combination of required readings, an interactive didactic presentation, an experiential learning session for running an SST group, and 6 months of follow-up clinical consultation. The program also provides seminars/didactics on advanced topics related to SST to VA staff members trained in SST and conducts a training program to train SST Regional Master Trainers. The VA PRT program has an evaluation plan to assess outcomes of the training. Additionally, the availability of Social Skills Training is required for individuals with serious mental illness as per the Uniform Mental Health Services in VA Medical Centers and Clinics (2008). Specifically, the handbook requires that:

  • Recovery and rehabilitation-oriented programs must be available for all SMI patients.
  • A minimum array of services available to Veterans in the program through PRRC staff needs to include Social Skills training.
  • Social skills training is an evidence-based psychosocial intervention that must be available to all Veterans with SMI, whether it is provided on site, by referral, or by telemental health.
  • Social skills training must be provided at all medical centers and very large CBOCs.

 

Components of the VA SST Training Program for Providers

The VA SST Training Program for Providers consists of 4 components. The same state of the art training model is employed by both the VA SST national training team and VA SST Regional Master Trainers:

  1. Required Readings/Independent Study
  2. SST Webcourse or Equivalent Face to Face Didactic Presentation
  3. Experiential Learning Session (Or with VA SST Training Program Manager approval, equivalent experience as a roleplay buddy in 3 SST groups led by a VA SST Trainer/Consultant)
  4. 6 Months of Consultation (Includes a Consultation Orientation Session)

The goal of the required readings, didactics and Experiential Learning Session is to provide training participants with the basic skills necessary to lead a social skills group at their respective facilities. In the Experiential Learning Session, training participants have the opportunity to lead a simulated SST group with support and feedback from SST trainers. On rare occasions, and with VA SST Program Manager approval, training participants may meet their experiential learning session requirement by engaging as a roleplay buddy in 3 SST groups led by a VA SST national or regional Trainer/Consultant. During the consultation period following completion of the Experiential Learning Session component, training participants are expected to start and run an SST group for a majority of the 6 month consultation period. During the 6-month consultation, training participants meet weekly for small group consultation with VA SST consultants, who are VA clinicians with expertise in SST who are part of the VA SST Training Program, to receive further support and feedback in learning the SST treatment model. In consultation, training participants are first oriented to the process and requirements of consultation with a structured Consultation Orientation Session which typically takes place over the first 1-3 consultation meetings. The consultation period is an essential component designed to enhance the overall training experience and help trainees refine their skills in the delivery of SST. During the consultation period, training participants obtain written consent from Veterans to digitally audiorecord the SST individual and group sessions. These recorded sessions are then uploaded to an online EBP portal for review by the assigned SST consultant. The VA SST Training Program includes criterion-based performance requirements for successful completion, including specific requirements for performance on an SST treatment fidelity measure.

VA SST Training Participant Eligibility Requirements

The eligibility requirements for training participants applying to offered SST trainings include the following:

  • Must be a permanent, mental health provider whose formal job responsibility includes the provision of psychotherapy or psychoeducational services to Veterans on a regular basis (at least 50% of VA duties are dedicated to direct patient care). Trainees are not prioritized for participation in most training events but may apply when indicated.
  • Must work in settings where SST (approximately 1-2 sessions per week) may be implemented.
  • Appropriate occupations include psychiatrists, psychologists, social workers, advanced practice mental health nurses, licensed professional mental health counselors, marriage and family therapy therapists, physician assistants, occupational therapists, and registered nurses. Non-license eligible occupations working in mental health such as recreational therapists, peer support specialists, addiction therapists and psychology technicians may also be eligible for this training program. Other disciplines not listed will be reviewed for eligibility on a case-by-case basis.
    • Non-license eligible VA staff members are required to conduct the SST groups during the 6-month SST training period with a co-leader who is either (1) a licensed VA staff member or (2) license-eligible indirect clinical supervision in one of the appropriate occupations listed above. This staff co-leader must have been previously trained in SST or currently participating in the SST training program.
    • It is recommended that non-license eligible VA staff members have at least 1 year of experience working as a provider in a mental health care setting at the VA or the equivalent experience outside the VA before applying for the SST training.
    • Following the 6-month SST training period, the VA Social Skills Training Program strongly recommends that all non-license eligible VA staff conduct SST groups with co-leaders who are licensed VA staff trained in SST.
  • Must have local support to implement SST and fully participate in all training and consultation activities.

