When it’s Always a BIG Deal: Using the 5-Point Scale

As I was reflecting back on my last couple of posts, I realized I should have included a small discussion (however one-sided it may be) about what to do when you introduce the idea of self-talk/self-coaching through the Big Deal/Little Deal flowchart, and EVERY problem or decision the child encounters is experienced as a BIG deal. The clients who tend to need some extra instruction about how to effectively use self-talk/self-coaching are also likely the ones who will have a hard time discerning between major issues and small glitches, because in the moment they genuinely may feel that even a small ordeal is a crisis.

Kari Dunn Buron and Mitzi Curtis introduced a fantastic resource for these moments: The 5-Point Scale. Since the scale can ultimately be accommodated to meet just about any situation where scaled decisions can be made, I highly encourage SLPs to understand how to use this scale and have it in their treatment toolkit. As you might imagine, the 5-point scale is simply a scale that helps clients to quantify and qualify their problems/decisions/reactions/volume/etc. into a more appropriate realm. In my Big Deal/Little Deal post, I said the following: Many of these kids have a hard time recognizing when a problem is REALLY BIG, and when a problem is totally minor. In other words, every problem is a crisis for them and they need to learn a way to coach themselves through these situations. This easy flow-chart I created is a good way to visualize the “coaching” process. To use the flowchart, begin by asking yourself: “Is this problem a big deal or a little deal?” While self-coaching through the flowchart steps is an important foundational skill for these kids, it’s also helpful to have a plan for when they simply tend to categorize everything as a big deal, and this is where the 5-point scale comes in.

Imagine that Johnny Q comes to you in hysterics because the blue marker, which is his favorite, is all dried up and no longer works for coloring the assignment. For most people, some Big Deal/Little Deal self-coaching would kick in and they would recognize that this is a pretty minor deal-one that could be solved by using a different color, asking around for another blue marker, or asking the teacher is there is another set of markers from which to pull a blue replacement. So how will you use the 5-Point Scale with Johnny? Begin by asking him where on the scale he thinks this problem falls. It’s important to point out that he (and all other clients) should previously have been taught how to distinguish between the numbers (ideally by letting the students pick examples for each number). A 1 is a minor glitch (like a broken pencil tip that can be almost momentarily fixed by sharpening the pencil). On the other hand, a 5 is a crisis (like a natural disaster-something that might take weeks to solve). 2-3 fall somewhere in the middle. Again, this scale can be highly individualized to each client. Your 5-Point Scale discussion with Johnny Q might look something like this:

You: Johnny, on our 5-point scale, where do you think this blue marker problem falls?

Johnny: A 5!!!!!!!!! (while crying hysterically)

You: Hmmm, I can see that it might feel like a really big problem right now, but remember…we decided that a 5 is something huge, like a natural disaster, that might take weeks to solve. Do you think this problem is going to take weeks to solve?

Johnny: No

You: I don’t think so either. So now that we’ve thought about it a little, where does the problem fall?

Johnny: A 4!!!!!

You: A 4 sounds better than a 5, but I still think it might be too high because we decided that a 4 is still a really big deal, like breaking your arm and having to go to the hospital and maybe even wear a cast. Do you think we can bring our marker problem even lower?

You would continue coaching Johnny through this process until he lands on a more appropriate number (1 or 2). Even though the client’s initial reaction might be to hugely overreact, it’s important to acknowledge how they are feeling and remind them how they agreed to represent each of the numbers (with specific examples assigned to each number) so they can more accurately define their problem. It may take Johnny a few times using the scale before he can really assign an appropriate number to a problem, and that’s ok! The goal is simply to keep moving him towards accurate self-talk, even if that is a process rather than a fast transformation.

The 5-Point Scale can be altered to fit a variety of situations: volume level (1 = whisper and 5 = screaming), decision-making (1 = no thought necessary and 5 = lots of consideration with pros/cons list), etc. Regardless of how you choose to incorporate the scale into a client’s therapy, it’s a great way to help them visualize the severity of problems/volume/decision-making and more accurately use their self-coaching skills.

Here are some ideas for integrating the 5-Point Scale into your therapy!