 

All training participants must complete an application for the offered SST trainings prior to participation. These applications are distributed at the time trainings are announced and include additional details regarding training participant expectations and include a training agreement for both training participants and their supervisors.

How to find out about available VA SST Provider Training Opportunities

The majority of SST training is currently provided by SST Regional Master Trainers in each VISN. However, the VA SST Training Program also conducts a limited number of videoconference trainings every year for facilities who do not have access to training with an SST Regional Master Trainer. If you are a VA provider or mental health leader interested in learning more about training in SST in your VISN, please reach out to the SST Regional Master Trainer for your VISN. Please contact the VA SST Program Coordinator Laché Wilkins lache.wilkins@va.gov to obtain the most current list of VA SST Regional Master Trainers. You can also obtain this information from reaching out to a local Evidence Based Psychotherapy Coordinator at a VA medical center.

For more information about the VA SST Training Program, please contact the VA SST Training Program Manager Elizabeth Gilbert, Ph.D. elizabeth.gilbert@va.gov. or the VA SST Program Coordinator Laché Wilkins, B.S. lache.wilkins@va.gov.

VA SST: Train-the-Trainer

The VA SST training program trains SST Regional Master Trainers to serve as expert trainers and consultants in SST for their particular VISN. Regional Master Trainers provide in person experiential training and follow-up consultation to clinicians in their VISN. Primary candidates for the Regional Master Trainer role will be individuals who previously completed the VA SST Training program. However, individuals with previous SST experience may also be considered without having to complete the VA SST Training program. Above all, potential candidates should be clinicians who excel in SST delivery, champion SST's overall cause, and most importantly, have ample time and support to serve in this role. For more information on the Train-the-Trainer workshops, please click on the following links:

VA SST Master Trainer Program Overview and Expectations

Social Skills Training Resources

Therapy Manual

The social skills model used is based on Social Skills Training for Schizophrenia: A Step-by-Step Guide (Bellack, Mueser, Gingerich, & Agresta, 2004).

SST Clinician Quick Guide

SST Roleplay Buddy Guide

Literature

Bellack, A.S. (2004). Skills training for people with severe mental illness. Psychiatric Rehabilitation Journal, 27, 375-391.

Bellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (2004). Social skills training for schizophrenia: A step-by-step guide. 2nd Edition. New York, NY: The Guilford Press.

Kurtz, M.M. & Mueser, K.T. (2008). Meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76, 491-504.

Tenhula, W.N. & Bellack, A.S. (2008) Social Skills Training. In K. Mueser & D. Jeste (Eds.) Clinical Handbook of Schizophrenia. Guilford Press, New York.

Kreyenbuhl, J., Buchanan, R.W., Dickerson, F.B., & Dixon, L.B. (2010). The Schizophrenia Patient Outcomes Research Team (PORT): Updated Treatment Recommendations 2009. Schizophrenia Bulletin, 36, 94 - 103.

Granholm, E. & Harvey, P.D. (2018) Social Skills Training for Negative Symptoms of Schizophrenia. Schizophrenia Bulletin, 44(3), 472-474.

Turner, D. T., McGlananaghy, E., Cuijpers, P., van der Gaag, M., Karyotaki, E., & MacBeth, A. (2018). A Meta-Analysis of Social Skills Training and Related Interventions for Psychosis. Schizophrenia Bulletin, 44(3), 475-491.

Advanced Tutorials

Implementing SST on Inpatient Units

Implementing SST on Individual (1:1) Basis

Individual Sessions: Orienting Veterans to SST Groups

SST Treatment Planning Using the Mental Health Suite

Sociocultural and Linguistic Considerations in Implementing SST

Setting Up for Success: How to Avoid Common SST Pitfalls

Starting SST Groups

Promoting Generalization in SST

Neuropsychology and SST

SST Group Handouts/Resources

SST Information for Veterans

SST Group Handouts - ALL

SST Four Basic Skills

SST Assertiveness Skills

SST Communal Living Skills

SST Conflict Management Skills

SST Conversation Skills

SST Coping Skills for Drug and Alcohol Use

SST Friendship and Dating Skills

SST Health Maintenance Skills

SST Vocational/Work Skills

SST Attendance Sheet

Brief Goal Assessment

SST Group Expectations Handout

SST Curriculum Domains

Examples of SST Curriculum Menus

Sample - SST Completion Certificate for Veterans

Outside Practice Sheets

Four Basic Skills

Listening to Others

Making Requests

Expressing Positive Feelings

Expressing Unpleasant Feelings

Conversation Skills

Starting A Conversation

Maintaining Conversations by Asking Questions

Maintaining Conversations by Giving Factual Information

Maintaining Conversations by Expressing Feelings

Ending Conversations

Entering into an Ongoing Conversation

Staying on the Topic Set by Another Person

What to Do When Someone Goes Off Topic

Getting Your Point Across

What to Do When You Do Not Understand What a Person is Saying

Assertiveness Skills

Refusing Requests

Making Complaints

Responding to Complaints

Expressing Angry Feelings

Asking for Information

Letting Someone Know That You are Feeling Unsafe

Asking for Help

Responding to Unwanted Advice

Conflict Management Skills

Compromise and Negotiation

Leaving Stressful Situations

Disagreeing with Another's Opinion without Arguing

Responding to Untrue Accusations

Making Apologies

Communal Living Skills

Locating Your Missing Belongings

What to Do If You Think Somebody has Something of Yours

Asking for Privacy

Checking Out Your Beliefs

Reminding Someone Not to Spread Germs

Eating and Drinking Politely

Friendship and Dating Skills

Giving Compliments

Accepting Compliments

Finding Common Interests

Asking Someone for a Date

Expressing Affection

Refusing Unwanted Sexual Advances

Requesting that Your Partner Use a Condom

Refusing Pressure to Engage in High-Risk Sexual Behavior

Health Maintenance Skills

Making a Doctor's Appointment on the Phone

Asking Questions About Medications

Asking Questions about Health-Related Concerns

Complaining about Medication Side Effects

Requesting a Change in Your Medication

Asking About a New Medication You Have Heard About

Reporting Pain and Other Physical Symptoms

Vocational – Work Skills

Interviewing for a Job

Asking for Feedback about Job Performance

Responding to Criticism from a Supervisor

Following Verbal Instructions

Joining Ongoing Conversations at Work

Solving Problems

Coping Skills for Drug and Alcohol

Offering an Alternative to Using Drugs and Alcohol

Requesting That a Family Member or Friend Stop Asking You to Use Drugs and Alcohol

Responding to a Stranger or a Drug Dealer

Forms & Handouts in Spanish

Several of the forms and handouts utilized in SST have been translated for the Spanish-speaking Veteran. A special thanks goes to Jose Reyes-Torres, Psy.D., who translated each of the forms listed below. Dr. Torres is a clinical psychologist with the VA Caribbean Healthcare System in San Juan, Puerto Rico.

SST Information for Veterans

SST Information for Clinicians

Brief Goal Assessment

SST Group Handouts – 4 Basic Skills

SST Training Completion

Successful completers of the VA SST program (trainees who complete workshop and 6-month consultation activities) will be granted a certificate of completion and will also be added to the VA's Evidence-Based Practice Provider Roster. An overview of the training completion guidelines is provided below.

VA SST Guidelines for Training Participant Completion

Additional Resources

VA Office of Mental Health and Suicide Prevention

VA Uniform Mental Health Services Handbook

Contact

For more information about the VA SST Training Program, please contact the VA SST Training Program Manager Elizabeth Gilbert, Ph.D. elizabeth.gilbert@va.gov. or the VA SST Program Coordinator Laché Wilkins, B.S. lache.wilkins@va.gov.

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